Healthcare In The Villages

The IRHS runs clinics in two villages in the rural semi-arid tropics of Andhra Pradesh: Dokur and Kotakadra. These villages are located in Mahbubnagar district. The rainy season is from July to September with occasional rain for the remainder of the year.

The majority of IRHS patients in the Mahbubnagar district are landless laborers, who survive on less than a dollar a day and owe far more in debts to money lenders. Malnutrition, a lack of health education and demanding physical labour cause villagers to be particularly vulnerable to health problems.

Each week hundreds of patients travel from all over the district to receive medical attention at our clinics. Experienced paramedics, healthcare workers and volunteer doctors staff the clinics. As the only reliable healthcare provider within a great distance, they a treat a large variety of illnesses and medical conditions.

Aside from serving patients at our village clinics, the IRHS also refers patients to government and private hospitals in Hyderabad, if they are in need of more sophisticated treatment than can be offered in the clinics or the district hospital. The IRHS follows each patient's case closely, to ensure that they receive appropriate healthcare, and provides support to patients and their families.

The IRHS is able to provide its patients with medicines either inexpensively or free of charge. Drugs are purchased from Locost, a non-profit drug trust, or are sourced locally. The IRHS gives free medicine to all children under 12.

Village Healthcare Workers

In rural India, women are the most likely to suffer serious ill health yet they are the least likely to seek medical help. Cervical cancer is the biggest killer among women. The promiscuity of women's partners, including the use of prostitutes, can lead to chronic levels of STDs.

The village healthcare workers at the IRHS clinics focus on both the physical and mental well being of women and children. Their duties include:

• Screening rural women for cervical cancer by VIA and VILI, as part of a cervical cancer screening program;
• Diagnosing and treating routine gynecological problems;
• Teaching health education, including nutrition and reproductive health;
• Working with mothers through all stages of pregnancy and childcare;
• Home visits to families that are unable to visit the clinic;
• Preforming lab tests, maintaining detailed patient records and helping to run the pharmacy.

Paramedics

The paramedics are the keystones in patient care at the clinics. Working closely with volunteer doctors, they diagnose, treat and manage the patients. The paramedics also work with the city staff by referring patients onwards for specialized treatment.

Village Clinics

• They are staffed by local people;
• There is an intense focus on training;
• The staff are patient centered;
• Close attention is paid to continuity of care;
• Patients are charged just 2 Rs, which includes a consultation and all lab tests;
• The cost of medicine prescribed from the clinic pharmacy is affordable;
• The IRHS has excellent links with hospitals, that provide free or affordable treatment of the highest standard;
• The state government is examining how the clinics could be used as a model for healthcare provision in rural areas with a population of over 76 million.
• The IRHS clinic staff monitor government immunization programmes;
• Clinics offer ante and post natal care;
• Clinics offer gynecological care to women in seperate sections.

The viewpoint of local people comes from closer to home. When villagers are asked why they go for treatment to the IRHS clinics a common answer is "Because they care".

Continuing Challenges

The main barrier to developing better healthcare in IRHS village clinics is financial. More resources would allow the clinics to employ more staff and provide more extensive facilities.

The clinic staff, volunteer doctors and the Institute's city-based personnel are striving to deliver better patient care and to improve the standard of living in the poor rural communities in Andhra Pradesh in many ways:

• Improving diagnosis rates;
• Conducting a wider variety of lab tests so that the clinics can diagnose and treat more patients locally;
• Developing health education through school visits and drama groups (especially in the fields of reproduction, HIV, hygiene, and nutrition;
• Offering health classes to village teenagers;
• Encouraging people to come to the clinic early enough to be treated;
• Breaking down superstitions that are barriers to healthcare e.g. eating dhal (pulses) causes puss in cuts and wounds;
• Refining the model of the IRHS village clinics and lobbying the state to build simple clinics all over India, run by locally trained paramedics (doctors do not want to serve in rural areas).