The Hindu : Tamil Nadu News : Programme to prevent renal disorders

Online edition of India's National Newspaper
Monday, Sep 29, 2008
ePaper | Mobile/PDA Version

Tamil Nadu

Tamil Nadu

Programme to prevent renal disorders

Shyam Ranganathan

— Photo: A.Muralitharan

AWARENESS DRIVE: Manjula Datta explaining features of the community-based renal failure prevention programme to participants at a workshop in Chennai on Sunday.

CHENNAI: When 70-year-old Rukmani leans on Manjula Datta after a brief spell of dizziness under the mid-day sun, she mumbles, “Lord Muruga is calling me.” But, Dr. Datta, an epidemiologist, knows the reason is much less dramatic and is recorded in Rukmani’s medical record: diabetes or hypertension.

Taking 20 participants of a two-day training programme, organised by the Kidney Help Trust, to villages served by its Rural Project, Dr. Datta introduces them to the project. Nearly 150 people in five villages around Edaiyarpakkam, Rukmani’s village, have been the beneficiaries of the Trust’s outreach project, which aims to bring down incidence of renal disorders through a community-based programme.

“Nearly 30 per cent of chronic renal disorders are caused by diabetes, with hypertension causing another 10 per cent. While dialysis for the renal disorder could cost up to Rs.20,000 per month, we work on diabetes and hypertension in the early stages at a cost of Rs.14.23 per person per year to reduce incidence of renal disorders,” Dr. M.K. Mani, nephrologist and trustee of the Kidney Help Trust, says.

In fact, in the first stage of the project covering 26 villages in Sriperumbudur taluk, with a population of 23,000, results show that blood pressure was controlled to ideal levels in 96 per cent of those who cooperated and blood sugar level improved in 77 per cent, says Dr. Mani.

The project has since been extended to a further 30 villages with a population of 21,000.

Started in 1996, the rural project has created awareness among villagers on what would normally be called “lifestyle diseases.”

Dr. Datta has another viewpoint: “In a city, diabetes and hypertension are caused due to lifestyle issues, but in the village it has more to do with lack of awareness about proper diet control and such things. These are really debilitating diseases and make life difficult in the village,” she says.

A number of old men and women lining up for the monthly monitoring offered by the Trust have oedema (swelling in the legs) and complain of dizziness. But, many like 60-year-old Chinnakulandaiammal cannot afford to stop working in fields even if they feel dizzy each day at noon.

So once every month they line up at the panchayat library, as a group of women, led by Ulaganayaki who lives in the same village, quietly looks at their records, test their blood sugar levels, and dispense medicines.

Both Dr. Datta and Dr. Mani attribute the successes of the project to five hand-picked workers, who manage the affairs in the villages. In a manner any lab technician could feel proud of, Ulaganayaki recites the process to test for blood sugar: “Heat 5 ml of Benedict’s solution over the spirit lamp. Add 8 drops of urine. Boil the mixture. If the colour changes to green, orange or red, the patient has blood sugar.”

And many of the participants in the training programme, including doctors, NGO workers and government health officers, are impressed by the +2-pass girl who also has completed a health worker course. “It is the same routine followed in all labs executed perfectly,” says Dr. Stanley Mathew, Health Officer, Tamil Nadu Department of Public Health.

Village workers go around creating awareness, making surveys of the population, cajoling those reluctant to come to the centre and even monitoring the social habits of their “patients.”

“He smokes often,” Ulaganayaki says quietly of Nagappan who argues for more pills to counter his increased blood sugar level.

In the end, any rural health project can only be successful with the commitment of the workers and the ability of doctors to delegate simple activities, says Dr. Datta. “If you can algorithmize any process and tell the health worker ‘Do A, B, C and D, and the patient will be cured,’ the whole programme can be successful. Else, there will only be wishful thinking for more doctors coming to the villages.”

And, the project is not just about “lifestyle diseases,” as Dr. Praveen Chopra, a participant in the training programme, from Haryana, points out.

The young health workers are actually creating awareness among villagers of health issues and taking simple but powerful messages like ‘Smoking is injurious to health’ to the hinterland, he says.

Printer friendly page
Send this article to Friends by E-Mail

Tamil Nadu