By Adithya Pradyumna, SOCHARA
Surat is a city that has been plagued with disasters and diseases, including plague! But it has shown a great degree of resilience, and over a period of time has become known for strong health and civic systems. A visit was made to Surat to further discuss a collaborative project between Urban Health and Climate Resilience Centre (UHCRC) and SOCHARA in the field of community role in disease surveillance.
The VBDSP (Vector-borne disease surveillance program) in Surat is well established. It has been around for almost 20 years, and based on what is mentioned by various local individuals and officials, it has had great impact. Vector-borne diseases have been controlled to a great extent, and are not considered now a priority health problem. None the less , the program is still going strong, with emphasis on prevention.
A fleet of 500 health workers are engaged in this program. With the city expanding in the recent past, more persons are recruited during the monsoon season (as there is greater risk for mosquitoes and mosquito-borne diseases). All areas are visited, from the high-end palatial bungalows to all the slums. Each house is visited once in a fortnight, and each worker has to cover between 120 and 150 houses each day. The responsibilities include – enquiring about cases of fever in the household (and taking blood samples if there is a case), give presumptive treatment, check for vector breeding sites, address the problem, and provide inputs on preventive measures.
One shift in recent times is that contract based workers have increased under the program. In addition, it is known that this cohort of workers is the ones who are most familiar with every nook and corner of the city, and hence they may be used for other purposes as well. There are several other challenges faced each day, from tough weather conditions, to complaints about all types of civic services. But they do report widespread cooperation when it comes to the VBDSP.
It is commendable that such a large field based workforce has been successfully maintained by a city corporation, probably without parallel in any other Indian city. It was also noted that recruiting new staff members has been a big challenge. It would be useful to study this program further to take forward lessons from this massive effort.