by Azam Khan, SOCHARA Fellow
Society for Community Health Awareness Research and Action (SOCHARA) is an independent, non-government organization registered under Karnataka Societies Registration Act 17A (1960).
SOCHARA started journey as Community Health Cell (CHC) in 1984 and then registered SOCHARA on 16th April, 1991. More than Two decades(1991 to 2016 : 25 Years) SOCHARA persistently strengthen health movements across the county, participate and support people, communities, professional bodies and governments for equitable health and development through a range of community and policy level interventions. As a registered society this year marks the silver jubilee (1991 to 2016: 25years) year. SOCHARA believe in collective action with community and Bhopal is not a new place for organization, after Gas Tragedy (in 1984) SOCHARA actively intervened with Medico-Friend Circle and in 2009 initiated Community Health Fellowship Programme (CHFP) in M.P. and engage with grass-root level interventions with other organizations. At this point SOCHARA celebrate its successful community health journey with learning's and future challenges in Two Region: for Southern – in Bangalore and for Northern: in Bhopal.
Bhopal 27- 28 April, 2016
(Madhya Pradesh, Chhattisgarh and Northern India Region)
This two day northern region silver jubilee meeting was inaugurated by Dr.Shashi Prabha Khare, Mr. Daman Ahuja, Mr. S.R. Azad, Mr. As Mohammad in traditional way of lighting the candle. At the outset Mr. As Mohammad welcomed all the participants, guests and thanked all who support SOCHARA continuously in North. Before self introductory session of participants and guests, Ms.Sapna from Barwani sung a song "Manviya Sanskriti Kranit, Bhartiya Sanskriti Kranti" and people clapped with her. After the introductory session Dr.Ravi D'souza briefed about two day silver jubilee programme.
On 27 mornings, the first session of the meeting focused on tribute to Late Dr. Ajay Khare, self-introduction of participants and guests lecture who shared their experience with SOCHARA. Ms. Nidhi Shukla Presented a photo presentation of Late Dr. Ajay Khare and her inspiring and encouraging experience when she was working with him.
In the guest address first Mr.S.R. Azad (M.P.Vigyan Sabha) said, "First of all I congratulate SOCHARA on this occasion of happiness, we have a mature relationship with SOCHARA we are working for people, analyze the problem collectively and try to make their life easy trough rational thought and communitization process. Health is not an independent issue it is interconnected with other issues. In context of health care services our major problem is budget utilization and trained human resource but the authorities interested to develop infrastructure. Now it is time to raise our voice collectively against it. "
Guests congratulated SOCHARA on the occasion of silver jubilee and memories contribution in Nation Public Health Movement assembly at Bhopal in 2007, Bhopal Gas tragedy (1984) and other community base intervention in other pockets of Madhya Pradesh.
After inauguration session Mr. As Mohammad welcome all, on behalf of executive committee and SOCHARA family. Through photo presentation he presented 25 years journey of SOCHARA which was based on these:
- Genesis and Evolution,
- Aim and objectives,
- Regional, national; global alliances,
- Achievements and challenges,
Journey of Sochara started from man-made-disaster in 1971 from East Pakistan refuge camps to natural-disaster 'Tsunami' between this period SOCHARA intervened on many places like Bhopal Gas tragedy, endo-salphan and others violence affected areas also. before SOCHARA the centre called CHC(Community Health Centre) and it is based on traditional concept of SARAI where people stay for short period share, experience and reflect(Like : traveler). And in initial stage they follow the stated pattern but after a period SOCHARA realized we need active and other interventions to empower the community to achieve "health for all". To address this SOCHARA initiated few Programmes like: life skill, women health and empowerment training, community health fellowship programme along with these organizations involved with policy level engagement (through task force, health policy, commission, evaluations), community action oriented programme, engage regionally to globally through Public Health Movement and other networks. Through active participation, value-base approach and community support SOCHARA achieved many things and set new mile stones in these journey. Through our rich traditional knowledge heritage they successfully established plural health system concept in public domain also.
After the presentation of Mr. As Mohammad in open forum participants raised these:
- Challenges in Programmes (Fellowship)?
Answer: we have so many challenges in programme (like: interest of fellows,) but through encouragement and motivation we solve it.
Answer: our failures are our learning and we utilize it as per circumstance.
- Establishment of issue in public?
Answer: Our Partners, network alliances, supporters and fellows are our actual strength who directly involved with community affairs and our collective approach make it possible. 73-74 amendment of constitution strengthen the process of communitization.
Session – III
In this session Mr. Dhirendra Arya presented a photo-journey presentation through power-point. His presentation was based on Madhya Pradesh fellowship programme, concept of fellowship, design and outcome. He said that we have a fellows-collective which covers 26 districts of Madhya Pradesh and more than 50 fellows in the state. Fellows-collective have strong presence in state and now people recognize its efforts. Fellows-collective address issue of malnutrition and other initiatives with other networks (like: Maternal Health Right Campaign). Fellows-collective have many question and I hope we will discuss it in the evening or tomorrow. He also shared memorable moment with mentors.
Dr. Ravi D'souza presented the overview of Centre for Public Health and Equity (CPHE) Bhopal through power-point slides which described the present status, operations and based on the following:
- Mentoring fellows(CHLP),
- Networking with other organizations and alliances,
- Provide training to NGO's,
- Intervene in slums through Anganwadi(In Two Slum: Mira Nagar, Indra Nagar)
After lunch break Ms. Sapna and Ms.Archana sung a song "Tum Mujhko Vishwas do, Main tumko Vishwas du". Between the songs everybody clapped and sung song with them.
The session was based on Fellows Sharing: before and after fellowship programme, it was chaired by Ms. Aarti Pandey, Ms.Sudipa Das, Mr.S.R. Azad and Mr.Jitendra Prajapati presented his presentation which was based on his identity and profession before and after fellowship and his present intervention on Malaria, VHND with his organization in Betul. His level of confidence, sensitivity, awareness and technical information on health increased after fellowship. And He also described the challenges which he faced in the community.
After his presentation fellows (Smrti, Archana, Sapna, Prabhu Sharan, Irshad, Dhirendra), raise questions and add few points.
After the presentation chair persons add these points :
Ms.Sudipa Das said, "Knowledge updation is necessary, we are living in the age of knowledge and information, you can utilize our knowledge collectively, fellows can establish an information centre on community health. Fellows can develop some manuals in the interest of community. Community and supporters observe us with our actions not plans."
Mr. S.R.Azad said, "Change is a continuous process, now-a-days we are shifting one place to another within short time span and it is bad for us and community also. Without political understanding we can not achieve "health for all", plan everything before intervention (like: time, place, stay) if you want to see the change in community through your efforts. I am happy to see SOCHARA fellows in our campus (MPVS)."
Ms. Aarti Pandey said, "First utilize your knowledge and skill as per conditions and second choose your partner and work happily."
Dr. Ravi D'souza's presentation was based on child and maternal health situation as per NFHS-4 and comparison with NFHS-3 also. After presentation he interpreted the following points:
- In the context of maternal health and child health, condition improve in comparison with NFHS-3 but not satisfactory.
- Anemia is still high.
- In the context of adult nutrition obesity and overweight numbers increased.
- Number of institutional delivery increased but the Caesarian number is also high.
- Total Fertility Rate (TFR) decrease and decrease in sex ration rapidly (961 =>948).
- Burden of Non-Communicable Disease (NCD) is high.
After the presentation in open form participants discuss Sample Size, Duration, Social Determinants, Anemia and malnutrition also.
On second day of silver jubilee programme Ms. NIdhi Shukla welcomed the participants, guests and Ms.Sapna sung a song," Maa Reva Tharo Pani Nirmal" people sing the song in Narmada Bachao Andolan. After the song participants recapped the previous day sessions and reflect also.
In the first session Dr.Sunil Nandeshwar (Sagar Medical College) presented Millennium Development Goals (MDG's), Social Development Goals (SDG) and its importance. MDG's address the limited issues like: Poverty, water and sanitation, malnutrition, education; under 5 years child mortality and the target period was 15 years (from 2000-2015). Before MDG's we are addressing the issues without timeline. MDG had 8 goals, 18 targets; 48 indicators with monitoring mechanism. After 2015 we could not achieve set goals than UN set new goals for the development which is called SDG and it have 17 goals and its timeline is 2016 to 2030. MDG was vertical programme and have target oriented approach wile SDG is horizontal and have wholistic approach to address the issues of development.
We can say SDG's are based on structural communitization process and partnership among state, public, other stakeholders and it will change the scene of development universally.
Open forum: After Presentation participants raised the issues of partnership, participation, accountability, transparency and responsibility among the entire stakeholder.
In conclusion Mr.As Mohammad thanked to Dr.Sunil and said that development is continuous process and without participation we can not achieve goals.
Mr.Kedar (MHRC) and Mr.Ajay (CHSJ) briefed about the Maternal Health Right Campaign's (MHRC) State Level Jan-Samvad (Public Dialogue) which was on April 29, 2016 at Bhopal. MHRC is working from last three years in 22 districts of Madhya Pradesh it is a non-funded programme. Under MHRC they inform, aware, monitor and advocate the maternal health issue in the state.
MHRC's secretariat is in Bhopal and most of the members of campaign are representatives of grass-root level organization they formed a co-ordination committee. Community Base Monitoring (CBM) is the key component of the campaign where they train the community members to monitor the health care system and measure the services as per infra and community opinion. They also invited the participants for next day's public dialogue with authorities and SOCHARA officials announced one day lodging support for the jubilee programme participants who want to participate in the programme on next day.
Session – III
Third session started with video message of Dr.Mohan Isac (President –SOCHARA) on silver jubilee.
The session was based on the nature of Community Health Fellowship Programme and Future Action; Mr.Prasanna first screened a video of SOCHARA which described fellowship programmatic approach in Madhya Pradesh. After screening he said that we have a very good number in M.P. more than 100 (SOCHARA+FELLOW+MENTORORGANISATION) in 51 districts. Before framing future plan of action expectations and suggestions of fellows, mentor organization and SOCHARA is important and initiated a group exercises in three groups: Fellows, Mentor Organizations, SOCHARA and they discussed it on these points:
- Work Plan
- Next Step.
After half an hour group discussion these groups presented their opinion on stated points.
- First fellow's group member Mr.Prabhu Sharan Masih shared the opinion on stated steps and in short they demanded continuous technical and knowledge support, support from Bhopal office (Space, Library), alliance with other organizations; fellows collective need concrete action plan and support.
- Second mentor organization's group member Mr.Chetan (Spandan) shared the opinion that our alliance is very nice and through your fellows we exchange knowledge and experience but we need active connection with SOCHARA, it is right time to review the programme(Mr.Arun Tyagi), we are ready to provide training on mental health(Padher Hospital, Betul); SOCHARA is reliable partner for us.
- Third SOCHARA mentor's Group member Mr.Sayyed shared his group's view that we need strong and active alliance, need support from partners and fellows; develop state level resource centre and research centre.
In conclusion Mr.As Mohammad said, "on behalf of SOCHARA I accept all the objections but we are all equal and we work collectively if you have anything to share please share it with us, we need strong collective action to address the social problems. And Silver Jubilee of SOCHARA is the right time to assess our action and improve according the situation."
Mr.Prasanna said, "We will discuss fellows' questions in the evening in fellows-collective meeting."
After lunch break Dr.Tripathi Sung a song" Cahlo Geet Gao,Chalo Geet Gao, Gagake Duniya Ko Sar Pe Uthao" after his energetic song session started.
Session – IV
Mr.Daman Ahuja (Advisory Group on Community Action) and Mr.Narendra's presentation was based on following points:
- Background of AGCA,
- Film ,
- Stage of communitization with Govt.
In first phase Mr.Daman explored the background, functioning and accountability framework of AGCA, in second phase they screened a film "Jan-Swasthy ke Badhte Kadam" and in third phase they briefed about monitoring mechanism and utilization of information in policy making.
Under NRHM, Community action for health is most important part and through AGCA's advise, feedback and module development we educate-aware society, share monitored information with various stakeholders and initiate public dialogue. Under Accountability framework first step is external survey, second routine programme monitoring (HIMS) and third is community base monitoring which assures participation of communities. Documentation is necessary for advocating the issue and AGCA use feedback, monitoring data in planning and evaluation also. Rogi Kalyan Samiti and VHSC is micro-level committee but very effective it is my suggestions not compulsions first actively involves with these committees and see the change. Diversified composition is the specialty of every committee. Dr.Thelma Narayan is also associated with AGCA and support to promote the activities of communitization
In conclusion Mr.Narendra said that community participation on each level is necessary for success of any programme.
Session – V
In this session Mr.Amulyanidhi (JSA) shared his experience on privatization of public health care system on the name of partnership. Madhya Pradesh is very unique state in India where all the experiment implemented in tribal belt (like: Jhabua, Mandla, Alirajpur etc.) on the name of partnership, a MOU signed between Rajya Swasthya Samiti and Dipak Foundation (Gujarat based CSR) who take care all the training of ASHA, VHSC but in MOU they did not mentioned the amount, similarly they initiated a knowledge partnership programme in Indore with Bhandari Hospital in Indore but the intervention of civil society, Doctors and nursing association they could not executed in Indore. Dipak foundation is CSR of Dipak group of companies and already in the loss of Rs.50 lakh. Before intervening the issue of tribal belt privatization of health care services they requested Vikas Samvad to conduct a study on IMR-MMR of the area and utilized the study in PIL and now the matter is pending Before Indore High Court. Regional language newspapers are supportive to raise public interest issue in Indore Patrika and Naiduniya newspaper raised the issue of Help desk with JSA and now the process stopped by the department.
Now JSA is working on two level first organize people, agitate and intervene legally. In conclusion if we want to intervene on policy level we should unite and intervene on every level.
In the concluding session Mr.Sayyed Ali briefed about Fellows Collective's Nutrition Programme in Madhya Pradesh on these:
- Causes of malnutrition,
- Intervention areas
- Plan of action
- Collaboration with others.
Under the programme they intervene in 2 slums of Bhopal (Miranagar; Indiranagar) and cover 300 children in collaboration of NGO's and Department through community base approach. They share the status with community and department, develop and Training Programme for community member and departments.
In the closing session, Mr.As Mohammad expressed pleasure about the presence of participants and members, appreciated presentations which were full of facts and information. The two days presentations and discussions were outstanding and give us new directions for future.
He recognize that we need more information and Knowledge and in next coming days we will exchange our knowledge, studies; information with our fellows and mentor organizations through different mode of communications.
Mr.As Mohammad thanked all those who made the silver jubilee programme memorable one in Bhopal.
- Fellows collective,
- Mentor Organizations,
- Administration Staff,
- Other participants