In August 2012, RMF CNE Santosh Pall found Pooja, a 9 month old girl, in Devigarh village, with a MUAC of 7.9. Picture the circumference of your thumb: that was the size of her upper arm.
Pooja was immediately rushed to the closest Nutritional Rehabilitation Centre (NRC) in the Thandla Hospital. There, she received the care that was required, and slowly began gaining weight. After 16 days in the NRC, she was released for home feeding.
RMF India Program Manager – Health and Nutrition Pratik Phadkule writes about his experience with CommCare and the challenges of treating Malnutrition in Madhya Pradesh.
Living in an age of extreme technological advancement certainly is a boon for mankind. This technological advancement has helped us in all the fields – communication, space travel, medicine, and engineering. Most importantly, with the help of this, our lives have become so much easier. I think, on this point, no one would disagree.
Two and a half years ago, I realized I had a large challenge in front of me. In order to complete the first step of our program, a baseline survey in 500 villages to determine the exact malnutrition situation we were dealing with, I was going to have to get creative. Sitting in front of me at the New Delhi train station, in heat of well over 100 degrees, were 500 survey books, over 1 ton of paper. I had a train ticket, 50 new workers at a training over 600 miles from where I stood, and 12 hours to get there.
Two of our Community Nutrition Educators learning to use the Commcare mobile phone survey tool
By Nyamat Bindra, Director, Education, Real Medicine Foundation, India
How to make the children not get bored in the summer? How can I make them enjoy staying at school? What can I make them do that is new, exciting, cost effective and something that the children would learn new skills from? What could it be …. Then it struck me! The one thing that Indians love…. Cricket!
I decided to organize a camp for the boys at school and art class for the girls!
Virgil wrote that fortune favors the bold, but I’m pretty sure this isn’t what he had in mind.
I’ve been in India for a grand total of 36 hours, most of it in transit, and it’s this last leg that is the most terrifying. Flashes of colour and sound as we hurdle down a road with what might generously be called lane markers, drivers in opposite directions flashing their headlights and honking frantically. There are seat belts in the car, but somewhat incongruously, the ones that actually have clips don’t seem to have anything in to which they buckle. Our driver (who, appropriately enough, has been dubbed ‘Michael Schumakr’ by the local staff) seems to revel in swerving away from oncoming trucks at the last possible second, dancing to and fro between lanes like a hippopotamus on roller skates, its sheer bulk and momentum defying the manoevres it seems to barely pull off.
My companion turns to face me, and grins. “Welcome to India.”
In March 2010, Caitlin and I were driving around Khandwa district on a motorcycle desperately searching for staff to begin operations of our ambitious “Eradicate Malnutrition” program. In our heads, we had a checklist of criteria for potential new staff, mostly focusing on education levels and any experience in the health, nutrition, or NGO sector. As we drove from hamlet to hamlet, over dried streambeds and through fallow, dusty farmland, the checklist was whittled down to one item: literate.
In July of 2011, 5 of our amazing CNEs from Khandwa are now on the cutting edge of technology, helping Microsoft design their Digital Slate technology for data collection in the field. At the same time, the rest of our Khandwa team is collecting information with an application on their phones specifically designed from RMF called Commcare. After a 3 month study, Microsoft Research will publish a paper based on the inputs of our team comparing these solutions to data collection problems. It seems that my initial pessimism, as it so often is, may have been a bit misguided.
The first week of March, I had the pleasure of visiting Caitlin McQuilling, Nyamat Bindra, and Naiara Tejados in Madhya Pradesh, India as part of a project I started to distribute solar-powered flashlights to the rural villages called Giving the Green Light. I traveled with my best friend and business partner, Stephany Torres. We met up with Caitlin in Khandwa who greeted us with a bright smile and fresh attitude along with Manisha and Anjana, RMF field workers. We were off to Ranai, a village in Khandwa that is home to Korku tribe of India, to check up on the MUAC kids and get Stephany and I acquainted with the villagers.
We are posting the Situation Analysis of Acute Malnutrition in Rajasthan and Madhya Pradesh written by our friends and colleagues at Action Against Hunger (ACF). While putting together this report their teams visited RMF in the field multiple times and spent time learning about ground realities from RMF CNEs and ground staff. RMF is always happy to host great organizations like ACF in the field and also learned a lot from their experts who visited. We’re looking forward to collaborating more with ACF in the future and thank them for this informative report.
RMF’s role in the study is mentioned by ACF here:
“Other than advocacy, under-nutrition is not a high priority activity for most local NGOs nor is there any specific technical expertise on this issue generally available in the local non-governmental sector. Real Medicine Foundation (RMF-India), an international NGO recently active in 500 villages of the Malwa Tribal Belt, runs a nutrition program aiming at improvement of community detection and nutrition education. They identify and facilitate the amelioration of missing linkages between AWC and community health structures, surveying the nutritional situation of the intervention area, collecting and analyzing data from the MUAC screenings.”
RMF Community Nutrition Educator, Samoti, and a child recovering from SAM. Photo Credit: Ximena Prugue
In March 2009, when I was conducting the initial field visits to develop RMF’s Malnutrition Eradication Program I visited a village called Shali Dana, in Kalwa block of Khandwa district in Madhya Pradesh. I remember being shocked and overwhelmed by the amount of children with severe acute malnutrition I saw in this village and the complete apathy and absence of government services in this village. We saw dozens of glassy eyed children with thinning hair, bulging stomachs, and protruding ribs, empty anganwadi centers, and children who had been tortured by traditional healers in the name of recovery because of the absence of government health services. Seeing this village convinced me that RMF had no choice but to do something drastic about this problem.
I’m often asked what keeps me going in the face of the hardships and emotionally taxing situations we face working on issues such as childhood malnutrition and HIV/AIDS day in and day out. My answer is simple: it’s all about finding inspiration in the most unexpected of places and circumstances.
Caitlin, and the mothers and children at the Malnutrition clinic
On Tuesday while out on a village visit we came across a little girl, Gila, who was extremely sick and dangerously malnourished. She and her family had just returned from a month long stay at a private hospital in Dahod, Gujarat where Gila was properly diagnosed with tubercular meningitis, but unfortunately was not given the proper treatment. Over the month she was there the family spent their entire savings and then some only to see Gila rapidly deteriorating. After a month when the family could no longer afford “treatment” they were sent home. This is when we found the family in the village, desperate for us to help in any way we could. As soon as I saw Gila I knew she needed expert medical care not available in the state of MP. We told the family that we would have to bring the little girl to the hospital immediately and they eagerly agreed without a second thought.