Summary

C-NES in collaboration with the National Rural Health Mission (NRHM) and the Government of Assam, has been providing basic health care services to the islands in the Brahmaputra River through specially designed boats equipped with laboratories and pharmacies since 2005.

Program goals

The goal is to take sustained health care to hundreds of thousands of people on the islands, for the first time since independence, and with a special focus on women and children who continue to be the most vulnerable in difficult conditions.

Key program components

Each boat carries a fully fledged medical team (two doctors, three nurses, and lab technicians and pharmacists) that conduct regular camps organized through a network of community health workers and other organizers in the district. The goal is to take sustained health care to hundreds of thousands of people on the islands, for the first time since independence, and with a special focus on women and children who continue to be the most vulnerable in difficult conditions.

The programme has been scaled-up since January 2009 to five more districts, bringing the total of participating districts to 10. The districts covered are Dibrugarh, Tinsukia, Dhemaji, North Lakhimpur, Jorhat, Sonitpur, Morigaon, Barpeta, Nalbari and Dhubri and over one hundred thousand people have been covered in the first year of the PPP with NRHM.

Services:

The Boat clinics provide the following services: routine immunization of children 0-5 years and pregnant mothers, vitamin A supplementation, pulse polio immunization, japanese encaphilitis vaccination (special programme), general health check-ups, family planning, and information, education, communication (IEC) & behavior change communication (BCC) activities, among others. In addition, the laboratory aboard each boat is used to conduct blood analysis for malaria and other parasites.

Strategy of district health camps:

At least one to two camps are held every day. An average of 130-150 general health check ups (this figure can reach at least 300-to-400 at times) and 15 – 20 routine immunizations are performed during each camp. Diarrhea, dysentery, RTI, ARI, ear infection, skin infection, anemia and fever are some of the common ailments. Between 15- 20 camps are planned for each month.

Progress:

The District Community Organizers (DCOs) are at the apex of boat clinic activities in the districts and are responsible for the smooth operation of the camps and coordination with the district administration and the line departments of the districts.

Human Resources of Boat Clinics:

Both technical and non technical staff was recruited by C-NES and NRHM for these districts. In each district there is a total of 15 team members. This includes one District Community Organiser, two Medical Officers, one GNM, one pharmacist, one Laboratory Technician, two ANMs, three community workers and four boat crew members.

C-NES’ unique health clinic story began with a single boat, a prototype called Akha in the Dibrugarh district in 2005. The project has since spread to other districts, first, through a partnership with UNICEF and more recently, with NRHM which is helping to scale the programme in order to reach additional socially and geographically excluded groups. UNICEF has been involved in the training and technical support and has also been supporting the Dibrugarh boat clinic programme.