Extending the Reach of Health Care
“Bhaiyya, can you check my blood sugar?” It was 6 o’clock in the morning when there was a man knocking on Ajay’s door. The last time this man had come for health check-up on the previous day, he had just taken his food and his blood sugar was elevated. So, Ajay had asked him to come again to repeat the test before eating food. Although surprised by this spontaneous visit, Ajay quickly got up and carried out the tests. Seeing that he was in action, four more members of the village also joined in.
This happened in the village of Sarai Noruddinpur in Uttar Pradesh, where health check-ups were carried out over five days at the beginning of September. Village coordinator Ajay Pathania had come from Himachal Pradesh for a ten-day visit to take relevant measurements of self-help group members and their families. He was accompanied by Ashish Mohan from Amrita CREATE, who is looking after a pilot project to collect health check-up data using a newly developed software for tablets. Ashish had come all the way from Kerala with the equipment, which they were going to use.
Initially, with assistance from the local Amrita SeRVe health worker Rekha, they went from house to house to inform and call people to attend the health check-up. Then they would conduct receptions from 9 AM to 5 PM in different locations of the village, so that members from all castes could easily participate. In total, 230 people were checked by the time the task was completed.
The health check-up consisted of measuring vital signs, such as height, weight, blood pressure and pulse. Other parameters like blood sugar, haemoglobin and calculated body mass index were also collected to complement the basic indicators. This field study, among other aspects of the health worker programme of Amrita SeRVe, is overseen by medical doctor Uma Nair who is serving as experienced consultant.
“In the allopathic way of evaluating a patient, we begin by measuring these parameters, which is a good starting place for understanding the patient’s present health status and monitoring the impact of an intervention,” Dr Uma explains. “Blood pressure (BP) is a simple method to get an idea about cardiovascular health, and body mass index (BMI) and haemoglobin of the nutritional status.”
In Sarai Noruddinpur, the team swiftly found a way to carry out the work fluently; while Ajay was taking the tests and chatting with the people, Ashish was entering the data directly into the tablet. Sometimes the needle was scary for people. On one occasion Ajay handled the situation quite smoothly by saying: “Seeing those tattoos on your hand, I can tell that you have endured so much continuous needling. This needle only takes a moment.” The ‘patient’ laughed and co-operated with Ajay.
Modern technology can play a key role in identifying chronic diseases at an early stage to refer critical cases to the nearest medical facility with appropriate urgency. The nearest Primary Health Center (PHC) is located 10 km away from the village.
One of the research groups of Amrita CREATE developed the Amrita Jeevanam software that the team is using for this study. Medical devices are used to obtain measurements that are entered into the application so that via mobile internet connection the data can be made available for review by consultant doctor Uma, who will then give feedback and suggest the next step in addressing apparent health issues. In this case, health workers are also given guidelines to identify when health parameters fall within critical limits that require immediate referral to PHC.
Uma has evaluated initial data from Sarai Noruddinpur as follows: “The measurements reveal the generally poor nutritional status of villagers, which is reflected in a low BMI for the majority of children. Another widespread deficiency observed appears in form of anaemia, affecting the whole gamut of patients including the very young and old.”
In many remote villages in India, the people are disconnected from the healthcare system whilst at the same time experiencing a decline in traditional knowledge. With the help of Amrita SeRVe’s health workers and coordinators, people previously isolated from the medical system are reached out to and connected to the infrastructure, put in place by the Central Government.