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The Light at the End of a Dark Tunnel

PIRAMAL FOUNDATION
November 06, 2018

A child is Mother Nature’s most unique and pure gift to a woman. A child’s laughter brings a world of happiness to its mother and its tears reduce her to the epitome of helplessness. In today’s day and age, we have become so engrossed with our journey of motherhood that we have completely ignored the most basic and fundamental right of all – healthcare. Healthcare for those mothers who are losing their lives in the process of giving birth, healthcare for the infants who are dying due to insufficient medical assistance and education for those families who are unaware about the intricacies of a pregnancy. We live in our pent-houses planning baby showers and room décor while thousands of babies lie still… while thousands of mothers never get to see the light of day.

Araku: When ignorance is not bliss

Driving into Araku Valley takes one through canopies of mist and scintillating panorama of Mother Nature. Cocooned by the Eastern Ghats, situated about 110 kms from Vizag, Araku is a pristine work of Natural art. Home to a host of indigenous tribes like Khonds, Gadabas, Jatapus, Kondreddys and Savaras. Araku is a paradise untouched by the concrete hands of mankind. The disconnect between the tribal population of Araku and our worldly civilisation is a breath of fresh air and yet, till about two years back, a gloom hung over these lands. The winds bore the cries of mothers who lost their new-born, the mountains hid the grief of lost mothers and the winding roads relayed the journey of families fighting for themselves.

With limited access to healthcare facilities, illiteracy, lack of awareness about nutrition and hygiene and poverty, Araku Valley had become an undeclared synonym of despair and desolation.

The Challenges

Nutritional anaemia was one of the major challenges plaguing Araku, that constituted high-risk cases, often caused due to multiple and closely spaced pregnancies. The lack of knowledge did not help the case. Mothers believed that early breast milk causes indigestion among the babies and hence breast milk from another lactating mother was given to the babies instead. In fact, the health benefits of colostrum were unheard of in this part of the world. The new-borns were fed with honey/crystal sugar, which was mixed with hot water for one to three days, causing the baby to miss out on the much-needed nutrition-rich colostrum.

A majority of the natives put churakalu (body scars) on child’s belly during the third month of birth with a hot iron rod. They believed that the scars would protect the child from stomach worm infestation, digestion problems and liver cirrhosis.

These were just a few “beliefs” that the Araku tribals based their lives around.

The Evangelist

For the last decade, Piramal Swasthya has been striving to make primary healthcare accessible and readily available in vulnerable, unserved and under-resourced India. In 2011, Swasthya entered Araku Valley and played a pivotal role in ensuring that pregnancy could actually be a harbinger of happiness in every family.

Changing mind-sets, changing the future

The ASARA Project, an initiative by Piramal Swasthya, aimed to provide free maternal and child healthcare services to pregnant women in the Valley through community outreach programmes and special services. Under its umbrella, ASARA services 1179 habitations covering approximately a population of 2.5 lakhs. There are fixed day visits by a team of Piramal Swasthya’s trained outreach workers who screen prospective mothers. Counselling about healthy and hygienic practices is offered not only to these women, but to young and adolescent girls too. The team also identifies high-risk cases that are then taken to the telemedicine unit.

With the efforts of ASARA in Araku, electronic health records of each beneficiary has been made available. Trained technicians monitor the vitals, record the findings, and maintain reports. ASARA does not limit itself to only medical prescriptions. The approach is holistic – tips and detailed instructions about the exercises that a pregnant woman can do. A diet plan to be followed along with other instructions are also a regular feature.

A recent report by UNICEF says that during the period from 1990-2015, Maternal Mortality Rate (number of deaths per 100,000 live births) came down from 385 to 216 globally. In comparison to these available statistics, Piramal Swasthya is proud of the contribution of ASARA in Araku. The number of institutional deliveries has significantly increased from a mere 18% to a formidable 68% in the period from 2011 to 2017. A whopping 4900+ pregnant women were served and there was ZERO Maternal Mortality in the past two years across the targeted area.

Piramal Swasthya, through ASARA, pledges to continue its efforts in Araku Valley and further increase its efforts across the nation, addressing the complex issues of making healthcare accessible to even the remotest parts of our vast country. This, to ensure that the dream of a better, brighter tomorrow doesn’t just stay a dream!

This is just the beginning.

If we want to transform the health parameters of Andhra Pradesh, the health parameters of Vishakhapatnam must change. And for that to happen, the health parameters of the tribal belt, which constitutes 68% of its population, must change. The learnings of the last 6 years from Araku Valley need to be incorporated in our programme to scale up our interventions across the tribal belt of Vishakhapatnam and other tribal areas in India. Focus on adolescence, nutrition, capacity building, communication strategies, robust data management and analytics, and co-creation with the Government (using the existing government infrastructure to set up the TMC) are now the elements of the journey of Asara 2.0 Competency-based flexible partnerships are absolutely vital in this journey. Based on a composite health index, a total of 184/707 districts have been identified as High Priority Districts by Government of India which gives us a platform for creating Private-Private Partnerships.

Our tribal health program is a unique model in the country which has demonstrated the meaning of sustainable impact in the toughest of situations in Araku Valley. The programme is ready to be replicated in similar tribal habitations across the country, thus contributing to the overall reduction of maternal and infant mortality in India. The idea is to address the tribal populations across India, thereby contributing significantly to reducing the maternal and infant mortality of the country.

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