FPJ OPED Public health
“Free Press Journal and Karmayog.org have entered into a collaboration to promote the involvement and empowerment of citizens and community groups in civic and social issues. We will jointly present a special column every Thursday for featuring articles on social, civic and developmental issues. The articles carried herein will cover a diverse range of topics ranging from disaster management to public health, improving city governance to senior citizens, etc.”
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Good health is not merely a developmental resource it is an inalienable human right of every citizen of this country. Every Indian has the right to demand and obtain essential preventive, promotive, diagnostic and curative health services. It is the bounden duty of the state as well as society at large to ensure that this right is fully respected and adequately realized.
Part of Prime Minister, Dr. Manmohan Singhs inaugural speech at the launch of the Public Health Foundation of India, March 28, 2006, New Delhi
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Cities and Public Health
In the last 20 years, there have been few initiatives proposed to improve health for the citizens of India. When looking at the policies and initiatives proposed by the Central Government, there is a clear emphasis on improving rural health. However, with the urban poor population rising, the health needs of the urban poor communities are beginning to exceed those in the rural communities. The health care crisis of the growing urban poor, especially in Mumbai, represents a new challenge in providing health care to the masses. Over 50% of Mumbais population of 18 million lives in slums and are part of the growing urban poor. This population is plagued with uneven access to care, malnutrition, and poor maternal and child health.
The MCGM (Municipal Corporation of Greater Mumbai) provides medical services through three levels of care, primary, secondary and tertiary. This includes an intricate network of teaching hospitals, secondary hospitals, maternity homes, health posts and dispensaries. Although the infrastructure is complex, there is a multitude of improvements needed to address the health needs of the urban poor population in Mumbai. The various challenges plaguing the MCGM health system are growing as rapidly as the population and need to be addressed urgently. The challenges include:
- Human Resources: A large amount of vacancies in the public health department of the MCGM lead to the apathy of the staff and patients.
- Infrastructural: Lack of equipment and services at the primary and secondary level of care; lack of referral systems to direct patients to the appropriate care level; lack of quality assurance
- Systems: Lack of a centralized data system, lack of awareness of existing programs within the MCGM
- Ethical: Dilution of the value and faith in the public health system as a facility for all, not just the indigent and underprivileged. This is a phenomenon that affects the patients as well as the staff.
- Educational: Educational materials for prevention of disease and promotion of health are under-utlilized or unavailable, patients do not understand the complexities of their own health
With a confident team, collaborations, and an open attitude toward change, there are many options for the MCGM health system to become an accessible service for people seeking quality health care at an affordable price. A no-frills health care system that emphasizes good quality at the lowest possible cost to the consumer will not only benefit the poor, but also those taxpayers whose money is being invested in the government run health care system. Working with existing private providers and NGOs can be beneficial for the MCGM system in terms of decreasing the burden and using best practices of existing programs.
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The above is an extract from a report titled Recommended Policy Guidelines for Public Health in Mumbai prepared by Meenakshi Verma, MPH, Public Health Consultant for the NGO Council and submitted to MCGM.
This report serves as an initial document to understand the health care needs of the people of Mumbai. This document can be utilized by practioners, administration teams, doctors, nurses, medical students, NGOs and more. An in-depth analysis of the MCGMs health care system can give all those involved in the field some insight into the inner workings of Mumbais premier public health system in addition to citing specific areas for improvements. A healthier community can contribute to the overall wealth of Mumbai, making it healthy, wealthy, and wise.
(Full report available at http://www.karmayog.com/publichealth/draftpublichealthpolicy.doc )
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Rights and Responsibilities of Patients
Resident doctors in Mumbai went on strike early this year, after one of their colleagues was attacked by a patient’s relative. In the recent past there have been a number of such strikes in various parts of the country, and these strikes focused attention on the poor state of affairs in public hospitals in India. Such protests can be seen to be indicators of the condition of the existing public health system that is inadequate to meet the people’s needs. Governments, both Central and State, have expressed their commitment to a universal medical care system; however, they have yet to provide the money to make this a reality.
However, despite the severe conditions, several of the public hospitals and their team of doctors, have rendered outstanding and exemplary service in times of crisis for the city, such as was seen in the case of recent Mumbai train blasts, as well as in earlier incidences such as the Mumbai floods of July 2005. Patients and doctors actually need each other; instead the bad working conditions, overcrowding and inadequate facilities are responsible for the increased friction between patients and provider and for them seeing each other as adversaries.
It is in this context that the Patients Bill of Rights and Patients Bill of Responsibilities were drawn up as the first step in educating and informing the participants of the public health system.
Patient Bill of Rights: (includes the following)
1. To be treated with dignity irrespective of their caste, class, sex, religion, and disease
2. To have a list of exact services available and corresponding fees (for supplies, bandages, etc), including a list of emergency services such as blood banks and ambulatory services.
3. To be informed about the documentation needed for treatment, and to have minimal documentation for emergency cases
4. To receive Reproductive and Child Health Services free of cost at public health facilities
5. To receive medications and vaccinations from the local public health post or dispensary
6. To obtain from the doctor complete information concerning the diagnosis, treatment, and prognosis in language the patient can understand.
7. To receive necessary information from the doctor such as long-term effects, side effects etc., before giving any prior consent to a medical procedure and/or treatment
8. To receive the records or a certified copy that gives the details of the disease, treatment, and follow-up necessary at the time of discharge
9. To refuse the suggested treatment and be informed of the medical consequences thereof
10. To privacy during medical check-ups
11. To be assured that all communication and records will be kept confidential
12. To receive a bill cum receipt after the payment is made
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Patients Bill of Responsibilities:
Patients are also responsible for their personal and environmental well-being. The following code of conduct emphasizes some of the responsibilities of a patient while seeking medical care. As a patient:
1. You should provide the doctor with accurate and complete information about his/her medical history, past illnesses, allergies, hospitalizations, and medications
2. You should ask for clarity if the doctors prescription and diagnosis seem unclear
3. You should follow the doctors treatment plan
4. You should pay your medical bills promptly
5. You should follow hospital rules and regulations
6. You should help your doctor help you, if something isnt working, be clear and the doctor can advise alternative care
7. You should participate actively in your own medical care (in terms of awareness and preventions)
8. You should ask the doctor questions to clarify any doubts or misconceptions in your mind
9. You should treat the doctors with respect
10. You should not ask doctors for false bills or certificates for any reason
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Public Health Department Officers and Contact Numbers
Following are some of the officers in the MCGM Public Health Department along with their Contact Numbers :
Dr. Jayraj Thanekar 24135467
Executive Health Officer 22620588
Dy. EHO
Zone 1, Ward A,B,C, D, E, 23054831
Dr. J G Thanekar 24135467
Dy. EHO, Ward F&G (Zone 2)
Jt. EHO 24134560
Zone 3, Ward HK
Dr. A A Bandiwadekar 24135541
Dy. EHO, Zone 4, Ward P&R
Dr. G. T Ambe 24901168
Dy. EHO, Zone 5, Ward L&M
Dr. K I Harsora
Dy. EHO, Zone 6, Ward N,S&T 24135469
Dr. (Smt.) Surekha Mehta 24180521, 2662270
Special Officer (FM &MCH) 24134560 Extn 310
Dr. Chitra Wagh 24309459
Asstt. Health Officer (Schools)
Shri Deepak R Adsul 22619206
Insecticide Officer
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How You Can Help
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Following are brief profiles of some NGOs active in the Public Health sector in Mumbai. You can assist them by volunteering for some of their programmes, acting as a Resource Person, donating material and medicines as required, as well as sponsoring beneficiaries and funding their on-going programmes.
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1.
AVSAR: Healing Through Healthcare & Education
AVSAR (Alliance of Volunteers for Service, Action, and Reform) is a US-Based 501 © 3 organization that was founded in late 2003 through the initiatives of Dr. Ashish Goya, and is committed to improving the healthcare of the underprivileged in India. By recruiting worldwide volunteers to share their skills (medical, business, public health, etc) with inspirational grassroots NGOs (Non-Governmental Organizations), AVSAR strives to provide high quality volunteer experiences with an emphasis on sustainability and capacity building of the organization.
AVSAR is a non-profit organization dedicated to help expand and improve the services of grassroot organisaions which function as the primary source of healthcare and education for much of Indias underprivileged population. Through these efforts, AVSAR hopes to increase access to quality healthcare and education services, as well as inspire a greater sense of volunteerism within Indias own communities and beyond.
Contact Details:
Dipika Banerjee, Program Director, AVSAR
Alliance of Volunteers for Service, Action, and Reform
13A, 2nd floor,
Anand Nagar, Mumbai 400022
Tel : 9820888974
Email : avsarpd@GoyalMD.com
Web : www.AVSARIndia.org
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2.
SNEHA
The Society of Nutrition, Education & Health Action (SNEHA) was founded in 1999 by Dr Armida Fernandes and a group of concerned doctors and social workers committed to improving the total well being of women and children living in urban slums. SNEHA believes that the health needs of this overwhelmingly large section of the society are neglected, and they work towards planning scientific models of healthcare, which can be replicable and sustainable.
Some of SNEHAs on-going programmes include: a Hospital on Wheels for street children, the City Initiative for Neonatal Health (CINH), a Centre for women in crisis and SNEHA Shakti, a centre that provides support services to women and children in education, self-employment and healthcare.
SNEHA works in 6 vulnerable wards n Mumbai, and also is working on eliminating malnutrition, in Asia’s largest slum Dharavi.
Contact Details:
SNEHA (Society for Nutrition, Education & Health Action)
Urban Health Centre. 60 ft. Road, Dharavi
Mumbai – 400017.
Contact: Dr. Armida. Fernandez
Tel : 24040045, 24042627
Fax : 24086011
Email : smehamumbai@smehamumbai.org
Website : www.smehamumbai.org
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3.
HOSMAC / HOPES India
HOPES the Help Organization for People, Environment & Society, was set up in November 2000, by the Hosmac Foundation as a logical extension to formalize the charitable and environmental causes that its founders were already involved in since 1995.
The conviction and commitment to move towards a larger goal of taking care of people, their health, environment and the community at large, protecting and nurturing the weakest is what gave birth to HOPES.
Some of the activities that HOPES is currently involved in are conducting biomedical waste management training programs with implementation assistance, spreading awareness amongst public to sensitize them towards environment protection, empowering them with tools and methods to search their own ways to protect the environment; taking a major role in imparting education even at the grass root level. The target audience has been students, healthcare professionals, organizations, corporates, and the general public.
Contact Details:
HOPES
Jagruti Bhatia
120, Udyog Bhavan,
Sonawala Lane, Goregon (East),
Mumbai – 400 063
Phone: 26863447/ 26867120
Fax: 26863465
Email : jagruti.bhatia@hosmacfoundation.org
Website: www.hosmacfoundation.org
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4.
Niramaya Health Foundation – Good Health For All
‘Niramaya’ is a Sanskrit word meaning ‘Good Health’. The Niramaya Health Foundation, founded in June 2001, is a non-profit, non-government, community based health services organization, which serves underprivileged communities in the urban slums of Mumbai city in an attempt to provide them an opportunity to live a good, healthy, disease free life.
Niramaya aims to provide Comprehensive Health Care to improve the immediate and long-term health focusing on pre-schoolers, children in the labour force, school going and school dropout adolescents, youth and women.
Some of the services offered by Niramaya include: Micronutrient Intervention camps for Balwadi Children (2-6yrs), Health check up camps for women, children and adolescents, Eye and Dental Check up camps in the community and outreach for working children, and Adolescent Sexuality Education Training Programme for the adolescent boys and girls in the schools.
Contact Details
Niramaya Health Foundation
Flat No. 3, 2nd Floor
16B, Krishna Niwas
Dr. Ambedkar Marg
Naigaon (Dadar)
Mumbai 400 014
Tel : 24168746
Fax : 24161110
Email : niramayahealth@gmail.com
Website : www.niramaya.org
Dr. Janaki Desai , Hon. Medical Director
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5.
Yuvak Pratishthan
Yuvak Pratishthan is an NGO dedicated to social, cultural and constructive causes for the last 25 years. It provides an open platform for all youth to come together, join hands and participate for different causes and issues, and works as an Umbrella Organization, taking on the role of Motivator, Guide, Philosopher and Friend of smaller organizations.
Yuvak Pratishthan is actively involved in urban slums with Health and Sanitation Projects, Environmental Projects, and Sports and Cultural Activities. In the Public Health sector, it has 2 focus areas: a) Prevention and b) Care and Support.
Prevention is covered through projects such as Hepatitis B Free Mumbai, Nirogi Balak Nirogi Mumbai, AIDS Free Mumbai, T.B. Free Mumbai, Maha Arogya Mela, Tobacco Control Activity, etc. To celebrate its silver jubilee year, Yuvak Pratishthan has launched CATARACT FREE MUMBAI Netra Suraksha Abhiyaan with a target of 400 Free Eye Check-up camps, 10000 Operations and 100000 Beneficiaries throughout Mumbai.
Contact Details:
Yuvak Pratishthan
Jatashankar Dosa Marg,
Below East-West Fly Over Bridge,
Mulund (West),Mumbai – 400 080
Tel – 25644022 / 44 Fax – 25647496
Website – www.ypmumbai.org
Email – yuvak@vsnl.in,
Contact : Dr. Medha Somaiya
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(Compile responses in a column on the right hand side of the page)
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Responses to tie-up between Karmayog and Free Press Journal
1.
The tie-up between Free Press Journal and Karmayog is a collaboration in the truest sense, as Free Press Journal is one of the publications which has been doing a great job.
I have been a regular reader and I have always found Free Press Journal doing its job fairly, without taking sides or being impartial and non-political (not playing games) and not bending to the powers that be.
Have a great time and great success.
Good luck
Purushottam Amin
2.
Hello,
This tie-up is good news! May we all take this opportunity to bring more
people together on social justice, namely… environment & cleanliness!
Regards,
Percy Jamshedwala
percy@freedahanu.org
3.
This collaboration is a very important step that has been taken. When people see that efforts are being made to improve the civic situation, those efforts get more support and increases the involvement of the people. Congratulations!
I always felt that there should be an audit of work done by various departments of Mumbai Municipal Administration to find out where things could be improved – not find fault, not to retrench people, but to improve the work. If people have to be retired early, they should be given generous compensation; and all this with the co-operation of the worker’s union.
Second thing that I suggest is, that we should draw up a plan of action to improve civic affairs with the help of experts – garbage collection and disposal, road maintenance, building approvals, municipal schools, water supply – and discuss with all concerned – Municipal Administration, Union, affected or concerned people and NGOs.
With good wishes,
M.D.Kini
kinis68@gmail.com
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For more information on Public Health, including articles, views and research papers, see http://www.karmayog.com/publichealth/publichealthindex.htm
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