Health:

In the un-divided Bihar, when Jharkhand was the south Bihar, since that period, the health indicator of this state is very low due to the unawareness of the rural poor people about the basic health and hygiene practices and also for the use of the traditional health measures. On the one hand, most of the poor people could not able to arrange even two meals per day through out the year, on the other hand. Due to the unawareness of the basic health and hygiene practices, they often caught by so many different endemic diseases like malaria, kala-azar, diarrhea, tuberculosis and they had to spend their money for the treatment of the diseases and some time, even they compelled to accept credit from the local money lenders on a high rate of interest which they usually can not able to pay, thus, continue to be in the extreme poverty forever. The contradict starts when they sink into the extreme poverty and due the sickness not sufficiently fit to do any work. That way, poor becomes poorest in all these areas.

Observing all these things from the very beginning of the organization, Lok Prerna decide to adopt “Health” as another thrust area of the organization and started working for the development of the health indicator in the Devipuir Block of Deoghar district, Jarmundi block of Dumka district and in the Amrapara block of Pakur district. In the first ten years, Lok Prerna started information dissemination on the issues of basic health care, health and hygiene practices, safe mother hood and Ante-natal care and post – natal care, immunization of the mother and child, etc. Besides that, Lok Prerna also started awareness generation on the different health services provided by the government, especially to improve the health status of the rural poor. The organization also started to arrange health camps in presence of local health authorities in order to improve the

knowledge, practices and the accesses to health services. Rural health practitioners and even unregistered health practitioners got training for early detection of malarial cases. In addition, Lok Prerna has also launched an AIDS awareness programme, too. During the meetings with women Self-Help Groups, lok Prerna started to give inputs on the importance of intake of nutrition, breast-feeding, antenatal and post-natal care and monitoring growth of children, etc. Simultaneously, during this period, to make every birth safe for both the mother and child, Lok Prerna organized a training programme for traditional birth attendants, too.

But, still the “National Family Health survey, 2001” said that, the child mortality rate in Deoghar district is 67 compared to 54.3 per 1000 at state level, only one out of five children is fully immunized and only one out of 16 pregnant women have received tetanus shots and iron folic acid supplements. About half of the children are underweight and 60% of women are suffering from iron deficient anemia, about 48% of the children are stunted and 25% wasted. So, Lok Prerna could not find any reason to drop the health improvement initiatives even after the ten years efforts.

In between, the “National Rural Health Mission (NRHM)” started by the government of India to improve the health status in the rural India to ensure the inoculation, regular health check ups and the basic health care of the community. But, it is very difficult to found the functional health mechanism in the rural areas and the implementation of that programme also unsatisfactory from the all level. Inspite of that, the programme has insufficiency as far as the special situation of the women and girls are concerned. In the Deoghar district, the maternity death amounts to 5.4 of 1000, apx. 50% of the children, mostly girls, are underweight and 60% of the women suffer from iron deficiency. The mal-nutrition and intake of insufficient quantity of calories lead to growth problems and 48% above all girls have lagged behind their development. The lack of minerals and vitamins, like iron, lack of folic acid leads to growth disturbance in the womb and is among other things, responsible for the deformation occurring in the new born babies.

So, Lok Prerna again took initiatives first to make community more health conscious and also for the better and successful implementation of the NRHM through community mobilization. Lok Prerna started awareness generation by the use of IEC materials on the issues of immunization and preventive care, mobilization Community for the intake of iron, folic supplements, started campaigning on pulse polio, Anemia, Night Blindness and Malaria, etc.. The organization also involves the ANMs, Traditional Birth Attendants and Registered Medical Practitioners to mobilize the community to become more health conscious and to avail the benefit of the NRHM. One of the basic components of NRHM is to form Village Health Committee (VHC); appointment of ASHA/Sahiyya health volunteer, creation of Village Health fund, to promote reproductive and child health, strengthening health faculties and capacity building of health workers for better services. Lok Prerna gets involved in the process of selection of Sahiyyas and also conducted a series of trainings have been designed to build capacity of the VHCs & Sahiyya’s.

Not only that, Lok Prerna also started campaign on the issues of water, sanitation, health and hygiene among rural communities. Simultaneously, it was an initiative to provide safe drinking water source as a check against water born diseases and demonstrate sanitary latrine and roof rainwater harvesting technology; to develop and enhance the capacity of the rural people for sustainable management of the new resources created with respect to sanitation health and hygiene; to improve the health status of the rural people through necessary activities involving CBOs and rural committees.

More than that, Lok Prerna also started awareness generation on the life taking disease like HIV/AIDs. Lok Prerna started to aware the target groups like Truckers, Migrants and Commercial Sex Workers on the preventive issues of the HIV/AIDs to bring changes in their Behavior. Besides that, lok Prerna also started running a STD clinic in the Deoghar district to prevent the transmission of HIV/AIDs among the targeted community. Referral services for the suspected HIV/AIDs cases, promotion of Condom, etc. are the other initiatives taken by Lok Prerna at that time to prevent the spread of HIV/AIDs among the community.
All these aforesaid initiatives taken by Lok Prerna are implemented in the districts of Deoghar, Dumka, Jamtara, Giridih and Pakur of the Jharkhand state. In most of the cases of Health and Hygiene, basic health care practices, ANC-PNC, Reproductive and child health, immunization, Control of HIV/AIDS, water and sanitation, etc., Lok Prerna able to bring a massive change in the behavior of the community by the time. But still a long way to go, so, still Lok Prerna is very much involve for the improvement of the health indicator of the Jharkhand state.