karuna-shechen 1st quaterly report 2015

QUARTERLY REPORT

JANUARY-‐MARCH, 2015

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CONTENTS PAGE NUMBER

Introduction 3

Health

v An Overview of Medical Activities 4 v Access to Primary: Shechen Medical Centre in Bodhgaya, Bihar

and Hata, Jharkhand 6

v Mobile Clinics 9

v Health Education Program (HEP) with Special Focus on Women Hygiene & Sanitation

12

Education

v Early Childcare and Development 14 v Non-‐Formal Education (NFE) 16

Environment

v BodhGaya Clean Environment, Hygiene and Sanitation Program 17

v WASH 18 v Rainwater Harvesting 19 v Solar Electricity 20

Social

v small money BIG CHANGE 21

v Kitchen Garden 24

Other Important Activities and Events 27 Annex

v Case Study 31

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INTRODUCTION

The first quarter of 2015 witnessed several interesting activities and events. We have catered to 27,192 patients in Bihar and Jharkhand through our OPD and Mobile Clinics. Our Mobile Clinic service in Bihar was extended to two new villages, Bongiya and Patsugiya. Besides, we launched our Kitchen Garden program in Jharkhand covering 438 households across 26 villages.

We installed sanitary napkin vending machines and incinerators at our OPD for the benefit of our female patients and staff members.

We installed smokeless ovens at Anganwadi centres in Dema and Banahi in order to prevent the anganwadi workers and children from the harmful smoke and soot emitted by the traditional ovens, which are a source of various respiratory diseases and add to environmental pollution.

Our volunteer from Portugal, Ms Alice Cardos, along with the support of our staff, painted the walls of 5 Anganwadi centres with active participation of the village children. We distributed school uniforms and study books among the students of Babua schools at Dema and Masuribar. Fitness dresses were given to the Yoga students in Mansidih.

We participated in the annual three-‐day fair, Buddha Mahotsav where our organisation’s stall was visited by numerous people. Their inquisitiveness about our programs and appreciation of our humanitarian efforts made our participation in the fair a great success.

A General Meeting was held in BodhGaya in the presence of our President, Matthieu Ricard; the Board members of Karuna-‐Shechen; members from our donor organisation, Chanel foundation, Secretary, SRPC Trust and other important visitors. After 2 consecutive days of meeting on the 6th and 7th March our esteemed guests visited some of our programs in the villages of Dema and Chando.

This report provides the details of all the activities and events that we undertook in the first quarter of 2015.

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HEALTH

AN OVERVIEW OF MEDICAL ACTIVITIES

In the first quarter of 2015 we registered 22,869 patients at our OPD and Mobile Clinics in Bihar and 4,323 patients in Jharkhand.

Table 1: Total Number of Patients at OPD and Mobile Clinics in Bihar and Jharkhand

Bihar Jharkhand

Month OPD Mobile Clinics OPD Mobile Clinics

January 2,716 3,821 967 507

February 3,448 4,371 1003 586

March 3,952 4,561 765 495

Total 10,116 12,753 2,735 1,588

Direct Observed Therapy (DOT)

Out of 1935 medical tests conducted in our pathology laboratory 170 were Sputum tests (for Tuberculosis). Out of these the number of people who were diagnosed with TB was 10. While 7 patients have successfully completed their DOT course in this quarter 23 TB patients are currently undergoing treatment.

Table 2: Details of DOT Program

Indicators January February March Total Number of patients tested positive for Sputum test 2 5 3 10

No of TB patients started medicine 3 7 4 14

Refer TB Patients 1 3 3 7 Patients who have completed DOT course 1 3 3 7

Total No. of TB Patients are undergoing treat. 30 30 23 23

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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.

Table 3: The Types of Diseases that our Patients suffer from

Types of Diseases Patients in Bihar Patients in Jharkhand

Diarrhoea/children 149 8 Diarrhoea / dysentery adults 54 14 Amoebiasis 782 257 Typhoid 0 130 TB 96 5 Gynaecological patient 1,128 177 Bone & joints patients 5,956 1,017 Burn patient 37 3 Worm manifestation 14 62 Skin diseases of all kinds 2,128 329 Ophthalmologic infections 0 31 Number of identified malnourished children 0 20

Cardiac Infection 0 36 HTN 1,278 156 Diabetes 376 38 Asthma & COPD 834 35 Cough & Cold 3,622 231 Epilepsy 45 0 ENT patient 503 27 Lymphadenopathy 0 1 I&D Dressing 63 19 Other Patients 5,804 1,727 Total Patients 22,869 4,323

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ACCESS TO PRIMARY HEALTHCARE: SHECHEN MEDICAL CENTRE IN BODHGAYA, BIHAR& HATA, JHARKHAND

Patients being treated at our OPD in BodhGaya, Bihar

Treatment of TB patients at the DOT centre in BodhGaya

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The total number of people who came to the Medical centre in Bodhgaya and Hata for Consultations in first quarter of 2015 was 10,116 and 2,735 respectively. The OPD in Bihar saw an 18.34% rise in the number of patients compared to the last quarter of 2014 (8,548 patients).

Table 4: Total Number of Patients at the OPDs in Bihar and Jharkhand

Month Bihar Jharkhand January 2,716 967 February 3,448 1003 March 3,952 765 Total 10,116 2,735

Table 5: Total Male, Female and Child Patients at OPD in Bihar and Jharkhand

Bihar Jharkhand Male 2,694 1,123 Female 4,983 1,329 Children 2,439 283 Total 10,116 2,735

Bihar, January, 2,716.00

Bihar, February, 3,448

Bihar, March, 3,952

Jharkhand, January, 967

Jharkhand, February, 1003 Jharkhand,

March, 765

Patients at OPD Bihar Jharkhand

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Both in Bihar and Jharkhand the women mark the highest number of patients, followed by men and child patients.

Patients at our OPD in Hata, Jharkhand

Bihar , Male , 2694

Bihar , Female, 4983

Bihar , Children, 2439

Jharkhand, Male , 1123

Jharkhand, Female, 1329

Jharkhand, Children, 283

Male, Female & Child Patients at OPD Bihar Jharkhand

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MOBILE CLINICS: 3 IN BIHAR & 1 IN JHARKHAND

Patients at Mobile Clinics in Bihar

New Mobile Clinic at Huntergunj

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We have added two new villages to those visited by our Mobile Clinic teams in Bihar-‐ Bongiya and Patsugiya.

In the first quarter our Mobile Clinics in Bihar and Jharkhand registered 14,341 patients.

Table 6: Total Number of Patients at Mobile Clinics in Bihar and Jharkhand

Month Bihar Jharkhand January

3,821.00 507

February 4,371.00 586

March 4,561.00 495

Total 12,753 1,588

Table 7: Total Male, Female and Child Patients at Mobile Clinics in Bihar and Jharkhand

Bihar Jharkhand Male 3,728 371 Female 6,787 959 Children 2,238 258 Total 12,753 1,588

Bihar, January, 3,821.00

Bihar, February, 4,371.00

Bihar, March, 4,561.00

Jharkhand, January, 507

Jharkhand, February, 586

Jharkhand, March, 495

Patients at Mobile Clinics Bihar Jharkhand

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Patients at Mobile Clinics in Jharkhand

Bihar, Male , 3,728

Bihar, Female, 6,787

Bihar, Children, 2,238

Jharkhand, Male , 371

Jharkhand, Female, 959 Jharkhand,

Children, 258

Male, Female and Child Patients at Mobile Clinics

Bihar Jharkhand

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HEALTH EDUCATION PROGRAMME (HEP) WITH SPECIAL FOCUS ON WOMEN HYGIENE & SANITATION

Apart from distribution of sanitary napkins among poor women and girls we are continuing with our awareness programs in schools and rural communities in Bihar. We have introduced these women health-‐related knowledge dissemination sessions in Jharkhand also. A new initiative towards this program has been the installation of sanitary napkin vending machine and incinerator at our OPD in BodhGaya, Bihar.

Sanitary Napkin Vending Machine Sanitary Napkin Incinerator

Menstrual Hygiene program at a School

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Table 8: Number of sanitary napkins (single pieces worth INR 2) sold

Month Bihar Jharkhand

January 275 612

February 1,425 955

March 2,500 784

Total 4,200 2,351

Table 9: Number of sanitary napkins (packets of 6 napkins worth INR 6) sold

Month Bihar January 980 February 0 March 0 Total 980

These packets went out of stock after January and remained unavailable for the next two months. Thus, in Jharkhand only the single piece sanitary napkins were sold in this quarter.

The women health and hygiene related awareness sessions in Bihar were organised in 5 schools with 260 participants and in 9 villages with 203 women from the communities. In Jharkhand the program has just been started with a workshop conducted at a school in Jamshedpur (with 17 students).

As mentioned earlier we have installed a sanitary napkin vending machine and incinerator at our OPD in BodhGaya for the convenience of our female patients and staff members. Several schools in and around BodhGaya have shown interest in installing the two machines. We will begin the process of installation in these schools early next quarter.

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EDUCATION

EARLY CHILDCARE & DEVELOPMENT

Role of Play in the Life of a Child

Wall Painting by the Children and our Volunteer

Children playing with dolls and other indoor play materials

We continue with the regular monitoring of the program which is running in 10 villages. In this quarter we welcomed a new volunteer from Portugal for the program. With the support of our village coordinators and interns and through active participation of the children enrolled with the Anganwadi centres our volunteer painted the walls of the centres in the villages of Banahi, Dema, Gopalkhera, Mansidih and Trilokapur. Apart from wall painting we have white washed the walls of the Anganwadi centres in Bakraur, Chando and Lohjhara and of the above-‐mentioned villages.

In the next quarter we will be introducing some more exciting games to help the overall development of the rural children.

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Babua School

Students of Babua School in Uniform and with Books distributed to them

We have provided books to the students of Babua Schools for learning basic English, Hindi and Mathematics. We have also distributed school uniforms for the students (110 uniforms in Dema’s Babua School and 30 in Masuribar).

Yoga Classes

Children doing Yoga in the Fitness uniforms distributed among them

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Our yoga and fitness classes are conducted regularly with enthusiastic rural children. We have distributed 90 Yoga dresses for our Yoga students in Mansidih. We will be distributing more such yoga uniforms in all the other villages in the coming months.

NON-‐FORMAL EDUCATION (NFE)

Our NFE program continues to provide educational and skill enhancement services to 363 rural illiterate women across the 12 villages where our NFE centres are running successfully.

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ENVIRONMENT

BODHGAYA CLEAN ENVIRONMENT, HYGIENE AND SANITATION PROGRAM

Jute Bags distributed among patients in Jharkhand & children at Buddha Mahotsav in Bihar

Snack Boxes distributed among shop owners and vendors

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918 Jute bags were distributed amongst patients at OPD and Mobile Clinics, schools and at the Bodh Mahotsav (fair organized in BodhGaya in the month of January).

Table 10 : Jute Bags distribution

Month Bihar Jharkhand January 202 129 February 84 378 March 31 94

Total 317 601

We participated in the Buddha Mahotsav (a three day fair organized in BodhGaya in January every year and is filled with cultural and religious activities) where we organised drawing competition with 40 children to raise their environmental awareness. We distributed jute bags among them.

WASH

Our volunteer from France, Sacha Durbec, a WASH-‐expert tested the quality of drinking water for all our operational villages of Gaya district. In Masuribar the level of fluoride was found to be high but within permissible limits. Particular handpumps at Masuribar, JP Nagar and Gopalkhera were found to have bacteria and village coordinators were instructed to tell the people to avoid having water from those handpumps. Apart from these the overall quality of water in the villages was found to be safe for drinking.

Water testing being conducted at a village

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RAINWATER HARVESTING

Our water management and replenishment program, Rainwater Harvesting has continued to benefit the rural poor in this quarter through the instalment of water tanks in 74 households across 5 villages.

Table 11: Details of Villages and Households where Rainwater Harvesting systems have been installed

Name of Villages No. of Households where RWH tanks were installed

Mansidih 23 Karhara 17 Trilokapur 7 Dema 23 Gopalkhera 4 Total 74

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SOLAR ELECTRICITY

Our new Solar Engineers, Lakshmi Devi and Puja Devi installed solar systems bought from Barefoot College, Rajasthan in the three Kadal, Barsuddi and Chando.

Table 12: Details of Villages and Households where Solar Sets have been installed

Villages No. of Households Kadal 21 Barsuddi 7 Chando 81 Total 114

Puja Devi and Lakshmi Devi, our Solar Engineers, setting up the solar systems

Solar sets being distributed at Chando and Barsuddi

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SOCIAL

SMALL MONEY BIG CHANGE

Smokeless Ovens

The traditional oven used in the villages emits a considerable amount of smoke, exposing women and children who congregate near the ovens, to pollution consisting of carbon monoxide and miniscule particles of sooth which causes various respiratory and lung diseases. Besides, these ovens release large amount of carbon dioxide thereby adding to global warming. Apart from the adverse health and environmental impacts the traditional oven results in negative economic consequences in terms of greater expenditure on fuels.

With the objective to prevent the rural people from the multi-‐fold harmful impact of traditional ovens we have started a project to replace them with smokeless ones at the Anganwadi Centres where the children and Anganwadi workers (AWWs) are directly exposed to the harmful fumes of the traditional ovens where the children’s mid-‐day meals are prepared. We started with the project in this quarter, installing smokeless ovens at the Anganwadi Centres in Banahi and Dema.

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The visible and short run benefits are clear from the following table:

Problems faced while using Traditional Ovens

Benefits of using Smokeless Ovens

Generated huge amount of smoke The smoke emitted goes out of the chimney nd saves the children and AWWs from inhaling the fumes

The Oven consumed fuel worth INR 200 per week

The smokeless oven consumes about half the fuel that was used for cooking on a traditional one

Food took a lot of time to cook Food is cooked much faster and is also cooked well

The walls of the Anganwadi Centre was getting dirty from the sooth

The problem is solved as there is no more sooth

Community Toilets

About half of India's total population — 595 million people — do not use a toilet, making India home to world’s largest number of open defecators. The practice not only leads to environmental contamination and risks rising from so much untreated human waste, but also has enormous health implications. It makes people, especially children highly susceptible to contracting diseases such as diarrhoea and hepatitis. It can be even be more hazardous for women and girls since each time they use the outdoors to relieve themselves they face the danger of sexual assault.

The government of India has several policies and programs to combat the problem of open defecation but these have mostly failed due to lack of water in the community toilets and/or uncomfortable/ poor infrastructure which makes it difficult and hence reluctant for the target population to accustom to the new habit.

An unused toilet built by the Government at a village

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From October 2014 we have started a pilot project to make community toilets in four villages, namely, Banahi, Bhupnagar, Kadal and Chando. In each village there is provision for 2 toilets for men and 2 for women, i.e., there are a total of 4 toilets for community use.

The program aims at combating open defecation by focusing on the two primary problems:

• Making toilets comfortable enough to encourage the beneficiaries to easily adapt to the new practice of using them instead of the age-‐old custom of relieving themselves in the open;

• Secondly, providing adequate water supply to maintain clean and hygienic toilets. As using water after toilet is a cultural practice in South Asia provision of uninterrupted water supply becomes mandatory to make such a project successful. For this we ensure that the toilet is built near a hand pump or pond, at a safe distance as per WHO recommendations. We have also installed tanks at every toilet in order to use water accumulated through rainwater harvesting system at rainy season.

Our Community toilet in Banahi is now complete and ready for use by the villagers. It cost INR 1,73,929 (USD 2,899) wherein the cost borne by Karuna-‐Shechen was INR 1,45,929 (USD 2,432) and contribution of the community through labour and locally available raw materials was INR 28,000 (16.10% of total cost). The toilets in Bhupnagar, Kadal and Chando are on their way to completion. These toilets are aimed at discouraging the practice of open defecation as also an attempt towards the protection of women’s privacy and safety, which are often at risk due to the unavailability of proper toilets in the villages.

Female Toilets at Banani Male Toilets at Banahi

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Rainwater Harvesting Tanks for water supply in rainy season only The Inside Look of a Toilet

KITCHEN GARDEN

We launched our Kitchen Garden program in Jharkhand early this year, reaching out to 438 households across 26 villages in the very first quarter.

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Table 13: Details of Villages and Households in Jharkhand where Kitchen Garden program has been started

Villages No. of Households

Bharatpur 27 Mundakati 19 Jota 5 Gopalpur 7 Chowarbandha 31

Khoerkpcha 5

Sedadih 22 Tepantor 7 Piyaldih 6 Salboni 28 Kesarsore 7

Tangorjora 12 Padnamsai 9 Sososmoli 19 Balarampur 11 Majgaon 10 Bhatarbeda 22 Lakhipose 16 Bisrampur 20 Kenmundi 22 Bidri 7 Matkambeda 44 Tuibasa 12 Bedakudur 8 Borakunabeda 59 Sosodih 3 Total 438

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In Bihar the program benefitted 484 households

Table 14: Details of Villages and Households in Bihar where Kitchen Garden program has been started

Villages No. of Households

Dema 125 Lohjhara 40 Gopalkhera 60 Banahi 14 Bhupnagar 12 Karhara 72 Simariya 20 Trilokapur 28 Kadal 15 Barsuddi 8 Masuribar 20 Chando 25 J P Nagar 13 Mansidih 10 Kharati 12 Sripur 10 Total 484

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OTHER IMPORTANT ACTIVITIES & EVENTS

BUDDHA MAHOTSAV/FAIR -‐ 2015

We participated in the Budhha Mahotsav (as mentioned earlier), a three-‐day fair organized in January in BodhGaya. Our stall was visited by many inquisitive people who asked to whom we gave a short explanation about our organisation’s objectives and the various on-‐going activities. Several visitors bought the candles that were on display. We organized our environmental awareness drawing competition with 40 children and distributed jute bags among them.

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ORIENTATION PROGRAM -‐2015

Our annual staff orientation program for 2015 was organized on 30th January and was facilitated by Shamsul Akhtar. In the interactive day-‐long session the participants got the opportunity to extensively discuss the achievements and challenges faced by our programs and by the staff in 2014, the upcoming events and program activities of this year and lastly, expectation management of all the staff members.

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GENERAL MEETING – 2015: KARUNA-‐SHECHEN

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We had the honour of welcoming the founder President and Board members of Karuna-‐Shechen, Secreatry of SRPC Trust, and other benefactors on a 3-‐day General Meeting and Field visit (6th-‐8th March) to BodhGaya.

The General Meeting, held on the 6th and 7th of March, started off with a warm welcome speech by the revered Matthieu Richard. It was followed by presentation on program activities by the country representatives of India, Nepal and Tibet.

On the third day our esteemed guests were taken on field visit to Dema where they were shown our various ongoing programs like Babua school, early childcare and development activities at the Anganwadi centres, Rainwater Harvesting, Non-‐formal Education (NFE), Candle-‐making vocation practiced by the poor women of the village, and Mobile Clinic services. In the evening the guests paid a visit to Chando where solar lights have been installed this very quarter.

DETAILS OF PROGRAM-‐WISE EXPENDITURE

Expenses incurred in the first quarter (January-‐March) of 2015 are shown below:

Areas of Intervention BIHAR JHARKHAND INDIA

USD % USD % USD %

Health 38,781 28 5,857 27 44,638 28

Education 7,878 6 - - 7,878 5

Environment 69,143 50 - - 69,143 43

Sustainable Development 3,768 3 9,562 44 13,330 8

Functioning Cost 19,239 14 2,507 12 21,746 14

Equipments and Assets 481 0 3,760 17 4,241 3

TOTAL 1,39,290 100 21,686 100 1,60,976 100

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ANNEX-‐ CASE STUDIES ON MENSTRUAL HYGIENE MANAGEMENT

The following case studies exhibit how the female population in the remote villages of Bihar are benefitting from our Menstrual Health Management program:

Rinki Kumari, a 14 year old girl from Karhara village would previously have menstrual bleeding for 15 days at a stretch every month instead of the 5-‐7 days of monthly cycle. She felt weak due to excessive bleeding and hence had to miss out on several days of schooling.

Prior to our women health awareness sessions in her village Rinki would use cloth, an unsanitised and therefore unhygienic menstrual protection. She was neither aware of nor had access to sanitary napkins. But after learning about the hygienic protection through our community women health programs she started using sanitary napkins during her periods. After a few months of using proper hygienic menstrual protection she now has periods for not more than 7 days a month.

Sarita Kumari, a 9 year old girl from Karhara, had not heard about menstruation till she started attending our menstrual hygiene programs in her village. Early this year she had her menarche. Often girls in the rural belts are not aware of this normal biological process and thereby become afraid, often during menarche thinking that they are suffering from some serious illness.

Sarita is thankful to our women health program which educated her about menstruation and prepared her mentally for the process. During her menarche she knew exactly what had happened to her, why and how to deal with it. She uses our sanitary napkins and opines that our menstrual hygiene sessions have helped her in every way to be prepared and equipped to handle it her menses with ease and comfort.

Rinki Kumari Sarita Kumari

karuna-shechen 1st quaterly report 2015

Government & Nonprofit