Melghat: A region full of challenges and solutions

Melghat, a cluster of 320 villages spread over the area of 4000 sq. km is known for its scenic beauty, teak forests, exotic fauna and “malnutrition.”Our journey began when we reached MAHAN after crossing the sharp ghats in Satpuda ranges. MAHAN is an NGO, run by Dr. Ashish Satav. MAHAN works towards controlling mortality in the rural tribal population through its child care, deaddiction and nutrition programs. They also organize a number of eye care and surgery camps with the aim of bringing quality healthcare to inaccessible areas of Melghat.

Working around Power cuts and poor connectivity

The villages in Melghat are sparsely populated and lack basic infrastructure and transport facilities. The fact that really struck us was that inner villages at Melghat had no connectivity or telecommunication networks and hence emergency communication or calling ambulances at time was not an option for them. Power availability in this region is also extremely poor, despite constant attention of government and several NGOs. This gets worse during the rainy season and accessibility to these regions is completely lost. Under such circumstances, it is a challenge to run surgical and opthalmological camps.

Mesh of Health workers

Given the economic background of this area, we could also notice a serious lack of proper education amongst the local tribes. The literacy rate in this area is as low as 45%. Yet, MAHAN has managed to work with low level of education and lack of skilled workers in this area. MAHAN trains a large group of village health workers every year, who are then made responsible for health check-ups, monitoring and tracking pregnant mothers, providing ante-natal care, assisting with labour and delivery, coordinating for home based child care programs, deaddiction programs and other initiatives undertaken by MAHAN. The VHWs are extensively trained to counsel the villagers and promote health awareness in the villages.

Maternal and Child Health at Melghat

A special focus is given by MAHAN towards maternal and child health. Melghat has been long known for its high infant mortality rate and large number of cases of severe malnutrition. At an average more than 500 children between age 0-5 years die due to malnutrition in Melghat. In view of this MAHAN started working with severely malnourished children. A weekly home based child care regimen was established where regular anthropometric measurements are done and children are categorized based on their height, weight and MUAC. After the categorization is over, they are recommended to the RUTF program, where nutritional food (based on UN standards) is provided to children at several locations in the village. The RUTF is made locally using easily available resources such as jaggery, peanuts and pulses. MAHAN also trains local women on preparing RUTF for domestic consumption.

Apart from tackling malnutrition, MAHAN has also been able to achieve significant progress in ante-natal care. Trained VHWs go from door to door to promote awareness of pregnant mothers. Pregnant mothers are tracked and monitored and fetal health is also recorded by the VHWs.

Anthropometric measurements: a challenge?

Constant data is collected from the village. This data includes anthropometric measurements and disease spreads for HIV, typhoid, pneumonia, malaria and diarrhea (among others). On interaction with these health workers and other doctors at Melghat, we noticed several discrepancies in collection and reading of anthropometic data. An urgent requirement, hence, in this sector would be to have automatic measurement systems with electronic readouts or data consolidation mechanisms.