• madhipura@eha-health.org
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The MCH – Community Health & Development Program

The origins of the project

The Madhepura Community Health and Development Program is an integrated development program which was started following the Koshi river flood in 2008. The programme started under the leadership of Mr.Abraham Dennyson. Our current project manager is Mr.Johnson Digal, who was also involved in the flood relief and rescue in 2008. The program is being implemented in Murliganj and Alamnagar Block (Madhepura District) and consists of Anti- Human Trafficking measures, Livelihood , Health and Nutrition, Disaster Preparedness and Dalit Empowerment.

Why is this development so essential?

Madhepura is situated in the river plains. It is gifted with fertile soil with abundant water resources, especially ground water resources. Rice, wheat, and maize are the major crops in the district. In Madhepura, 40% of the target population do not have their own land and their main source of income is migration and agricultural labor. 60% of the target population have their their own lands, but with a size of less than one acre. Natural disasters like floods and drought affect the area. Farmers in Madhepura are currently facing a crisis, as farming is now an non-viable option for them due to rising input costs, low productivity, falling profitability and increasing costsof living. Traditional methods of farming, unfortunately, can sometimes contribute to low productivity.

A combination of rising expenses coupled with poor crop productivity creates a vicious cycle of debt. Debt ridden farmers often consider unsafe migration which leaves the women and children in a very vulnerable position.

CHDP believes in the transformation of the whole lives of people, not just their physical health. We also believe in the transfer of knowledge and skills to the community, so that they are able to address their problems as a united community. We also search diligently for the poorest of the poor, and try and address the huge inequalities that they grapple with on a daily basis, their whole lives. We partner with other NGOs in the area and do whatever is possible to improve the lives of those whom God gives us the privilege to serve.

Identifying families that are vulnerable to trafficking and providing them timely and appropriate support is one of the ways the CHDP program aims to help the community

The current status

The project has developed into its current stage through disaster response to disaster risk reduction (DRR) and now into a community development program. EHA over the years since responding to Kosi floods in 2008, has moved systematically from disaster response, to disaster preparedness and now moving on to reducing socio-economic vulnerabilities of the most marginalized communities in Muraliganj and Alamnagar block of Madhepura by making their livelihood sustainable and empowering them through awareness programmes. During the course of the progression the project we have also realized the seriousness of the issue of human trafficking in the communities EHA has been working with.

Currently we work in Murliganj and Alamnagar Blocks of the Madhepura District of North Bihar. We work to

  • Improve Health and Nutrition
  • Disaster Preparedness
  • Improve Livelihoods
  • Stop human trafficking
  • Dalit Empowerment
  • Training and transfer of knowledge and skills to all levels of the community

We hope to start new services in Mental health and Rehabilitation. We are always happy to welcome visitors and volunteers.

Community Heath and Development

The Community Health and Development team focused on alleviating poverty and its root causes through building community capacity for diversified sustainable livelihoods, disaster preparedness, and reducing the disease burden. This helped to improve economic resilience, reduce the incidence of child trafficking and abuse and promote safe migration. The approach adopted was community sensitization and empowerment, focusing on the most marginalized people group – the Mahadalits.

We have daily health clinics in addition to 5 tele-health centres in addition to palliative care, community disability and community psychiatry programs. Patients and families are also followed up through routine home visits as needed.

Identifying and enrolling young people from the village for Health Assistant Course- they are now well trained, confident and equipped for better employment opportunities. Livelihood initiatives such as agriculture, horticulture, animal husbandry, milk cooperatives, goat rearing, fishery, horticulture, petty shop business, pigeon rearing, crop spacing method and seed treatment are some options given to the community. A few girls also attended the basic tailoring course and one has started her own tailoring shop. Training and support to women for microenterprises such as agro- based household business is also given.

13 villages have disaster preparedness plans and mechanisms. 230 members in Village Disaster Management Committees have updated disaster management plans in 13 villages and 14 schools. The primary purpose of the Disaster Management and Task force groups is to keep their communities safe during natural and man-made disasters by periodic community-based risk assessment, analysis and development of risk mitigation plans to increase community preparedness. Capacity building trainings are conducted for the frontline health worker, PRI member and school teachers on disaster management.

Education and Anti-Trafficking activities

Non-formal schools help bridge the gap between the school dropouts and mainstream schools, providing children with a good educational environment. 10 adolescent groups in the villages make the young people aware of their rights and help them to be safe from social evils like early child marriage, trafficking, and exploitation.

1. MCH Academy

During the pandemic, a small tuition group was formed on the MCH campus to keep the children occupied while their parents worked. This has now evolved into the MCH academy which includes a creche facility for ages 0 to 3 years, a primary level Montessori centre for our 3- to 6-year-olds and an NIOS (National Institute of Open Schooling) coaching centre for the older children.

The Montessori school currently has 14 children. Dr. Amy Mathew is the Principle and Correspondent of the academy. Our other teacher is Mrs Arpita Nothaniel. The emphasis on hands-on independent learning, make them self-directed learners with a sense of independence and confidence in their abilities. The mixed age groups allow the children to learn from each other and develop life skills such as inclusion and acceptance. The vision for education also includes children with special needs.

Ms Naomi Ruth from Maryland, USA, a certified Montessori teacher, visited us this year. She conducted a weeklong in-house training for the teachers. We incorporated lesson planning, record keeping and student observation.

2. Creche

This year we started a creche facility for all our working moms. The creche has a colourful, safe, and inviting rumpus room with toys and books, a quiet room for children to sleep or mothers to feed, and a kitchen. An ANM staff and a helper take care of children daily between 8am and 5pm. Currently we have around 8 children who utilize this facility.

3. Non- Formal Schools

We have also begun widening our educational activities in the community. Mr Ravi Kumar has spearheaded the introduction of the EFA (Education for all) curriculum in one of our maha-dalit tolas. We hope to start training the village teachers and eventually introduce this curriculum to all our non-formal schools. Our biggest challenge is to find teachers who share this vision and understand education in a broad sense.

4. SHRISTI Community College

We also run the SHRISHTI community college that trains young women from marginalized families and provides them skills to ensure employment. This is accredited to the National Skills Development Corporation of India. We have a number of adolescent girls’ groups who are trained in computers, stitching, etc. to build capacity and improve employability. Two batches of students have successfully graduated from the health- assistant course.

Trainings:

Classes have been taken on spoken English to help our staff have a better grasp over the language and to remove all communication barriers. Medical training for the nurses in the labour room and ANC OPD to take up the role of being efficient midwifes, for NICU and ICU nurses to optimize our care for the new-born and to implement critical care training. Frequent examinations and assessments are also being done to evaluate their progress.

We also have a number of candidates who are undergoing various courses, both in-house and correspondence. Many of these are financially sponsored by the hospital. Some of the areas our staff have been taking training in include hospital administration, law, mental health, finance, palliative care, etc.

5. Village Child Protection Committee

Poverty, lack of awareness and opportunities for education are some of the chief reasons that force children into trafficking or child labour. To prevent and monitor this situation we have set up Village Child Protection Committee to facilitate safe migration in the villages. Regular meetings are organized by the committee to educate and spread awareness regarding child marriage, child labour and trafficking. Active members have been linked with the "District Child Protection Unit" in Madhepura, under the district administration. Village Child Protection Committees members meets every quarter with the concern officials of District Child protection Units to review their work.

6. New Community Health Initiative

We have recently begun a new initiative to bring health and development to the poorest tolas of our district. We have chosen 15 mahadalit communities for this initiative, mainly from the Moosahar caste, so named because of their diet that includes rats. This community is considered the poorest community in India and hardly access healthcare, if ever. Our main focus at the moment is on setting up a village clinic network in strategic Moosahar villages that will help us to take healthcare to them and along with it, understand their needs and desires. From this understanding we hope to get involved in their lives partnering with them to envision the future together.

Rupantran - Community Entrepreneurship Programme

Rupantran is a community entrepreneurship initiative. Holistic empowerment of women is the missing link in transformation of any under developed community. We focus on building their capacity to be confident and self-reliant agents of change, so that they can be in charge of their lives. This will not only alleviate their financial strain, but also give them self- confidence and a social stand which will enable them to be self- reliant. We train women in various skills related to production- fabric and fashion jewellery, greeting cards, soap making, baking, bamboo weaving, etc. The trained women are helped to form groups and an incubation centre is set up in their own villages, from where they work and sell their products.

Since empowerment is incomplete without literacy, and entrepreneurship will demand literacy, Rupantran is working with TCS to teach women reading, writing and arithmetic towards helping these women attain functional literacy, financial and digital literacy.

Formal trainings so far include skills training by Mr. Paul C Dass, proVision India and training for the trainers for adult literacy programme by TCS.