Report of Sahabhag 2.0

Report of Sahabhag 2.0 (Social Responsibility Cell of CM Office) Medical Camp in Tribal area of Palghar on Friday June 21, 2019 – International Yoga day with MOGS / IAP Thane - Palghar

Objectives –Screening High Risk Mothers / Children – Capacity building of Local Medicals / Paramedicals – Increasing patient awareness

Total of 21 PHC centers were covered with 36 attending Doctors. 20 Ob/Gyn and 16 Pediatricians (IAP) attended the camp. There were 16 cars simulataneously going from Mumbai to Palghar district. Ante natal patients were examined and screened mainly for anemia / preeclampsia and pediatric patients were screened mainly for malnutrition.

The camp started with sumptuous breakfast at President Dr Jaydeep Tank’s house at 7 am followed by another at Shree Dutt’s restaurant on the way. After this, all cars with Medical personnel departed for their respective PHC.

At PHCs, all Antenatal patients were screened with detail history taking, Blood investigations along with clinical examinations.

History taking revealed most of the patients were having regular 3 meals in a day but intake of milk / milk products was lacking due to paucity. Aanganwadi / State health schemes were providing them with nutritional dietary supplements and protein powder. Despite provision of medical supplements we noticed that there was some social hurdle that prevented rural females to consume those that on regular basis.Another important observation was there is a distinguished lack of ultrasound services in these areas even for high risk pregnancies.There were quite a few unmarried pregnant females around 18 years of age. It appeared to be trend in tribal area of live in relationship and to have children.

Clinical examination – Weight / Height / TPR / BP / pallor / edema feet were checked and record was kept on Antenatal card given to them. Regular Obstetrical Examination and FHR were checked with Fetal Doppler/stethoscopes. Referral consultation with other specialty branches like dermatologist / physician / surgeon if required was brought to notice of respective PHC in charge. High risk patients were referred to higher centers. Breast examination was done at First ANC visit by para medicals.

Contraception: Gravida third and more were counselled for Contraception. Barrier contraception condom) was available. IUD insertion was being done and Tubal sterilization / Vasectomy was performed by qualified personnel once a month or depending upon demand under LA after required pre-operative investigations.

Investigations done like CBC, HIV, HbsAg, Blood Group, RFT, LFT & TFT were checked and extra investigations that were required were asked for in Consultations with Chief Medical Officer of respective PHCs. Patients with Hb less than 9 gm % were given Iron Sucrose injections and record was kept and repeat Hb was done after 2 – 3 weeks.

USG was done two times during pregnancy depending upon availability. In few centers, USG facilities were not provided. Most of the patients had reports of USG from Private practitioner.

2 doses of Inj TT 4 weeks apart was given to all patients. There was a short supply of TT currently due to change in the protocol and upgradation to usage of DPT instead of TT. All patients were provided with Iron / Calcium / FA tablets/protein powder. All of them were counselled for warning signs / signs of labor and were provided with information about reaching Health Care center in time. All patients were given health awareness talks on topics like Diet and nutrition, Contraception counseling, Menstrual Hygiene.

This was followed by an interactive session with all paramedical / ANMs / ASHAs and PHC Medical Officer to solve queries and difficulties. The issues mostly included topics like Post partum hemorrhage, Partograph, Retained placenta.Various ground level issues / areas needing attention were identified and resolved.

Total of 1548 ANC patients were screened.Out of which, 440 were found to be of high risk category .Total of 213 patients were referred to higher centers for further management. That included Breech, BOH, previous C section,Posdatism , IUGR, Oligohydramnios, GDM,  and in labor. PNC patients were examined and given BF / contraceptive advice.

Total of 1089 pediatric patients were screened for malnutrition by IAP members. All malnourished children were diagnosed / mothers were counselled and 58 were refereed to higher centers for further management.

After good lunch, all of us departed from respective PHCs.

We would like Thank Organizers, President MOGS Dr Jaydeep Tank, Secretary MOGS Dr Niranjan Chavan and Ms Priyanka Shah - Consultant with CMs office for giving all of us an opportunity to work in Palghar Tribal area and give some positive and helpful guidance to improve health indicators. We would also like to thank IAP (Indian Association of Pediatrics) – Thane / Palghar for joining with us in this program.

Master Chart of Individual PHC attached.

Dr Bhumika Kotecha Mundhe