Training Paramedical Workers at THI

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Training Paramedical Workers at THI

  1. 1. TRIBAL HEALTH INITIATIVE Sittilingi, Tamil Nadu, India Experiences in training Para-medical Workers Dr. Lalitha Regi Presentation at ARSICON2008 Wardha Helping tribals heal themselves……
  2. 2. Invocation To the tribal Gods who protect our people
  3. 3. Sittilingi Valley …..enveloped by the Kalrayan and Sitheri hill ranges Sittilingi and the Avalur valleys have 21 hamlets which are home to about 10,000 people of whom 95% are tribals
  4. 4. Need of the area  Remoteness – nearest referral centre was 100km away  No “modern” facilities  Staff need to understand and empathise with the tribal population  Villagers need to feel comfortable with health care providers
  5. 5. Selection  Initially looked for educated girls – 8th Std  Now we send out information – applicants have a written test on basics of language and mathematics; then interview  Selection based on aptitude, attitude, region, income levels  6th batch in progress
  6. 6. Health Worker Training Caring , respect and shared concern Balance classes with practical work
  7. 7. Training – general principles  Design according to the need of the area  Emphasize student’s role as educator  How things are taught is more important than what is taught  Caring , respect and shared concern  Balance classes with practical work  Understand social causes of ill health  Make people more self reliant and less dependant on institutional health care  Participatory training
  8. 8. HWs’ manage most of the Hospital •See Out patients 4 days a week •Conduct deliveries and assist surgeries •Manage Ward and emergencies
  9. 9. Deliveries & Neonatal Care Advanced Neonatal care About 30 deliveries a month and 3 - 5 for neonatal care per month
  10. 10. Surgical Work About 20 – 30 surgeries every month including emergencies .
  11. 11. Surgical training ·       1. How to do basic dressings ·       2. Injuries – how to examine, clean, debride and do the suturing if needed. ·       3. Check ante-natals, monitor and assess labour and conduct deliveries including some of the abnormal deliveries like breech delivery ·      4. Examine and do incision and drainage of abscesses        5. Surgical removals of small swellings like sebacious cyst, lipomas etc. ·       6. Local anaesthetic blocks, giving and managing of drugs like ketamine and thiopentone 7. Manage spinal blocks and intra-operative management of general anaesthesia
  12. 12. Surgical Training Simple surgical procedures like cysts and other swellings
  13. 13. Surgical Training Assisting Major surgeries Dressings, I & Ds
  14. 14. Anaesthesia training Spinal Blocks General Anaesthesia
  15. 15. Community Health Health Care at the doorstep – postnatal care Health Workers now plan and implement the Community Health Program
  16. 16. Field Clinics Health education is the key
  17. 17. Laboratory Technician  Basic tests we taught – practical & theory  Biochemistry & maintenance – other hospitals  Government recognised lab – TB & HIV  Seniors train juniors and we check – 5 have skills  All Health Workers learn basics  TB/HIV – Government uses our lab as an example
  18. 18. X-ray/ ECG technician 1. Theory taught by us 2. Practical learnt in large hospital 1. Seniors train juniors , theory we teach 2. 5 Health Workers know
  19. 19. Pharmacy  Drug names and actions taught – to all  Basics of dispensing taught – to all  Stock keeping and ordering – one person specialises, one assistant
  20. 20. Advantages/Disadvantages •Brings down workload •Treatment inexpensive •Knowledge passed onto community •Increased confidence & self esteem •Gives us time to look into other problems in the community LEGAL PROBLEMS !!!? Non – Recognition from other hospitals
  21. 21. Achievements  No maternal death – 5 years  Infant mortality – from 147/1000 to 32/1000  Malnutrition – down by 50 %  Antenatal mothers check up – from 11% to 95 %  Almost 100% completion of treatment in TB  Hospital attendance from our area – decreased from 50 % to 20%
  22. 22. Tribal Hospital – Staff pattern Non tribals Locals  3 doctors  14 Health Workers  1 Administrator  2 Lab Techs  1 X-ray tech  2 Pharmacists  3 Admin assts  2 Drivers  7 HW trainees
  23. 23. That formal education is mandatory to do health care is a myth Help people heal themselves…..
  24. 24. References  Health for all-Alma Ata declaration and after -N.H.Antia  The Alma Ata declaration and goal of health for all -David Werner  Health Care in India ‘a profile’ -Devraj Chauhan,N.H.Antia,Sangita Kamdar
  25. 25. Thank you For more information check out www.tribalhealth.org

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