Karuna Shechen Report Q1 2014 January- April 2014

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FIRST QUARTERLY REPORT
JANUARY-MARCH, 2014

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CONTENTS PAGE NUMBER
Main Activities and Achievements 3
Introduction 4
Health
 An Overview of Medical Activities 5
 Access to Primary Healthcare in Urban Area: Shechen Medical
Centre in Bodhgaya, Bihar
8
 Mobile Clinics 12
 Medical Camps
15
 Health Education Program (HEP)
17
Education
 Early Childcare and Development 20
 Non-Formal Education (NFE) 22
Social
 Vocational Training for Youth and Women 24
 Kitchen Garden
25
 Networking with other NGOs
26
Environment
 Bodhgaya Clean Environment, Hygiene and Sanitation
Programme
27
 Rainwater Harvesting 28
 Solar Electricity 29
Other Important Informations
 Finances 30
 Recruitment of New Staff 30
 Jharkhand Visit and Future Plans 31
Annex-Success Stories 32

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MAIN ACTIVITIES & ACHIEVEMENTS
Health
 In the first quarter of 2014, the total number of Patients who availed the healthcare services
of our OPD (Outreach Patients Department) Mobile Clinic and Medical Camps was 18,066.
 1566 medical tests were conducted in our pathology laboratory.
 Total number of Sanitary Napkins distributed was 2337.
Education
 We started our new programme- The role of play in the life of a child: A way to contribute to
children well-being and healthy development’ in Gopalkhera, Chando, Dema and Banahi.
Environment
 31 households in the village of Bhupnagar received solar lights.
 3660 Jute bags were distributed among local people in order to reduce the rampant use of
plastics
Social
 The first session of Computer Training for the youth came to a close with all 35 students
who ahd taken the test, passing out with good marks.
 A new session was started in March with 55 students.
 227 Households and 2 Schools (Kadal and Barsuddi) were given vegetable seeds for kitchen
gardens.
Other Events and Activities
 3 new staff members were recruited for positions of medical officers (2) and village
coordinator (1).
 We had the honour of welcoming our external visitors Tarek Toubale, Chief Operating
Officer of Karuna-Shechen and his wife, Laura.
 A visit to Jharkhand was made in March where meetings with several CBOs and NGOs were
conducted and field visits to villages made.

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We stepped into our 14th year of relentless humanitarian service to the underserved populations of
Gaya district (Bihar) with the continual commitment to improving and expanding our existing
activities as also to introducing new programmes in order to ameliorate the lives of our beneficiaries.
The first quarter of 2014 witnessed two big achievements in terms of the commencement of our new
Educational programme- ‘The role of play in the life of a child: A way to contribute to children well-
being and healthy development’ in 4 villages (Gopalkhera, Chando, Dema and Banahi) and Solar
electrification of a new village, Bhupnagar. Our first session of free Computer courses with 35 students
came to a close and in March a new session began with 55 enthusiastic youths hailing from poor
communities. Besides, as part of our Bodhgaya Clean Environment, Hygiene and Sanitation
programme we distributed 3660 Jute bags in order to discourage the use of bio-non degradable plastic
bags. In an effort to reach out to a greater number of beneficiaries and serve them better we have
hired a second female medical officer and a female village coordinator. We have taken the first and
important step towards the geographical extension of our activities to Bihar’s neighbouring State,
Jharkhand. In March we made a visit to the State, engaging in discussions with various NGOs and CBOs
and deciding upon our potential partners. We also made field visits in the process of village selection
for our future humanitarian activities there. In this quarter, we also had the honour of welcoming our
Chief Operating Officer, Tarek Toubale and his wife, Laura to our India office.
This report will give the details of all our existing programmes, activities and events that happened in
the months of January through March, 2014.
INTRODUCTION

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AN OVERVIEW OF MEDICAL ACTIVITIES
OPD, Mobile Clinics and Medical Camps
In the first quarter of 2014, the total number of Patients who availed the healthcare services of our
OPD (Outreach Patients Department) Mobile Clinic and Medical Camps was 18,066 which is 4.7 %
more than Quarter 4 of 2013 (17,247). New patients (for OPD and Mobile Clinics) constituted 5824
people (34.16 % of total number of patients at OPD and Mobile Clinics).
Table 1: Total Number of Patients at OPD, Mobile Clinics and Medical Camps
Months OPD Mobile Clinics Medical Camps Total
January 2613 3240 0 5853
February 2384 3075 513 5972
March 2668 3071 502 5739
Total 7665 9386 1015 18,066
 The number of patients refered to PHC & Government Hospitals was 71 (0.39 % of total
patients).
 The total patients who were treated “Free of Cost” (Pregnant women, children and aged
people above 60 years) was 9225 ( 51.06 % of total patients treated).
From the above graph and table we observe that for every month the Mobile Clinics have registered
slightly greater number of patients than OPD, which may be due to an increasing number of patients
from satellite villages.
HEALTH

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Table 2: Total Number of Patients Referred to PHC and Government Hospitals
Months OPD Mobile Clinics Medical
Camps
Total
January 0 5 0 5
February 5 1 29 35
March 6 1 24 31
Total 11 7 53 71
Direct Observed Therapy (DOT)
Out of 1566 medical tests conducted in our pathology laboratory 125 were Sputum tests (for
Tuberculosis) which is 42% more than the last quarter (88 tests). Out of these the number of people
who were diagnosed with TB was 3. Currently, the total number of TB patients undergoing treatment
is 103.
Table 3: Details of DOT Program
January February March Total
Number of TB patient’s started medicine
3 4 4 11
Number of sputum tests conducted
34 33 58 125
Sputum Positive
1 0 2 3
Refer TB Patients
3 2 2 7
Completed TB Medicine
7 3 11 21
Total Number of TB Patients currently
undergoing treatment (OPD and Mobile) 36 37 30 103
Types of Diseases observed among Patients in OPD and Mobile Clinics
The following table gives us information about the various types of diseases observed among the
patients in our OPD and Mobile clinics.

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Table 4: Types of Diseases
The table and graph show that the most common health problems observed among our patients were
Cough and Cold, Bone and Joint pain, Skin diseases and HTN.
Types of Diseases Total
Diarrohea/children 29
Diarrhoea / dysentery adults 195
Amoebiasis 431
Typhoid 1
TB 194
Gynecological patient 644
Bone & joints patients 4544
Burn patient 45
Worm manifestation 13
Skin diseases of all kinds 1308
Ophthalmologic infections 6
Number of identify malnourished children 10
Cardiac Infection 0
HTN 1031
Diabetes 125
Asthma & COPD 650
Cough & Cold 3773
Epilepsy 52
ENT patient 493
Lymphadenopathy 7
I&D Dressing 149
Other Patients 3269

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ACCESS TO PRIMARY HEALTHCARE IN URBAN AREA: SHECHEN MEDICAL
CENTRE IN BODHGAYA, BIHAR
The total number of people who came to the Medical centre in Bodhgaya for Patients in the first
quarter of 2014 was 7665, which is 10.34% higher than previous quarter (6966 patients). Out of this
total 3068 were new patients, representing 40.02 % of total patients in OPD.

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Table 5: Details of Patients in OPD
January February March Total
Total Patients 2613 2384 2668 7665
New Patients 1068 911 1089 3068
Men 712 608 697 2017
Women 1283 1187 1342 3812
Children 618 589 629 1836

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The above graphs show that majority of the patients at our OPD are women and children (73%).
Pathology Laboratory
Total number of patients who came in the first quarter of 2014 for different medical tests was 543.
Total analysis done was 1566 which is 19.54% greater than the previous quarter (1310analysis). The
number of patients and tests are different because one patient may go for several tests.
Table 6: Types of Medical Tests conducted in our Laboratory
Types of Medical Tests Conducted Total Number of
Tests
TC/DC 238
ESR 217
HB% 163
Malaria 37
Uric Acid 29
Blood Sugar 232
Serum Blirubin 29
AFB (Sputum test) 125
ECG 19
Urine routine examination 83
Urine culture sensitivity test 55
Other Tests 339
Total 1566

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From the above table and graph we see that the highest number of medical tests conducted are TC/DC,
ESR, Blood Sugar, HB% and AFB (Sputum Test).

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MOBILE CLINIC
MOBILE CLINICS
Number of patients who came for the consultations in mobile clinic from 18 villages was
9386 out of which 2756 (29.36 % of total patients at Mobile Clinics) were new patients. The total
number of patients in this quarter was 7.38% greater than that in the previous quarter (8741). The
number of patients who were treated Free of Registration Charge (Pregnant women, children and
aged people above 60 years) in the Mobile Clinic was 4042 (43.06 % of the total patients at mobile
clinics).

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Table 7: Details of Mobile Clinic Patients
January February March Total
Total Patients 3240 3075 3071 9386
New Patients 1098 879 779 2756
Number of Satellite
Villages from where
Patients come
803 686 724 2213
Number of Patients from
Satellite Villages
2347 2232 2253 6832
Men 909 849 1758 3516
Women 1647 1571 3218 6436
Children 684 655 1339 2642
From the above table we see that majority of the patients 6832 (72.79% of total patients at Mobile
Clinics) in the rural areas come from the satellite villages around the one where our outreach medical
team pays regular visits. This is a big achievement for us as it shows the level of satisfaction among the
beneficiaries which results in spread of information about our healthcare services by word of mouth
and the eventual increase in the number of patients from nearby villages.

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The months of February and March register slightly lower number of patients at Mobile clinics than
January. This can be attributed to the celebration of the Spring festival and the onset of the Harvest
season.
The graphs clearly show that, like that in the OPD, here too women and children form majority of the
patients (73%).

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MEDICAL CAMPS

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Free Medical Camps for the underserved and needy people were organised in Bodhgaya in the months
of February and March where 1015 patients availed our medical services.
Table 8 : Details of Medical Camp Patients
January February March Total
Total Patients 0 513 502 1015
Men 0 214 157 371
Women 0 187 196 383
Children 0 112 149 261
No medical camps were organised in January. Both in the months of February and March more than
500 patients were registered.

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From the above table and graphs we see that, just like in OPD and Mobile Clinics, at medical camps too women
and children for majority of the patients (64%).
HEALTH EDUCATION PROGRAMME (HEP)
Our Health Education Programme continues to run successfully as can be seen from the following
tables:
Table 9: Some Details of HEP
Indicators
Total Population reached
9449
Total Households reached
1285
Total Families reached
1936
Total Number of Health Groups 87
Total Number of Members in Health Groups 516
Total Number of Home Visits by Village Coordinators (vc) and Motivators
(m)
406 (vc) and
1324 (m)

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Table 10 : Reproductive and Child Health
Indicators
Total Number of Sanitary Napkins distributed 2337
Percentage of Pregnant Women Followed-up by Village Coordinators and Motivators 93
Percentage of Pregnant Women sent for Immunisation by Village Coordinators 33
Percentage of Pregnant women immunized with TT1& TT2 95
Percentage of Pregnant Women having Institutional Delivery 61
Percentage of new-born children immunized with BCG and 1st DPT 73.2
Percentage of Neo-natal deaths 0
Table 11 : Total Number of Sanitary Napkins reaching the Poor Women and Girls
OPD Mobile Clinics Medical Camps
January 177 695 0
February 158 586 102
March 108 613 135
Total 443 1894 237

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We observe from the graph that sanitary napkins reaching the target population have been much higher for
the villages than those distributed at our OPD in Bodhgaya. The primary reason that the motivators, who are
members of the village communities themselves, sell the napkins.

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EARLY CHILDCARE AND DEVELOPMENT
Recognising the vital role of play in the social, emotional, physical and cognitive skills development of a child
we have introduced our new programme, ‘Role of play in the life of a child: A way to contribute to children
well-being and healthy development’ in collaboration with Inter’Lude, France. The programme, which focuses
on children (0-6 years age) at the Anganwadi centres, was initiated in January after getting the approval and
encouragement of the District Magistrate (DM) and the District Programme Officer (DPO) of Gaya district.
This programme is being led and supervised by a volunteer from Inter’Lude who has been working with us
since the programme’s inception. He made several visits along with our village coordinators to the Anganwadi
centres in our operational villages, interacting with the Anganwadi workers, children and the local
communities. Having acquired a clear idea about the Early Childcare scenario there and about the socio-
economic-cultural aspects vital to the efficacious planning and implementation of the programme our next
step was to search for locally available games and play materials for the children. This was followed by a day-
long training session organised for select staff members of our organisation, Child Development Project
Officers (CDPOs) of the blocks where the four villages belong and Anganwadi Workers of those villages. In this
interactive training, which was given by our volunteer from Inter’Lude and our Director, the participants
learnt about the importance of play in a child’s growth; the objectives, methods and expected outcomes of our
programme.
We have been conducting drawing sessions with the Anganwadi children, providing each of the 4 Anganwadi
centres with various indoor and outdoor games like hoops, stilts, construction games, sensorial mats, etc. Our
regular, often surprise, visits to the Anganwadi centres to monitor and supervise the programme have already
started showing very satisfactory results in such a short while, in terms of the role of the Anganwadi workers
as animators and the active and enthusiastic participation of the children.
Presentation on the programme activities in front of the DPO and CDPOs of Gaya district
EDUCATION

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Participants at the Training Display and Explanation about different types of Games
Drawing session at Anganwadi centres

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Outdoor Games In-door Games
NON-FORMAL EDUCATION (NFE)

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Our NFE programme continues to run in our villages.
Table 12 : NFE Attendance details
The average attendance at the NFE centres is lower than the usual, in this quarter, at 43% as this is the time of
the Spring festival as well as the Harvest season.
Name of Villages Number of Students
enrolled in NFE
Average Attendance
in NFE classes
Banahi 30 15
Dema 30 16
Gopalkhera 30 16
Lohjara 30 12
Bandha 32 10
Nawatari 32 12
Mansidih 31 8
Sripur 30 12
Mastibar 25 12
J.P.Nagar 28 8
Kharati 18 10
Karhara 60 30
Trilokapur 21 6
Bhupnagar 25 15
Kadal 25 10
Total 447 192

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VOCATIONAL TRAINING FOR UNDERPRIVILEGED YOUTH & WOMEN
Computer Courses for the Underprivileged Youth
The first quarter of 2014 marked the completion of the first Computer training session and the beginning of
the second. Out of (no enrolled in classes) 35 students appeared for and passed the written and practical
examinations with 46% of the students achieving between 60% and 80% marks and a ‘Good’ grade. 3% of the
students attained a ‘Very Good’ with more than 80% marks.
Table 13: Marks obtained by students of the first computer session
Marks Obtained out of 100 No of Students Achieving the
Marks
Percentage (%) of Students
Achieving the Marks
0 – 40 06 17
40- 60 12 34
60-80 16 46
80-100 01 3
An overwhelming 75 youths applied for our second session of Computer courses out of which 55 were
selected on the basis of their performance in the written examination and interview. Classes started in
March with the 55 students divided into 6 batches.
SOCIAL

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Vocational Training for Rural Women
The women who had attained advanced training in candle-making in Jamshedpur continue to impart
refresher and advanced guidance on candle-production and marketing to the students at the various NFE
centres. In this quarter the NFE students at Banahi, Gopalkhera, Bandha, Nawatari and Dema received
tutelage from the vocational trainers.
KITCHEN GARDEN

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Our Kitchen Garden programme that focuses on improving the nutrition status of the rural poor continues to
run successfully. In this quarter seeds of seasonal vegetables were distributed among 277 households across
18 villages and 2 schools (Kadal and Barsuddi).
Table 14: Vegetable Seeds distributed among households
NETWORKING WITH OTHER LOCAL NON-GOVERNMENTAL ORGANISATIONS (NGOS)
The scale and scope of developmental challenges requires that all organisations sharing similar mission and
goal work collectively towards the realisation of their common aspirations. With the aim of forming a
network of like-minded humanitarian organisations we have completed, in this quarter, collecting detailed
information about NGOs working in Gaya district. The total number of functional NGOs in the district was
found to be 98. Our next step will be to bring them together on a common platform to organise an NGO fair.
Name of Villages Number of Households
receiving Vegetable Seeds
Schools receiving Vegetable
Seeds
Banahi 12 -
Dema 31 -
Gopalkhera 14 -
Lohjara 20 -
Bandha 11 -
Nawatari 12 -
Mansidih 20 -
Sripur 10 -
Mastibar 14 -
J.P.Nagar 9 -
Kharati 9 -
Karhara 44 -
Trilokapur 11 -
Bhupnagar 17 -
Kadal 14 1
Chando 14 -
Barsuddi 5 1
Simariya 10 -
Total 277 2

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c
BODHGAYA CLEAN ENVIRONMENT HYGIENE AND SANITATION PROGRAMME
Distributing Food Covers to Vendors at Gaya Station
Distribution of Jute bags among NFE students
ENVIRONMENT

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With the pledge to reduce the indiscriminate use of bio-non degradable plastics we have been distributing
Jute bags to each of our patients, our NFE students and to all the students and faculty of the schools where
we had conducted drawing, and speech competitions last year. We have been able to give away 3660 bags in
the past three months.
Another major step taken towards cleanliness and hygiene was the distribution of 21 covers for the food
sold by the vendors at Gaya station. This has been followed-up by our staff who have paid several visits to
the station to monitor whether the vendors are actually using the covers and to get their feedback regarding
the same.
RAINWATER HARVESTING
Our programme on Rainwater Harvesting which was started at the end of last year continues with water
tanks being installed in 18 households across 3 villages (Dema-5households, Chando-11 and Karhara-2) this
quarter. Besides, 3 tanks have been provided to the school at Lohjhara.

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SOLAR
SOLAR ELECTRICITY
People of Bhupnagar enjoying their evening in the light of a Solar set
Our Solar Engineers installing solar lights in Bhupnagar
Our Solar Electrification programme which was running in the villages of J.P. Nagar, Kharati and Banahi for
more than 2 years, has been scaled-up to cover Bhupnagar which is one of the remotest and most backward
of all our operational villages with hardly any possibility of electrification in the near future. Therefore,
acting on the demand of the community we have installed solar lights in 31 households of the village with
the help of our new Solar Engineers. These LED sets are cheaper than the sets that we had previously
installed in the 3 above-mentioned villages. We have collected a one-time amount of INR 2000 from each
beneficiary as their contribution.

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FINANCES
The expenses incurred in the first quarter of 2014 are presented below:
RECRUITMENT OF NEW STAFF
We appointed 3 new staff members to better serve our beneficiaries- 2 female medical officers, one of
them being hired on a daily basis and a female village coordinator. For the position of the village
coordinator our 4 village coordinators had to compete with the other shortlisted applicants. Two of
our existing village coordinators qualified while for the third position a new, experienced and well-
qualified woman was selected.
OTHER INFORMATION

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JHARKHAND VISIT AND FUTURE PLANS
With the objective of reaching out to more people in dire need of humanitarian services we have
decided to expand our area of operation to the neighbouring state of Jharkhand this year onwards. The
State is bound by Bihar in the North, West Bengal in the East, Odisha in the South and Chhattisgarh
and U.P. in the West.
Jharkhand, like Bihar, not only ranks as one of the poorest states in the country but also fares very
badly in most of the human development indicators and is Maoist-affected with several districts being
declared as Red Corridors.
We are targeting the East Singhbhum as it is one of the most backward districts of Jharkhand and the
Maoist-Naxalite groups here are less active compared to the other districts. Jamshedpur (the largest
industrial city of the State and headquarters of East Singhbhum) will be our potential base in
Jharkhand. Besides, the city’s connectivity with the rest of the State and other parts of India are much
better than other big cities of Jharkhand like Ranchi and Dhanbad. Also, various amenities required
for establishing and running our office and programme activities will be easily available. Again, in
Jamshedpur more human resources and better logistical facilities are likely to be available compared
to the other two cities as it is the third largest city in eastern India after Kolkata (in West Bengal) and
Patna (in Bihar).
In March Shamsul Akhtar along with our COO, Tarek Toubale visited Jharkhand for this purpose. There
they engaged in discussions and meetings with Community Based Organisations (CBOs) and Non-
Governmental Organisations (NGOs) and went on field trips to various villages in the district of East
Singhbhum. Thereafter it was decided that from late May or early June, after the General Elections in
the country are over, we will start working in Jharkhand in collaboration with a CBO called Dhad
Disham Vikas Sangh (DDVS) and two NGOs- Grace India and Cause for Change. Our areas of
intervention will be Jamshedpur, Potka, Jadugora, Musabani and Ghatshila towns of East Singhbhum
district.
DDVS works with and for tribal communities, focussing primarily on improving their livelihoods, land
rights and women empowerment. We intend to collaborate with them on outreach activities like
Kitchen Gardening, Vocational Training, Rainwater Harvesting, small money Big Change and Medical
Camps. Grace India is an NGO which organises regular Medical Camps for the underserved people.
Cause for Change collects unused medicines from households and redistributes them among the
needy populations through medical camps. Therefore, with both these organisations we envisage
working on the common ground, i.e., healthcare activities. Both the above-mentioned NGOs will send
us formal proposals for our future endeavours.
We also held meetings and field visits with two other NGOs, Yuva Jagriti Swavalamban Kendra and
Catholic Charity/SJVK. From the end of the third quarter of this year we intend to start looking for
possibilities to work in collaboration with both the above-mentioned NGOs.

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Jagiya Devi, a resident of Bhupnagar Village narrates how life has become better after
the installation of Solar Lights at her Household
Jagiya Devi can now cook in the evening with the help of the solar light
The latest village to receive solar lighting facilities through Karuna-Shechen, India is the remote and
backward village of Bhupnagar. Acting on the demands of the community in the village we installed
solar lights in 31 households early this year, collecting a one-time payment of INR 2000 per
household. Jagiya Devi, a recipient of solar set is very satisfied with our initiative. She narrates how life
for her family in particular and the village communit, at large has become easier and more
comfortable than before.
She says that previously, after sunset, the villagers could not perform any activities as there was
complete darkness. They would have no choice but to go to bed early. ‘Pehle raat ko saanp aur bichhoo
ka dar bana rehta tha’ (previously, at night, we would have to face the threat of being bitten by
poisonous scorpions and snakes). Another big threat was kerosene lamps, which are a serious fire
hazard especially for the children. With the installation of solar lights at their household Jagiya Devi no
longer has to worry about such mishaps.
She points out that the primary benefit to the village community as a whole has been the extension of
their workday into the evening hours. Previously, for example, she had no choice but to complete
most of her household chores before the onset of evening. Cooking dinner in the insufficient light of
the kerosene lamp was very difficult for her but now, since the installation of solar lights in her
household this problem has been solved. Besides, children can now study by the solar light after dark
which, she believes, would enable them to improve their education levels in the long run. She offers
her heartfelt thanks to Karuna-Shechen for taking the initiative to light up the lives of her community.
ANNEX-SUCCESS STORIES

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Satyendra Manjhi- A patient of Tuberculosis with enlarged gland
Swollen Gland at start of Treatment (May,2013) Swelling reduced during DOT treatment (Oct, 2013) Swelling cured after DOT treatment(Jan, 2014)
Satyendra Manjhi, a 30 year old resident of Arjunbigha, Bodhgaya, had come to our clinic to treat a
lump in his neck, which had been developed for quite sometime and was causing him a lot of pain.
After several futile efforts of local doctors around his village to cure him he went to Varanasi, in the
neighbouring state of Uttar Pradesh, in search of proper treatment. Unfortunately, there too nobody
could diagnose his problem correctly and he returned to his village utterly dejected. His physical
condition was so weak that he had to leave his job as an out-migrant labourer and return to his village.
This caused a huge set-back for his family consisting of his parents, wife and four brothers, as he was
the main source of earning.
At last, following a friend’s suggestion he visited the Shechen clinic in Bodhgaya where, after several
medical tests he was diagnosed with tuberculosis. He started his CAT II treatment at our DOT centre
from early May, 2013. Within a few months there was a remarkable improvement in his physical
condition. Eventually he revived his lost energy and physical and mental strength. The glandular
swelling on his neck started to reduce and by the end of 8 months of his treatment it had completely
disappeared.
Satyendra Manjhi now feels healthy and is strong enough to have started working as an agricultural
labourer in his village. He is immensely thankful to Karuna-Shechen for diagnosing and treating him
properly, with utmost care and for granting him a new lease of life.