ANS. TO COMMENTS FROM AID, AUSTIN, TX


1. I am sending you the Annual Report at attachment file-1 & Health Status Study (Post Survey Study) at attachment-II for your information & necessary action.

2. The top three critical health issues/factors in the local community are as follows :

* Problem of primary health care, especially the curative (clinical) particularly at night by qualified doctor, trained attendants in the whole island areas there is no health centre /clinic to serve the ailing people in need!

* Problem of referral scope/transportation by mobile boat of serious patients (during child illness, pregnancy, snake bite, cholera etc.) to the distant urban hospital of about 20/30 K.M.distance.

* Problem of spot diagnosis & treatment towards common diseases, prenatal & postnatal services for mothers aged & children and incidental necessity. Therefore, development of infrastructural facilities (medicine bank, equips) is of an urgent issue.

The clinic will atleast serve our sick neighbours at first through diagnosis & post diagnosis treatment by a qualified doctor in close association with trained attendants/health worker/s. If not possible-then the clinic can refer the serious patients through the proposed referral medium to the distant urban hospitals etc.

3. The average daily wages of the local community is Rs.40/- only & thus, average monthly income usually goes upto Rs.800/900 (if sets 20/22 days working scope)!

* Out of the income they must have to contribute pay Rs.24/- P.M. or 288/- per year to the clinic Administrative Fund (CAF) and then each family can fully rely on our day-to-day healthcare services and can have a chance to save themselves from the money lenders to whom they are to pay lot inplace of only Rs.24/- P.M./or 288/- per year!

* Moreover, there has a plan to introduce Savings for Emergency (Healthcare) Services (SES). Each family will be motivated to save atleast Rs.20/- P.M./240.00 per year against which necessary loan in Emergency will be provided. Otherwise, if (Rs.240/-) will be the beneficiary family's savings by which a family can purchase a family Health Card (FHC) of Rs.288/- which is meant for CAF (Clinic Administrative Fund).

4. There will be 6 Health Workers i.e. 6 Rural quacks who are in services for their own interest. There 6 Rural Quacks will be under a one year on campus Training by the qualified doctor for the health centre. From the second year each trained paramedical staff (Rural Quacks) from each of the six villages will take over a charge of his village and just open a sub service centre (SSC) at his own house. He will at first try to solve the patients problem otherwise he will refer him to the central health centre. Several weekly camps will be there-through these above efforts we will try to make an effective coverage. In the third year, our efforts will be to introduce FHE under the new PSS (Parivar Swastha Sangha) So, within a period of 5 years it may have a good coverage out of next 9,000 target population.

5. Our six (6) villages are very close to each other. From all the 6 villages patients can come to access the clinic. Moreover, at everyweekend our doctor's team will be at a place to run a medical camp-where patients from nearby villages can come and have a chance atleast.

6. Medicines of Rs.1,00,000 (1 lakh only) will be purchased time to time and stored at our Revolving Medicine Bank (RMB) from where our patients will purchase the necessary/prescribed ones with the exact price which will be lower than the market price. So, the fund for the same RMB will be revolued on repair cost of medi equips will be managed some how from the said other Administrative cost and clinic-shed repairing cost. Every year it would not be needed to repair the clinic shed!

7. The Boatman will be chosen from the expert ones of our area. But to handle emergency situations there would be in boat out trained attendant with our doctor's every emergency advices of course, there will their one/two trained paramedical worker from the concerned village from which the patients come/referred to.

8. Only the qualified doctor will come from outside community. Rest of the staffs will be from the project community. Rural quacks (quite experienced but yet to be well trained by a qualified doctor), trained attendant/nurse and other qualified staff will be available so, local staffs can be able to sustain the project.

The next part of the this question is not clear to us.

9. Our Annual Profile (which is attached) will answer all your question at this part.

10. This contribution will be continued (next 2 years) till the other 50 PSS and after organisation of 50 other PSS, the former one will be exampled from contributing to the project.

11. Training matrials can be requested from yours side. Next, there will be A-V aids and casebles etc. Govt. trg. Materials & personnel will be encouraged here.

12. No. only funding for this particular project is being requested from AID.

13. Local G.P., Block P.H.C. Medical officer (BMOH) will be involved.

14. Preventive ones are precautionery measures but curative ones are clinical measures.