Caring for vulnerable children living in the slums and villages of India

Shravan Health Center

Since its inauguration in August 2015, the Shravan Health Center (SHC) has established itself as a premier, community-focused medical clinic in the Bhaskar Nagar slum neighborhood in Kalwa north of Mumbai. The Center provides a full range of medical services to primarily children and mothers in the slums, enabling this 200,000 member vulnerable community to receive accessible, affordable, quality health care for the first time in its history.

The modest and efficient three-room facility, including doctor care, nursing care, an on-site pharmacy and community outreach professionals, has serves over 1000 patients per month, 40 patients per day, mainly mothers, children and senior citizens. The center's focus is on child and maternal care and has a strong community medical outreach component as well as child vaccination programs. 

SHC, located in the heart of the Kalwa slum and accessible by foot to all the community residents, provides medical care that has, until now, been largely unavailable to this population. It is the first time that a medical clinic exists in the Kalwa community, and is a vital component in advancing a long-term vision for health and hygiene for the members of the community. SHC partners with the community, and has already garnered tremendous good will and support from the community, recognized for this important work that ultimately brings benefit all.

SHC has plans for increasing impact in addressing malnutrition, hygiene, vaccinations, and other vital issues, and is seeking to expand its community of sponsors and supporters.

Operated in partnership with Doctors for You, a local grassroots Indian NGO based in Mumbai, The Shravran Health Center provides the following services:
  • Minor acute care
  • Treatment for burns and injuries 
  • Immunizations (in conjunction with Indian Medical Services)
  • Health and nutrition education
  • Prescription assistance
  • Preventive checkups
  • Vitamin A and Iron Folic acid supplementation
  • Curative services  
  • Growth monitoring
  • Periodical deworming
  • Referral services (partnerships with hospitals in the area) 
  • Referrals to specialists
  • Health and nutritional education
  • Minor procedures such as cleaning and dressing
  • Preventive health check ups

Initial set-up 
Finding the right location for the center was a challenge. The Shravan Health Center required an usable substructure, a central location, easy access to ambulances, protection from flooding during monsoons, and a sanitary environment. Thankfully, we were able to find wonderful site that required only some modest renovations. We signed a three year contract and started renovating, painting and furnishing the structure. We were pleased that all carpentry, electrical work, building, metal work, painting and plumbing work was sourced locally.

We overcame many logistic challenges along the way. Problems of unreliable water and electricity supply were resolved by installing a pump at the nearby well, mounting a 400 gallon water tank and fitting a battery run generator. 
Today, the Shravan Health Center has an enclosed waiting area, a doctor's treatment room, reception desk, in-house pharmacy, bathroom and a large treatment room. 

Ongoing Program Activities
The Shravan Medical Center currently operates the following program activities
  • Daily outpatient services
  • TB DOTS program
  • Children's immunization program
  • Malnutrition control program
  • Antenatal care (ANC)
  • Health status outreach program
The following is a brief snapshot of these ongoing activities at the Shravan Health Center: 

Daily outpatient services
The primary activity of the Center is outpatient services, operated by a doctor, pharmacist, social worker, nurse and patient registration staff and conducted on premises. The services operate six days a week, from 10am to 4pm and 4pm-7pm three evenings a week, an average of 40 patients served per day, or 1000 patients per month. The majority of the patients (92.4%) served are women (25.6%) and children (66.8%). Some 21.8% of patients are babies and toddlers, 23.8% are children aged 5-12, and approximately 11.6% of women and men treated were senior citizens. Outpatients pay a registration fee of 15 cents (Rs.10) -valid for 3 days, which includes free basic medicines. Other medicines are provided at 30-40% cost. A special fund is in place in order to cover any patient who cannot afford treatment and/or medicines

Treating Tuberculosis: TB DOTS program
The Shravan Health Center has completed registration with the Government of India's Revised National Tuberculosis Control Program (RNTCP) program and began an immunization program in December 2015. Patients have been identified and are being administered the medications along with monitoring of their condition. The health center's para-medical outreach personnel  refer possible new TB patients as they visit families in their homes, to early treatment at the Shravan Health Center. The medication is provided by the Government of India, and the Center is in regular contact with relevant municipal medical institutions.

Children's immunization program
The Shravan Health Center is operating immunization programs, having registered under the Government Universal Immunization Program (UIP). The Center held three medical immunization camps in December and January, with medicines provided by the Indian Government. In addition, immunizations sessions are conducted on every second Friday of the month. As an extra incentive for patients, Sundara soap and hygiene education instruction is given free to all who avail of this immunization service.

Malnutrition control program - babies and infants
The Shravan Health Center has adopted the universally acclaimed malnutrition program Integrated Child Development Program (ICDP). Through this program, children undergo a weight check for height, weight check for age and mid upper arm circumference. Approximately 100 children have been identified as being malnourished. Seventy children were identified as MAM (moderately acute malnourished) and 30 children under SAM (severely acute malnourished). Parents of Identified children that fall into the net of the Malnutrition control program ICDP are provided nutritional counselling. Nutritional supplements are provided and administered. 

Health Status Outreach program
The SHC has embarked on an ambitious program of community mapping, via home-to- home outreach throughout the slums. SHC has devised a survey to collect and record relevant data of all the family members. The focus is on malnutrition, unimmunized children and women needing ante-natal care. The four outreach workers are specially trained to take and record vital health measurements like blood pressure, fetal heartbeat and diabetes. During the community mapping, staff offers provision of vitamin A and deworming for children, with follow-up and curative measures at the Center.

Antenatal care (ANC)
Initial activities have begun to provide vital, comprehensive antenatal care to pregnant women. Approximately 30 women have joined the ANC program thus far. 

Planned activities for 2016-2017
There are pressing medical needs in the Kalwa community, and the Shravan Medical Center aims to gradually address these needs. Over the coming two years, plans include the following programs, some of which have already begun in pilot stages: 
  • Creating a premier family-planning program.
  • Conducting Hygiene and health workshops for children and the community in general, run by Sundara in cooperation with GPM, to focus on hygiene, disease prevention and healthy living. 
  • Delivering an oral hygiene pilot program spearheaded by the Humble Smile Foundation and run by GPM has started in December 2015.
  • Providing technology (IT) classes in the late afternoons for 7th to 12th graders that will also teach hygiene and health topics
Take a virtual tour of the Shravan Health Center: