May 10-11 - CONCH, CHAD and RUHSA

CONCH:

We visited a variety of sites run by the Rural Community Health Department starting bright and early Monday morning. There are a total of 20 sites, each entirely run by nurses. Nursing students from the College of Nursing spend a considerable amount of time at these sites learning assessment skills, patient education skills, and community health theory. We were guided by Mrs. Priya, a nurse-midwife with nine-years experience and a fellowship in Family Practice. She is also a tutor (lecturer/clinical instructor) at the CoN.
On Monday we visited Arapakkam, a village with a population of approximately 2,000 people. The nurse run clinic there is associated with the College of Nursing Community Health (CONCH) program. They provide care in the clinic as well as making home visits. They do home visits for antenatal patients, postnatal patients, patients with chronic illnesses (most commonly hypertension and diabetes), infants and malnourished children. We visited a government run preschool in the village, took a tour of the village, observed a home visit for an elderly women with hypertension and observed prenatal care at the clinic. Below is a shot of the medication being dispensed at the clinic.

On Tuesday we visited our second CONCH site, another rural health clinic, again accompanied by the fearless Mrs. Priya, who somehow had not run out of patience for us! The model was the same as the first with a few more programs such as a geriatric day program being conducted as well as a community health lesson for local mothers about child, home safety. Coincidentally, we also saw a young boy come in with his mother with burns from spilled hot tea which served as an anecdote during the lesson. He was given first aid and referred to the hospital for further treatment.

Of interest, the temperature hit 108F today.
CHAD:

Community Health and Development (CHAD) is a Christian Medical College (CMC) run program serving the Kanniyamvadi block. Our orientation leader, Julius, a college tutor and nurse, gave a thorough overview of the available services offered at the base hospital and the outreach services.
They offer a family centered model of care. Weekly specialist clinics include TB and HIV, high-risk antenatal care, general clinics, diabetes and leprosy. They also pride themselves on their research collaborations with CMC, NGOs and international partners. In terms of outreach services, CHAD runs doctor-run and nurse-run clinics. Both models extensively involve nurses to deliver home base care and gather vital population statistics for each village. Other outreach services include income generating activities for women, a suicidal intervention program, marriage counseling, and training and development for village health nurses.

RUHSA:

The Rural Unit for Health and Social Affairs (RUHSA) is another CMC run program serving the K.V. Kuppam block, which is composed of 100+ villages, 18 centers and approximately 100,000 (1 lakh) people. Each is managed by a rural community officer who coordinates the volunteer corps that helps run health, social development and economic development initiatives. They have an integrated model for rural development which complements government initiatives. They organize youth groups, trade co-ops, women's groups, elderly daycare centers, tribal development education programs and a community college.

Along with their community initiatives they also have a 75 bed hospital with secondary care services which serves the 100+ villages. They can perform a limited number of surgeries including tubal ligation (tubectomy) and cesarean sections. Pictured below are the labor and delivery beds and the laboratory for in-house blood tests and urinalysis.