MAJOR HEALTH PROBLEMS OF ORISSA

 

By Dr Nihar Ranjan Ray

  

Orissa is a high focus state for its culture, heritage, rich with minerals and diseases as well. It has rated as one of the measurable state so far the health care is concerned. Badly affected by the poverty, illiteracy, natural disasters Orissa registered very poor health indicators as per the WHO reports. Its state with a population of 3.68 crores, comprising of 85% rural habitants, with 22% Scheduled Tribe and 16.5% Scheduled Caste population. From a lot of health issues I need to focus the following topics with bird vision felling their importance and seriousness.

 

 Infant mortality

Infant Mortality Rate (IMR) is only 53 per 1,000 live births in urban areas as compared to 76 in rural areas, only 26.4 per cent of tribal children are immunized when compared to 43.7 per cent among the general population in the State and anemia is very high of 61.2 per cent among women.

The State needed to arrest the malnutrition trend as early as possible. “The level of malnutrition in the State is quite high. Over 30 per cent of children are severely malnourished. As per the latest survey, 40.7 per cent under age of 3 are underweight, 45 per cent are stunted and 19.5 per cent are wasted. About 65 per cent of children aged between 6 and 35 months are anemic.

Maternal mortality rate

One woman dies every seven minutes from complications related to pregnancy and child birth in India and in Orissa nine women die everyday for the same reasons.

The MMR in the state has come down from 367 per one lac (100,000) child births in 1993 to 358 deaths per one lac births in 2003 which is a very negligible drop. In fact there has not been any significant reduction in the rate of maternal deaths in the last few years and this is a worrying factor, said participants at the “Know Your Entitlements” organized here to coincide with the National Safe Motherhood Day.

The White Ribbon Alliance-Orissa in collaboration with Department of Health and Family Welfare, government of Orissa, Unicef and UNFPA organized the workshop.

With a view to curb this problem by minimizing maternal death rate, the White Ribbon Alliance for Safe Motherhood unites individuals, organizations and communities who are committed towards increasing public awareness on this issue and promote Safe Motherhood.

This year, the Central government declared, “Know your Entitlement” as the theme of the National Safe Motherhood Day. The objective was to generate awareness amongst women and family members on their entitlements under various schemes and policies taken up by the government.

Several NGO’s working in the health sector across the state including the Nehru Yuva Kendra which has trained 12,000 youths for the purpose participated in the workshop here today.

Flood ravaged Orissa

Floods cause health problems in Orissa: Oxfam India has warned that 8.5 million people affected by July’s floods are facing serious health threats. 78 870 cases of diarrhoea have occurred, resulting in 41 deaths; 124 cases of jaundice were reported, with two deaths. 300 people have been bitten by snakes, leading to 22 deaths.

Malaria

Malaria is the foremost public health problem of Orissa contributing 23% of malaria cases, 40% of Plasmodium falciparum cases and 50% of malaria deaths in the country. The tribal population are badly affected by the  Malaria. More than 60% of tribal population of Orissa live in highrisk areas for malaria. Though the tribal communities constitute nearly 8% of the total population of the country, they contribute 25% of the total malaria cases and 15% of total P.falciparum cases. Various epidemiological studies and malariometric surveys carried out in tribal population including primitive tribes reveal a high transmission of P.falciparum in the forest regions of India, because malaria control in such settlements has always been unattainable due to technical and operational problems. In a specific

study conducted in undivided Koraput district, it was observed that the district is endemic for malaria and is hyperendemic in top hills where Bondo primitive tribes are residing.

 

Diarrhoeal Disorders

Water-borne communicable diseases like gastrointestinal disorders including acute diarrhoea are responsible for a higher morbidity and mortality due to

poor sanitation, unhygienic conditions and lack of safe drinking water in the tribal areas of the country. In a cross sectional study conducted by RMRC, Bhubaneswar in 4 primitive tribes of Orissa, the diarrhoeal diseases including cholera was found to occur throughout the year attaining its peak during the rainy season .Generally the infants ,preschool children and adolescent groups are mostly affected.

 

Micronutrient Deficiency

Orissa is very much infamous for starvation death cases. Micronutrient deficiency is closely linked with nutritional disorders and diarrhoea. Deficiency of essential dietary components leads to malnutrition, protein calorie deficiency and micronutrient deficiencies (like vit A, iron and iodine deficiency). Vitamin A deficiency in the form of Bitot’s spot, conjunctival xerosis and night blindness was observed

 

Skin Infection

Skin problems like scabies is a major health problem amongst the rural population of orissa and the problem is much worse in the primitive tribes because of overcrowding and unhygienic living conditions as also close contacts and lack of health awareness. In a study conducted by the RMRC, Bhubaneswar.

 

Intestnal Paracitism

Intestinal protozoan and helminthic infestations are the major public health problems and were observed in Most of these infections are due to indiscriminate defecation in the open field, bare foot walking and lack of health awareness and hygiene. The problem enhances in the rainy season. These are preventable with repeated administration of anti-helminthic and protozoal treatment at 4 months interval which can be used effectively in national parasitic infection control program.

 

 

 

HEALTH INDICATORS OF ORISSA

             The Total Fertility Rate of the State is 2.6. The Infant Mortality Rate is 73 and Maternal Mortality Ratio is 358 (SRS 2001 – 03) which are higher than the National average. The Sex Ratio in the State is 972 (as compared to 933 for the country). Comparative figures of major health and demographic indicators are as follows: 

Table I: Demographic, Socio-economic and Health profile of Orissa State as compared to India figures 

S. No.

Item

Orissa

India

1

Total population (Census 2001) (in million)

36.80

1028.61

2

Decadal Growth (Census 2001) (%)

16.25

21.54

3

Crude Birth Rate (SRS 2007)

21.9

23.5

4

Crude Death Rate (SRS 2007)

9.3

7.5

5

Total Fertility Rate (SRS 2006)

2.6

2.9

6

Infant Mortality Rate (SRS 2007)

73

57

7

Maternal Mortality Ratio (SRS 2001 – 2003)

358

301

8

Sex Ratio (Census 2001)

972

933

9

Population below Poverty line (%)

47.15

26.10

10

Schedule Caste population (in million)

6.08

166.64

11

Schedule Tribe population (in million)

8.15

84.33

12

Female Literacy Rate (Census 2001) (%)

50.5

53.7

 

 

 Table II: Health Infrastructure of Orissa 

Particulars

Required

In position

shortfall

Sub-centre

7283

5927

1356

Primary Health Centre

1171

1279

-

Community Health Centre

292

231

61

Multipurpose worker (Female)/ANM at Sub Centres & PHCs

7206

6768

438

Health Worker (Male) MPW(M) at Sub Centres

5927

3392

2535

Health Assistant (Female)/LHV at PHCs

1279

726

553

Health Assistant (Male) at PHCs

1279

168

1111

Doctor at PHCs

1279

1353

-

Obstetricians & Gynaecologists at CHCs

231

NA

NA

Physicians at CHCs

231

NA

NA

Paediatricians at CHCs

231

NA

NA

Total specialists at CHCs

924

NA

NA

Radiographers

231

8

223

Pharmacist

1510

1984

-

Laboratory Technicians

1510

311

1199

Nurse/Midwife

2896

637

2259

(Source: RHS Bulletin, March 2007, M/O Health & F.W., GOI) 

Health Institution

Number

Medical College

4

District Hospitals

32

Referral Hospitals

 

City Family Welfare Centre

 

Rural Dispensaries

 

Ayurvedic Hospitals

8

Ayurvedic Dispensaries

624

Unani Hospitals

-

Unani Dispensaries

9

Homeopathic Hospitals

-

Homeopathic Dispensary

603

  

  

  

  

  

Conclusion

     Despite the above said problems we have to make our stands strong to fight against the disease, poverty, illiteracy and natural as well as the man made disasters(Naxlite problem).Now under the able leadership of Mr Naveen Pattnaik Orissa has registered record foreign investment as well as an appreciable economical growth. Now it is time to flex our muscles and brain to expedite our development in health care system. Orissa is doing well in the influence of NRHM .Orissa has many a miles to go to improve its health indicators that needs a lot of patience, composure and brain storming.

                             

                                                                       Dr.Nihar Ranjan Ray

                                                                       Dt.29th july 2008

By: Dr Nihar Ranjan Ray

Do you find it challenging to stay motivated when endeavoring to make changes to your health? Are you aware that changes must be made in your daily life but you do not know where to begin? If so then Health and Wellness Coaching might just be the solution you have been seeking.

Health and Wellness Coaching is a service offered by trained professionals who work with you individually to assist you reach your Wellness goals. Health and Wellness Coaching motivates, guides, and supports a person in order to reach sustainable behavioral changes by offering creative solutions to their problems.

Health and Wellness Coaching provides individually designed programs to meet your unique needs by focusing on physical, mental, and emotional health. They assist you become proactive in your life by removing unhealthy behaviors and making Wellness a priority.

Benefits of Health and Wellness Coaching for Your Staff Members

Staff Members can benefit from Health and Wellness Coaching in a variety of ways. Health and Wellness Coaching can assist individuals decrease major health risks in their lives by changing high risk behaviors. Some of the many reasons why employees work with Wellness Coaches are to get in shape, lose a little (or lot) of weight, reduce stress, stop using tobacco, and design balance in their lives. Wellness Coaches aid individuals with current health problems as well as preventing future health issues.

Because each program that a Wellness Coach designs is unique to suit the needs of the individual, they can be sure that it’ll be a program that is right for them. Most busy employees mistakenly believe that they do not have the time for Health and Wellness Coaching. Fortunately Health and Wellness Coaching professionals are able to offer their services in a variety of convenient ways. While electronic Health and Wellness Coaching through the use of e-mails and instant messaging has become a popular method due to its convenience, telephone and face-to-face interactions may also be used. Staff Members have the ability to reach their goals and improve their lives through the assistance of Health and Wellness Coaching.

Benefits of Health and Wellness Coaching for the Company

The overall benefits of Health and Wellness Coaching for a business are remarkable. Staff Member high risk behaviors such as tobacco use and obesity cost companies millions of dollars every year. These high risk behaviors often cause preventable illness and keep employees from coming to work. Health and Wellness Coaching guides, supports, hold individuals accountable, and ensures that they receive continued motivation to assist them reach their Wellness goals and eliminate unhealthy behaviors in their lives.

By implementing Wellness Plans and using Health and Wellness Coaching in their companies, employers reduce the risk of preventable illness in their companies. This improves the overall health of employees, reduces healthcare and insurance costs, decreases absenteeism, and ultimately enhances performance and productivity. When employees experience the benefits of higher levels Wellness in their lives it causes an improvement in job attitude, energy, and morale. Companies that utilize Health and Wellness Coaching for their employees experience the benefits of higher productivity.

Wellness Coach

Wellness incorporates many facets of our daily lives. From the amount of sleep to the water we drink, to the food that we eat and the activity that we maintain, our health is dependent upon many factors of our lifestyle. Working to improve our Wellness can be challenging to reach on our own. That is why we can utilize the assistance of a Wellness Coach.

What’s a Wellness Coach?

A Wellness Coach is a highly educated professional who is trained in behavioral change. Wellness Coaches generally have degrees in Exercise Science, Health Education, Exercise Physiology, Counseling and Education. A Wellness Coach assists individuals in recognizing current health concerns as well as preventing future health related issues. These professionals work with individuals in a variety of ways including; face-to-face, phone, via instant messaging and / or email. The latter of those is also referred to as electronic Health and Wellness Coaching and is the most efficient and cost effective method of working with a Wellness Coach. No matter what method is used for communication a Wellness Coach provides a personalized program specifically designed to address the needs and concerns of each personal client.

In what ways can a Wellness Coach assist me? 

Most individuals maintain several healthy habits in their lives. One person may be a fitness enthusiast; another may abstain from alcohol and tobacco; while another may maintain a healthy daily diet. However, overall Wellness is much like a puzzle, and a high level of health is only achieved when each piece of this puzzle is in place. A Wellness Coach will aid an individual in correcting his/her missing piece of the puzzle. An web-based Wellness Coach may address the needs of sleep deprivation, stress management, diet, or any number of health related issues. The Wellness Coach will motivate, guide, and offer valuable resources to offer individuals with the necessary tools to make life changes.

How is a Wellness Coach unique?

A Wellness Coach serves a distinctly different purpose than a personal trainer, a counselor, or a supportive family member or friend. First, a Wellness Coach is an expert in his/her personal field. When a client determines the need for a Wellness Coach he or she will complete a Health Risk Assessment (HRA). based on this assessment the individual will be assigned a Wellness Coach specifically selected to address his/her individual needs. Next, a Wellness Coach is available electronically 24 hours per day. Through web-based communication individuals have the opportunity to contact a Wellness Coach as much or as little as he may like. Communication with a Wellness Coach may range from daily to weekly, and can occur by e-mail, journal or a combination of both. Finally, a Wellness Coach is trained to aid in changing the way that the individual thinks and the way that they view themselves. A Wellness Coach maintains the purpose of helping the individual to work towards achieving a higher quality in life. This happens by addressing the cause of a certain problem rather than simply addressing the effects of a problem. A Wellness Coach will assist individuals recognize their needs, determine goals, and take the necessary steps towards achieving these goals.

While Wellness are growing concerns in our daily lives, it may seem challenging to make the time to educate oneself and address the needs or our well being. Working with the assistance of a Wellness Coach enables us to emphasis on our personal needs and make progress towards changing.

By: ravi triken

MEDICAL / HEALTH INTERNSHIP IN NEPAL/ MEDICAL ELECTIVES IN NEPAL

Volunteer Society Nepal aims to mobilize medical students and volunteers with health backgrounds in rural places where people do not have access to any health institutes, as the government is not able to provide adequate health services. On the other hand, rural Nepali people are often reluctant to go to the hospital and other modern health services because of orthodox thinking, superstition and other cultural influences. Some of the Nepali people may visit a witchdoctor when they are suffering from an illness. Therefore, it is possible that they die without getting the benefit of modern medication. VSN is playing an active role in linking people in rural areas with volunteers from the west and health volunteers within the country who are really eager to serve the many unprivileged people in Nepal.

Volunteers will mainly be involved in following three activities:-

(1) Working in the Health Post/ Clinic/ Hospital in Nepal  Medical/ Premedical  students will be assigned to clinics, sub-health posts, hospitals and other health institutions. These are either run by the government or a local community in both rural and urban settings. Health students will work with health assistants, doctors, nurses or some combination within. Your daily work will include helping to perform the health staffs’ job. It will also involve researches of common diseases and health issues. Students will get the opportunity to learn about the basic medication system in Nepal. The work will be daily, 3 to 5 hours, 6 days a week.

The Health institutions provide health services to the poor and marginalized people in the community and volunteers will observe and practice following activities:

• Health Post Based Activities

1. General daily clinic

2. MCH

• Family planning (Temporary devices)

• Immunization

• Ante-natal and post –natal clinics

• Health education

• Health post based normal deliveries

• Immunization

3. Pharmacy

4. Simple surgeries

5. Community oral health Clinic

6. Nutritional Rehabilitation center

7. Health Post based nutrition follow up

8. TB Clinic

1. Maternal and Child Health Care

• Immunization

• Under 5 health screening

• Antenatal care

• Postnatal care

• Normal home and health post based delivery

• Identification and referral of high risk pregnancy

2. Family Planning Services

• DMPA

• COC Pills

• Norplant

• Condom distribution

3. General OPD Services

• General clinic

• Pharmacy

• Dressing and injection

• Minor surgery

4. TB dots clinic

• Identification

• Counseling

• Treatment

• Follow up

(2) Health Camps in Nepal

Part of volunteer’s program will be deployment to work in health camps for a predetermined amount of time: 1 day to 3 days. (Volunteers will work with their Nepali experience medical personnel. The students’ responsibilities are to distribute medicine and consult with citizens about health-care.

Through this Health camp, poor and marginalized people in the community will be provided general health services and students will observe and practice following activities:

Community Health Camp

• Examining patients

• Providing general medicines

• Identification and referral if needed

• Immunization

• Education on oral hygiene

• DMPA, COC Pills, Condom distribution

• Heath post based follow up

(3) Health and Sanitation Awareness

Volunteers will be mainly involved in teaching about proper health-care and sanitation and will work with youth clubs, women groups and other local organizations. In addition, they will provide HIV/Aids awareness, First-Aid information to the local people in rural villages and thereby providing them with a practical life-skill. Similar educational lectures will be given to children, by Groups, in government schools, lasting from several days to a week in duration. Again, the Groups’ major focus will be to educate and mobilize community groups who can then pass the information onto the community at large.

Following activities will be organized

Community and School Based health program Activities

• HIV/Aids awareness

• Community health education activities

• School health education activities

• Anti smoking program

• Oral health education

• Reproduction health and sexual education

• First aid training and FA box distribution

Others

Apart from, learning and experiencing health related issue, students will get a maximum benefit:-

• Developing work experience in a marginal society and third world country

• Developing their personal and life skills

• Developing a deep understanding of the Nepali people, their language, and their various cultures

• Making a contribution to the ongoing development process of Nepal

• Enjoying such opportunities as taking part in local festivals, weddings, farming, and visiting different areas in local villagers

Visit at http://www.vsnepal.org

For details and reservation please contact at vsnnepal@ntc.net.np Application instructions:

To make reservation, please forward

+A brief resume

+A photo scanned small sized

+A cover letter mentioning the program of choice, duration of stay and arrival date

To

Mr. Sugandha Shrestha

VOLUNTEER PROGRAM DIRECTOR

Volunteer Society Nepal

Kathmandu, Nepal

Mailing Address:-

Volunteer Society Nepal

P.O.Box : 8975 E.P.C. : 1589

Kathmandu, Nepal

Phone No:

(+977)1-2040353

(+977) 9851009342

By: Volunteernepal