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Karuna-Shechen Report 3rd trimester 2013


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Karuna-Shechen Report 3rd trimester 2013

  2. 2. CONTENTS CONTENTS Main Activities and Achievements PAGE NUMBERAPAPGEER 3 Introduction 4 Health  An Overview of Medical Activities  Access to Primary Healthcare in Urban Area: Shechen Medical Centre in Bodhgaya, Bihar  Mobile Clinics  Malnutrition 5 12 17 20 21  Health Education Program (HEP) Education  Strengthening Basic Education  Non-Formal Education (NFE)  Vocational Training for Women 25 26 28 Environment  Bodhgaya Clean Environment, Sanitation Program  Solar Electricity Hygiene and Social  Small Money Big Change  Kitchen Garden  Computer Course-Vocational Training for the Youth  Networking with other NGOs Other Important Informations  Finances  Upcoming Activities  Our Partners 30 31 33 35 38 39 40 41 41 Annex  Case Study I  Case Study II 2|P ag e 42 43
  3. 3. MAIN ACTIVITIES & ACHIEVEMENTS HEALTH  Total number of consultants in OPD (Outreach Patients Department) and Mobile Clinics was 13,868, where number of new consultants was 5607.  The second phase of the Malnutrition Baseline Surevy was conducted in our 6 new villages.  The number of Sanitary napkin packets sold was 3459.  The Shechen clinic is now open on all seven days of the week.  2 medical officers including a lady doctor have been recruited EDUCATION  Bright and enthusiastic woman was recruited as support faculty for the school in Gopalkhera.  Yoga and fitness training was conducted in schools of 9 villages.  Several PTA meetings were held in Dema, Gopalkhera and Chando.  Vocational training commenced with 3 workshops where our NFE students participated.  Computer training courses were started within the premises of the Shechen clinic, Bodhgaya. ENVIRONMENT  Four freshly graduated students of Magadh University were hired an interns to conduct surveys and organize awareness campaigns in relation to the Bodhgaya Clean Environment, Hygiene and Sanitation Program SOCIAL  The small money Big Change program was extended to Gopalkhera and Banahi  A new program, Kitchen Gardening, was launched in the outreach areas. 3|P ag e
  4. 4. INTRODUCTION The third quarter of 2013 can be deemed to be more successful than the last two quarters as the total number of consultants at the Shechen clinic in Bodhgaya and at the Mobile clinics in our 18 adopted villages registered the highest number in comparison to the first six months of the year. Also, the currently running programs are progressing steadily, despite the monsoons which make roads to the remote villages almost inaccessible and the construction work in the outreach areas extremely difficult and tardy. The third quarter saw the commencement of our Vocational training program including the Computer course for the poor and marginalised youth and Kitchen Gardening. Other new activities include the DOTs training and refresher, apart from the Green Schools Program training at the Centre for Science and Environment, New Delhi. In a nutshell, this quarter was full of currently running and new activities and was therefore, quite eventful. In the following sections of the report we will see the progress of programs under each of our four areas of intervention: HEALTH EDUCATION AREAS OF INTERVENTION SOCIAL 4|P ag e ENVIRONMENT
  5. 5. HEALTH AN OVERVIEW OF MEDICAL ACTIVITIES OPD and Mobile Clinics In the third quarter of 2013, the total number of Consultants who availed the healthcare services of our OPD (Outreach Patients Department) in Bodhgaya and Mobile Clinic in 18 villages was 13,868, wherein new consultants constituted 5607 people (40.43% of total number of consultants). Table 1: Total Number of Consultants at OPD and Mobile Clinics Months July August September Total OPD 1851 1904 2218 5973 Mobile Clinics 2572 2311 3012 7895 The third quarter of 2013 has registered the highest number of consultants (13,868) in comparison with the first and second quarters where total number of consultants at OPD (Outreach Patients Department) and Mobile clinics were 7358 and 8152 respectively. This was partly due to the fact that during the monsoons people are susceptible to water-borne and other diseases. The increase in the number of consultants at mobile clinics (7895 consultants compared to 3524 and 4390 in first and second quarters respectively) shows the increasing awareness among the people in and around the new villages and their growing confidence in our services.  The number of patients refered to PHC & Government Hospitals was 82 ( 0.59% of total consultants at OPD and Mobile Clinics ).  The total patients who were treated “Free of Cost” (Pregnant women, children and aged people above 60 years) in the OPD Clinic and by our Doctors were 8724 ( 62.91% of total consultants).  The third quarter has registered 70.12% higher consultants than the second quarter. 5|P ag e
  6. 6. Total Number of Consultants at OPD and Mobile Clinics OPD MOBILE 3012 2572 1904 1851 July 2311 August 2218 September Table 2: Total Number of Patients Referred to PHC and Government Hospitals Month OPD Mobile Clinics July August September Total 4 19 16 39 14 17 12 43 Total Number of Refer Patients at OPD and Mobile Clinics OPD 19 MOBILE 17 14 16 12 4 July 6|P ag e August September
  7. 7. Table 3: Total Money Collected from Registration Charges Month OPD Mobile Clinics July 22980 16480 August 24020 14645 September 27305 Total 74305 18115 49,240 Direct Observed Therapy (DOT) TB patient at DOT centre in Shechen Clinic 7|P ag e DOT services in villages
  8. 8. Out of 1677 medical tests conducted in our pathology laboratory 128 were Sputum tests (for Tuberculosis). Out of these the number of people who were diagnosed with TB was 9. Currently, the total number of TB patients undergoing treatment is 35. Table 4: Details of DOT Program July Number of TB patient’s started medicine Number of sputum tests conducted Sputum Positive Refer TB Patients Completed TB Medicine Total Number of TB Patients currently undergoing treatment (OPD and Mobile) August September Total 7 34 2 0 5 5 38 3 0 3 10 56 4 2 3 22 128 9 2 11 27 28 35 35 DOTs Training After receiving proper DOTs training our efficient pathology laboratory technicians and village motivators have been successfully running the DOTS program at the clinic in Bodhgaya and in the villages respectively. With the inclusion of 6 new villages under the ambit of our organisation early this year there was a need to provide DOTS training to the freshly recruited motivators of these villages. With the twin objective of extending the success of our DOTS program to the new villages and reducing the burden of our lab technicians at the OPD we organised a one-day DOTS training in Bodhgaya on 26th July for village motivators, village coordinators, doctors, nurses, laboratory technicians, a senior pathologist, research and documentation officer and receptionist. This training not only served to teach those who had no prior training in DOTS but also acted as a refresher for those actively involved with our DOTS 8|P ag e
  9. 9. program. The training was given by the District TB Officer (DTO) and an eminent team of members from RNTCP and Primary Health Centre (PHC). Meeting with TB patients TB Patients who attended the meeting We conducted a meeting with the people who have been cured of TB through their treatment at our DOT centre and those on their way to recovery as we are planning to invest the money received as registration charges in the amelioration of livelihood opportunities of the TB patients. As this disease leaves a person weakened and fragile, leading to loss of several days of work hampering their socio-economic lives we realise that curing them is only a part of bringing them to normalcy. Therefore, in order to help them restore their socio-economic loss we envisage providing them with some start-up capital and other possible assistance to ensure them better lives. At the meeting we discussed our plans with the TB patients, seeking their opinion and feedback. 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. 9|P ag e
  10. 10. Table 5 : Types of Diseases Total Types of Diseases Diarrohea/children Diarrhoea / dysentery adults Amoebiasis Typhoid TB Gynecological patient Bone & joints patients Burn patient Worm manifestation Skin diseases of all kinds Ophthalmologic infections Number of identify malnourished children Cardiac Infection HTN Diabetes Asthma & COPD Cough & Cold Epilepsy ENT patient Lymphadenopathy I&D Dressing Other Patients Total 15 517 324 176 329 849 3411 204 10 1660 100 0 45 699 131 754 3560 168 1590 25 244 3146 17,957 The table and graph show that the most common health problems observed among our OPD and Mobile clinic patients were Bone and Joint problems, cough and cold, skin diseases and ENT. Identity Cards for Medical Consultants In order to keep track of the medical history of each patient identity cards are issued to every individual seeking medical help from us. These cards cost a mere INR 5 and have to be brought along in every visit to the OPD or Mobile clinics. The total number of identity cards issued in this quarter is 5037 which is 52.64% higher than the total number (3300) issued in second quarter. 10 | P a g e
  11. 11. Table 6: Number of Identity Cards Issued to Consultants at OPD and Mobile Clinics Month July August September Total OPD Mobile Clinics 848 865 893 2606 857 773 801 2431 The number of identity cards issued in this quarter (5037) is much higher than the previous quarter (3300) Appointment of Two New Medical Officers including a Lady Doctor In the third quarter we hired two new medical officers including a young and dedicated lady doctor. 11 | P a g e
  13. 13. Outreach Patients Department (OPD) The total number of people who came to the Medical centre in Bodhgaya for Consultations in the third quarter of 2013 was 5973. Out of this total 2646 were new consultants, representing 44.30% of total consultations in OPD. The number of patients at OPD in the third quarter is 58.77% higher than in the second quarter. Table 7 : Details of Consultants at OPD OPD July August September Total Total Number of Consultants 1851 1904 2218 5973 Total Number of New Consultants 858 881 907 2646 Men 482 501 591 1574 Women 821 878 1028 2727 Children 548 525 599 1672 Consultants at OPD Total Number of Consultants Total Number of New Consultants 2218 1904 1851 858 July 881 August 907 September The above table and graph show that the total number of consultants have increased steadily from July to September. The growing number of patients can be attributed to the monsoon season when people are, in general, susceptible to water-borne and other 13 | P a g e
  14. 14. diseases. Again, September being the festive season records the highest number of patients in this quarter. Number of Men, Women and Children at OPD Men Women Children 1028 878 821 482 548 525 501 July August 591 599 September Percentage of Men, Women and Children at OPD Men 26% Children 28% Women 46% From the above graphs we can see that women and children form majority of the consultants at OPD (72%). OPD is now open on Sundays In lieu of the growing demand for our healthcare services our OPD is now open on all seven days of the week. All the concerned staff members render service on Sundays on a rotational basis. The Saturday prior to one’s working Sunday is his/her day off. 14 | P a g e
  15. 15. Pathological Laboratory ECG conducted at Shechen Clinic Blood test at the Pathology Laboratory 15 | P a g e
  16. 16. Total number of patients who came in the third quarter of 2013 (July-September) for different medical tests were 547 and total anaysis done was 1677. The number of patients and tests are different because one patient may go for several tests. Total amount spent from Poor Patient’s Fund for patient’s medical tests was INR 32349. Total money collected from these tests was INR 18675. Table 8: Types of Medical Tests Conducted Medical Tests Number of Tests 319 260 259 186 30 128 18 93 37 347 1677 TC/DC ESR HB% Blood Sugar Serum Blirubin AFB (Sputum test) ECG Urine routine examination Urine culture sensitivity test Other Tests Total Medical Tests 347 260 259 186 128 30 93 18 37 The table and graph show that the highest number of medical tests conducted are TC/DC, ESR, HB% and Blood Sugar. 16 | P a g e
  17. 17. MOBILE CLINICS 17 | P a g e
  18. 18. With the expansion of our outreach activities to 6 new villages in the first quarter services of our Mobile Clinic was also extended.  In the third quarter of 2013 (July-September), the number of patients who came for the consultations in mobile clinic from 18 village was 7895, out of which 2961 were new patients representing 37.50 % .  4162 consultants from 189 satellites villages around our 18 adopted villages who sought medical help from our mobile clinic services.  The total patients who were treated for Free of Registration Charge (Pregnant women, children and aged people above 60 years) in the Mobile Clinic was 5829 (73.83% of the total consultants at mobile clinics).  The total number of consultants at the mobiel clinic has increased by 79.84% from the last quarter. Table 9 : Details of Consultants going to Mobile Clinics Mobile Clinic Total Number of Consultants Total Number of New Consultants Men Women July 2572 August 2311 September 3012 Total 7895 1040 853 1068 2961 566 1256 564 1149 721 1436 1851 3841 Children 750 598 855 2203 Consultants at Mobile Clinics Total Number of Consultants Total Number of New Consultants 3012 2572 2311 1040 July 18 | P a g e 853 August 1068 September
  19. 19. We can see that, as in the OPD, at the mobile clinics too the maximum number of patients registered was in the month of September, the primary reason being it the month of festivals. Again, as mentioned earlier, the number of patients are much higher than in the previous quarter due to the high prevalence of seasonal diseases during the monsoons. Number of men, Women and Children at Mobile Clinics Men 1256 Women 1149 750 566 July Children 1436 721 564 855 598 August September Percentage of Men, Women and Children at Mobile Clinics Children 28% Men 23% Women 49% Women and children constitute 72% of the total consultants at Mobile clinics, which is similar to the trend in last quarter where they formed more than 70% of consultants at both OPD and mobile clinics. 19 | P a g e
  20. 20. MALNUTRITION The second round of MUAC measurements With intensive training forming the foundation of our Malnutrition program the nutrition team soon started the first phase of the baseline survey in the 6 new villages, using Middle Upper Arm Circumference (MUAC), universally recognised as a standard tool for measuring malnutrition, to measure children up to 5 years of age. As acute malnutrition is seasonal in nature the baseline survey was conducted in two phases to get a clear picture of the prevalence and intensity of the problem; the first phase was conducted in February, the time of the year when food shortage does not usually take place and so chances of finding severe acute malnutrition is much less. Besides, this was the only time that the Consultant, Dr. Nadine Donnet, could give for such survey. The second phase was conducted through this quarter (July-September) during the monsoons when people, especially children are susceptible to water-borne and other diseases. It is also the season of food scarcity. Thus the second phase of the baseline study gives us an accurate figure of the rate of Severe and Moderate Acute Malnourished children in the chosen villages. During the second phase children found with MUAC> 12.5 cm and those absent during the first phase of the survey were measured. 20 | P a g e
  21. 21. HEALTH EDUCATION PROGRAM Health Education Program (HEP), which was introduced in our 12 villages in 2010, continues to run smoothly. Currently there are 87 health groups with 534 members under HEP. Table 10: Some Important Data on HEP Total Number of Home Visits by Village Coordinators Total Number of Home Visits by Motivators No. of People who Received the Message regarding Health & Hygiene Number of trainings/group follow-ups on HEP given by Village Coordinators Total Number if Health Group Meetings by Village Motivators Total Number of Hand Pump Committees Total Number of Functional Hand Pump Committees Number of Hand Pump Meetings held by Village Coordinators Number of Hand pumps Repaired Table 11: Some Important Data on Reproductive and Child Health (RCH) Indicators RCH Meeting By Village Coordinators RCH Meeting By Motivators Total Pregnant Woman Number of New Pregnant Women Identified Total Number of Pregnant Women who have taken T.T.1 Total Number of Pregnant Women who have taken T.T.2 Total Number of Pregnant Women who have taken T.T.0 Total Number of New Born Children Number of Child Deliveries at PHC Number of Child Deliveries at Home New Born Children Immunized Other Children Immunized Total Number of Sanitary Napkins Sold (at OPD and in the Villages) 21 | P a g e Total 42 181 142 88 48 93 2 64 35 29 47 672 3459 Total 539 1558 1397 73 172 63 48 39 15
  22. 22. A great achievement in this quarter is that 73.44% of the total new-born children have been immunised compared to 63.79% in the Second quarter. Again, more than half of the total Child Deliveries (54.69%) in this quarter have taken place at the PHCs which shows that RCH program has been successful in creating awareness amongst the target population about the health hazards and risks involved in the traditional practice of child deliveries at home by midwives. A huge achievement in the RCH program is that related to Menstrual Hygiene and Sanitation where 3459 napkins have been sold in this quarter compared to 607 in the last quarter (a 470% increase in this quarter compared to the last one). These achievements illustrate the success of our incessant efforts to sensitise the target population on health and hygiene, including reproductive and child health. Menstrual Health and Hygiene A woman with packets of sanitary napkins Our Community Health Worker with rural women Menstrual Hygiene is one of the most important yet neglected health issues in our society. It has remained a taboo subject, surrounded by silence and shame that restrict mobility and access to normal activities and services. As women and girls make up more than 70% of our healthcare consultants it becomes imperative for us, as an organisation pledged to provide all possible quality healthcare services to the underserved populations, to pay special attention to their menstrual health issues. Our Menstrual Health and Hygiene program, which took off in June this year, intends to tackle the problem at two levels; providing the rural women with appropriate materials 22 | P a g e
  23. 23. to enable proper management of the menses by distributing good quality sanitary napkins at minimum possible prices to the rural women and girls who are otherwise denied access to the same. Secondly, the program attempts to address the issue through awareness creation of the target population by imparting education about hygienic practices related to periods and the safe disposal of sanitary pads, and encouraging women and girls to voice their problem and queries regarding the same. Table 12 : Number of Sanitary Napkin Packets sold Month OPD July Aug Sep Total Mobile Clinics & Total Motivators 1910 2077 784 988 322 394 3016 3459 167 204 72 443 Total Number of Sanitary Napkin Packets Sold OPD Mobile Clinics & Motivators 1910 784 167 July 204 Aug 322 72 Sep The above table and graph show that the total number of sanitary napkins sold in the villages is much higher than in the OPD for all 3 months (July-September). This is primarily on account of the fact that in the villages both the mobile clinic team and village motivators act as distributors of sanitary napkins, while at the OPD the medical nurses are the sole distributors. The motivators being part of the communities where they work it is easier for the women to buy sanitary napkins as and when required, instead of having to wait for the mobile clinics to come. A reason for the huge number of napkins (1910) sold in the villages in July and then the gradual decline in the next two months clearly highlights the need for awareness and education on target issues. In the 23 | P a g e
  24. 24. months of June and July one of our staff members, a nurse cum community health worker conducted regular meetings with the women and girls of all the 18 villages, discussing menstrual health and other related issues. However, August onwards it was not possible to hold such meetings very frequently as she became involved with the second round of Baseline Survey for our upcoming Malnutrition program. This vividly brings out the vital need for constant discussions and information sharing on problems which are otherwise considered as social taboos and hence neglected. 24 | P a g e
  25. 25. EDUCATION STRENGTHENING BASIC EDUCATION The education scenario in Bihar is very grim. The State needs nearly twice the number of teachers currently in service to achieve the national pupil teacher ratio (PTR) and the RTE (right to education) norm of 30:1. Around 60,000 schools in the state do not have a permanent campus and less than 3% of the school management committees (SMCs) are actively involved in planning and development work. Through our new program, ‘Strengthening Basic Education’ we attempt to ameliorate the basic educational standards in Bihar and provide a joyful learning environment. Last quarter a Parent-Teacher Association (PTA) was formed in Dema village. By the end of this quarter PTAs have been formed and Parent-Teacher Meetings conducted in three villages; Chando (1 meeting), Gopalkhera (2 meetings) and Dema (3 meetings). A Yoga trainer, hired to teach physical and breathing exercises to school children, had started fitness classes in 3 villages namely, Chando, Dema and Bandha in the last quarter. By the third quarter 9 villages were covered. Table 13 : Number of Students taught Yoga in the Villages Serial Number Number of Students attending Yoga classes 1 2 3 4 5 6 7 8 9 25 | P a g e Village Dema Gopalkhera Sirpur Mansidih Bandha Nawatari J.P. Nagar Chando Kharati 150 200 80 110 105 65 60 100 80
  26. 26. While in the last quarter a support faculty had been provided to the government school in Dema village, this quarter we have been successful in providing a well-educated and enthusiastic support faculty to the school at Gopalkhera village. Besides, our motivator at Banahi has started conducting informal education for children in the 6-10 years agegroup who are not enrolled in schools. Apart from the above initiatives, we continue to supply Teaching-Learning Materials (TLM) to schools in an effort to fulfil the basic requirements of teachers and students and help improve the education standards in rural schools. NON-FORMAL EDUCATION (NFE) 26 | P a g e
  27. 27. Our NFE program, which was scaled up from 6 villages in 2011 to 16 villages in April, this year continues to run successfully with satisfactory 62.84% regular attendance as can be seen from the table below. Table 14 : NFE Students Enrollment and Average Attendance VILLAGE Banahi Dema Gopalkhera Lohjara Bandha Nawatari Mansidih Sripur Mastibar J.P.Nagar Kharati Karhara Trilokapur Bhupnagar Kadal NUMBER OF STUDENTS ENROLLED FOR NFE 30 30 30 30 32 32 31 30 25 28 18 60 21 25 22 AVERAGE ATTENDANCE IN NFE CLASSES 20 22 18 16 20 22 12 14 20 15 15 44 10 16 15 Total 444 279 Although when the program was scaled-up in April 488 women had enrolled themselves for NFE classes, in this quarter the number has slipped to 444. Factors, such as disapproval of husband/family members and lack of time during Harvest season, account for this decline. The high 63% average attendance shows the sincerity and interest of the students towards NFE classes. 27 | P a g e
  29. 29. Recognising the vital role acquisition of new skills can play towards income generation and poverty alleviation, we have introduced Vocational Training as a component of our Non-Formal Education (NFE) program. As the first major step towards our Vocational Training program we conducted, in the month of July, 3 workshops spanning 7 days. A proficient vocational trainer from Jamshedpur, Jharkhand was appointed for the purpose. The workshops were attended by students from our 18 NFE centres. All our village motivators and some staff from Shechen clinic (Bodhgaya) also participated in the same. In each workshop the participants got the opportunity to learn 2 types of vocations; incense sticks and candles, 2 popular snacks, and phenyl and chalk. The vocations were selected on the basis of their market demand, income-earning capabilities and interests of the NFE students. While 2 workshops were held in Bodhgaya the third was organised in one of our new villages, Chando. The travelling, food and lodging expenses of the participants was borne by our organisation. All 3 workshops were very successful in terms of the participant turnout and their satisfaction in being able to learn some useful livelihood skills. The enthusiasm of the participants can be gauged from the fact that the one-day workshop on candle and incense sticks making had to be extended to an extra day as 90 participants, against the anticipated 40, turned up for it. As the second step seven participants from the candle and incense stick making workshop were chosen on the basis of their ability to produce what they had leant, and sent to Jamshedpur, in August, for a week-long intensive advanced training. 29 | P a g e
  30. 30. ENVIRONMENT BODHGAYA CLEAN ENVIRONMENT HYGIENE AND SANITATION PROGRAM These are two of the few food covers that we have chosen for distributing to the street vendors In order to conduct survey among the locals, tourists and street vendors and to spread awareness regarding the importance of cleanliness and hygiene among the people we have hired four bright and enthusiastic youths as interns from the Department of Rural Development and Management of the esteemed Magadh University. Besides, we have conducted an extensive search and market survey on the types of covers that can be used by the street vendors for covering the food from the dust and germs by the roadside while it is on display. We have selected a few types of covers and will finalise which ones to order only after we have received the feedback and responses of all street vendors in Bodhgaya regarding the same. As the first step towards creating awareness regarding clean environment, sanitation and hygiene among school students so as to make them responsible citizens of the nation, three of the staff members (the Director, a Village Coordinator and the Research and Documentation Officer) attended a 2-day intensive training program (Green Schools Program) at the Centre for Science and Environment (CSE), New Delhi. We envisage conducting the Green Schools Program in collaboration with CSE at the schools in our 18 villages and those in Bodhgaya town. 30 | P a g e
  31. 31. Green Schools Program training at the Centre for Science and Environment, New Delhi SOLAR ELECTRICITY In the last quarter we had sent four women from our villages to the Barefoot College, Tilonia, Rajasthan to attain 6 months training in Solar Engineering. However, one woman had to return to her village in the middle of the trainingdue to family reasons. While these women prepare to be Solar Engineers we studied, analysed and evaluated the data collected from the survey that was conducted in the villages of J.P. Nagar, Banahi, Kharati (where our Solar Electricity program is running), Chando, Barsuddi and Kadal (where the program will start soon) to evaluate the impact of the existing solar program and to understand the feasibility of the program in the new villages. The ‘Socio-economic Impact Assessment and Feasibility of Solar Home Lighting Systems in Gaya District of Bihar’ Report was prepared by an economist Dr. Amit K. Bhandari of the esteemed Kalyani Institute of Applied Research, Training and Development. The following key findings were observed:  Around 97.6 per cent respondents have expressed their willingness to use solar lighting and are willing to pay around Rs. 1,700 during the time of installation that is 70% higher than the current price paid by the households. 31 | P a g e
  32. 32.  Majority of the households are not paying installments at regular intervals, while some households haven’t paid any monthly installments at all. This raised question mark regarding preferred mechanism for solar energy.  Per capital income of the respondents is higher for those who haven’t installed solar lighting system, which in turn indicate money is not a constraint for installing solar power.  Household with solar lighting installed enjoys better quality of life compared to those without it.  Variables that have found to have significant impact on willingness to pay for solar lighting are per capital household income, per capital energy consumption, type of house and holding saving bank account.  Parents are willing to spend more on home lighting system whose children performed satisfactory in their study. However, there is no reflection in education performance between household with or without solar lighting.  No significant difference is found in amount willing to pay between household with school going children and without. However, students performing better in study, parents willing to spend more on solar lighting system for their study. The empirical study found that people from rural villages from are ready to pay more than the current installation price of solar lighting system. Regarding preferred mode of payment for solar photovoltaic systems, contrary to popular belief monthly payment system should be abolished for better penetration of solar energy. Villagers from financially well off households, better educated, higher energy consumption per month and have access to financial services are the important determining factors for willingness to invest for solar home lighting system. The study also reveals that there is an improvement in quality of life for the people living in remote villages through the spread of solar energy. Further expansion of solar energy can be adopted in order to achieve universal access to energy to rural non electrified areas. 32 | P a g e
  33. 33. SOCIAL SMALL MONEY BIG CHANGE Land levelling in the agricultural fields at Chando Work in progress at Kadal 33 | P a g e
  34. 34. Bathroom for women being constructed at Kadal Bathroom and well completed Land levelling in front of Chando school Under the ‘small money Big Change’ program we had started working in three villages, namely Chando, Barsuddi and Kadal from June this year. In this quarter the program was extended to two more villages, Gopalkhera and Banahi. In Gopalkhera an existing check dam, which had been broken and had remained dysfunctional for long, was successfully repaired. This has enabled rainwater to flow straight into the village pond which will not only allow the villagers to perform their daily activities but also provide water for the agricultural fields, increasing crop productivity and consequently improving the villagers’ livelihoods. A small pond is being dug in Banahi village. Due to the monsoons work had to be stalled as it was not possible to continue due to bad and erratic weather conditions. Of the total 34 | P a g e
  35. 35. 8 ft depth to be dug, 3 has been done and 5ft will be completed soon after the monsoon is over. The work of land levelling continues in Chando where the agricultural field of 15 villagers has already been levelled which will make crop sowing and crop management much easier and also considerably increase the yield and quality. Again, in Chando government school, the school filed which was uneven and hence could not be used for playing outdoor sports has been levelled and can now be used as a playground. At Kadal, the well whose repair work had started in June was completed at the beginning of this quarter. Next the construction of a bathroom for the women of the village and the digging of the nearby pond began. The bathroom is now complete and the digging of the pond has also progressed well with not much left to be done. The construction of the check dam in Barsuddi, which had begun in the previous quarter had to be stalled due to the bad weather. The work will resume as soon as monsoon is over. This quarter saw the ‘small money Big Change’ program cover two more villages in addition to the initial three. While the work in most villages progressed smoothly it was a bit tardy as we had no option but to slow down or stall our work in certain places due to the erratic monsoon pattern unlike other years. KITCHEN GARDEN 35 | P a g e
  36. 36. Looking at the abysmally high incidence of malnourishment in Bihar (around 80% of children below five years of age and 68.2% of women in reproductive age group (15-49 years) in the state are malnourished) and the extreme poverty of small and marginal farmers where 91% of the land holdings in the state belong to small and marginal farmers who practice cash cropping in an effort to escape the grinds of acute poverty, we have started a program on Kitchen Gardening from the third quarter. Commercial agriculture, in which crops are cultivated according to the market demand, limits the production of certain food crops and does not allow for self-consumption by the farmer’s family. Kitchen Gardening, on the other hand, fills the gap by providing proper nourishment through inexpensive, regular and handy supply of fresh vegetables devoid of chemicals used in farming. Besides, it is a well-known fact that growing a kitchen garden positively improves the overall health conditions of the family. We have planned the program so that 50% of the produce grown in the kitchen garden are kept aside for self-consumption by the families and the rest sold in the market to earn some additional income. 30% of the profit from sales will add to the farmer’s household savings/consumption and the remaining 20% will have to be contributed towards community welfare. Thus, while the target population will be able to utilise 80% of the produce for direct personal benefit (through own-consumption and earning from sale of vegetables) they will be indirectly benefitted through the community’s development, towards which they will be making a minimal contribution. We have started the program by distributing vegetable and fruit plants and seedlings to our villages like brinjal, tomato, chilly, pumpkin, sponge gourd, bitter gourd, raddish, ladies finger, mango, lemon and guava. 36 | P a g e
  37. 37. Table 15: Number of Households that have received vegetable plants for Kitchen Gardening Serial Number 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 37 | P a g e Villages Number of Households Bhupnagar Karhara Simariya Trilokapur Kadal Barsuddi Banahi Dema Bandha Nawatari Mansidih Sripur Mastibar JP Nagar Kharati Chando Total 24 23 21 8 31 24 17 114 20 20 24 25 10 18 15 28 422
  38. 38. Table 16 : Number of Households that have received fruit plants and seeds for Kitchen Gardening Serial Number 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Villages Number of Households Banahi Dema Gopalkhera Lohjhara Bhupnagar Karhara Simariya Trilokapur Kadal Barsuddi Mastibar JP Nagar Kharati Chando Mansidih Sripur Bandha Nawatari Total 40 101 35 43 45 52 51 37 22 26 70 22 20 20 110 40 61 45 840 We envisage manifold advantages from this particular project. This entire model of kitchen gardening will generating productive, income-earning opportunities for poor and marginalised communities, which is pivotal to reducing chronic poverty. At the same time, through the consumption of fresh, chemical-free vegetables, it will help ameliorate health conditions of the target populations. Lastly, it will make way for the community’s development. COMPUTER COURSE-VOCATIONAL TRAINING FOR THE YOUTH With the objective of empowering the poor and marginalised communities with eliteracy skills we have started free computer training courses for youngsters hailing from remote villages in Gaya district, Bihar. We aim to equip the rural youth with adequate digital skills to provide them with better employment opportunities, economic self-sufficiency and socio-economic empowerment. Two types of computer courses are being taught at our Bodhgaya office namely, Office Management (which will teach MS Office) and DTP (Page maker, Coral Draw and Photoshop). The duration of each course is 6 months. 38 | P a g e
  39. 39. Prior to the commencement of the courses on 16th August a day-long interview was conducted for the 101 enthusiastic applicants. 58 shortlisted youths were divided into 3 batches; two batches for Office Management course and one batch for DTP. These batches also accommodate our office staff who wanted to join these e-literacy courses. While the trainings are imparted free of charge it is mandatory for the students to devote 5 hours per week towards voluntary services in their respective villages. This provision will fulfil the twin objective of promoting computer literacy amongst the marginalised communities and serving the rural poor. NETWORKING WITH OTHER LOCAL NGOS We have started collecting details of all Non-governmental organisations working in Gaya District as the first step towards networking with organisations with similar goals and views. 39 | P a g e
  40. 40. OTHER IMPORTANT INFORMATIONS FINANCES The budget and expenses for the third quarter of 2013 are presented below: Table 16: Budget and Expenses Budget in USD($1=50 INR) Expenses in USD($1=50 INR) Administration, transportation and functioning cost 82,993.45 13,797.38 OPD direct benefit to population in Bodhgaya town and close surroundings 14,590.58 18,234.42 Mobile clinic benefit to population in 18 villages 20,128.80 21,818.82 Education direct benefit to population in 18 villages 13,441.07 9,132.42 Environmental Program 32,033.33 1,315.58 Social Program 20,853.33 20,177.24 Program Support 7,000.00 109.66 400.00 3,304.56 6,007.87 25.80 Investment: Equipment Contingencies Total 40 | P a g e 1,97,448.43 87,915.88
  41. 41. Budget and Expenses in USD 90,000.00 80,000.00 70,000.00 60,000.00 50,000.00 40,000.00 30,000.00 20,000.00 10,000.00 0.00 Budget in USD($1=50 INR) Expenses in USD($1=50 INR) UPCOMING ACTIVITIES  Meeting with key stakeholders for the ‘Bodhgaya Clean Environment, Hygiene and Sanitation’ project will be conducted.  A training for Anganwadi workers on child development through play where, apart from other things they will be taught to make various Teaching-Learning Materials.  Rainwater Harvesting in the villages  Green Schools Program in villages  School Competition to raise awareness among students about cleanl environment and hygiene. OUR PARTNERS Current Partner: Barefoot College in Tilonia, Rajasthan Prospective Partner: Centre for Science and Environment, New Delhi. 41 | P a g e
  42. 42. ANNEX -SUCCESS STORIES CASE STUDY 1 During the treatment After the treatment Nageshwar Manjhi, a smallholder farmer of Rampur village, approached Shechen clinic for treatment. He was extremely weak and emaciated. The doctor suspecting tuberculosis asked him to go for x-ray, sputum and blood tests at our laboratory. He was tested positive for Pulmonary TB and underwent DOT treatment at our DOT centre in the Shechen clinic. He has completed his treatment and his post-treatment sputum test was negative. His X-ray and blood tests are yet to be conducted but now, unlike previously when he did not have the strength to walk a few steps, feels healthy and strong. 42 | P a g e
  43. 43. CASE STUDY II Chandni Kumari at our Computer Classes Chandni Kumari, an undergraduate student, has joined the 6 month long DTP course at our newly launched computer training program. She says that previously she was totally computer illiterate and whenever she saw her friends and classmates working on or discussing computers she would feel a severe lack of self-confidence. But now after a few weeks of attending classes she has already started gaining confidence. She can now work on MS Word and has just started learning Photoshop. She enjoys her classes and expects to find a good job after completing this course. 43 | P a g e
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