Oases of excellence

A small team that runs a primary health centre in Gujarat proves what difference social commitment can make in achieving developmental goals.

`MARKETPLACE' talks and `Coffee room' discussions on government offices and their work culture often tend to revolve around a perception of `sloth'. Even for many of us in the government, a state-run school or health centre conjures up images of tardiness.

Returning from a surprise visit to a primary school in a village in northern Gujarat, I saw an inconspicuous board giving directions to the PHC (primary health centre) at Jeetpur. I decided to go there. With a `usual' PHC in mind, I had a `tick list' ready for ticking off the Medical Officer by way of improving the general atmosphere, cleanliness, and so on. On reaching the PHC, I found it hard to believe that this was it. The place was basic, yet very well maintained with a neat array of carefully tended plants. Sitting inside, watching the young and enthusiastic doctor examine his patients and give them their medicines, one could not help noticing the deep respect and faith the patients had in him - be it the ailing old man or the young mother with a sick baby in her arms. Walking around the small, spartan building, one was struck by the cleanliness, care for details and simple innovative `systems' in place. The staff of about eight was taking me around, showing me their updated registers, talking of the types of patients they had dealt with and their success stories. The soft-spoken doctor talked of the team he had built and the PHC they had set up over the last three years.

Realising the need for community participation, they had carried out a series of meetings and sabhas with the opinion leaders and people of the village. Simultaneously, Dr. Chandramani, the young doctor, started working with determined `positiveness' on the competence, skills, values and attitudes of his staff. The first few months were very trying. There was that usual lack of credibility and apathy that people working in the government face initially. In most systems, for a sincere, conscientious worker, the environment is often hostile, with various vested interests operating. While these power structures may directly constitute a very miniscule percentage of the community, they are very vocal and influential.

Often writing off good efforts, creating many obstacles, they label those that toe their line as `good' and `successful', branding others as `not useful'. However, given a reasonable tenure and with persistent, single-minded efforts, the threshold of opposition is crossed. The silent majority too starts supporting the good work and, at times, goes to the extent of marginalising the vicious elements.

In spite of being an outsider to the State, with a language barrier, the persistent efforts of the doctor helped him eventually win the support of the community. Seeing the commitment of the team, the villagers started supporting its members, which, in turn, goaded the PHC team to work even better, treating over 80 patients daily. The targets with respect to immunisation and family planning were surpassed. There was a significant decline in maternal and infant mortality rates, which was also very encouraging. Extensive environment-building activities for prevention of diseases and epidemics were also taken up with good results.

During subsequent visits to the village, it was heartening to see that the efforts of the doctor motivated others too. This was clearly visible in the case of the woman sarpanch, Kamlaben Maliwad, a graduate in Agriculture.

With sincere efforts, she was able to make a lot of headway in this backward village. The community, under her leadership, with pro-active initiatives of the government officials, particularly the medical officer, had significantly improved the regularity and quality of service in the Anganwadi and the primary school with nearly cent per cent enrolment. On the health front, the incidence of diseases came down drastically. For instance, cases of malaria dropped from over 200 to less than 40 over the two-year period. The construction of a road connecting the village with an inaccessible hamlet was completed in record time. She talked of all these achievements with passion and pride.

There are many such success stories, many such `spots of brightness' strewn across the country. While there may be perceptions of despair and gloom, one has found that there is no dearth of `committed' people like this in the community at large. In almost every organisation or community, there are champions who can be compared to the load-bearing structures, holding our country in place. And they do this despite the seemingly never-ending obstacles that dot their tracks. Even across the apparently `barren landscape' there are these numerous, little oases of excellence, doing their best, fighting their lone battles with a `never-say-die' attitude! Empowering and networking these `workers' can act as a catalyst for mobilising the community which, ultimately, is the foundation for the sustainable fulfilment of our developmental goals.