Importance of Preventive and Promotive Care in Homoeopathy

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Importance of Preventive and Promotive Care in
Homoeopathy

• Dr Chandrasekhar Goda,
• M.D. (HOM) (MUMBAI)
• ICR, Mumbai

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REACH WHERE NO ONE REACHES
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PERCEIVING RURAL HEALTH SYNOPSIS

• HEALTH is A positive Concept and not merely
  the absence of Disease.
• A Co-ordinate, Balanced Functioning at
  different levels and Areas of Human economy, so
  that all-round Efficiency is promoted in the
  achievement of Good life living from the
  Ethical as well as material angle.

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HEALTH is Balance Results
from -Balance is
promoted by
Balance and is
maintained through -Balance.


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• HEALTH demands
• Intelligent
• Creation of
• Ordering of
• Mobilization of and
• Optimal utilization of
• Resources in Space-Time.

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• HEALTH PROMOTION and MAINTAINANCE demand
• Attention to PRIMARY NEEDS
• Air, Water,Food, Shelter, Growth and
  Development
• through Effective Communication
• (Mental as well as Physical).
• Evolution of the Sense of Responsibility.
• Adequate Freedom of Action for the due discharge
  of Responsibility.

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• DISEASE demands
• Prevention early Detection and containment
  easy, early and effective restoration of the
  State of Health
• CONTROL which involves the effective use of
  Medical knowledge and Personnel through active
  participation of the Community, in the welfare
  directed to all,
• irrespective of Caste, Creed, Socio-Economic
  Disabilities, Sex or Age differences or so on.

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ALL HEALTH CARE and WELFARE SCHEMES are entirely
dependant on the acceptance and participation of
the community for successful outcome in terms of
Achievement of the set Objectives with definite
measurable Criteria. Active Educative Effort
on the part of the Promoting and Executing
Authority, therefore proves essential for
success.
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Homoeopathic Medical Colleges will prove
effective in the Delivery of Health Care and
Family-Welfare to the Extent they are able to
inspire confidence in the Rural Communities
through their active participation in relieving
their troubles caused by pestilence and disease.
Their role in this capacity would prove a
stepping stone for Health-Care. Compulsory
Internship year under the active supervision and
control of the senior staff of the college and
the attached hospital.
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TRAVEL

• THE CARE OF INDIVIDUAL PATIENT
• TO
• CARE OF THE COMMUNITY
• URBAN
• TO
• RURAL
• TO
• TRIBAL.

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PALGHAR A.K HOUSE (1989)MANOR(1990)MOBILE
SERVICES(1995) PALGHAR RHH(2000)BHOPOLI
COTTAGE COMMUNITY CENTRE (2002)
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RURAL AND TRIBAL HEALTH SERVICES
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HOMOEOPATHY IN THE RURAL COMMUNITY
THE FIRST ENCOUNTER EXPERIENCE OF THE NANDGAON
VILLAGE CAMP WELL INTENTIONED WELL PLANNED WELL
EXECUTED EVERY ONE HAPPY WITH THE NATURE OF THE
IDEAL CAMP
ANTI CLIMAX VILLAGERS DIG A PIT OUTSIDE THE
VILLAGE AND DUMP ALL THE MEDICINES IN THE
PIT THEY BOYCOTT THE TRUST
HOW DO WE LOOK AT THIS EXPERIENCE? WHAT LESSONS
DO WE DRAW?
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EYE OPENER
LESSONS LEARNT

• ABILITY TO ACCEPT FEED BACK FROM THE COMMUNITY
• NEED TO UNDERSTAND THE COMMUNITY PSYCHE
• NEED OF ORIENTING THE COMMUNITY
• IMPORTANCE OF IEC-INFORMATION EDUCATION
  COMMUNICATION

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COMMUNITY MEDICINE CONCEPT? DOES IT MEAN
PREVENTIVE SOCIAL MEDICINE? WHAT IS THE CONCEPT
AND DEFINITION OF HEALTH, POSITIVE HEALTH? HOW
DO WE GO ABOUT THE PROCESS OF UNDERSTANDING THE
HEALTH OF THE COMMUNITY?
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COMMUNITY ? TO UNDERSTAND THE MAGNITUDE OF
PROBLEM . TO UNDERSTAND
DISTRIBUTION OF PROBLEM. TO
UNDERSTAND THE CONTRIBUTING FACTORS.
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• Method can be used? quantitative or qualitative.
• Base is community ? primary or secondary. Source
  of information
• Based on this information one can prepare
  conceptual model/ framework.
• Analysis of data can help to set the objectives
  with proper infrastructure

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INPUTS MANPOWER MATERIAL MONEY TIME INFORMATION
MANAGEMENT PLANNING ORGANIZATION IMPLEMENTATION MO
NITORING SUPERVISION DECISION MAKING
OUTPUT ORGANIZATIONAL OBJECTIVES
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5 To treat a Chronic case we need to discover
the Fundamental cause, which Is generally due to
a chronic miasm. In these investigations, the
ascertain- able physical constitution of the
patient, his moral and intellectual
character, His occupation, mode of living and
habits, his social and domestic relations, His
age, sexual function, etc are to be taken into
consideration.
We shall try to apply this fundamental concept
that Hahnemann has instructed us to do. This will
involve a visit into the life living of this
apparently simple folk living in the interiors
of the villages and jungles. Known as
ADIVASISmeaning original inhabitants having a
unique culture and socio-economico-religious
setup.
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• POPULATION WHO ARE
• MARGINALIZED
• OUT MIGRATED
• LOOSING IDENTITY

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CASTES MALHAR KOLI
WARLI, KATKARI,
KOKANA,
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EARLY AGE GIRLS 15 OR 16YRS
OR
MENARCHE

BOYS BY 20YRS PREVIOUSLY NO INTER-CASTE, NOW
LOVE-MARRIAGES GOVERNMENT RULES HOOD-WINKED IN
CONNIVANCE OF VILLAGE SENIORS SARPANCH EARLY
MARRIAGE LEADS TO EARLY PREGNANCY THE WOMAN
BUSY HANDLING A NUMBER OF CHILDREN. WOMAN STARTS
WORKING ON 5th DAY OF DELIVERY. CONCEPT OF ANC
PNC VERY DIFFERENT
MARRIAGES
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• POOR LITERACY. ZP SCHOOLS FOR 1-4 STD MANAGED BY
  THE ALL IN ONE ONLY ONE TEACHER
• SECONDARY EDUCATION AVAILABLE FAR OFF FROM
  VILLAGE HENCE AFFORDED BY FEW.
• SO POOR LITERACY HAS IN-DIRECT EFFECT ON HEALTH
  OF THE TRIBAL PEOPLE.

EDUCATION
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LIVELYHOOD
FARMING RICE, NAGALI, WARI,CHAWALI, UDIT,
KAKADI DEPENDS OF SEASONAL RAINS. THIS WILL HELP
THEM TO HAVE ONLY A BASE. THEY NEED MONEY TO BUY
SEEDS, VEGETABLES, MILK, OTHER SPICES
ETC.HENCE THEY HAVE TO MIGRATE IN SEARCH OF WORK
LIKE BRICK-KLINS, VEGETABLE-FARMS, FISHING,
GOVT. LABOUR ETC.FARMING SEASON JUNE TO
NOVEMBER.
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NUTRITION HEALTH
THE BASIC STATE IS SO POOR THAT WE NEED TO BUILD
UP ON IT TO A GREAT EXTENT. IF ONE LOOKS AT THE
FOOD AVAILABLE IT IS CLEAR THAT THEY GENERALLY
REMAIN UNDERNOURISHED. THEIR CONCEPT OF HEALTH
HAS BEEN ROOTED IN RELIGION, SUPERSTITION
BELIEFS. THEY CAN NOT AFFORD THE COST OF HEALTH
SERVICES
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ATTITUDE TOWARDS GOVT. MEDICAL SERVICE
PROVIDERS. WHAT THEY EXPECT FROM US.. THE
ATTITUDE PERSPECTIVE WE NEED TO KEEP TOWARDS
THEM SO THAT WE DEVELOP A MUTUALLY BENIFICIAL

RELATIONSHIP
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DEMANDS OF RURAL PRACTICE LACK OF ORIENTATION
ABOUT HOMOEOPATHY AMONG THE PATIENTS SCANTY
DATA LACK OF INVESTIGATIVE SUPPORT STRUCTURE
DEMANDS ON THE HOMOEOPATHIC PHYSICIAN KNOWLEDGE
OF THE LOCAL LANGUAGE, CUSTOMS, DISEASES,
SOCIO-ECONOMIC-POLITICAL SITUATION. GOOD
KNOWLEDGE OF HOMOEOPATHIC MATERIA MEDICA KEEN
ABILITY TO OBSERVE GOOD SKILLS TO CLINICALLY
DIAGNOSE THE CONDITION. PRESENCE OF MIND TO
ADAPT TO DIFFICULT SITUATIONS
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NANDGAON AANGANWADI DAY CARE CENTER CHILDREN
HOMOEOPATHIC.TREATMENT
CHILDREN UNDER THE AGE OF 5YRS. SPENDING HALF A
DAY IN THE DAY CARE CENTER. LOOKED AFTER BY
TEACHER AND ATTENDANT.
WEEKLY VISIT BY PHYSICIANS OF THE TRUST. CASES
DEFINED WITH THE HELP OF INFORMATION FROM THE
TEACHER AND ATTENDANT. OBSERVATIONS BY PHY.
THEMSELVES. PROPER CASE RECORD MAINTAINED.
CONSTITUTIONAL TREATMENTGIVEN.
TEACHER
OBSERVATIONS
ATTENDANT
PHYSICIAN
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RESULTS NOTED AT END OF ONE YEAR OF
INTERVENTION OVERALL HEALTH DEVELOPMENT
FASTER AND BETTER. CHILDREN ESCAPED THE USUAL
EPIDEMICS THAT ATTACKED OTHER CHILDREN IN THE
VILLAGE. CHANGES IN BEHAVIOUR NATURE OF THE
CHILDREN WITH DOCUMENTED EVIDENCE.
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EXPERIENCE OF THE ANEMIA PROJECT SCHOOL CHILDREN
CONDUCTING SURVEY Hb. ASSESMENT DIAGNOSTIC CAMP
HOMOEOPATHIC CASE TAKING CAMP ON SCRs.
CONSTITUTIONAL HOMOEOPATHIC TREATMENT ALONG WITH
LOCALLY MADE FOOD SUPPLEMENTS HEALTH HYGIENE
ORIENTATION LECTURES THROUGH CHVS MPWS.
CHILDREN ORIENTED ORGANIZED TO ACT AS CHANGE
AGENTS.
RESULTS IMPROVEMENT OF HB FROM 4gms to 11gms.
OVERALL HEALTH HYGIENE IMPROVES Limitation
IMPACT LASTS ONLY TILL TRUST INTERVENTION
ACTIVE.
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Female child Age 6 days old baby
Sensation Loose stools2 Profuse2, yellow,
Offensive No pain Vomited once small quantity
milk Urine- passed, 5-6 times
Location GIT- Rectum since yest. Night O
sudden F 10-12 times
Modalities A/F ?
Accompaniments Activity-Good Irritable App ?
2 ? demands feeds as stool freq ?
PHYSICAL EXAMINATION T. 99.4º F P 130/min R
40/min Weight 3.4 kg Skin Turgor (N) peeling
in axilla Tongue white coated No signs of
dehydration PA soft, NAD. LoSo, mild
distension Anus- No perennial redness CLINICAL
DIAGNOSIS ACUTE GASTRO-ENTERITIS BACTERIAL
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PHOSPHORUS 200

• ACUTE TOTALITY
• App ? 2- diarrhea with (hungry diarrhoea during)
  Characteristic physical general concomitant
• Painless diarrhoea Characteristic physical
  sensation
• Stool- profuse2Characteristic sensation of c/c
• Stool- offensiveCharacteristic sensation of c/c
• Stool- yellowCharacteristic sensation of c/c

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SEVERE CASE OF PNEUMONIA IN A CHILD
11/2 YEAR OLD MALE CHILD WITH
TEMP. 103 degrees. RR 80/Min. Grunting.
Constantly lying down. Refusal to feed. DROWSY.
Unable to Cough. Occ. Rattle heard. Complaints
since 3 to 4 days. O/e RS Creps Rt.UZ MZ
Hardly responding to stimuli.

• Very interior hamlet of the village.
• Both parents illiterate.
• Father just joined daily wage labour one day
  back. Just listened to the doctor about the
  childs condition said that he cant take him
  to the hospital now.

ANTIM. TART. 200. 3HRLY.
Decision to treat. MSW trained to monitor RR. MSW
visits the hamlet 3 times a day and administers
medicine. Case managed. Child well in 3 days.
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identified the need for village based HEALTH
CARE PROVIDERS Community Health Volunteer-
bare foot doctor training program that aims
at empowering illiterate or semi literate women
to mange common basic health problems locally.
(Aarogyamitra program similar to ASHA) It is
also looking at integrating the indigenous health
care systems prevalent in the area.
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CHV TAKING WT
CHV TAKING BP
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THE TEAM APPROACH
COMMUNITY
CHV(COMMUNITY HEALTH
VOLUNTEER)
LOCAL SCHOOL TEACHER

ê
MEDICAL SOCIAL WORKER (MSW)
MPW(MULTI-PURPOSE
GRAM PANCHAYAT
WORKER)


ê
DONORS
TRAINEE DOCTOR

ê
TISS
SENIOR PHYSICIAN

ê
TATA INSTITUTE OF SOCIAL SCIENCES
PHC GOVT.
CONSULTANT
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PARTNERSHIPS GOVT NGOS COMMUNITY TISS FORMERLY
URCD NOW CENTER FOR COMMUNITY ORGANIZATION AND
DEVELOPMENT PRACTICE
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TISS PARTNERSHIP LEAD TO FOCUS ON The focus
here has been in addressing dysfunctional aspects
of migration through creating livelihood security
and support resulting in more integrated
community health and development.
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Definition of livelihood

• A livelihood comprise the assets
  (natural,human, financial and social capital ),
  the activities, and the access to these (mediated
  by institutions and social relations) that
  together determine the living gained by the
  individual or household.

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Vision

• Creating rural communities as self reliant
  systems with progressive grassroots leadership,
  wherein livelihood security and stability exists
  for all. Concurrently there will be opportunities
  for persons with initiative to create surplus for
  themselves and enhance their quality of life.

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HEALTH
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MOBILE VAN UNDER - MOTHER AND CHILD PROJECT
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Arogya Mitra Training Programme
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LIVELIHOOD
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EDUCATION
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COMMUNITY HEALTH PROGRAMME
HEALTH SERVICES
EDUCATION AND TRAINING
LIVELIHOOD

• S.H.G.
• LAND
• WATER
• WARLI ARTS

• M.C.H.
• SCHOOL HEALTH
• RESEARCH

• INTERVENTION
• IN FORMAL EDUCATION/
• STUDENTS.
• HEALTH EDUCATION
• IN THE COMMUNITY
• AND SCHOOL.
• AROGYMITRA TRAINING
• YOUTH CAPABILITY BUILDING.

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HOMOEOPATHY IN ALL THIS

• HOMOEOPATHY IS A HOLISTIC SYSTEM WHICH IS
• CURATIVE
• PREVENTIVE
• PROMOTIVE

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HOMOEOPATHY IS

• ECO-FRIENDLY
• USES THE MINIMUM FORCE
• HAS A LARGE EFFECT
• CAUSES THE LEAST DISTURBANCE (SIDE EFFECTS)
• RELIES ON REGENERATION OF INNER POTENTIAL OF THE
  LIVING BEING
• SUSTAINS ON A LONG-TERM BASIS
• IS THE MOST COST-EFFECTIVE

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WE THUS VIEW HOMOEOPATHY

• AS AN
• ECO-FRIENDLY
• HEALTH CARE KNOWLEDGE-BASED SYSTEM
• IN TUNE WITH THE
• DEMANDS OF THE TIMES

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WE WOULD LIKE TO SEE HOMOEOPATHY .

• NOT AS A FANTASY BUT AS SOUND AND SOLID
  EVIDENCE-BASED MEDICINE
• NOT AS MAGICAL HIT BUT AS A SCIENTIFIC SYSTEM
  WHICH CAN BE TAUGHT AND LEARNT AT THE BEDSIDE
• NOT AS AN ALTERNATIVEBUT AS MAINSTREAM THE
  ONLY SUSTAINABLE ECO-FRIENDLY HEALTH CARE SYSTEM
  FOR THIS PART OF THE WORLD

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WHAT DIRECTION WOULD WE NOW LIKE TO TAKE?...

• WE ARE NOW PREPARED TO
• TEACH STANDARDIZED HOMOEOPATHY TO THE
  UNDERGRADUATE FROM THE BASE
• REACH HOMOEOPATHY TO THE WIDER COMMUNITY THROUGH
  THE PUBLIC HEALTH SYSTEM

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WHAT DIRECTION WOULD WE NOW LIKE TO TAKE?...

• EXPLORE THE BENEFIT OF HOMOEOPATHY IN ANIMALS AND
  PLANTS
• INTEGRATE POSITIVE HEALTH WITH SUSTAINABLE
  COMMUNITY DEVELOPMENT
• EVOLVE A MODEL OF COMMUNITY CARE WHICH CAN BE
  REPLICATED ALL OVER THE THIRD WORLD

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HOMOEOPATHY IN VETERNARY PRACTICE Treatment of
poultry chickens, bull etc.
CALLED UPON TO TREAT CHICKS IN THE POULTRY
FARM. c/o CHICKS DYING EVERY ONE HOUR EACH CHICK
KEEPS PASSING FROTHY STICKY STOOLS AND THEN GETS
EXHAUSTED DIES THIS HAS BEEN HAPPENING SINCE
3-4 DAYS NO EFFECT OF THE ALLOPATHIC
MEDICINES. CAN WE DO SOMETHING??
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PHYSICIAN DECIDED TO OBSERVE THE CHICKS WE FOUND
THAT THE CHICKS WERE ACTUALLY DYING IN FRONT OF
OUR EYES WHAT SYSTEM HAS BEEN AFFECTED PROBABLY
THE G.I.T WITH A DIARRHOEA WHICH HAS A RAPID
PACE THE CHICKS WERE ALSO DRINKING WATER OFTEN
FROM THE POT THE ENTIRE AREA WAS GIVING OUT A
BAD OFFENSIVE ODOUR THE STOOLS SEEM TO BE LEAKING
OUT OF THE RECTUM
ARSENIC.ALBUM V/S PHOSPHOROUS
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BASICALLY AN IRRITABLE SENSITIVE BULL WAS MORE
IRRITABLE SINCE SOME DAYS. CHIEF COMPLAINT
BELCHING LOUDLY SO LOUD THAT ONE
COULD HEAR IT FROM FAR
ASOEFITIDA
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WHAT IS ACTION RESEARCH

• IT IS A DISCIPLINED INQUIRY (RESEARCH) WHICH
  SEEKS FOCUSSED EFFORTS TO IMPROVE THE QUALITY OF
  PEOPLES ORANIZATIONAL, COMMUNITY AND FAMILY LIVES

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ACTION RESEARCH PROCESS

• LOOK
• DATA GATHERING
• DESCRIBE AND DEFINE
• THINK
• EXPLORE AND ANALYSE
• THEORIZE
• ACT
• PLAN
• IMPLEMENT
• EVALUATE

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ACTION RESEARCH IS

• REFLECTIVE
• PARTICIPATIVE
• HAS A PRACTICAL OUTCOME
• ACTION-CONTINUED
• COMMUNITY BASED

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CASE STUDY-1 DRINKING WATER
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NECK BACK ACHES

• Mobile visit to a village in summer
• Women with backaches, neck pain
• Acute, Phase Chronic Treatment failed to
  relieve completely
• Relapses frequent

• Physician Searches For
  Maintaining Cause
• Starts inquiry into life of the
  women

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DATA COLLECTION ACTION

• Fetching drinking water for 2-3 Km at 2-3 am
  daily
• Village well dry and the watering hole dries in
  the early morning
• Village meeting
• Govt. Well sanctioned but not dug

• Status reviewed and letter signed by all the
  villagers
• sent off to sarpanch
• Nothing happened for three months
• MLDT as a
• Facilitator

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FACILITATION

• Another Village meeting
• BDO approached through another letter stating the
  involvement of the MLDT as a local NGO
• Villagers morcha and the letter submitted

• BDO cooperated
• Survey carried at the time of the Physician team
• Another hitchsanctioned amount insufficient
• Emergency village meeting

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A MASTER STROKE

• SKILFULL FACILITATION WHICH PUT FORWARD THE
  POSSIBILITY.AND
• VILLAGERS AGREED TO DO SHRAMDAAN
• PROBLEM OF LOW BUDGET ALLOCATION RESOLVED
• FIRST INTERVENTION OF THE MLDT IN COMMUNITY
  DEVELOPMENT

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SHRAM-DAAN
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SHRAM-DAAN
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MOTIVATED EMPOWERED VILLAGERS
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AT PRESENT

• WELL WITH WATER THROUGHOUT THE YEAR
• NO BACKACHES
• VILLAGERS FULL OF CONFIDENCE IN THEMSELVES AND
• EAGER FOR FRESH INITIATIVES

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WATER IN SUMMER
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SOME REALITIES
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THE LEARNING

• Homoeopathy-a holistic approach
• Not only a healthy mind in a health body, But
• A healthy individual in a healthy community AND
• A healthy community in a healthy environment
• HOMOEOPATHY AS AN ECO-FRIENDLY SYSTEM
• and
• COMMUNITY DEVELOPMENT WITH HOMOEOPATHY AS A PIVOT
  
• ROAD TO POSITIVE HEALTH

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Tamsoma jyothirgamaya Asotoma sadgamaya Mrutyorm
a Amrutamgamaya OM SHANTI SHANTI SHANTI !
Thank you