Achievement at a glance: Boat Clinic

Progress Report of the Boat Clinic Programme implemented by C-NES in
partnership with NRHM, Assam

C-NES has been
providing basic health care services, through specially designed boats equipped
with laboratories on board as well as pharmacies, to the river islands in the
Brahmaputra – through a Public Private Partnership (PPP) with NRHM, Government
of Assam since 2008. C-NES was given the responsibility to take health care –
Curative, Reproductive and child care, Family planning and laboratory services
to these islands. The MOU agreed on coordination, microplanning,
coordination committees, referral transport, manpower, reporting and
documentation.

C-NES’ unique
health clinic story began with a single boat, a prototype called Akha in
Dibrugarh district in 2005; since then it has spread to other districts with
partnerships first with UNICEF and more recently with NRHM to upscale the
programme to reach the socially and geographically excluded groups. UNICEF has
been involved in the training and technical support and has also been supporting
the Dibrugarh boat clinic programme.

On board also are
fully fledged medical teams (two doctors, three nurses as well as lab
technicians and pharmacists) which conduct regular camps organized through a
network of community health workers and organizers in the district .The goal is
to take sustained health care to lakhs of persons on the islands, for the first
time since independence, with a special focus on women and children, who are the
most vulnerable in difficult conditions.

The
programme has been upscaled since January 2009 to five more districts, making a
total of 10. The districts covered are Dibrugarh, Tinsukia, Dhemaji, North
Lakhimpur, Jorhat, Sonitpur, Morigaon, Barpeta, Nalbari and Dhubri and more than
one lakh persons were covered regularly in the first year of the PPP with NRHM
in 2008.

“The
new districts will join the others where we are running the boat clinics to
bring sustained health care to lakhs of socially and geographically excluded
island dwellers on the Brahmaputra, especially women and children for the first
time in their lives, and to reach one third of the flood-vulnerable population
of the state by 2010” said C-NES’ Managing Trustee Sanjoy Hazarika.

The
inaugural camps in the new disrtrics of Jorhat , Lakhimpur, Sonitpur, Nalbari
and Barpeta witnessed a huge turn out even from the neighbouring villages and
was held simultaneously on 16 March at Lakhimpur and Barpeta, at
Nalbari on 18 March, Jorhat on 23 March and at Sonitpur on 24 March 2009.

Services

The Boat clinics
provide the following services – Routine Immunization of children 0-5 years
and pregnant mothers, Vitamin A Supplementation, Pulse Polio Immunization, JE
vaccination (Special Programme), General health Check ups of Patients, Family
Planning activities IEC & BCC Activities etc. In addition, blood and other
analysis are done for malaria parasite etc on the lab on board each of the
boats.

Strategy of district health camps

During each day, at
least one or two camps are held. In one camp on an average 130-150 general
health check ups are done (this figure can reach at least 300-to-400 at times)
and 15 – 20 Routine Immunizations. Diarrhea, Dysentery, RTI, ARI, ear
infection, skin infection, Anemia and fever are some of the common ailment.
Between 15- 20 camps are planned in a month.

Progress

The
District Community Organizers (DCOs) are at the apex of boat clinic activities
in the districts and are responsible for the smooth conduct of camps and
coordination with the district administration and the line departments of the
districts. The DCOs meet the district administration, health officials, district
NRHM staff, and chalk out district plans for conducting health camps. Responses
from all the districts have been overwhelming

Human Resources of Boat Clinic

Both technical and
non technical staff was recruited by C-NES and NRHM for these districts. In each
district there is a total strength of 15 team members. This includes one
District Community Organiser, Two Medical Officers, One GNM, One Pharmacist, One
Laboratory Technician, two ANMs, three Community workers and four boat crew
members. The Project Management Unit includes the Project Director, Programme
Manager, Associate Programme Manager, Assistant Programme Manager,
Communications Officer, Accounts Manager, Data Analyst and Office Assistant .

Outreach

The district wise breakup of population proposed to be covered and number of
river islands where boat clinics are functioning so far are as follows:

Source: Block, District Health Society and C-NES survey

Our goal is to reach one lakh persons this year and 2.5 lakh next year
culminating with one million patients (ten lakh) in 2010, a major campaign at
reahing the flood-affected and marginalized groups; the ten lakh figure
represents one-third of vulnerable island populations in Assam and the basic
number of those affected by flooding and high water every year – this is
reaching the bottom million(s).

Strengths and Weaknesses of the Programme

The strength of the boat clinic programme lies in the dedication and
commitment of the team members and the concept. The Project Management Unit at
Guwahati and New Delhi has been very active and able to consolidate the
activities of the programme implementation very smoothly. Good coordination and
support of the district administration and the line departments as well as with
NRHM at the district and state levels have been critical to the success of the
program..

Limitations such as delays in allotment of technical staff, non-availability of
vaccines and reagents in some districts, and short supply of medicines existed
at the initial stages and are being resolved.

C-NES BOAT CLINICS: 10 DISTRICTS (Partnership with NRHM)

Achievement at a glance: Boat Clinic, 1st April 2009 onwards (monthly)

TINSUKIA DISTRICT:

DHEMAJI DISTRICT:

DIBRUGARH DISTRICT

MORIGAON DISTRICT:

DHUBRI DISTRICT:

LAKHIMPUR DISTRICT:

JORHAT DISTRICT:

SONITPUR DISTRICT:

NALBARI DISTRICT:

BARPETA DISTRICT:

Boat Clinic under NRHM,(10 District) 1st April 2009 onwards (Total)