It is led by a teaching faculty and a trained bio-statistician in the department. We have a couple of computers and basic software programs such as Epi info, Statistical Package of Social Sciences (SPSS), and WHO Anthro for quantitative data analysis and Atlas-ti (demo version) for qualitative data analysis installed in it.
This unit plays a key role in day to day data management. It monitors and ensures the daily entry of data collected during passive epidemiological surveillance in our hospital and the data collected during routine field based clinics. This information helps us to initiate preventive measures in the given locality. All internship monitoring formats are entered and stored in electronic formats. The monthly RHTC and UHTC reports are entered and processed here. This unit is active in educating post-graduates, medical students and interns on use of free public health software - Epi_info.
We have entered and analyzed survey data of 1800 elderly subjects in Tamil Nadu and Kerala. It was a large community-based survey for evaluation of community-managed palliative care program run by HelpAge, India. In future, we envision developing this centre for ensuring better technical support to our post-graduate students, medical students and teaching faculties of SMVMCH.
In December 2011, we have extended our partnership with HelpAge, India from research activities to service provision. Under this, fortnightly we are conducting health clinic at elderly village of HelpAge, India at Tamaraikulam, Cuddalore. Our post-graduate, a teaching faculty and medical intern conducts this clinics and offer their medical advice and care. We have started using standard screening tool to identify the health needs of the patient and plan care for the patient. So far, we have conducted four clinics with approximately 15 to 20 patients per clinic. Clinic is held every first and third Saturday at elderly village at Tamaraikulam, Cuddalore
We have supported HelpAge India in conducting health camps for elderly in cyclone affected villages. The post cyclone activity went on for four days. Each day our team covered two villages offering medical care to approximately 400 patients.
A team of teaching faculty, post-graduate and medical interns of SMVMCH supported the field-based mobile clinics for elderly in cyclone hit villages in Pondicherry.
Since last two years, we are conducting routine passive epidemiological surveillance in our hospital. Every day, medical interns posted in Department of Community Medicine pay visit to hospital wards of SMVMCH and note down the socio-demographic details, date of onset, laboratory findings and status of confirmed diagnosis of enlisted infectious disease conditions among the admitted patients. We report the cases of Malaria, Cholera and Acute Flaccid Paralysis to the District Health System. Based on this data, we have recently investigated the reasons for high number of enteric fever cases in the last two subsequent years.
Our undergraduate teaching aims to make a complete primary care physician. We follow the norms set by the Medical Council of India and the Pondicherry University. We are in process to develop community oriented undergraduate teaching and to make it relevant to the local health needs. Since last two years, medical undergraduates are exposed to ‘hands-on training program on community based research’ and undergraduates are currently motivated to undertake problem-solving community-based projects and participate in national health program activities.
Apart from didactic lecture sessions and community exposure visits, we facilitate ‘small group’ interactive teaching sessions, to maximize learning on the topics which are relevant to public health problems in India and their university assessment plan. We have communicated our best teaching practices and innovations in the scientific journals of International level. We are developing a program for community-based teaching for medical undergraduates. Such activities are often seen as a challenge due to constraints such as lack of commitment at various levels, shortage of trained manpower and institutional support. We look forward to its successful implementation and its mainstreaming in our routine teaching activities.
We have also introduced a project based learning system, where undergraduates are motivated to take up research projects. They plan, execute and present the entire research project on their own, with the help of faculties who play the role of facilitators.
Figures in parenthesis are percentages
We expect post-graduate candidates to ‘learn by doing’ and become competent to work in teaching and research institutes, and in services of government and voluntary health sectors. Yearly, we admit three post-graduates in Community Medicine. They are exposed to outcome oriented program over the period of three years. Apart from their hands-on exposure in Rural Health Training Centre and Urban Health Training Centre, they are posted at a Primary Health Centre where they get exposure to understand the functions and working of peripheral government health-care system.
We have developed a strategic partnership with HelpAge India, which is the recognized national level voluntary body with a mission to work for the cause and care of disadvantaged aged persons and improve their quality of life. Our PGs are actively involved in the field activities of HelpAge, India.
An online group has been started within the department to facilitate e-based learning, to increase the interaction among post-graduate students and faculty regarding various topics of academic importance and to provide an additional platform to the post-graduate students for learning and sharing their views and opinions. Post-graduate students, faculty from the department and experts in the subject from other colleges and organizations are the members of this group.
The progress of PG’s are monitored through log books. Their performance in academic activities such as journal clubs and seminar presentations are monitored and immediate feedback is ensured.
Post-graduates from the department of community medicine were trained in the basic epidemiology and teaching-learning methods during this month in the interactive sessions planned and conducted by the faculties from the department for the duration of 32 hours.
With a view envisioned towards acquiring skills in application of teaching-learning methods, a workshop was planned and conducted on 27th June on ‘Basic epidemiology’ to assess the cognitive domain of PG students and to strengthen experimental learning among them. This hands-on exposure of conducting workshop was followed by a qualitative interview of presenter PG’s to obtain a feedback of their self-reflection. Feedback from the participants of this workshop was also obtained and analyzed. Overall exercise proved to be a fruitful venture in inculcating the skills of session planning and session delivery among post-graduate students and self-reflection helped them to identify their strengths and limitations.
The epidemiology unit is led by a teaching faculty and a trained bio-statistician in the department. We have a couple of computers and basic software programs such as Epi-info, Statistical Package of Social Sciences (SPSS), and WHO- Anthro for quantitative data and Atlas-ti (demo version) for qualitative data installed in it.
This unit plays a key role in day to day data management. It monitors and ensures the daily entry of data collected during passive epidemiological surveillance in our hospital and the data collected during routine field based clinics. This information helps us to initiate preventive measures in the given locality. All internship monitoring formats are entered and stored in electronic formats. The monthly RHTC and UHTC reports are entered and processed here. This unit is active in educating post-graduates, medical students and interns on use of free public health software Epi-info.
In December 2011, we have extended our partnership with HelpAge, India from research activities to service provision. Under this, fortnightly we are conducting health clinic at elderly village of HelpAge, India at Tamaraikulam, Cuddalore. Our post-graduate, a teaching faculty and medical intern conducts this clinics and offer their medical advice and care. We have started using standard screening tool to identify the health needs of the patient and plan care for the patient. So far, we have conducted four clinics with approximately 15 to 20 patients per clinic. Clinic is held every first and third Saturday at elderly village at Tamaraikulam, Cuddalore.
Activity We provided onsite medical team for the Walkathon for elderly organized by HelpAge India on June 15th, 2013. Faculty and post-graduates from the department participated with full enthusiasm in it.
Inauguration function of ‘Walk against elder abuse’ by HelpAge India at Pondicherry beach
Our undergraduate teaching aims to make competent primary care physician. We follow the norms set by the Medical Council of India and the Pondicherry University. We are in process to develop community oriented undergraduate teaching and to make it relevant to local health needs. Last year, we have developed a ‘hands-on training program on community-based research’ for medical undergraduates and currently we are motivating undergraduates to undertake problem-solving community-based projects and to participate in national health program activities.
Apart from didactic lecture sessions and community exposure visits, we facilitate ‘small group’ interactive teaching to maximize learning on the topics which are relevant to public health problems in India and their university assessment plan. We have communicated our best teaching practices and innovations in the scientific journals of International level. We are developing a program for community-based teaching for medical undergraduates. Such activities are often seen as a challenge due to constraints such as lack of commitment at various levels, shortage of trained manpower and institutional support. We look forward to its successful implementation and its mainstreaming in our routine teaching activities.
Mass Drug Administration (MDA) for elimination of Filaria – A National Health Program activity
We expect post-graduate candidates to ‘learn by doing’ and become competent to work in teaching and research institutes, and in services of government and voluntary health sectors. Yearly, we admit three post-graduates in Community Medicine. They are exposed to outcome oriented program over the period of three years. Apart from their hands-on exposure to Rural Health Training Centre and Urban Health Training Centre, they are posted at a Primary Health Centre where they get exposure to understand the functions and working of peripheral government health care system.
We have developed a strategic partnership with HelpAge India, which is a recognized national level voluntary body with a mission to work for the cause and care of disadvantaged aged persons and improve their quality of life. Our PGs are actively involved in the field activities of HelpAge, India. The progresses of PGs are monitored through log books. Their performance in academic activities such as journal clubs and seminar presentations are monitored and immediate feedback is ensured.
Post-graduates at a workshop on ‘Qualitative Research Methods’ at MGIMS, Sewagram
The department of community medicine organized and conducted a workshop on Workshop on basics of educational project development on 23 November 2012. The workshop was designed for faculties with the objective to make the participants aware of the basics of educational project development and the opportunities available (Fellowship, Distance learning) for their professional development. The workshop had 18 participants from various departments. The programme schedule is given below.
Since last five years, we have been supporting and organizing four and half day residential workshops on qualitative research methods for young health professionals in India. Two sessions were held at Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha and three sessions were held at our department. Our workshop curriculum content is blended with participatory, in-depth and systematic techniques of qualitative methods. It offers hands-on experience on manual content analysis and software-aided analysis of qualitative data. The workshop curriculum is based on our previous experience and participants’ feedback.
A workshop was held at Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry from 7th January to 11th January. The workshop had 22 participants from various parts of the country.
The training program was held on 19thand 20th April, 2013 as per the schedule the Seminar hall of Department of Community Medicine, SMVMCH, Pondicherry, with emphasis on the following section,
Section 1: Ensuring Identification of TB suspects
Section 2: Collecting sputum from TB suspect and staining
Section 3: Categorization of TB patient and referral system
Section 4: Safe Disposal of contaminated material
Lesson plan was worked on for the activities related to RNTCP with emphasis on interactive lecture sections, demonstration, hands on training (to fill up sputum form, Lab register and treatment card and AFB staining of Tubercle bacilli , diagnosis using X ray) , group work for case based learning and discussion. To maximize the learning by interactive section 20 interns posted in community medicine were included for training (subsequently other interns will be trained in batches). Pre –test and post- test feedback was obtained.
To Government Chest Clinic, Puducherry and Mission Director, PSHM.
A workshop was held by the Epidemiology unit on 16th and 17th May 2013. The participants were 10 teaching faculties and 7 post-graduates from various departments of SMVMCH, Pondicherry. The workshop participants were registered on the first-come-first-serve basis. The resource persons were two trained community medicine teaching faculties and the Biostatistician in the department. Session plan for the workshop is given below.
Overall, the consensuses for all the sessions were good. There was significant improvement in participants’ skills in entering and analyzing data using statistical software. As perceived by the workshop participants, the workshop was helpful for the students and faculty and more such workshops were expected in near future with added emphasis on hands on sessions and data analysis
A workshop was organized and conducted by the Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital on ‘Ethics in Research’. Dr Geetanjali Batnamabane and Dr. Raveendran, two distinguished professors of Pharmacology from Jawaharlal Nehru Institute of Post-graduate Medicine and Research (JIPMER), were the guest speakers for the workshop. Dr. Amol R. Dongre, Professor and Head, Dept. of Community Medicine, SMVMCH spoke on Ethical issues in qualitative research. 21 faculty members from SMVMCH were the participants for this workshop. The overall program of this one day workshop was as follows:
Orientation Workshop was conducted for the newly joined batch of post-graduates from pre-clinical, para-clinical and clinical subjects for the year 2013. Full day sessions over a period of three days from 2 nd July to 4th July 2013 were conducted for sensitizing the new post-graduates on research methods. There were 43 participants and the sessions were interactive and participatory in nature. The sessions were conducted by five faculties from the department of community medicine. Dean (Academic) and Professor of Forensic Medicine, Dr. R. Kagne sensitized the participants on medico-legal issues in medical research. Dr. Jafrin from department of Pharmacology talked on ‘Animal Experiments’. The program of this workshop is given below:
Groups work on their
(Amol, Dr Kalai,
Dr Murugan and
Medico-legal issues –
A workshop was organized for the faculty and postgraduates from various medical colleges on 19th and 20th August 2013 on ‘Basics of Survival Analysis’. Dr. Pradeep Deshmukh, Professor of Community Medicine from Mahatma Gandhi Institute of Medical Sciences, Sewagram was the resource person for the workshop. There were 21 participants for the workshop. Participants learned about the basics of survival analysis along with hands-on experience with various exercises solved over the same. Participants took this workshop as an opportunity to understand Survival Analysis for using it in future endeavors.
(under the auspicious of Sri Ramachandra Medical College and Research Institute)
26th – 28th November, 2013.
Second Basic Course Workshop in ‘Medical Education Technologies’ was held from 26th to 28th November, 2013 at SMVMCH. A total of 22 senior, mid and junior level faculties’ form our institute participated in the workshop. Dr.Pankaj B Shah, was the observer from SRMC &RI, Chennai (MCI nodal center).
Last year, we have admitted first batch of post-graduates in 7 pre-clinical subjects and in Community Medicine. Half –a-day sessions over a period of six days from 13 June to 18 June 2012 were conducted for sensitization of post-graduates on research methods. There were 13 participants and sessions were interactive and participatory in nature. Following topics were covered by Department of Community Medicine. We also had a very informative session on ‘how to write a thesis protocol’ by Dr Gitanjali Batnamabane, a distinguished faculty of Jawaharlal Nehru Institute of Post-graduate Medicine and Research (JIPMER), Pondicherry, currently working as Technical Officer at World Health Organization, New Delhi. As reflected in the feedback, the sessions were well received by the participants. There was significant improvement in their pre and post median scores.
Post-graduates doing group work in a interactive session during their orientation program
Since, last three years, we have been supporting and organizing four and half day residential workshops on qualitative research methods for young health professionals in India. Two sessions were held at Mahatma Gandhi of Medical Sciences, Sewagram, Wardha and one session was held at our department. Our workshop curriculum content is blended with participatory, in-depth and systematic techniques of qualitative methods. It offers hands-on experience on manual content analysis and software-aided analysis of qualitative data. The workshop curriculum is based on our previous experience and participants’ feedback.
A workshop was held at Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry in South India from 28 March to 1 April, 2011. The participants were eleven mid-carrier teaching faculties (Community Medicine-9, Obstetrics and Gynaecology-2) and two first year post-graduate students in the subject of Community Medicine. The workshop participants were registered on first-cum-first-serve basis. The resource persons were two trained Community Medicine teaching faculties. Session plan for the workshop is given below.
Workshop on ‘Qualitative Research Methods’ at SMVMCH, Pondicherry
Overall, the consensuses for all sessions were good. There was significant improvement in participants’ skills in application and analysis of qualitative data. As perceived by the participants, the facilitating factors in workshop environment were - better care of physiological needs of the participants, good physical environment, and well-planned interactive session.
List of participants for workshop on ‘Qualitative Methods in Health Research’ at Sri Manakula Vinayagar Medical College and Hospital, 2011
List of assignments and on-going projects where DCM is\was actively involved
The Urban Health Centre (UHTC) is ten kilometre away from the hospital campus. It is running since year 2005 and is one of the oldest activities of the Department of Community Medicine. It is run by a team of post-graduate student, medical inters and nursing staff under supervision of faculty in charge. It also supports local Primary Health Centre in implementation of national health programs and special activities like Health day celebrations. We work in 19 villages of two primary health centres having total population of 47,402. It is our field practice area for community-based research, health education and community-orientation to medical undergraduates.
Faculty in charge for the centre monitors the activities of the centre on daily basis. He also conducts supervisory visit to the centre once a week. A post-graduate in Community Medicine is posted for the period of three months. All the activities in the centre are planned, organized and executed through the dedicated staff of the centre.
Every week days we run OPD at centre during morning hours. Health care is free of charge and basic drugs are provided in the pharmacy. Two third of the beneficiary were women and were from elderly age group. Patients with musculoskeletal problems and respiratory tract infections accounted for more than half of patients. From the month of January 2012 to December 2012 centre has served 8415 patient population with an average 935 cases/month. The details of the number of patients in each month are given below.
We encourage our medical interns, post-graduate student and social worker to attend monthly meeting of PHC staff and offer their support if requested. The purpose of this activity is to ensure hands-on exposure to our medical interns to peripheral government health care system and avoid any duplication of efforts.
A team of Faculty and 6 interns supplemented the Pulse Polio Immunization activity on Sunday. The team was divided into 4 groups. Each group along with the school volunteers conducted home visits to remind and motivate the parents for polio immunization. The groups further monitored the immunization activities of the peripheral sub centres and finally reported to the Department Faculty and Medical Officer from PHC at the end of the day. In the process, interns learned about administrative and supervisory activities of the Intensive Pulse Polio Immunization program.
World TB day was celebrated on 24th March, in collaboration with the PHC, Thirukkanur. Awareness session on TB was enacted by school children. Locally crafted material and informative posters on causation, spread and prevention of tuberculosis were displayed in exhibition in the school. The exhibition was open to general community for two days.
In 1960, the Government of India constituted a School Health Committee to assess the standard of health and nutrition of School children. In view of the crucial importance of school health, the Government of India constituted the Task Force to propose an intensive School Health Service Project, which could be implemented on a trial basis. The Task Force identified the following reasons for the poor state of School Health Programme
Our purpose to initiate school health programme was to improve the health status of local school going children. Another purpose was to provide an opportunity for medical interns and post-graduates in Community Medicine to get hand-on exposure in running school health program. We have been working in the field of school health education program since last two years. In order to make it more refined, a need was felt to specify its needs based objectives, health education strategy and evaluation plan.
Our post-graduate students posted at UHTC with the Health educator carries out a school health education sessions on weekly basis. Needs-based health education program is followed here. It is an opportunity for medical interns and post-graduate in Community Medicine to have a hands-on experience of running a school health program. The topics for a month are scheduled as follows.
As a part of Breast Feeding Week Celebration in 1st week of August, 2012 awareness session for Student trainees of Auxiliary Nurse Midwives (ANMs) was conducted. Student trainees were actively involved in the session. At the end of the session, quiz was conducted and winners were awarded the prizes.
Social workers from the department have been actively and consistently involved in forming adolescent group meetings. In the last year, monthly meetings have been in regularly organized with two adolescent groups. Similar efforts are in process to set up more groups over the time.
We have organized health education sessions on Tuberculosis for two women’s self-help group members. The purpose was to disseminate scientific messages on common injury management and potential harmful practices in injury management. We used flipbook developed at our department after careful research.
WORLD TB DAY was celebrated by UHTC unit of Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital at Bharathiyar Tailoring Institute, a governmental training centre on 26th March, 2013. Thirty four members of the institute attended the programme.
WORLD TB DAY was celebrated by of Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital at Kalitheerthalkumpam pet & Andiyarpalayam with Self Help groups. In total 45 members attended the meet.
During the program, Mrs. Pushparani, head of the institute welcomed the health team. The introductory speech was given by Dr. Muruganandham. Mr. Ganapathy delivered the health talk on the cause, symptoms and prevention of tuberculosis. Colourful posters showing the symptoms and treatment modalities were displayed and explained to the participants by Mrs. Jayanthi. Dr. Arun Ghorpade summarised the health talk and appealed for spreading take home message on TB by distributing pamphlets in neighbourhood. Ms. Maheshwari, student from the institute gave the vote of thanks. Program concluded question answer and clarification of doubts during tea and snakes session. During one and half hour interaction, all the participants were interactive and enthusiastic. They assured to give their fullest efforts for a TB FREE INDIA!!!
We post our medical interns to UHTC and PHC for peripheral exposure. Medical interns are given ‘Internship card’ to document their daily activities under the supervision of faculty in charge and Post-graduate in Community Medicine. Interns are involved in the every activity of the UHTC. At the centre they are trained for medical management of diseases and surgical/operative procedures at the primary care level. We provide them opportunity to interact with community members during field based surveys, SHG meets, school health activities etc.
In afternoon, it is mandatory for interns to be actvvely involved in academic activities. The prototype schedule for the afternoon discussion is as follows.
In addition to above activities, all batches of interns are trained on RNTCP guidelines for Medical Officers and Analytical software like Epi Info. Medical interns are given ‘Internship card’ to document their daily activities under the supervision of medical officer and Post-graduate in Community Medicine. We did the analysis of Internship Cards submitted by 91 medical interns of 2007 batch, which is our first batch of recently graduated students. The findings are given below. We are in process of making our internship program more relevant to competencies required for basic primary care physician. The exposure varies from basic medical management of minor ailments, basic surgical/operative procedures to interaction with community members during field based health camps and rural mobile health clinics.
Department of Community Medicine has set up a water surveillance system for four villages under UHTC, Thirukkanur.
From each village five varied drinking water bodies (i. e. Over head tank, Public school, Anganwadi centre, Public tap and a household sample) are monitored on monthly basis. These samples are tested for chemical and biological quality standards in Public Health Lab of Department of Community Medicine. The standard operating procedure suggested by Tamil Nadu Water Supply and Drainage (TWAD) Board, Chennai is strictly followed. The reports for the water samples are formally informed and submitted to the concerned authority. For the unsafe quality reports, technical support for the water safety is provided.
Many salts / chemicals are normally dissolved in water and WHO and BIS have prescribed guideline values for various water quality parameters. When these guideline values are exceeded some diseases may be caused and may also affect the aquatic life and crops. The field water testing kit developed by Tamilnadu,Water Supply and Drainage Board (TWAD board) is a simple device, which can be used for testing some critical water quality parameters in the field. The results will be useful in planning and formulating various water supply schemes and will be useful for proper maintenance of water supply schemes.
For testing the water in the field, the following aspects are important
Using the measuring jar, measure 10 ml water and pour it into the 100 ml polypropylene/titration cup. By observing the water in the cup, record qualitatively the appearance, odour and turbidity.
Recorded appearance as follows:
Colourless & clear/ Brownish/ Greenish/ Blackish / Slightly whitish/ Turbid etc.
Record odour as follows:
None/ Soil smell/ Algal smell/ Objectionable odour/Rotten egg smell etc.
Record turbidity as follows:
No turbidity/ Slightly turbid / Moderately turbid/ Highly turbid
pH booklets have been provided to measure pH value of water. Tear a portion of the pH paper and hold it by your fingers. Using the ink filler add 1 drop of water sample on the paper. Wait for 10 seconds. The colour change taking place on the wet portion of the pH paper is observed and compared with the pH chart provider in the cover page of pH booklet. Record the pH value.
Using the 10 ml measuring cylinder, measure 20 ml of water sample (2 x 10ml) and pour it into the clean titration cup. Add 5 drops of ‘A1’ liquid. The water turns bluish green. Using the ‘1 ml syringe’ provided in the kit, add ‘A2’ liquid (starting from the 40th division). At the end point, the colour of water changes into Orange/ Yellow. Record the number of division of ‘A2’added to reach the end point.
Calculation: Alkalinity mg/L = No. of Division of ‘A2’ added x 10.
Using the 10 ml measuring cylinder, measure 20 ml of water sample (2 x 10 ml) and pour it into the clean titration cup. Add 5 drops of ‘H1’ and then 5 drops of ‘H2’ liquids. The water in the titration cup turns pink in colour. Using the ‘1 ml syringe’ add ‘H3’ liquid in drops (starting from the 40th division). At the end point, the colour of water changes into Bluish colour. Record the number of divisions of ‘H3’ liquid added to reach the end point.
Calculation: Hardness mg/L = No. of Divisions of ‘H3’ added x 10.
Using the 10 ml measuring cylinder, measure 20 ml of water sample (2 x 10 ml) and pour it into the clean titration cup. Add 5 drops of ‘C1’ liquid. The water turns yellowish in colour. Using the ‘1 ml syringe’ add ‘C2’ liquid in drops (starting from the 40th division). At the end point, the colour of water changes to slight reddish in colour. Record the numbers of divisions of ‘C2’liquid added to reach the end point.
Calculation: Chloride mg/L = No. of Divisions of ‘C2’ liquid x 10.
The approximate value of TDS can be arrived at by the following calculation:
Calculation: TDS mg/L = (Alkalinity + hardness + chloride) x 1.2.
Take 5 ml of water sample in the 10 ml glass bottle. Add 5 drops of ‘F’ liquid. Mix. Compare the colour with “Fluoride chart” provided and records the fluoride value.
Using the measuring cylinder, take 10 ml of water sample in the 10 ml glass bottle. Add 5 drops of ‘Fe1’ liquid and 1 drops of ‘Fe2’ liquid. Mix. Then add 5 drops of ‘Fe3’ liquid. Mix well. For colourless samples wait for 2 minutes. For turbid sample wait for 5-10 minutes till a persistent, the colour of water will change into red. Compare the ‘red’ colour with the ‘iron chart’ provided and record and record the iron value.
Using the measuring cylinder, take 10 ml of water sample in the 10 ml glass bottle. Add 5 drops of ‘AM’ liquid. Gently shake the bottle. If there is no Ammonia, the colour will not change. If Ammonia is present, the water turns yellow. Compare the ‘Yellow’ colour developed with the ‘Ammonia chart’ provided and record the Ammonia value.
Using the measuring cylinder, take 10 ml of water sample in the 10 ml glass bottle. Add 2 drops of N2 and 2 drops of ‘N3’liquids. Gently shake the bottle. If there is no Nitrite, the colour will not change. If Nitrite is present, the colour or water will change into pink. Compare the ‘pink’ colour with the ‘Nitrate colour chart’ provided and record the nitrite value.
Using the 1 ml syringe take 1 ml water sample in the 10 ml glass bottle. Using the measuring cylinder add 9 ml bottled/distilled water to the same glass bottle. Using a mini spatula add a small pinch (one mustard size only) of metal powder (N1). Add 2 drops of `N2’ and 2 drops of `N3’ liquids. Shake continuously and vigorously for 1 minute. Wait for 5 minutes and immediately compare the colour developed with the `Nitrate colour chart’. If there is no Nitrate, the colour will not change. If Nitrate is present, the colour of water will change into pink. Record the nitrate value.
Using the measuring cylinder, take 10 ml of water sample in the 10 ml glass bottle. Add 5 drops of `P1’ liquid. Gently shake the bottle. Then add 1 drop of `P2’ liquid. Again gently shake. If there is no phosphate, the colour will not change. If Phosphate is present, the colour of water changes into blue. Compare the `blue’ colour with the `Phosphate chart’ provided and record the phosphate value.
Using the measuring cylinder, take 10 ml of water sample in the 10 ml glass bottle. Add 5 drops of `RC’ liquid. Slightly shakes the bottle. If there is no residual chlorine, the colour will not change. If residual chlorine is present the colour of water ill change into Yellow. Compare the `Yellow’ colour with the `Chlorine Chart’ provided and recorded the residual chlorine value.
Note: In the tests for rinsing use Distilled water or Bottled/mineral water
The test is conducted using H2S vials. The water should be added up to the mark in the H2S vial. After screwing the cap, keep the vial for 24 hrs. After 24 hrs observe any one of the following changes.
T: Thirukannur, C: Chettipattu, K: Kunichampattu, M: Manalipet
O: Over head tank, S: School, P: Public tap, H: House hold, A: Anganwadi
Periodic Knowledge, Attitude and Practice (KAP) surveys are carried out to explore the community perspective on specific health issues (eg: Breast feeding practices). Focus group discussions (FGD) and interviews are conducted with the supervision of the chief medical officer involving the paramedical workers of the centre. The information generated is used to provide important health education messages for the community. The interns and the field workers are sensitised to the community by field visits conducted to assess community awareness of specific diseases, awareness of availability and utilisation of health services. The following are the lists of research projects conducted in 2012.
We work in the field of two primary health centres having population of 47,402. There are 14 villages in Primary Health Centre, Thirubhuvani and 5 villages in Thirukkanur Primary Health Centre. Thus, we cover 19 villages under our UHTC field practice area.
The inaugural function of Urban Health Training Centre (UHTC), Villipuram was held on 25 January 2013. Shri M Dhansekaran, the Chairman and the Managing director, has graced the occasion as the chief guest, while Vice chairman Shri S.V. Sugumaran, director Dr D Rajagovindan, Dean (Academic) Dr Kagne, Medical superintendent Dr. Boopathy, Dean Dr M Amarnathan were the guest of honour. HODs of all the clinical departments, RMO Dr Asai Thambi, Nursing Superintendent Mrs Kamalanaveni and Deputy Nursing superintendent Mrs Greeta Gunacilan were present for the inauguration.
The Urban Health Training Centre is fifteen kilometres away from the hospital campus, located in the heart of Villupuram, near the new bus stand. It is run by a team of Assistant professors, post graduates, medical interns and nursing staff. The nearby slum of Valudhareddy having a population of 4104 is the field practice area of the UHTC. The outreach activities are in the form of mobile clinic at Chintamani village, Kanai village and Virattikuppam Pattai.
The OPD is run on every week days at the centre. Health care is free of charge and basic drugs are provided in the pharmacy. Counselling about prevention of disease and promotion of Health is the main focus.
As a part of outreach activity of the UHTC, mobile clinics are held at Chintamani village, Kanai village and Virattikuppam Pattai. Cooperation of the respective village panchayat’s is taken for the success of the mobile camps in the form of place for camp and publicity of the camp. Every Wednesday mobile clinic is held at Chintamani village, having a population of 3124.Since June every alternate Thursday’s mobile clinic is being held at Kanai village, having a population of 3950 and Virattikuppam Pattai, having a population of 3677.
(January 2013 to June 2013) = 1453 (OPD + Mobile clinic)
Two Higher secondary schools in Villupuram 1) Government High school, opposite BSNL office and 2) Government High school, Poonthottam are given Health education sessions monthly by Medical Social worker Mr Ganapathy, postgraduates and interns.
On 28/3/2013 at Government high school, opposite BSNL, Villupuram, exhibition with digital banners about Tuberculosis and Quiz programme on Tuberculosis and its prize distribution was done.
Theme for World Health day 2013 is high blood pressure. So a role play was held at Valludhareddy slum on Hypertension on 5/4/2013. The audience were also given a health talk and their queries were cleared. This was followed by Blood pressure check up of 70 adults. Refreshments were also provided to the audience.
A Health check-up camp was organised at Urban Health Training Centre, Villupuram on 1/6/2013 by the Department of Community Medicine, SMVMCH, in partnership with the Micro-financing Institution Equitas. The camp was held from 9.30 to 1.30 with MSW, ANM, interns, postgraduates, Assistant professors and was supervised by Head of the Department of Community Medicine Dr Amol Dongre, Associate Professor Dr Kalaiselvan. All the patients were given free health check-up, free medicines and counselling. The total number of patients who were checked was 66.
A Health check-up camp was held at Villupuram UHTC in collaboration with the Girubalaya NGO on 15/6/2013. The Bus from SMVMCH picked the beneficiaries from Maharajapuram and Thamaraikulam slum. Medical social worker Mr Marianathan along with NGO members helped in assembling the patients at UHTC. The patients were given a health talk and orientation regarding the services provided by UHTC Villupuram by the MSW and doctors. A team of Assistant professor, post graduates and interns conducted the health check-up. The patients were also given free drugs by OPD ANM. The camp was held from 9.30 am to 1pm. The total numbers of patients were 70. The patients thanked the Villupuram UHTC after the successful completion of the camp. The patients were dropped back near their homes after the camp by SMVMCH Bus.
Residents of the nearby slum Valudhareddy were approached through their Councellor, Mr MuthuGaneshan and Anganwadi worker Mrs Baby.
Mrs Laxmi representative of Kasturibai NGO helped Mr Marianathan MSW for door to door visit to the houses and issuing of pamphlets.
Pamplets were distributed with the help of Mrs Prasann,a a social health activist.
Women self help groups were approached through following Micro Finance Institutions
School Principals and Physical education teachers of following schools in Villupuram were given information about the services of our UHTC and they disseminated this information to their students.
Elumalai Poly-technique college, Trichy main road, staff was is informed about the UHTC.
Our Medical Social Worker Mr Marianathan persuaded the Parish Priest of Saint Xaviers Church and Madha Koil Church, Villupuram to announce about the UHTC at the end of Sunday Mass(prayer) and also the pamphlets were displayed at their notice boards.
Adolescent girls form a vulnerable group and their needs are rarely met. In order to provide them with a holistic understanding about their needs like the social and reproductive health needs, nutritional requirements and mental health problems, we will be forming at least two adolescent groups with 10 to 12 members each in the age group 12-19 years, with more focus on school drop- outs from a nearby place from the UHTC. This programme will benefit the adolescent girls as well as be a tool to improve the OPD attendance of UHTC. We also wanted to provide them with counselling sessions with the help of our female social worker if required. The groups will be equipped with life skill education during the follow up visits.
To provide health services to the people residing in the surrounding places of the UHTC and to keep a log of their health records and to provide adequate follow up care, we have planned to make family folders for about 150 to 200 households in Vazhudhareddy area which is about 1 km from the UHTC and has around 900 households. The social worker had already initiated the work and obtained permission from the Councillor and sought the peoples’ cooperation in the carrying out the process. In the first step, we will be making a map of the area with the help of social workers and PG’s. Later the family folders will be filled by the same team by house to house visit. The data will also be fed in the system for future research purpose
Rural Health Training Centre (RHTC), Thiruvanainallur is located 26 km away from the medical college campus and hospital in Villupuram district of Tamil Nadu. The centre is equipped with basic medical facilities and laboratory services. The care provided is free of cost. It is run by a team of medical officer, medical interns, social workers and a post-graduate in Community Medicine.
Its new building was inaugurated on 6 December 2009 and started operating from 12 March 2010. The centre provides basic health care to neighbouring villages. It also provides an opportunity for medical interns and post-graduates in Community Medicine to sharpen their clinical and epidemiological skills required to manage common public health problems in our local area. The present centre is seen as a potential place for community-based teaching of medical undergraduates.
OPD runs every weekday from 8.30 am to 1 pm and then 2 pm to 8 pm. It receives laboratory support with basic investigations such as basic blood and urine examination, haemoglobin estimation (Draskin method), blood sugar (calorimetric method), and serum cholesterol and blood urea. OPD is also supported by a counselling centre. It offers free treatment for minor ailments. We are in process to initiate essential drug pharmacy managed by medical interns and nurses. The centre has a pharmacy attached to it. Patients who need referral are referred to our hospital or nearest government hospital at Villupuram. The details of the number of patients in each month are given below.
A physiotherapy unit was started with a trained physiotherapist. The unit consist of infra red radiation, wax bath, short wave diathermy, inferential therapy, ultrasound stimulator, wood radar and marine wheel. Conditions like osteoarthritis, neck pain, low backache, stroke etc were treated.
As a part of OPD a geriatric clinic was started for old patients (>60 years), twice a week. A team of trained medical interns, a post-graduate, a faculty in Community Medicine and a counselor screen and counsel the elderly patients for common medical and mental health problems. The screening tool is structured and has been adopted from NIMHANS experience during our faculty’s Fellowship at NIMHANS, Bangalore. The screening tool consists of the General Health Questionnaire (GHQ-5), Psychosis screening, Alzheimer’s disease (AD8) questionnaire and checklist of common medical conditions. We screen the patients for early detection of health problems, counsel them\their caregivers and refer them to specialty OPD for further care.
Among the most visible activities of RHTC, is ‘Rural Mobile Clinic’ (RMC) in the villages. During these clinics, Primary care for minor ailments is provided at village level. It is conducted from Tuesday to Friday (four days) during the morning hours on fixed days in the village. We have selected four villages within ten kilometer area. It is run by a team of medical interns and nursing staff. No user fee is charged for the service. It provides an entry point for other health promotive and preventive activities in the village. It is an opportunity to build-up contact and faith among the villagers and to develop better understanding of the community among the staff of RHTC. It offers an opportunity to medical interns to educate patients in their social environment. The details of the number of patients in each month are given below.
We post our medical interns at RHTC for field exposure. Medical interns are given ‘Internship card’ to document their daily activities under the supervision of medical officers and Postgraduate in Community Medicine. Medical Interns have to work in centre OPD, Rural Mobile Clinic, participate in school health education program and weekly academic program where we cover treatment guidelines and National Health Program. We did the analysis of Internship Cards submitted by 113 medical interns of 2007 batch, which is our second batch of recently graduated medical doctors. The findings are given below. We are in the process of making our internship program more relevant to the competencies required for the basic primary care physician.
Interns’ academic activities are held at RHTC every afternoon. They are given the topic of standard treatment guidelines of common conditions developed by the ministry of health and family welfare, India, which are relevant to their day to day practice. The discussion was facilitated by faculties and post graduate from the Community Medicine department.
In the present system of medical education in India, community orientation and practical exposure of medical undergraduates to the health care delivery system, field realities and community problems is lacking. In South East Asia and especially in India, there has been an increase in the number of medical schools implementing a community-oriented education program. Most medical schools experience difficulties providing the right quality and quantity of educational experiences due to lack of curricula to respond to the needs of the local community. We developed a needs based community-oriented education program for our undergraduates. Hence, the objective was to expose the third semester medical undergraduates to this program. In this process COME program was held between 6 – 10 August, 2011 at Eanathimangalam village situated in Villupuram district of Tamil Nadu served by our Rural Health Training Center (RHTC).
107 students of second year MBBS were exposed to the COME program by the Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India. The program started with self introduction and briefing with the student about the importance of the program. The program was conducted as per the schedule mentioned in table 1. The students were divided into small groups and each group was guided by the faculty or post graduate. The students were introduced to the allotted family by the guide. The students collected demographic characteristics, identified the environmental risk factors and carried out personal hygiene for the family members of the allotted house using the format. The students also identified the family members suffering from acute and chronic medical problems. On the last day of the program medical camp was organized in the village to treat the acute medical condition. To ensure early clinical exposure, the students were asked to accompany the family members with medical problems to the medical camp and to observe the management by the treating doctor. Feedback in the form of retro-pre and open ended questions were obtained from the students on the final day. To know the perception of the community regarding the COME program, two Focus Group Discussion (FGD) (one each among men and women) was conducted in the village.
In the analysis of retro-pre feedback questionnaire, post-exposure mean score for all the responses were highly significant (p<0.001). The three broad categories of common responses from the manual content analysis emerged from the open ended feedback: 1). I learned the problems of the people, 2). Acquaintance gained by attending the camp and 3). Opinion on doctors
The best thing about the program was ‘development of communication skills’ and ‘Time was very less’ was the barrier in this program as reflected from their feedback
A team of faculties, post graduates and medical interns conducted the health camp. Students identified health problems in the family members they visited and mobilized them to the camp. A total of 474 vilagers were examined and students provided health education about their illness.
In order to promote health awareness among students, schools were identified in the villages of field practicing areas of RHTC. Every month on a particular topic health education and awareness was provided by a team of health educator, medical social worker, post graduate and medical interns. This activity helps generate awareness among students and in training medical interns.
As a part of breast feeding week celebrations, we decided to conduct a one day workshop for first year students of auxiliary nurse midwife courses and offer them skills based training on –counselling the mother about importance of exclusive breastfeeding, show the mother how to position the child and attach the child to the breast and management of inverted breast nipples by using a disposable plastic syringe. We used an Integrated Management of Neonatal and Childhood Illnesses (IMNCI) guidelines which is recommended under the National Rural Health Mission. We could offer these skills-based training to 52 first year ANM students in surrounding two Para- medical schools. We used photographs, handouts and PowerPoint presentations. We also emphasized the importance of breast feeding week and its theme. We also emphasized the importance of Infant Milk Substitute, Feeding Bottles and Infant Foods (Regulation of Production, Supply and Distribution) act, 1992 as provided by MoHFW, India and distributed the hard copy of the circular to all. The sessions were conducted by faculty of the Community Medicine department and the other team member was a health educator from our department.
Material distributed: IMNCI guidelines on breastfeeding, pamphlets on breastfeeding week and IMS act, 1992.
Yes, it addressed the training needs of the health care providers and in the long term it will benefit to the surrounding community. Training of health care providers is the most important upcoming issue
We aim to carry out context specific public health research of national relevance and research which will help us to improve our quality of services in our field practice area.