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Progress Report

South Asian Development Partnership with Emmanuel Hospital Association

16th March 2001

Introduction: EHA had sent a team of doctors consisting of 2 physicians, an orthopaedician , a junior doctor & nurse to Gandhidham in the Kutch area , by the 29th January, to work alongside the EFICOR team, which was providing relief in terms of food, blankets & tents. Many acute cases & limb injuries were attended to. This team returned after 10 days & another team of 2 junior doctors & nurse continued having mobile clinics in affected villages. As a number of NGOS & international medical teams were now delivering services, it was decided to assess the need for EHA to continue provision of services in the quake-hit areas.

Period of survey: Dr. Ashok Chacko , the Community Health Secretary of EHA, was deputed to visit the quake-affected areas from the 18th - 21st of February. The areas visited included Gandhidham town, Bhuj city, Bachhau town, villages in Anjar Taluka, Jamnagar town & villages in Jodia taluka of Jamnagar district. Mr.Vinod Mehta, Project Officer from one of EHA's projects, also visited villages separately, a week before Dr.Chacko's visit.

Methodology: Key informant interviews were conducted with senior government health officials, district collector, NGO leaders, Headmen of villages, & pastors involved in relief.

FINDINGS

KUTCH AREA: Bacchau town though badly affected, had medical teams from the Ukraine, VHP, ICRC & Gayatri serving the needs of the people. The Govt. hospital was functioning from tents & prefabricated rooms were being constructed. There were a number of doctors visible with very few patients in sight.

Gandhidham town was not very badly affected. The Govt. & private health facilities were functioning as usual.

Bhuj city had a virtual hospital in tents set up by the ICRC ( Red cross) The Salvation Army had also set up a dispensary providing free medical care, near the Civil hospital.

Adhipur , a suburb of Gandhidham had an ultramodern hospital, functioning from tents set up in front of the damaged govt. hospital by a team from Denmark. Here again hardly any patients were seen. Private hospitals were also functioning as usual ( around 6 of them).

Visits to the villages of Mathak, Nagavwaladia, Betalwaladia, Thuna, & Wandi revealed a lack of pressing medical needs. Govt. ANMs from subcentres were visiting as usual & people accessed medical care form Adhipur, 10-20 kms away.

The OM team had doctors from Germany, ministering to a dwindling number of patients, near the town of Lakadiya.

The EHA mobile team, were visiting villages & towns in different areas, & felt that people were coming & to them so as not to disappoint them, for visiting them from afar. Often the village would have received care from other mobile teams.

JAMNAGAR: This town lies on the west coast of Gujarat, around 250 kms south of Gandhidham. The town which was under the Jadeja rulers in the past, has a small port with trade going on with the middle-east. It is a known cyclone-prone area, which has been reeling under drought conditions for the last 2 years & was partially affected by the earthquake. The major industries in the area include

  • Reliance petroleum - a huge township 20kms form the town
  • Major brass industry making many types of brass parts for industry
  • Textiles - DIGJAM
  • Salt farming
  • Fishing

Most people in the rural areas are still dependent on agriculture. Due to drought conditions persisting, there is large-scale migration from Jodia taluka.

The town has a 1000 bedded govt. hospital & medical college, which helped meet the acute problems of the quake -affected, with more than 900 patients being treated after the quake.

JODIYA TALUKA: (Approx 84,000 population of which around 20% are scheduled caste). Although 6 talukas of Jamnagar district were affected by the quake, the most severely affected taluka (block) was Jodiya. Of 9551 houses from 17 villages, surveyed by the govt., housing a population of 36786, 8580(90%) were totally damaged & the remaining had major or minor damages. Another group of 7 villages with a population of 6335 had houses with moderate damages. 82 deaths were reported from this taluka. The District Collector, Mr.Mukesh Pandya, while mentioning these figures, said that there was still a need for around 500 tents to help start schools where the building had been damaged. He was very appreciative of the relief work being carried out by Pastor Ravi Beatty of the CNI Church at Jamanagar who had been providing food packets & blankets to persons in the 17 severely affected area with a small team of volunteers & help from CASA & other donors.

MEDICAL NEEDS: The District Health Officer, Dr.Nagar, mentioned that 11 out of the 36 PHCs ( Primary Health Centres) & 2 of the 11 CHCs (Community Health Centres, with 30 -bedded hospitals) were damaged. The CHC at Jodiya was severely affected & now functioning from 3 tents. A new prefabricated CHC was being constructed.. However there were adequate supplies & medical personnel available.

On visiting the villages with Pastor Ravi, we found that many villages were on rough roads & away for the main road. People were unhappy about the care received & were quite eager to access other medical care. As many were a distance from main roads, people found it difficult to travel either to Jodiya or Jamnagar & were grateful for medical services being delivered by mobile teams working for short times with the pastor. A Korean Medical team that was present there at the time, treated around 100 patients in just 1 village in a day. They plan to be there till the 1st of March. Pastor Ravi mentioned that there were no charitable hospitals in the area, & no Christian medical work. Besides the Govt. Medical College, there were a number of private practitioners who charged exorbitantly & hence were not accessible to the poor.

RECOMMENDATIONS:
1] EHA to partner with the CNI church to provide medical services to poor people in need, both in the town & quake-affected villages. This could consist of mobile medical care services initially. Following more detailed situational analysis of needs, to consider long - term health services through a small health centre.
2] As the area has been subjected to repeated natural disasters, leading to poor agricultural & economic activity, to consider setting up an integrated watershed management project, helping in developing natural resources for affected villages. This could go hand-in hand with medical services, leading to wholistic development of concerned villages.

SUBMITTED by Dr.Ashok Chacko

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