anna maria barry-jester

india: strengthening the health system

Innovative programs all over India are attempting to strengthen the health system, and give access to people who have been traditionally isolated. These are a few of their stories.

More images available for each story upon request.

Since 2005, travelling boat clinics have brought the first consistant health care to the river islands. Here, community health workers check in patients through the front window of one of the boats. A partnership between the Center for North Eastern Studies (a local research group), the Assamese government, and UNICEF has provided expanding care over the last four years.
  
Hindu pilgrims visit the brahmaputra to preform a ritual puja, or offering. The Brahmaputra has an average width of 6.5 miles, and is 1800 miles long, running through China, Tibet, India, and Bangladesh. Within the river, there are some 2500 small islands, which are home to 3 million people.
   
Mysin villagers wait for the "boat clinic" to arrive. Living only 10 aerial km from the main land, it takes more than six hours in boat to navigate the river networks during the dry season. Approximately 3 million people live on 3000 islands in Assam. The population mostly consists of local indigenous groups such as the Bodo and Mysin, as well as Bangladeshi immigrants and Assamese.
     
  
A government employed Asha meets with boat clinic doctors to update them on pregnant women in the community where she works.
  
A baby receives a polio vaccination in Upper Assam, on an island in the Brahmaputra River from Akha Boat Clinic staff.
   
A pregnant woman is given a neonatal exam. Doctors have counselled her to deliver at a mainland hospital, where she can be cared for by trained birth attendants. However, from her particular island it is a 10 hour journey by canoe to the nearest hospital.
     
  
Ushara, 22, was given an expected date of arrival by boat clinic staff and decided to make the trip to Dibrugarh, the nearest district hospital, for the birth of her second child. Government incentives pay both the families and ASHAs (Accredited Social Health Activists, government sponsored local health educators and monitors) for each baby born in a hosptial. If the baby is a girl, a savings account is opened with 5000 Rps (approx 110 USD), available to the girl on her 18th birthday, a scheme started to curb female infanticide.
  
Posters hang around a temporary camp set up to house a medical clinic. They educate on safe water practices, as well as the importance of immunizations and breast feeding.
   
A woman waits at the pharmacy on an Akha boat clinic that runs along the Brahmaputra River in Assam, India. The Akha are traveling boat clinics that run along the Brahmaputra River in Assam, India. The work of a private public partnership between a research institution, private business, NGOs and the Indian government, they bring primary medical care to over two hundred thousand of the three million people living on islands in the Brahmaputra. Previously, most of the islanders had no access to basic medical services.
     
  
Experts estimate there are approximately 2 million people living with autism in India. Currently, most children with developmental handicaps attend "special schools," institutions exclusively for special needs children.
  
In addition to autism, a myriad of other developmental handicaps means there are millions of children with special education needs in India.
   
A new movement in the southern state of Goa is promoting "resource rooms," special classrooms within the tradtional school setting that allow children to get individualized educations while interacting with other students.
     
  
Students from a resource room classroom walk to school in Pilerne Village, Goa.
   
  
     
  
   
  
     
  
   
A group of residents wait to participate in a free check up for glucose and blood pressure. A pilot study is testing whether chronic disease prevention can successfully be added to kerala's renowned primary health care system.
   
Children sit at a preschool in Kerala, India. Kerala has the lowest maternal and infant mortality in the country, comparable to many wealthy countries. In an effort to maintain their reputation as a place that outperforms in health, despite its poor economic state, the government is attempting to address chronic diseases, currently one of the most pressing concerns in the state.