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Nayantara Jyotirmaya

Towards Cataract Free Dhar

Introduction

Dhar is a tribal dominant district. Eleven of the thirteen blocks have a tribal majority. The district had a population of 13.67 lacs according to 1991 census of which 53.5% was tribal. Tribal population has a significantly higher proportion of cataract affected patients. This has happened due to poorer health services in tribal areas, lack of health & eye care awareness amongst tribals and a significant backlog of untreated cataract patients. So it was felt that there is a need to tackle the problem on a campaign basis so that the menace of cataract can be effectively eradicated.

Mega Camp Approach

The regular dispersed continuous camp approach is easier to organise. However, such camps typically cater to the needs of only those patients who are alive to the need for surgical eye care. A comprehensive district level camp and campaign spread over several days has the benefit that even the relatively disinclined patients are motivated to come for operation. Further, it is easier to monitor the cases left behind since the entire district is being covered within a fortnight. Thus, the nayantara jyotirmaya campaign and the Mohankheda eye camp were conceived of.

Survey

To begin with, ophthalmic assistance and health workers did a comprehensive survey of the district in July 1998. 7800 cataract cases were detected and classified as mature/immature and left/right/both eye(s). Thereafter, a resurvey was done in December, 1998 to identify any cases not detected earlier. In this, 2900 additional cases were detected. Out of these 10700 cases, approximately 6000 cases were estimated to be operable. These patients were verified as being operable by eye specialists and ophthalmic assistants. During this verification, the patients were informed of the Mohankheda camp and the facilities which would be provided their.

Community Mobilisation

Community mobilisation is a must for any campaign in which participation of the community is needed. Precisely for this purpose the camp was given wide publicity through schools, rallies of school children, mobile loudspeaker announcements in haat bazars and towns. Banners were displayed and handbills and posters distributed. Patwaris, health workers, panchayat secretaries, anganwadi workers were organised into groups for contacting and persuading patients to avail of the facilities of the Mohankheda camp. The planning was done through meetings organised from village to the district levels.

Preparation For The Mega Camp

Site Selection: For mega camp Nayantara Jyotirmaya selection of site at Mohankheda jain teerth separately provided for male and female patients. Generator sets were installed to ensure uninterrupted power supplies. Four ambulances, life saving drugs and a range of medical equipment were provided for taking care for unforeseen circumstances. Fire tender, drinking water, electric supply, inquiry facilities and low cost refreshment facilities were also made available

Total 350 para medical staff including staff nurses ANMs ward boys, sweepers, other technical staffs were deputed by the Health department of the district to render the services to the beneficiaries. 400 voluntary workers were made available to provide continuous services about supply of food, transportation of the patients and to assist the operated cases in post operative period.

Camp site was covered under close circuit T.V. to supervise the activity under the campus and to control the staff by instructions from the control room and it is facilitated the supervision work to improve rendering of services to the patients at different level.

Patients were brought according to a definite plan from January 1 onwards. Different days were fixed for patients of different blocks/districts. Patients were collected in buses organised for the camp. Patients were also brought from Jhabua and Badwani districts. After the camp the remaining cases would be covered through small camps and the district would be made cataract free by March 31, 1999.

So far, 10292 patients have been registered have been registered. 4917 patients had been admitted to the indoor ward by January 11 and 4006 operations had been successfully done. Further, over 400 intra-ocular lens transplantation operations would be done at Mohankheda on January 14 & 15.

117 corneal opacity cases have also been identified. Eye donation campaign is also being carried out at the camp-site. Further, a data bank of eye patients would also be ready which would provide ready reference for various eye care activities.

Approximately 13000 patients from Dhar district, 2000 patients from Jhabua district and a few hundred cases from Badwani district are expected to arrive at the camp. On arrival, the patients are first registered. Thereafter, they are admitted to OPD for eye test and operable cases are then admitted to the indoor wards. Free boarding and lodging arrangements are available for the patient and his/her attendants. Patients found to be inoperable are given medical advice, free medicine and free meals (for patients and attendants) before being sent home in free transport. 221 buses and 240 jeeps are being used for bringing the patients to the camp. In addition, many people are coming on their own as the word about the camp and its services has spread throughout the region. Half-hourly buses are regularly running between the bus depot at Rajgarh and the camp site at Mohankheda to cater to these patients. A separate parking lot has been provided to ensure systematic functioning and a senior officer is supervising to ensure that no problems occur at the parking site. Each bus bringing patients has a patwari/panchayat secretary/health worker as a route guide. These route guides bring a list of patients and hand it over to the transport officer upon arrival. Even patients with no attendants are being attended to.

District Blindness Control Society, Dhar has contributed Rs.22 lacs. Kundan Electric Group, Mumbai/Chennai/Delhi has arranged food at an estimated cost of Rs.8 lacs. Pithampur Industrial Association has contributed Rs.5 lacs. The Trader Associations of Dhar, Dhamnod and Badnawar have each contributed Rs.1 lac. Other organisations and donors have also contributed. The total cost for the camp is estimated at Rs.48 lacs. The camp has been rendered special assistance by Shri Adinath Rajendra Jain Shwetambar Trust Pedhi, Shri Mohankheda Teerth (Working Trustee Shri Sujanmal Jain), Shri Manav Sewa Mandir Trust, Rajgarh (Trustee Shri Prakash Chandra Kavadia), Gokuldas Charitable Trust, Indore, Netra Chikitsalaya Trust, Central Mobile Unit, Indore (Medical College, Indore), Sant Hirdaram Sewa Trust, Bhopal and District Hospital, Dhar.

2% of the patients were up to 50 years of age. 11% patients were in their fifties. 48% patients were in their sixties. 31% patients were in their seventies. 7% patients were in their eighties. 1% patients were 90 plus. The oldest patient so far has been Smt. Dagadubai, a tribal women from Sundrel village of Dharampuri block who was operated on 8.1.99. She was 107 years old. the youngest patient was 7 year old Bansingh S/o Bhangada, a tribal boy from Bakhtala village of Gandhwani block who was operated on 8.1.99. Over 400 volunteers are giving free services for taking care of patients and other arrangements.

The camp has been organised under the continuous guidance and supervision of Dr. Rajesh Rajora, Collector and Chairman, District Blindness Control Society, Dhar. The camp and the nayantara jyotirmaya campaign were conceived of by him. The campaign was inspired and blessed by the spiritual leadership of Shri Rishabchandraji Maharaj of Mohankheda Teerth. Years ago, the then head of this teerth, Sant Vidyachandra Soorishwar Maharaj had resolved to make Mohankheda unparalleled in the area of blindness removal. He believed that every person coming to Mohankheda should get spiritual and physical light. The teerth would also inspire other social organisation to take up this humanitarian cause.

This camp would be followed by tracking down of individual cases who still remain untreated and by covering these through dispersed camps and mobile units the entire Dhar district would be " cataract free " by March 31, 1999 in the sense that by that time all patients having operable cataract conditions would have been covered.