At the time when over
200 people died of cholera in southern Orissa's Rayagada, Koraput and
Kalahandi districts recently, the deadly virus did not enter villages
in the neighbouring villages of Gajapati district.
The virus did not spread into the villages of at least five blocks of
Gajapati district as the tribal villagers are well-informed in their
health care, thanks to the People's Rural Health Promotion Scheme, an
integrated health insurance launched by the People's Rural Education
Movement (PREM) in association with Plan International.
The scheme was launched 4 years ago to provide medical services, as
well as health insurance to tribals and fishermen of the operational
areas of PREM with a minimum and one time premium.
Praising the scheme the International Labour Organisation says,
“Preventive health care programme of PREM-Plan and peripheral care
offered through Village Medicine Depots help to reduce referral
morbidity and thereby reduce the expenditure load on PRHPS.”
Under the scheme, if a patient suffers from any disease, he is first
treated at the Village Medicine Depot set up by the organisation. A
trained lady from the respective village is appointed to provide
medicine to the patient for minor ailments. After three days, if there
is no improvement, the patient is referred to the nearest Public Health
Centre and to the medical college at Berhampur.
At the VMD, the treatment is given for at least 15 minor diseases
including fever, malaria, diarrhoea, dehydration, minor injuries,
cough, scabies, safe delivery and immunisation. The quality and
low-cost medicines are stocked in the VMD. Trained women of the
respective villages serve the medicine with elaborate health advice on
sanitation and hygiene.
In order to insure his health, a person has to be enrol his or her name
under the scheme paying Rs 30. The fund collected from the members
becomes a corpus and managed by the villages themselves. “Our role is
very limited as the scheme is operated by the villagers themselves,”
said PREM president, Jacob Thundiyil.
The scheme is presently operating in 333 villages under 4 blocks —
Mohana, Nuagada, Gumma and Rayagada in Gajapati district, 144 villages
in 3 blocks — Krushnaprasad, Bramhagiri and Kakatpur in Puri district
and covers over 80,000 people.
“We are planning to extend the scheme to Gunupur block in Rayagada
district, Sanakhemundi and Dharakote blocks in Ganjam district and
Vizianagaram district in Andhra Pradesh and to cover another 40,000
people,”he said.
The organisation has been provided some infrastructural facilities in
all the referral government hospitals including the MKCG Medical
College and Hospital, Berhampur for better treatment to their insured
patients.
In MKCG Medical College and Hospital, PREM was donated at least 15 beds
in the Orthopedic department.
“We never refer to any patients to the private nursing homes" he said.
"In this way we teach the people about the access to the government
hospitals,” he added.
All the referral ad treatment expenditure will be borne by the
organisation if the patient is enrolled under the scheme.
“The distance from our village to PHC is about 10 km while the district
hospital and medical college are about 40 km and 160 km away
respectively. Serious cases are taken to Paralakhemundi district
hospital by bus or tractor. From the insurance we are being reimbursed
the cost of the medicines,” said Digu Digal of Sadanga in Gumma block
of Gajapati district.
“In our village one person had gone through a stomach operation,
another person had a paralytic stroke. The scheme helped both the
cases,” said Janab Majhi of Paleri village of the same district.
Jacob, the founder of the scheme said the People’s Rural Health
Promotion Scheme was aimed at breaking the link between ill-health and
poverty by ensuring the health care of the tribal and fishermen who are
the focal groups of PREM-Plan’s development activities.
The scheme is embedded in the other health and development activities
of PREM-Plan. He was influenced by other community health insurance
schemes of RAHA in Chattisgarh and ACCORD in Tamil Nadu to launch the
scheme with improvisations for the project areas of the organisation.
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