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Project Proposal for

Health problems of women and children in a tribal region : exploring application of traditional medicine

Implementing Agency
Academy of Development Sciences

Kashele Post, Karjat Taluka, Raigad District
Maharashtra 410 201, India

February, 2001

 

The words 'folk medicine', 'traditional medicine' and 'herbal remedies' have been used interchangeably in this proposal to indicate the local traditions of health prevalent in the region.

The term vaidu/s is used to indicate the whole range of folk practitioners, including sueens (traditional birth attendents), vish chikitsaks (treatment of poisons), daag vaidus, haad vaidus (bone setters), bhagats, etc.

 

Project Summary

The proposal seeks to strengthen traditional medicine and explore its application in the treatment of health problems faced by women and children in tribal areas of Raigad and Thane Districts. The poject will serve to demonstrate contemporary relevance of traditional medicine in meeting primary health care needs of local tribal communities.

 

Definition of the problem

Traditional or folk medicine is an oral tradition of health care prevalent amongst most tribal and rural communities in India and other parts of the world. It is a decentralised, autonomous and community supported institution based on local knowledge and resources (mainly plants). Even today, traditional medicine is known to cater to the health needs of over 70% people in developing countries. However, the situation is rapidly changing as the Government-sponsored Western or "Allopathic" medicine is wiping out traditional medicine from tribal areas. In the process, tribal communities are becoming dependent on a centralised and external input-based system of health care - a system that fails to meet the health needs of a majority of poor people. Moreover, Allopathic medicine is known to have serious limitations in terms of untoward effects, drug resistance, high costs, technical expertise, etc.

Tribal communities in Raigad and Thane Districts are facing a similar dilemma. Their own systems of health care are being replaced by state-sponsored hospitals; primary health centres; private dispensaries and so on. The government run health delivery system does not function properly and so tribals are forced to depend on private medical practitioners even for their basic health needs. Some private practitioners are not even formally qualified to prescribe or use allopathic medicines. At times they do so with disastrous consequences. Tribals do not have any option but to avail of the substandard medical services from private practitioners at exhorbitant costs.

Definition of the problem (Contd.)

 

 

Women and children constitute a marginalised section within tribal communities. Their plight is even worse. Women face difficulties in discussing their health problems with doctors, most of whom are men. As a result, even minor health problems, which could be easily treated in the initial stages, assume chronic and serious proportions. For instance, untreated gynecological problems in adolescent girls often lead to abortions and complications or even deaths during deliveries. The tribals then end up spending a lot of money for expensive treatment outside the region. Apart from money, the whole family loses out on agricultural and wage work due to preoccupation with treatment of the patient in a distant hospital.

Heavy workload and poor nutrition make matters worse for women. The low literacy rate amongst girls and early marriages are other issues which need to be addressed. Health issues affecting children are also a cause for concern.

All these factors have a bearing on the health and well being of women and children.

 

What can be done ?

There is a need to strengthen traditional medicine and to explore its application for addressing health problems of tribal women and children. Issues like drinking water, sanitation, education, social customs, nutrition, etc. also need to be given serious consideration. Women should be empowered to take care of common health problems at the village or community level.

Improvement in health status of women and children will have positive implications for the development of the tribal community.

 

What is the proposal ?

The proposal is to strengthen traditional medicine and explore its application in the treatment of health problems faced by women and children in 20 villages of Raigad and Thane Districts.

Efforts will be made to strengthen the institution of folk practitioners (vaidus) and improving availability of medicinal plants (nurseries, backyard herbal gardens, village herbal gardens, etc). This will lead to improvements in traditional medicine.

Systematic surveys will be carried out to properly understand the nature of health problems faced by women and children. Tribal women will be trained over a period of time to manage primary health problems at the village level through use of herbal remedies. Importance of issues like drinking water, sanitation, education, social customs, nutrition, etc. will be discussed with women and they will be encouraged to bring about appropriate changes.

The process will be documented and findings of the programme will be shrared with support agencies and other NGOs towards the end of the programme. Experiences of the programme can lead to a strategy on traditional medicine and women's health in tribal regions.

 

 

What are the proposed activities ?

A. Strengthening traditional medicine

  • An informal organisation of vaidus will be formed in efforts to consolidate the institution of folk practitioners.
  • Monthly meetings will be organised for vaidus in Murbad Taluka (Thane District) and Karjat Taluka (Raigad District). The objective of these meetings is to enable vaidus to periodically meet and discuss issues of concern. It is expected that the meetings will facilitate exchange of knowledge amongst vaidus.
  • Home-level dispensaries of prominent vaidus will be improved by setting up displays (charts, posters, etc.) and providing better facilities for preparation and storage of herbal medicines (utensils, bottles, etc).
  • Contribution of prominent vaidus will be publicly acknowledged by putting up their sign boards in villages and by instituting an annual award.
  •  
  • The traditional medicine dispensary at ADS will be improved in terms of infrastructure and facilities. Vaidus will be encouraged to utilise the ADS dispensary for providing treatment to patients from nearby villages. The ADS dispensary will serve as an important centre for training, documentation and clinical validation of traditional health practises.
  • 3-4 vaidus from the younger generation will be encouraged to work with older vaidus at the ADS dispensary. This will help in transmission of oral knowledge to the younger generation.
  • Exposure visits will be organised for vaidus.
  • Women will be encouraged to set up nurseries and backyard gardens of medicinal plants in villages. This will improve availability of herbal medicines at the village level.
  • Selected vaidus will be helped to grow near their houses the medicinal plants that they commonly use.

 

B. Health care for women and children

  • The programme will be implemented in 20 villages of Karjat and Murbad Talukas.
  • A team of four village-level women health workers (2 in Karjat and 2 in Murbad Taluka) will be given the responsibility to implement project activities in the 20 target villages. It will be easier for local women field staff to establish a rapport with tribal women and to understand the health problems they face. Choice of local field staff will also ensure continuity of activities beyond the project period.
  • A one-month training and orientation programme will be organised for the women staff on issues like health problems of women & children, growing of medicinal plants, processing of herbal medicines, treatment using herbal remedies, effective communication and participatory approaches, etc.
  • Surveys will be conducted in the target villages to understand the nature of health problems facing women and children.
  • Women staff will periodically visit villages to understand health problems and to train local women in the management of common ailments. The training will be on issues like setting up nurseries and herbal gardens, processing and use of herbal medicines in the treatment of common ailments, etc.

The training programmes will be aimed at creating a cadre of trained women health workers in villages.

  • Issues like reproductive health and mother & child health will be given priority.
  •  
  • Efficacy of various herbal remedies will be systematically documented.
  • Camps on health issues of women and children will be organised in villages. Experiences of the programme can lead to a better understanding of the role traditional medicine can play in meeting primary health needs of women and children in a tribal region. This will hopefully lead to replication of the programme in other tribal villages and help evolve a focussed strategy on traditional medicine and women's health.
  • Importance of issues like drinking water, sanitation, education, social customs, nutrition, etc. will be discussed with women and they will be encouraged to bring about appropriate changes. Involvement of women SHGs will be sought in the programme in villages where such groups exist.
  • A discussion meeting will be organised towards the end of the programme to shrare findings of the programme with support agencies and other NGOs.

 

What will be the duration of the programme ?

Duration of the programme will be three years. A period of three years is essential for systematic work on capacity building of staff, survey and meetings in villages, treatment of ailments, training of village women, observations, documentation, etc.

 

 

Where will the programme be located ?

The programme will be located in 20 villages of Karjat Taluka (Raigad District) and Murbad Taluka (Thane District). The location is shown on the map (Annexure I).

Lack of access to proper health care for women and children is a major limiting factor in the development of tribal communities in the region.

What will be the outputs ?

It is difficult to spell out quantitative outputs at this stage but there will certainly be substantial qualitative improvements in work related to traditional medicine and women's health. The broad outputs are listed below.

 

  • Improved understanding of health problems faced by women and children in tribal villages.
  • Development of trained women health workers.
  • Capacity building of women in villages for managing health problems at the village level.
  • Improved access to health care for women and children in the target villages.
  • Setting up of nurseries and herbal gardens in villages.
  • Strengthening of traditional medicine.
  • Systematic documentation of the remedies and the process.
  • Sharing of experiences with support agencies and NGOs.
  • Replication of the programme in other villages.

 

Who will benefit and how ?

The programme will benefit tribal women and children in terms of improved access to health care at the village level. The programme will also create a cadre of trained women health workers. This will be an important asset for the villages beyond the project period. Replication of the programme in other tribal villages and regions will benefit a larger tribal population.

More importantly, the programme can help in the development of a strategy for addressing issues of women's health in tribal regions.

 

 

Linkages with other development programmes

The work on traditional medicine and women's health is an integral part of the larger ADS concern to address problems facing tribal women. ADS is actively working to empower tribal women in dealing with development problems in villages and in effectively participating in the decision making process of local governments (Panchayati Raj).

Role of women

Women from villages will be actively involved in the programme. Efforts will be made to involve Self-Help Groups of women in villages where such groups exist.

 

Evaluation and follow up

The implementing agency (ADS) will be responsible for follow up and monitoring. Evaluation of the programme can be carried out by external agencies.

 

What experience does ADS have ?

ADS has been actively involved in work on herbal medicine and primary health care in the Karjat Tribal Block.

ADS has been working with women Self-Help Groups since the past four years. Over 60 SHGs have so far been established in villages of Karjat Tribal Block. See Annexures I and II for details about activities of ADS.

 

Time schedule of activities

No.

Activity

Year 1

Year 2

Year 3

1.

Appointment of staff

X

--

--

2.

Training, orientation of staff

X

--

--

3.

Survey in villages

X

--

--

4.

Field work in villages

X

X

X

5.

Training programmes for women in villages

X

X

X

6.

Health camps

X

X

X

7.

Meetings of folk practitioners

X

X

X

8.

Programmes for folk practitioners

X

X

X

9.

Setting up nurseries and herbal gardens in villages

--

X

X

10.

Documentation

X

X

X

11.

Discussion meeting

--

--

X

12.

Monitoring

X

X

X

13.

Evaluation

--

X

X

14.

Reporting

X

X

X

 

Budget

Estimated expenses over a period of three years

No.

Particulars

Year 1

Year 2

Year 3

Sub Total

Own / Other contri-bution

Support Needed

1

Staff salaries

a. Project co-ordinator (@Rs. 4,000 / month)

48,000.00

48,000.00

48,000.00

144,000.00

30,000.00

114,000.00

b. Women field staff (4) (@ Rs.2,000 / m / p)

96,000.00

96,000.00

96,000.00

288,000.00

96,000.00

192,000.00

2

Travel (Local)

35,000.00

35,000.00

35,000.00

105,000.00

0.00

105,000.00

3

Travel (Outstation)

20,000.00

20,000.00

20,000.00

60,000.00

0.00

60,000.00

4

Consultancy

15,000.00

20,000.00

15,000.00

50,000.00

10,000.00

40,000.00

5

Meetings of folk practitioners (@ Rs. 2,000 pm)

24,000.00

24,000.00

24,000.00

72,000.00

12,000.00

60,000.00

6

Support for assisting prominent vaidus

0.00

40,000.00

40,000.00

80,000.00

0.00

80,000.00

7

Improvements in ADS dispensary

100,000.00

0.00

0.00

100,000.00

25,000.00

75,000.00

8

Honorarium for nav vaidus (@Rs.2,000 pm)

24,000.00

24,000.00

24,000.00

72,000.00

0.00

72,000.00

9

Exposure visit for vaidus

0.00

15,000.00

15,000.00

30,000.00

0.00

30,000.00

10

Nurseries and herbal gardens in villages

20,000.00

50,000.00

50,000.00

120,000.00

0.00

120,000.00

11

Health camps in villages

10,000.00

10,000.00

10,000.00

30,000.00

0.00

30,000.00

12

Documentation

10,000.00

15,000.00

20,000.00

45,000.00

0.00

45,000.00

13

Office expenses

20,000.00

20,000.00

20,000.00

60,000.00

10,000.00

50,000.00

14

Discussion meeting (for 25 people)

0.00

0.00

25,000.00

25,000.00

0.00

25,000.00

15

Monitoring and evaluation

5,000.00

10,000.00

15,000.00

30,000.00

5,000.00

25,000.00

16

Report preparation

0.00

0.00

10,000.00

10,000.00

0.00

10,000.00

Sub Total

427,000.00

427,000.00

467,000.00

1,321,000.00

188,000.00

1,133,000.00

17

Institutional Expenses (@ 10 %)

42,700.00

42,700.00

46,700.00

132,100.00

0.00

132,100.00

Total

469,700.00

469,700.00

513,700.00

1,453,100.00

188,000.00

1,265,100.00

Yearwise ADS Contribution

61,000.00

66,000.00

61,000.00

188,000.00

Yearwise support needed

408,700.00

403,700.00

452,700.00

1,265,100.00

 

Annexure I

Academy of Development Science (ads)

 

Background

The period 1973-79 saw the initiation and development of the Graduate Volunteer Scheme at the University of Bombay. The Scheme received international recognition for its innovative efforts in linking education to community needs. Academy of Development Science was established as an autonomous institution in 1980 by the same team that designed and led the University project.

 

Social Perspective and Role

Academy of Development Science is a people oriented Science & Technology organisation. It is primarily concerned with the problems faced by village communities, particularly the tribals, the landless and small & marginal farmers.

It sees the rural environment as relatively more balanced than the urban industrial environment. The Academy is committed to rural work based on an appreciation of many positive features of rural life and society. It sees a big challenge in revitalisation of the rural economy whilst strengthening its ecological base.

One of the constant endeavours of the Academy is to motivate ‘knowledge’ as a social function (as represented by individuals and knowledge-oriented institutions) to serve the need of ordinary "shramik" people in rural areas. This has become necessary today on account of distortions in the social order as a result of which we find ‘knowledge’ largely serving power and wealth and minimum needs of millions not being met.

It draws inspiration from the rich and diverse indigenous cultures and knowledge systems. At the same time it believes that it is necessary to assimilate western S & T wherever it is relevant to national needs.

 

Legal Status

The Academy of Development Science is a registered Public Trust and Charitable Society. It has a 7-member Managing Committee (Board of Trustees) which is responsible for policy decisions. The Executive Committee, consisting of project leaders of various programmes being implemented, is responsible for day-to-day management.

Annexure I, Page No. 2

 

 

Location

ADS campus, with simple infrastructural facilities, is situated on 40 acres near Kashele village in the Karjat Tribal Block, Raigad District, Maharashtra. A map showing location of ADS is attached.

ADS is 16 kms from Karjat town which is midway between Bombay and Pune on road and rail routes. Kashele village lies on the Karjat-Murbad Road.

 

 

Sources of Funds

The Academy accepts funds from sources that respect its autonomy and are willing to contribute to its self-reliance. Donations made to the Academy are exempt from Income Tax under Section 80G of Income Tax Act.

 

 

Long-term Role

The Academy is being developed as a science, technology and development education ‘training’ centre for village-level workers of rural social-action groups, environmental and health organisations and other rural institutions interested in S&T. Training in S&T related areas is the long-term focus of Academy. Applied research carried out at Academy is intended to develop people-oriented programmes and ‘feed in’ the research experiences into its teaching programmes. Grassroots ‘action’ undertaken by Academy is confined to villages of Karjat Tribal Block.

 

 

Thrust Areas

  1. Traditional medicine and primary health care.
  2. Biodiversity conservation.
  3. Village technologies for employment and self-reliance.
  4. Watershed development.
  5. School education.
  6. Empowerment of women through Self-Help Groups.
  7. Food Security.

 

Annexure II

 

Report of activities during 1998-2000

 

Traditional Medicine and Primary Health Care

Objective of the project is to demonstrate contemporary relevance of local health traditions in meeting the primary health care needs of local tribal communities. Activities during 1998-2000 were:

 

  • Setting up of a traditional medicine dispensary managed by vaidus (traditional practitioners).
  • Training programmes for vaidus, nav vaidus, house wives and NGOs on various aspects of traditional medicine.
  • Medicine preparation.
  • Production of training material and publications.
  • Documentation.

 

Biodiversity Conservation

The focus of Academy’s work on biodiverstiy is to promote conservation and sustainable utilisation of indigenous plant genetic resources of agricultural crops, medicinal plants, bamboos, forest and fruit trees. An account of activities undertaken during 1998-2000 is given below:

 

Medicinal Plants Garden and Nursery

 

  • A comprehensive list of medicinal plants found in the region was prepared.
  • Medicinal plants were collected from different forests for plantation in the garden.
  • Saplings of over 120 species were raised in the nursery for distribution.
  • Saplings of medicinal plants were planted in villages as part of the watershed project.
  • Training programme on identification and nursery techniques was organised for NGOs.
  • Documentation and exhibition aspects of the garden were improved.
  • The raw drug, seed museum and herbarium was further strengthened in terms of further collections and documentation.

Annexure II, Page No. 2

Report for 1998-2000

 

Agricultural Biodiversity Project

 

  • Collection and documentation of traditional crop varieties from different areas of Konkan.
  • Establishment of a seed bank and field gene bank.
  • Awareness training programmes for farmers and NGOs.
  • Multiplication and distribution of seeds to farmers.
  • Organisation of a biodiversity competition for school children on cultivated and uncultivated food crops of the region.
  • Experimentation on selected traditional varieties.

 

Horticulture and nurseries

 

  • Management and strengthening of the field genebank of fruit trees and bamboos.
  • Multiplication and distribution of grafts of various fruit tree varieties.
  • Setting up of village nurseries.
  • Plantation of fruit and forest species on barren lands through watershed, orchards and other projects.
  • Organisation of a fruit show for farmers.
  • Awareness / training programmes for farmers and school students.

 

Village Technologies for Employment and self-reliance

Food Processing Centre

Objective of the Food Processing Centre of ADS is to generate ecologically sound and sustainable sources of employment for tribal people. The unit has done innovative work in developing and standardising several products based on processing of locally available fruits, vegetables and cereals. Main activities during 1998-2000 were:

 

  • Production and marketing of over 15 tonnes of different fruit products (chunda, pickles, jams, squashes, candy, etc).
  • Development of new food products from Jackfruit and Finger Millet.
  • Organisation of training/orientation programmes for NGOs, women's groups and school students.

Annexure II, Page No. 3

Report for 1998-2000

 

 

Rural Technology Workshop

Academy has established a rural technology workshop to impart training to tribal youth and women in various technical skills like fabrication, blacksmithy, wood work, lacquer ware, cane & bamboo work and construction technology. The workshop has been registered as an independent co-operative society. The co-operative provides fulltime employment to about 30 tribal persons. Activities during 1998-2000 were :

 

  • Production and sale of handicrafts / furniture worth (approx.) Rs. 7,00,000.00
  • Development of new products.
  • Training programmes (1-6 months) on bamboo craft for village artisans and women's groups.

 

 

School Education

Academy has set up a formal school on the campus. In addition to conventional subjects, children are taught to work with their hands and learn skills like carpentry, bamboo work, lacquer ware toys, nursery/ grafting techniques, sewing, book binding, etc. The aim is to give enough opportunities and freedom to the children to learn and to develop their own interest and also to generate in them an understanding and love for nature. The school strives to make education a meaningful and joyful experience for children. Co-curricular activities during 1998-2000 were :

 

  • Designing of syllabus for work experience.
  • One hour skill training every day on crafts like bamboo, wood work, sewing, stitching, etc.
  • Organisation of biodiversity competitions (fish, medicinal plants, food crops).
  • Documentation of tribal songs, dances, festivals and rituals.
  • Practical training on nursery and grafting techniques, vegetable cultivation, etc.
  • Activities on toy making from waste material.
  • Training programmes on environment education for teachers and students from other schools.

 

Annexure II, Page No. 5

Report for 1998-2000

 

Self-Help Groups (SHGs)

ADS is engaged in serious efforts to improve the socio-economic status of women by promoting formation of SHGs in villages of Karjat and Murbad Taluka. 60 SHGs have been established so far. Activities during 1998-2000 were :

 

  • Formation of 30 new SHGs in villages of Karjat and Murbad Taluka.
  • Meetings of SHGs.
  • Savings and credit programmes for members.
  • Awareness programmes on mother & child health.
  • Training / awareness programmes on social and rural development issues.
  • Training programmes on Panchayati Raj.

 

Food Security

ADS is promoting food security of marginalised sections through setting up of village level grain banks. ADS provides the initial grain loan and entrusts management of the grain bank to a Village Panch Committee consisting of village elders. Each village grain bank achieves self-reliance by repaying the grain loan borrowed from ADS over a period of four years.

ADS has so far established grain banks in 90 villages of Karjat and Murbad Taluka. The grain banks have promoted food security of small & marginal farmers and landless people and have reduced their dependence on sahukars (money lenders). The Government of Maharashtra has taken up replication of the ADS Grain Bank Programme in all tribal areas of the State. Activities during 1998-2000 were :

 

  • Meetings of village grain banks and Gavki Vikas Samiti (federation of grain banks).
  • Setting up of 10 new grain banks in tribal villages of Murbad Taluka.
  • Training programmes on food security for NGOs.
  • Facilitating a network of NGOs in Maharashtra State to promote food security in tribal and other backward regions of the state.

Annexure II, Page No. 5

Report for 1998-2000

 

 

Watershed Development

The Watershed Development programme of ADS is involved in augmenting the natural resource base in the region for improved livelihood opportunities to local people. Village watershed committees are responsible for planning and implementation of the programme. Activities during 1998-2000 were :

 

  • Meetings of village watershed committees.
  • Implementation of soil / water conservation measures at three watershed sites.
  • Setting up of village nurseries.
  • Tree plantation on barren lands.
  • Social development programmes in watershed villages.