Through multiple meetings (formal and informal) with community members, key opinion makers and local leaders, Mitanins (village level community health workers/ASHAs) and those working in the public health system (Primary health centers staff of the adjoining areas), community engagement activities are initiated. This has helped us in localising our first clinic in the Biniya village with local support, get support for renovating the clinic and raise awareness about the clinical activities in the area.
Also visits to families where a member has a serious medical illness like Tuberculosis, heart disease, cancer, stroke etc have been done. These are people who either visited clinic or are relatives of community members who we interacted with during village visits.
Biniya is where SANGWARI has started operations of its first Community clinic. It is a quite village in the forested parts of Lakhanpur block of Surguja district. It is located around 60 km from the district headquarters of Ambikapur and it takes about 2 hours to reach the place from the town. The first clinic was on 5th of March 2021. The clinic is housed in an old rented house on the road to the village. Biniya is at the border of both Lakhanpur and Udaipur blocks of Surguja. It is expected to cater to about 50 villages belonging to different tribal communities like PahadiKorwas, Uraon, Maanjhi, Manjhwars and Kanwars. They are among the most geographically and socioeconomically marginalized people of the state. The location of the clinic was finalised in consultation with local people. The people also suggested the day of our weekly clinic to be a Friday which is a day for local haat (weekly Baazaar) for the people of around 20 villages.
The clinic starts at around 10:30 am every Friday and goes on till 6 pm. The patients are offered expert consultation for common acute and chronic problems for all age groups in the clinic. The centre is already equipped to handle certain common emergencies for stabilisation and further referral. Basic laboratory services like blood sugar, Hemoglobin, urine examination, rapid kit test for Malaria, Dengue, Hepatitis B, Hepatitis C and Human Immunodeficiency virus (HIV) are available at the centre. Electrocardiogram (ECG) using a portable ECG machine is being regularly used for patients in our primary care set up in line with our agenda to provide comprehensive primary care. Our pharmacy provides more than 150 different drugs in various formulations to provide for needs of our patients. The average amount of money people are paying is less than forty rupees for consultation, investigation and a month’s drugs supply at this Sangwari clinic. All the clinical data is stored electronically too.
The clinic team consists of 2 doctors, a community nurse, a pharmacist, a community organizer and a driver who doubles up as a registration clerk. We offer quality comprehensive primary care to all our patients. This is offered irrespective of individual paying capacities of our patients in one of the most backward regions of the state and country. The clinic represents our commitment to the people of Surguja as ‘SANGWARI’ or a friend in the form of primary care health services on the principle of pragmatic solidarity. At the end of a month, we surmise that there is a large hidden burden of chronic diseases that people suffer from, and are either untreated or inadequately treated such as hypertension, stroke, diabetes and epilepsy. While an increasing number of people come for care to this village clinic from around, the relevance of this clinic will be best realised when people are diagnosed and treated in their homes. Further, activities aimed at primary and secondary prevention for these illnesses are just picking up.
At the end of a month, we surmise that there is a large hidden burden of chronic diseases that people suffer from, and are either untreated or inadequately treated such as hypertension, stroke, diabetes and epilepsy. While an increasing number of people come for care to this village clinic from around, the relevance of this clinic will be best realised when people are diagnosed and treated in their homes. Further, activities aimed at primary and secondary prevention for these illnesses are just picking up.