27 September 2016, Kotagiri: The Keystone health team brought together eight community health workers and staff for a meeting to help the Health and Community Wellness Programme plot a course for the next five years. This day-long session began with a discussion on the concept of wellbeing. Initiating the discussion, the health team began with what could cause a lack of wellbeing. The team discussed the obvious factors of disease, family issues, tensions related to property and alcoholism that cause mental stress which would then, after a point, manifest itself as physical illness.
Shyamjith from Nilambur also highlighted that there were significant differences with regard to health seeking behaviour within various communities. For example, a snake bite is generally considered a medical emergency requiring immediate specialized care, but for the Kattunaickans this is treated within the village using traditional medicine. Shyamjith said that there has hardly been any instance reported of a Kattunaickan travelling to a medical facility for snakebite or of having succumbed to snakebite. Akin to this, there are various situations in which different communities proves themselves equal to the task of maintaining wellbeing. These aspects also need to be identified and encouraged as they contribute to the resilience of the community.
The community health workers (CHW) were asked to ponder the question of how they see themselves as being an agent of change. Some of the responses were
- Generate awareness of on the concept of wellbeing, WASH hygiene, nutrition, diet and education,
- Form groups of wellness workers and empowering them to engage with decision makers,
- developing better rapport with the community,
- Provide counselling sessions for alcohol and drug abuse,
- Facilitate clear communication between the patient and visiting doctors regarding illness,
- Provide information and support regarding access to specialized medical facilities as required,
- Counsel villagers, especially women, to overcome their shyness and voice their concerns and issues.
The next questions were regarding what changes would the CHW want to see the levels of personal, family, village and community. At the personal level, the changes were mostly related to nutrition, education and WASH (water sanitation and hygiene). At the family level, the changes related to increased awareness related to nutrition and wellbeing, better participation in government sponsored health programmes like the Pulse Polio Programme, and more unity with the family when dealing with illnesses. At the village level, the wish list included proper sewage and waste disposal, curbing alcoholism and drug abuse, protecting community water resources, anganwadi for children, adult education and bank accounts for every family. For the community, the CHWs have noted that the government initiatives have undermined faith in traditional healing, the community needs to be made aware enough to be able to choose when to transition between traditional and modern medicine. Besides this, encouraging the cultivation of traditional crops and use of wild foods, finding a balance between traditional and modern day practices, ensure mid-day meals in schools, and above all foster an atmosphere of tolerance and unity within and without the community.
While the CHWs were having their animated discussion with Abhishek moderating and juggling Malayalam, Tamil and Kannada to ensure no one was left out, the core team were brainstorming on routes to ensuring community wellbeing, reach of the programme, resource persons, and linkages and networks. The core health team will now amalgamate the ideas that have emerged from the CHWs and their own plans for the programme to strategize for the coming years. The Health and Community Wellness programme is indeed poised to spread its wings and take off.