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Sent in April 2009

Official Annual Letter-2008

Dear Folks: This letter was to reach you well before January- but he spirit was willing but the flesh was weak and distractions of the holiday Season took precedence. We did not communicate at Thanksgiving as India was mourning a dastardly attack on innocent citizens of Mumbai. The effects of global recession and loss of jobs, has definitely slowed economic growth. Some industries have accepted China's strategy and even though less than buoyant, but fervently hope that massive investment at this juncture will yield impressive results in 15 to 20 years. Indian banks are still resilient, with the National Agriculture Bank for Rural Development (NABARD) continuing support for rural development and an optimistic forecast for the next 15 to 20 years. NABARD is enticing investors with 12% interest on their deposits and bonds.

Ω According to the ‘succession plan’ and the actions of the Executive Committee and Board of Managers in (2007), a new position of Advisor to the Director from April 1, 2008 was sanctioned. This letter will only briefly summarize important events and for details kindly refer to the Annual Report (April1, 2007 to March 31, 2008). .

Ω The first major change was at the helm of NIRPHAD with Dr. Sanjay Nanda taking over as Director from April1, 2008 and Mr. Banwari Lall as the new Coordinator and Finance officer, as Mr. Murli Agarwal retired after 28 years of exemplary service. The office of the Finance Officer cum Coordinator moved to Chattikara Growth Centre. The HQs of NIRPHAD continues at 14, Boulevard Road, in order to fulfill the requirements of FCRA (in order to receive grants from foreign agencies)

1. NIRPHAD community health programmes had to gear its implementation strategies to new donor policies and un-met needs. 1.1. The Eye Care Services had to make the most radical paradigm shift, with CBM budgets

slashed on all recurring expenditures-which also included salaries. CBM further requested to save 25% from the 2009 budget for 2010. NIRPHAD will now have to find new resources.

1.2. However, CBM continues to financially support capital expenditure. CBM granted funds for a new surgical block at the Bajna Growth Centre, which is estimated to cost Rs.12, 00, 000 (at the present fluctuating dollar exchange rate, it will be about $26,666.). CBM also donated equipment and NIRPHAD paid for furniture and will under write maintenance expenditure.

1.3. This is the first step for graded sustainability.

Ω Evaluation Report of Dr. Sara Varghese and Vikas Katoch of CBM clarified new policies CBM and the need to move into more community-based activities for physically and mentally challenged.

z 00

From Office of the Director

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2. Self help groups: supported by HCDI/KNH and NABARD This group exhibited all the dynamism of emerging SHGs and empowerment of women, who could be a power house in the target villages. Achievements to develop traditional cottage industries, was considered insignificant and ordinary. A unique programme was developed in order to experiment with SHG members’ talents and give them an opportunity to grow to their full potential. The women excelled themselves in becoming stake holders-by owning and managing a tube well, pre-school projects and enthusiastically share responsibilities in the solar programme-the latter being one of its kind in the region. (yet to be funded)

Ω Holistic Child Development India (HCDI funded by KNH) recognized the efforts of NIRPHAD SHGs and commissioned Manageress Ms.Neel Prabha to share NIRPHAD’s experience and help the SHGs (Lutheran Church Project) in Andaman Islands, for a month. This is a commendable example of sharing. A Follow up and future of Ms. Neel Prabha’s input will indicate the impact of this endeavour as a stepping stone for future expansion and scaling up.

3. MCH Services (including FW): The UN Millennium Development Goals has developed bench marks for all developing agencies to reduce infant, child and maternal mortality. Increasing institutional deliveries provides the mother and infant the required ANC-natal-PNC and more importantly adequate new born care (NBC) to the infant. This head-start will go a long way in reducing infant morbidity/mortality and contribute to better child survival.

Ω ‘jinani soubhagwati suraksha’ (as mentioned in NRHS) programme (protection for the pregnant)- financed by the State Government has increased by more than 100% institutional deliveries at the Chattikara MCH Centre, because of the incentives the mother received. The role of traditional TBAs, ANMs and Accredited Social Health Activists (ASHA) volunteers has been crucial in the positive out comes of this programme.

3.1. Agra Urban Health Programme: Has completed two years under the USAID Environmental Health (EHP) Project. 18 slums in Agra City with the poorest health parameters were chosen, as one of the four experimental programmes by USAID. The other three chosen were in Kanpur City, near Calcutta and Indore. Since there is close cooperation with the Health Department of Government of U.P, it is expected that in due time the Project will contribute to the overall efforts of all Government health agencies, thereby strengthening the concept of Private, People’s Participation. The role of the Project Coordinator (Sarfaraj) has been commendable and was recognized by USAID. He was ably supported by Dr. Mrs Sharma, ANMs, link workers, ASHA volunteers and dais (TBAs). It was expected that financial support from the large industries would be galvanized and forthcoming-but resources, to develop a very innovative and aggressive campaign by dedicated full time staff was lacking, in order to produce positive results. More recently EHP-USAID has started negotiations with NIRPHAD for possible expansion and scaling up by implementing a MCH programme in another 18 slums.. This programme culminated Sept. 30, 2009

3.2. Agra Rural Family Welfare and community Health Project (entitled-Innovative approach to implement RCH Programme in three blocks). This Project has completed its tenure of two years, under a contract with the State Innovations for Family Planning Strategies (SIFPSA) and funded by USAID. NIRPHAD implemented SIFPSA activities for the last ten years in Mathura, Aligarh and Agra Districts. A PP review of the experiences was presented to USAID and SIFPSA enitled:challenges and lessons learnt.

Ω The power point presentation to SIFPSA and USIAD spanned the years 1978 to 2008, which included the establishment of the Methodist Hospital in Mathura City and develop a sustainable health

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infrastructure for the District (see also items 2). It is hoped that the challenges and experience will lay the foundation of good governance and quality, affordable health care, with equity of all resources and establishment of human rights to build a just society. There is little evidence that at the present time the State Government will completely take over and integrate the rural or the Urban (slum) programmes.

3.3. National Rural Health Mission is being implemented in five Districts of U.P. Agra District is included and four others which have inferior health parameters than Mathura District. SIFPSA is overseeing the implementation of the programme through NGOs which have community health programmes, mobile health units and curative referral facilities. Implementing NGO is required to deposit a security of Rs 15 lakhs. As a policy NIRPHAD does not subscribe to a security deposit, as grants are negotiated on the basis of mutual trust, whether with national or international (multi-national) agencies. Participative evaluations, which included monitoring by a time tested MIES, mid-term evaluations, mid-course corrections and final evaluations and a follow up have enabled NIRPHAD to not only provide acceptable norms of accountability, but innovative cost-effectiveness. Sustainability was emphasized from the planning stage of all programmes with peoples participation so that all activities reach deep into the soil of the community.

4. January 2008. Swarn Jayanti Samudiak Hospital (SJSH) completed 8 years since its inception under management of NIRPHAD. A tender was advertised for a new contract and NIRPHAD made a bid based on the previous format crafted by Dr. Pradeep Henry. How ever major modifications were necessary in the new format. Dr. Nanda and Mr. B. Lall were able to negotiate a new deal with the Mathura Oil Refinery (MOR)/Indian Oil Corporation Management. The discussions were difficult to say the least and the input for deciding the final Agreement needed a critical assessment from Mr. Chet Singh, a financial expert and member of the BOM. The recurring budget was increased by 30%, even though with the present upward spiraling of prices and the cost of living index-a 40% increase was a preferred target .

4.1. Mr. Kishen Mahajan ( a senior advocate of the Supreme Court and amicus curiae), Chair of the Monitoring Committee set up by the Hon. Supreme Court of India was chiefly instrumental in getting the approval of the Hon. Supreme Court of India, which oversees legal instruments pertaining to SJSH. Mr. Lee Bee Sen (GMHRD) on behalf of MOR/IOCL agreed to a new five year contract with a recurring budget of Rs13 crores (13,00,000,000/45=$ 28,888,889) for five years and a revised budget and Rs.50 lakhs – 50,00,000/45=$1,11,111 (for replacing obsolete equipment and general maintenance), which is still to be finalized.

4.2 SJSH Administration will now be able to attract better trained and committed doctors as some of the previous staff left for greener pastures.

4.3 Staff contracts are being revised and making them more equitable.

4.4 There was concern that some clinical departments had a steep fall in OPD and IPD patient statistics-except orthopaedics and paediatrics.

4.5. A technical evaluation of all the departments is long over due. This is more urgent of the leadership in the Nursing Department.

4.6. Accumulated evidence for the last few years showed that some corrupt practices needed to be addressed to, even in giving contracts to the medical shop. The staff is now involved, as one man, to decrease any irregularities. Institutionalized corruption is so in-grained in the psyche (has become a bane) of U.P. that it is accepted, as part of the norms of every day life. To change this mind set with a

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new paradigm shift will be a colossal challenge for NIRPHAD as it involves behavioral practises. The staff will have to be motivated and accept that any unconstitutional act is a crime and it is necessary to stand up to high principles and be counted.

5. NIRPHAD has been invited to the World Bank ‘Compliance Advisory Ombudsman’ (CAO) work shop and the whole issue of accountability and corruption will be discussed.

Ω NIRPHAD has moved the High Court of Delhi for non-receipt of Rs. 28 lakhs

(28, 00, 000/45=$62,222) from the Department of Health and Family Welfare of U.P.,

Ω This will be a test case, as in 2005 NIRPHAD presented to the USAID corrupt practices related to USAID (VOP I and II) funds. The core issue being, inability of the Department of F.P. Ministry of Health, of the state of U.P., to release Rs. 28 lakhs, after NIRPHAD had received about Rs.57 Lakhs

($12,667) from the Central Government

6. ‘Solar without Boundaries’ (SWB), an NGO from Belgium coordinated with NIRPHAD to implement a solar irrigation scheme. After an assessment of three villages Nagla Brahman was chosen. Bert Bernolet of Solar then applied to Ex-Change (an agency which supports scientific surveys) to defray his expenses in completing the Survey. Bert completed the Survey with NIRPHAD staff (Ramesh Saraswat-Agriculture Officer) and Dubey of AFPRO unit V (located in Gwalior) who made a study of the ‘ground water resources’. Tata Bp (Sanjay Dhar) provided the estimates for the solar PV panels and Intergogrow (Sunil Bhat) provided the estimates and details for the generator and electrical installations. For installing solar panels for a 20 acre farm, the cost estimate is about 46 lakhs (46,00,000/45=$104222) NIRPHAD has applied to NABARD for a grant of about Rs.30 lakhs(30,00,000/45=$66,667) which is being negotiated. SWB expects an initial grant of € 2700 (if a grant of € 15,000 is provided from other sources) . With the world wide economic melt down whether NIRPHAD and SWB can garner sufficient funds will be the acid test and bell weather for the other nine projects , which are expected to be implemented. Feasibility has shown that the impact can relieve poverty but the long term sustenance entirely depends on total participation of the pani panchayat (water committee) and excellent management. If the Project succeeds it will be a unique innovation and one of its kind in the region. ( yet to be funded)

7. Training: An old adage states that ‘a programme is as good as its training component’.

NIRPHAD realized (and consistently believes) that in a remote rural, backward area training local staff was the only, one and only, solution to overcome the paucity of trained personnel. Local staff development is one of the best components of training local talent, who have a greater chance to remain within their community and contribute to the overall development of the area to implement human rights (in all its varied forms); social justice to elevate and prepare the community to participate in sustainable development and to be part of general development of the area..

Material for innovation at the grass root level was readily available when the target groups fully participated. As an example the local farmers could indicate to hydrologists of Council for Advancement of People’s Action and Rural Technology (CAPART), that there was no need to change the location of the tube wells, which was apparently in one straight line as the levels of the water table was at different depths. If the level of water table for all the five tube wells was at the same depth, there was the imminent danger of one tube well draining water from the other and thus drying up the sources of the adjacent tube wells.

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Training of local staff was essentially relevant to the local needs of the programmes.

Training activities not only included specific technical details, but techniques of ‘teaching and learning’, communications skills, developing indigenous teaching material and impact of behavioural changes. NIRPHAD was in the forefront of translating five texts for WHO, (into Hindi) and had the financial support of Ford (who also provided for translation ‘ village lady social worker'); Canadian Public Health Association and Canadian Organization for Developing Education. During training the participants drew pictures of their tasks (cover page of ‘village lady social worker’), organized by Gerard Hatueker-a Belgian journalist, who had learned Hindi at the Banaras Hindu University.

NIRPHAD took advantage of the training programmes conducted by HCDI, CBM, USAID, VHAI, ISI and other development organizations. All the senior staff attended workshops in Europe, Africa, Far East and North America, which opened avenues for broadening their knowledge base.

Exposure training programmes to University students (from Denmark, USA, Africa, S. America and Canada (Laval University) has enabled a Continuing Medical Education Programme to be evolved and it is expected that an exchange programme will evolve with the latter.

8. Curamericas: In the year 2007, Dr. E. B. Sundaram and Mrs. S. Sundaram were invited to address the Board of Curamericas in Raleigh, N.C., The trip from Florida to Raleigh was arranged by our good friend Henry Perry. A PP presentation gave an over view of the present status, future possibilities of cooperation between Curamericas and NIRPHAD. By 2008 this arrangement was completed and it is hoped that a proposal to implement a child survival Project, using the ‘census-based impact oriented-methodology’ will be used and presented to the USAID for funding. The winning proposal will involve a strong component of operation research (OR). (USAID did bit fund trhis proposal, but Curamericas has agreed for NIRHAD to be its country partner

9. New web site and preparation of Brochure The current website and brochure which was published in 1985 has outlived its usefulness as the current activities have given a new character and colour to NIRPHAD, with new challenges to meet unmet needs. Costs of the web was undertaken by Dr. Deepak Malhotra, of Spokane, Washington.

It is hoped that the new web site, after it is posted, the same material can be used to prepare and publish a brochure. It is expected that the brochure will be presented to the BOM/Society at its Annual Meeting in March 2009

10. Annual Report: 2008 (April 1, 2008- March 31,2009):

NIRPHAD embarked on a training programme for senior staff, in-charge of a department or section ‘on how to write a report?’ It was stressed that the Annual report is the mirror, which reflects the activities of an institution. An important tool to assess the quality and quantity of the services provided-a lasting image to the donors, evaluators, more importantly to the community. Annual Reports and evaluations are preserved in the archives of the US Library of Congress. Three texts and two evaluations have been acquired by the Library and more acquisitions are being negotiated. These documents are important sources for the staff, students of health development, research scholars and for posterity. Annual reports are also required by the Government to fulfill FCRA requirements. From this year it is proposed to select the best clinical and non-clinical reports for recognition by the BOARD of Mangers and Society. The criteria for selection are as follows: (While the majority of the writers are passionate about their work-editors should understand that they are ‘sensitive souls-many times intelligent and hard working but easily bruised’).

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o How have the writers shaped the words into luminous sentences? o The sentences into exquisite crafted paragraphs, and o Weave the paragraphs into a near perfect Report?’(Adapted from the Essay by Michael

Kinsley. Time April 21, 2008. p52) o Have addressed to the unmet issues of the community? o Have presented a balanced report to advance the objectives of the Department and the

Institution in general. o How important is parts of the Report to reflect a strong purpose, punch and pizzazz?

The winners will be announced at the Annual BOM/Society meeting.

11. Message: If we look back and walk down memory lane it will be evident that the outstanding services of the founder of Dr. Gerwood laid the foundation Creighton-Freeman Christian Hospital in Vrindaban, U.P (over 100 years ago) and NIRPHAD is the offshoot of many incomparable missionaries like Dr. and Mrs. Charles Perril. One of their successors was Dr. Nallathambi, who is still remembered. With this pre-eminent foundation, if NIRPHAD can continue its services to the poor and needy it will go down in history as an icon of health care and development, which many NGOs would like to emulate. This Report will be my last Director, as next year (April 1, 2008- March 31, 2009) the new Director, Dr. Nanda will be responsible for writing this Report. It is my sincere hope that the objectives of NIRPHAD will be carried forward by the new team with zeal, verve and vigour. NIRPHAD was born and continues to be supported by many well wishers and donors by their very sacrificial giving. These agencies with members of the BOM have guided NIRPHAD through many a storm and in dire circumstances have stood by NIRPHAD staff. The faith of NIRPHAD supporters in the leadership of NIRPHAD has never faltered or failed and the Staff of NIRPHAD were never let down. This support has been the one source of success, sustainability and growth of NIRPHAD. Finally, I will be failing in my duty if I do not extend my sincere gratitude to all the staff, Board and Society members, donor agencies and consultants, who many times have worked unfailingly, beyond the call of duty, to fulfill their obligations-to all of them- too many to mention individually, my hearty thanks.

Ω Through the years God has richly blessed NIRPHAD and as we count our many blessings, it is realized that from a small unknown organization, with a start up budget of Rs 85,000 ($2833-at the present rate the dollar is equal to about Rs.45)-and a caveat from Bread for the World that NIRPHAD is likely to fail due inexperience. Today the budget of NIRPHAD is around Rs. 3 crores= 300,00,000/45 dollars= $666,667. In 1979 four staff sat under (today the staff component is over 325) a tree in Bajna village and wondered where and how to start the programme and realized that they were short of experience and expertise-but over enthusiastic with a burning fire and a will to learn and use failures as stepping stones. How ever the pioneers were committed in their vision and mission and with a prayer and a song, many times had to shed blood, sweat and tears. In its chequered career we were crushed but fought back and never accepted defeat.

God in His infinite grace and mercy has brought us to this day and promises to hold our hand in the future and lead us. Wishing all of you a challenging and meaningful, Year,-2009. The sky is the limit and there are many horizons to cross. Respectfully submitted,

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E. B. Sundaram, FRCSC., Director (1978-March 31, 2008) Advisor to the Director, from April 1, 2008

1.klassen(KNH), Rajkumar (HCDI) 2.Sheila, EBS, Dir.KNH E.B.S., Muggenberg , Sara, Sylvana, Chapparia, Nanda, .Lall

1 .Klassen and Rajkumar visiting field (ex.L). 2. Celebrating 10th Anniversary of (L) HCDI

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2 From the Director’s Desk Dr. S.E. Nanda, DCH etc Rubric “It is better to light a Candle than to curse the darkness” It gives me immense pleasure to present annual report of NIRPHAD for 2008-2009, to BOM. NIRPHAD is highly obliged, thankful and indebted to the community for showing their trust and faith in NIRPHAD through their participation and practical suggestions which had the bearing of the aspirations of the grass roots. We are also thankful to our donor agencies for their continuous support through their grants, advise, technical support and showing their faith in our capabilities and efficiency which enabled us to reach and serve the needy and underserved peoples. In 2008, some land mark achievements and decision were taken. In October, 2008 after evaluating the performance for last 10 years, Supreme Court recommended that NIRPHAD should continue to be the Manager of SJSH. A new contract was signed between IOCL/MOR and NIRPHAD for another 5 years i.e till 2013. Dr. Perry International Consultant arranged International exposure for me at Washington DC: Annual meeting of Christian Conventions for Global Health, Buckeys town, Annual meeting of the Global Health Council in Washington and Technical update meeting on Child Survival held by US Agency for International Development (May 2008). Funded by D. Cherian of the Board of Global Ministries. With the help of Dr. Henry I had visited ‘Building Resources Across Communities (formerly Bangladesh Rural Advancement Committee) BRAC, Bangladesh to get practical and first hand experience regarding the working and management of BRAC, which is the largest NGO in the World (September, 2008) MCH Centre Chhatikara was chosen as a service centre for (Janani Saubhagwati Suraksha Yojna) Govt. scheme for reducing infant and Maternal mortality by promoting institutional deliveries, under which 224 deliveries were conducted since July,2008 to March,2009 (9) months. CBM continued their support to the eye hospital base and field services at Chhatikara and Bajna Growth Centres. Total no. of eye operations in the last year= 3678

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Surgeries conducted in last three years

2190

3835 3678

0500

10001500200025003000350040004500

2006-2007 2007-2008 2008-2009

At Bajna Growth Centre a new block along with Operation Theater is complete and functional; NIRPHAD would like to take this opportunity for inviting Dr. Sara Varghese, Consultant CBM and her team for inauguration of this new block. HCDI through their donation from KNH continued to support NIRPHAD in implementing CFCD (Child Focused Community Development) programmes in 4 villages of Chhatikara. Miss Neelprabha, CFCDP Project in charge was invited as a consultant by HCDI for capacity building of SHG’s working in Andaman. SAIL project completed its tenure in July, 2009. However a new proposal for the donations of ambulances is in process. The SIFPSA project in 3 blocks of Agra came to an end on 31st October,2008. The UHRC project in 18 slum of Agra also completed its tenure in September, 2009. Some Achievement of UHRC NIRPHAD Project

May 2005 (Project started) September 2009 Institutional deliveries 22% 65% Immunization (0-1 yr) 22% 67% There are some new projects on which we are working upon at present.

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1. CBR (Child Based Rehabilitation) with CBM 2. CFCDP II.

NIRPHAD continued to be a part in dissemination of knowledge and experience not only by training Health Development trainees at National Level but also at International level. This year the 3rd batch of Laval medical students from Canada and postgraduate students from Emory university in United states were given multi-disciplinary training. . A three member team Mrs. Teresa wolf (Director), Mr. Ira Stolak Senior Program Specialist and Ms. Emily Dale, Programme Specialist of Curamericas (U.S.based NGO) visited NIRPHAD in January,2009 to prepare a proposal for a grant under Child Survival to be submitted for USAID. During their stay they made an in depth study of the different programs and the functioning of NIRPHAD. Unfortunately there was a mass tragedy in which Pilgrims and Sadhus (saints) were injured due to roof collapsing in a temple. They were brought to SJSH and our staff rose to the occasion by delivering needed services in time, not only free medical care but also took care of other requirements like food, transport etc. We are also thankful for our local donors from the community who came forward to participate in the services given by NIRPHAD. Thanks to the Board Members and Members on different committees for their support, advice and active participation I would also like to convey my appreciation and good wishes to all the staff of NIRPHAD for their dedication, hard work and integrity towards their organization. I will like to humbly submit myself and my organization to God for guiding us in difficult times and also giving us opportunities to be the torch bearers of his good work and messengers of change. “Trust in the Lord with all your heart, and lean not on your own understanding. In all your ways acknowledge him, And He shall direct your paths.” Proverbs 3 – verses 5-6 “God Bless” Dr. Sanjay Nanda Director, NIRPHAD & SJSH

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3.Administration

ASST. ADMINISTRATOR

ANIKET DUTTA, BBM, MHC AND HM.,

JOINING DATE: 13TH. DEC. 2003

Rubric: “Don’t wait until everything is just right. It will never be perfect. There will always

be challenges, obstacles and less than perfect conditions. Get started now. With each step

you take, you will grow stronger and stronger, more and more skilled, more and more self-

confident and more and more successful.”

Mark Victor Hansen

1, Achievements for the year 2008-2009:-

SUB-MERSIBLE PUMP :- WORK HAS BEEN COMPLETED SUCCESSFULLY AND PRESENTLY PUMP

WORKING SATISFACTORILY.

CENTRAL A/C:- FOUR COMPRESSORS HAD BEEN INSTALLED AND ARE WORKING PRESENTLY.

HOSPITAL REGISTRATION: -SJSH REGISTRATION WAS RENEWED . THE NEW REG. NO. IS A-178.

RENEWAL OF CONTRACT:- ANOTHER REMARKABLE ACHIVEMENT OF 08-09 IS THE

RENEWAL OF NIRPHAD CONTRACT FOR MANAGING SJSH FOR THE NEXT FIVE YEARS.

1.5. TWENTY TWO SADHU BABA (PILGRIMS) :- 22 SADHU BABA PILGRIMS WERE ADMITTED

IN SWARN JAYANTI HOSPITAL ON 6TH DECEMBER, 2008 AS THEY WERE INJURED WHEN A

ROOF COLLAPSED..

2. ON-GOING COURT CASES-

S.No. Name of the court Name of parties

involved

Action to be taken

1. National

Consumer Forum

1) D. Chauhan

2) SJSH,

3) Dr.Amaresh

Asthana,

Final hearing ispending

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(Treating

Physician)

4) Dr.M.K.Tandon,

(Treating

Surgeon)

2. Civil court,

Mathura

SJSH Vs SJSH

Karmachari Sangh

Last hearing was

on May 08 and

next hearing is

on 7th July, 2009

3. High Court

Allahabad

Dr. Brijesh Sharma

Vs SJSH

WS was submitted

against Dr. Brijesh

Sharma’s Rit, (appeal)

Next date of

hearing is

on……

4. Civil Court Junior

Division Mathura

Mr. Nadeem Sidaqi

Vs SJSH

Ws was submitted on

28th May, 2009

Next hearing is

on 2nd July,

2009, the

5. Civil Court Junior

Division Mathura

Mr. Ravindra

Kumar Vs SJSH

Ws was submitted on

28th May, 2009

Next hearing is

on 2nd July, 2009

1. 27 fire extinguishers are fully operational and presently all are in working

condition.

2. Renewal of AMC – the following AMCs have been renewed:-

M/s Logotech – Fully for semi-analyzer , M/s Kone Elevator-Lift

M/s Instromedix – Falcon anesthesia machine,M/s Wipro GE – Stenoscope,

X-ray machine and M/s UTS - Generator

3. Contract for disposal of bio-medical waste has also been renewed for the

financial year 2008-2009.

4. ROAD CARPETING OF SJSH RESIDENTIAL AREA COMPLETED.

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5. OVERVIEW - ROLE OF HOSPITAL ADMINISTRATOR

FUNCTIONS AS AN ASST. ADMINISTRATOR ARE AS FOLLOWS:-

• Maintaining functional communication with all the departments by effective decision

making.

• Sorting out the problems (trouble shooting) of the employees and solving them by

conducting monthly meetings or one on one or in small groups.

• To hold monthly meetings with pradhans and P.R.O for listening to community’s

expectations.

• Overall monitoring of the whole Hospital and the premises by conducting daily

rounds.

• To interact with IOCL officials and their queries. regarding administration and

financial issues.

• To organize training programs for the staff to enhance their efficiency.

• Nursing Superintendent arranges C.M.E classes for the nurses, one day in a week.

9. CHALLENGES AND ISSUES:-

• No maintenance of hospital building as well as residential flats including nursing

hostel since 9 years. Proposal of whitewashing already submitted to MOR. However,

maintenance schedule started in late July 2009.

• All the departments need to be computerized.

• The salary of the Asst Administrator is too low as compared to the market rate

and with the job responsibilities.

• Unnecessary involvement of P.R.O in administration as it hampers

administrator’s decisions.

10, CONCLUSION

In conclusion I would like to state that SJS Hospital would not been able to achieve its goals

without the excellent performance of all staff and cooperation from IOCL. If this type of

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performance, continues then in upcoming years SJSH will definitely touch the milestone of

excellence.

PERFORMANCE DURING FINANCIAL YEAR 2008- 09

Statistical review at a glance

Financial Year

2007-2008

Financial Year

2008-2009

Increase / Decrease

from last year

OPD Patients 48688 50980 2292

IPD Patients 2964 3274 310

Total no. of X-rays

9105 10880 1775

Laboratory no. of tests 9471 8935

536

Physiotherapy no. of patients 3934 4262 328

Total No. of operations( minor) 1866 2166 300

Total No. of operations (Major) 445 423 22

Ultrasound

221 61 160

Total no. of trauma cases 479

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4. Report of the Headquarters (NIRPHAD) –Delhi Name : Mr. B.LAL

Designation : Monitoring Officer Coordinator cum Finance officer (since Nov.2009) Experience : Employed with NIRPHAD since 1979 4.1 NIRPHAD with its Headquarters in Delhi is a unique Organization with its special focus on “Health and Development”. NIRPHAD has come a long way in completing twenty nine eventful years in the service of people, particularly the poor, disadvantaged, marginalized women and children.

4.2 As mentioned above the entry point was health care services and gradually expanded to other areas of unmet needs such as agriculture, irrigation, artisan crafts, water harvesting, various activities associated with income generation, social action to empower the powerless and in the process NIRPHAD evolved certain structures and established policies for the smooth functioning and efficient delivery of different programmes. 4.3 Prominent among these in addition to CBO’s, are: NIRPHAD Growth Centre at Bajna & Eye Hospital; NIRPHAD Growth Centre Chattikara with Eye Hospital, MCH and Poverty Alleviation Programmes. NIRPHAD Urban Health Project (slum) Agra, NIRPHAD SIFPSA (rural Agra) Programme, SAIL (Steel Authority India Limited) and Swarn Jayanti Samudaik Hospital, Mathura are specialized units.. All the above structures are at different locations with a certain level of functional autonomy in day-to-day activities

4.4 At the NIRPHAD’s Headquarters, the Advisor to Director, Dr. E.B. Sundaram, is assisted by a modest team of three including a Monitoring Officer, Mr. B. Lal, a driver and auditors, who implement the decisions of the Board of Managers/Society..

4.5. How are programmes selected and implemented?

4.5.1 All the programmes of NIRPHAD are finalized after the programmes are evolved from the grass roots, which are the real source of all activities. At the field level the following sequence of events takes precedence:

• Has the community fully appreciated and is committed to implement the activity • Is the specific activity improve the quality of life, especially of the poor? • Is the activity sustainable? And what is the contribution level of participation-

cash, kind and maintenance? • What are the possible innovations? • Is the activity replicable and possibility of expansion?

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• What may be the factors for failure?

4.5.2 When the above questions are satisfactorily answered and when a written agreement is completed, the following is undertaken by the designated group and NIRPHAD acts as the facilitator/enabler:

- Details of plan- including mapping of the target area.

- Develop details of organization- VLCs or pani panchayats or gender and age specific

- Strategize priorities and implementation techniques, which are most relevant and

adapt to help solve unmet needs.

- Coordinate all activities-including men, money and material.

- Establish control of every aspect of the programme the main responsibility being of the stake holders (beneficiaries).

- Fine tune monitoring and evaluation procedures.

- Test systems for graded sustainability to achieve self-reliance (revolving funds

4.6. Mobilization of resources: The field committee has the major responsibility of

discussing with the VLC the following modalities:

• Items mentioned under ten. • Selection of activity and field staff (accommodation and space for office and

meetings) and its various responsibilities. • Various activities and linkages and supportive supervision. under the programme • Budget.

4.7. Process for implementation

• The Project is then submitted after approval from the donor to the Finance, Executive and finally to the Board of Managers.

• The HQs is also informed about formats for writing progress reports and various steps for special studies, evaluation (mid-term and final), expansion if possible and replication.

• Periodically the various committees and donor agencies will require quarterly (half yearly or annual narrative) and statistical reports and financial reports (which includes audited statements of income and expenditure and compliance of audited statements).

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• Headquarters is involved in discussions and arrangements (including approval) of all Projects in conformity with the decisions taken in Board/ Society/finance Committee Meetings.

• Mobilization of resources for implementation of these programmes is carried out by the headquarters for its field units, when indicated.

• During this process the HQs and the field staff has to participate in several rounds of meetings, respond to queries and communicate according to requirements of all concerned.

4.8. The responsibilities/activities carried out by the Monitoring Officer during the year are as follows:

♦Job Schedules Monitoring Officer has to check that the program is being implemented in a planned manner and this entails a watchful eye on time frame, resources and man power.

Supportive supervision entails that specified number of activities are undertaken successfully by the staff deputed for the work within the budgeted resources, in any given time-frame as spelled out in the Action Plan in order to achieve the objectives.

♦The following activities are in the ambit of duties:

- Keeping in touch with the staff responsible for program implementation at the site by one-on one/small and large group discussions, at Hqs. or field visits.

- Visit to the field to assess the progress of work and share experiences of the implementing staff and help in identifying problems/issues and challenges, and suggesting possible solutions.

- ‘Trouble-shooting’ and resolving difficulties through a participatory process of problem-solving and decision-making is a difficult but crucial and recurrent activity and involves good understanding and cooperation of administrative and implementation staff.

- To examine, adapt or modify the quantity and quality of work in conformity with the specifications given in the Action Plans.

• Evolving a system of periodic reporting implemented from bottom up and sharing the findings with senior functionaries for further reporting to the funding agencies.

• Supervise that the FCRA funds are transferred to the Project activities in time so that delays in implementation are avoided. These accounts are supervised/monitored according to the schedules for each activity..

• Participation in mid-term and final evaluation of the Project e.g. HCDI evaluation, facilitating evaluations of MNGOs in 7 Districts of U.P., or to assess and

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supervise the performance of individual functionaries and encourage them for better performance by supportive supervision.

• To suggest mid-course corrections where needed, to achieve the targets within the specified budget and in the allotted time.

• The role as a Monitoring Officer is critical for ensuring successful execution of the Action Plans. Besides a number of other activities associated with the functioning of the office and fund raising as mentioned below are also undertaken.

• Co-ordination with donor/funding agencies and arranging meetings with the Director

• To provide Assistance in preparation of new project proposals with budgets and arrange to transmit to relevant funding agencies.

• Attending meetings for discussion/approval of new Proposals with the funding agencies and Government.

• Assistance in preparation and circulation of Agenda Notes and Minutes/Reports of all Board Meetings. Attends all Society meetings e.g. NIRPHAD Board/Society, Executive, Finance and Sub-Committee meetings.

• Compilation of data and information for different programs/activities for preparation of Annual Reports.

• Distribution of Annual Report of NIRPHAD, every year to donor agencies so that they will keep in touch with NIRPHAD.

- Co-ordination and assisting the Director in day-to-day activities.

4.9 Impact (performance of the Monitorig officer as related to his functions). Inputs were critical in achieving the planned targets. The Monitoring officer has to motivate the field workers in a friendly way and assist them by extending need-based suggestions for improvement of the tasks, both in quality and quantity. In fact, missing links were provided between planning and execution of programmes.

4.10. SWAT Analysis:

*Strengths:

• The Monitoring Officer has developed good understanding of the rural problems and potential to improve the complex and difficult rural situation as it exists today.

• Secondly, Monitoring Officer is down to earth so the staff at field level can relate with him and share their problems without any hesitation.

• By now, with over two decades of association with NIRPHAD and long years of experience has developed a sense of belonging. The Monitoring Officer co-operates with all the staff and maintains good functional relationship with colleagues, infusing a spirit of bonhomie and camaraderie in the Organization.

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• Besides, by virtue of long experience in the Organization many complexities are understood-which include functions, procedures, priorities and systems, which a relatively younger worker would be interested in acquiring.

*Weaknesses • I never perceived any. But no one is perfect and must endeavour to improve

himself consistently all his life. • . May be I had lesser opportunities of exposure and lack of formal training. • However, all weaknesses I have changed to stepping stones of strengths to

overcome short comings and reduced the impact of weaknesses with the help of senior functionaries.

• My seniors coax and goad me that I should be more assertive (speak out) in pointing out the mistakes of others (constructive criticism). The Director feels that I am too soft and hence have no enemies, which is detrimental for the progress and discipline of NIRPHAD. This is especially true because NIRPHAD staff is yet to develop a good work ethic.

*Opportunities

• NIRPHAD has a policy to give a free hand, in a graded manner for all staff to grow to their full potential. Once this was proven a staff member can take full advantage of his talents and produce results in an un-inhibiting environment.

• The ‘totem pole’ methodology permits a staff member to rise to his maximum. It all depends on the ability of the staff for hard work and his/her talents and interest.

• NIRPHAD can reach the pinnacle of developing a model for a holistic approach in linking health with socio-economic development, which can be the first innovative step for reducing poverty and emancipation of the weaker sections. This opportunity should not be lost due to lapses which will end in “precious opportunities ending in cheap choices”. The horizon is the limit.

*Threats • Even though there are no threats to my position or my job but for future it is

better that my practical training and experience is reinforced, by formal training. Otherwise future administration may consider this as a weak point in my career.

• Major threat to the programme is the poor motivation of the staff. Among the target group includes illiteracy, superstition, anti-opinion leaders, religious and social bigotry and lack of cooperation from the government or jealousy from other NGOs.

• Financial instability and poor performance. • Lack of strategies by the senior staff to motivate the community to a paradigm

shift provide more commitment for financial, kind and moral support

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• Some staff cannot understand that all types of corruption can be totally eradicated, otherwise NIRPHAD is doomed to failure or will have to wind up in disgrace.,

4.11. Conclusion:

• There are major changes in the Organization and it may be necessary for the office of the Monitoring Officer to be changed to take up more responsibilities as Finance Officer and Coordinator. This will mean spending two days in a week in Delhi Office to assist the Advisor to the Director and attend to FCRA, Provident Fund, new proposals and other liaison duties.

• A new position, with upward mobility brings with it new responsibilities and it is my ardent hope that Administrative staff and the BOM members will give me all the encouragement and support that will be necessary to more than fulfil the tasks entrusted to me. I shall endeavour to take NIRPHAD to greater heights of service in uplifting the poor and needy. . .

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5. Dr. Dhiraj Chhaparia- MS (Opth) Ophthalmologist, NIRPHAD Eye Hospital, 5.1.Objective of the Report

- Evaluate performance of eye dept. of Chhatikara, both narrative and statistical.

- To improve departmental services - Role of eye hospital in fulfilling community needs. - Recognize issue, challenges in delivering eye services and develop

sustainable solution. 5.2. Material and Methods

- Records of patients who attended base clinic, field clinic and camp is documented and the information is provided when required.

- Input of patients in the department is through various channels - Patient satisfactory survey

5.3. Process involved in performance

- Planning is very integral part of eye camps - Camp generally starts from month of September to April. - Before planning for a camp certain issues to be considered: Permission from District CMO Location and site of camp Availability of vehicle for canvassing Availability of surgical staff. As most of the patients are farmers harvesting season is also kept in mind.

5. 4. Organization

- Motivation of staff - Unnecessary leave not given - Stocks of instruments, IOLs and supplies are checked from time to time.

5.5. Manpower and Tools Administrator -1

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Refractionist- 2 O.T. Technician- 2 Ward Sister- 1 Receptionist 1 Peon – 1 Driver- 1 Sweeper-1 Interns- 2 5.6.Equipment OPD- Direct Ophthalmoscope Slit lamp Tonometer Synaphtophore Retinscope Refraction Box Auto refractometer, Keratometer, A-Scan Yag Laser 5.7.OT Operating Microscope Autoclave Hot Air oven Fumigation equipment Phaco machine 5.8.Implementation Before cataract surgery pre-operative evaluation of patient is done thoroughly to calculate the vision after surgery. 5.8.1 Implementation

- Volume of surgery in the department is very high so effective implementation of plan is very essential.

- A good rapport with the District CMO is very essential as for every camp a permission of CMO has to be taken and if there is any problem planning fails.

- Lack of good administrative officer also creates problems - Assessment after each eye camp

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5.9. Adequacy of staff/ instruments

- Strength is sufficient, but untrained - Hardworking, but sometimes little careless. - As far as instruments are concerned, they are sufficient

5.10. Activities

- Daily OPD is conducted except Sundays and Holidays. - Once a week visit to Bajna - In the camp once a week visit to Aligarh - Two field clinics one at Kosi and one at Sonkh done by one optometrist. - OPD conduced in the camp done by Doctor or Optometrist. - School Screening programme done by Optometrist

5.11. Training

- Regular training programe should be held - With the advancement of eye surgery the incision for cataract surgery has

become smaller, so training for Phaco is must. - Phaco training is planned in the year 2009. - One of our optometrist Mr. Reshu Gupta has attended training for 3 months

in “Optical Dispensing” in LAICO, Arvind Eye Hospital, Madurai. After the training his skill has improved and revenue generation in the form of glasses dispensed has increased.

5.12. Conferences Attended “Delhi Ophthalmic Society” in the month of November, 2008 “All India Ophthalmic Society” in the month of February, 2009 in Jaipur I have also attended one of the celebrations of our Partner (CBM) for completing 100 years of services at Badakal Haryana. 5.13.Visitors

- This year in October 2008 Dr. Sara Varghese, Medical Advisor CBM and Mr. Vikas Katoch, Project Officer visited. She was impressed with the changes which our centre has made after her first visit Report of the above visit is already published in the annual report of 2007-2008.

5.14. LAVAL Medical Students

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- In the year 2008-2009, six medical students from LAVAL University Canada had part of their internship in the eye department.

5.15. Issues and challenges

- Staff adequate, but needs training - Motivation among staff should be of higher caliber. - To perform better so as to compete with other charitable organizations in the

District. 5.16. Job Satisfaction

- Given free hand to deliver services - Emoluments are adequate - Volume and variety of patients satisfactory

5.17. Suggestions

- Training of staff - Good control of administration of the staff - Establish an optometry institute- it will be helpful for revenue generation

and staff deficiencies at the time of surgical camps 5.18.Statistical Data Total number of OPD Patients in Chhatikara 14370 Total number of patients at weekly clinics 4245 Total number of patients in camp OPD 4856 Total number of camps 18 - Refractions Refractions at Base Hospital 6354 Refractions at Weekly clinics 250 Refractions at camps 1267 5.19. Statistical Surgery Total number of surgeries performed at Base Hospital 454 Total number of operations performed in Camps 869 Total number of IOLs performed at Base 369 Total number of IOLs performed at Camps 821

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Months IOL CAT GLUCOMA OTHERS TOTAL

April - June

July 22 1 23

August

September

October 148 5 1 154

November 181 4 3 188

December 140 7 1 6 154

January 147 4 3 154

February 90 3 2 95

March 93 4 4 101

821 28 19 869

Base Hospital (April,08 to March,2009)

Months IOL CAT GLUCOMA OTHERS Yag

Laser TOTAL

April 31 1 4 2 38

May 30 1 3 4 3 41

June 12 1 1 2 2 18

July 25 4 2 31

August 17 1 2 1 21

September 19 1 1 1 22

October 19 1 1 21

November 38 2 45

December 44 2 12 58

January 41 1 1 7 50

February 44 4 48

March 49 1 4 7 61

369 8 10 50 17 454

NIRPHAD Eye Hospital Chhatikara (Operations in Camps) (April,08 to March,2009)

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Annual Report April 2008 to 31st March 2009

6. NIRPHAD Rural Eye Programme Bajna Mathura UP by A.K. Gupta

Report of Accountant/Assist. Manager. NIRPHAD growth centre Bajna Mathura, UP

Joining Date: 2nd October 1980.

Daily Routine: Voucher, cash book, eye recovery, OPD clinic eye motor cycle, moped, jeep,

generator, water pump, electricity, maintenance & repairing, log book records to be kept.

Supervision: Supervision of eye ward old OT, Doctor’s chamber, New OT, attendance, leave,

salary, stock register to be kept upto date.

Organize eye camps, eye activities at Aligarh. Supervision of construction & maintenance &

repairing of old building.

Meetings at CMO office at Aligarh for Finance and Administrative matters and eye related

works/activities.

Recovery from Patients : 21,42,125.00 A. Eye old clinic : 43230.00

B. Cost of S.O.L. Refraction and charges for contract operations 4,71,495.00

C. CMO office Aligarh : -

D. Donation for eye camp : 5100.00

E. CMO office Aligarh : 1622300.00

Total operation (Paid): 180

A. I.O.L. : 133 B. Cal. : 07 C. G.L. : 07 D. Others : 33 Total : 180

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Total No. of Patients attending OPD

A. Base clinic Bajna : 4426

B. Camps (49 Nos.) : 4657

Sl. No.

Total operation Free 2175 (Mathura + Aligarh)

A. I.O.L. Surgery 2088

B. Cataract 87

C. Gloucoma -

D. Others 22

Mathura Free operation Total operation : 22

A. I.O.L. : 16 B. Cat : 06 C. GL : - D. Others : -

Aligarh Free Operation: Total operation : 2153

A. I.O.L. : 2072 B. Cat : 81 C. G.L. : - D. Others : -

Problem: 1. Lack of monthly visit & meeting Director’s & Co-ordinator’s.

2. No permanent eye surgeon.

3. Shortage of trained staff.

4. Unsafe boundary wall/maintenance of building watch men.

5. Non-availability of medicine/medicine shop.

6. Lack of spectacles shop for patients.

7. Regular 10% increment not available.

8. Renovation of residence (Maintenance, electricity, water, white washing etc.

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9. No electricity due to disconnection of old 5 HP connection.

10. Delay in new connection of electricity.

11. Shortage of staff for Aligarh camps.

Present Staff: Mr. Anil Kumar Gupta

Mr. Subhash Singh

Mr. Reshu Gupta

Mr. Satayvir Singh

Mr. Mahesh Chandra

Mrs. Shiva Sweeper

Three security guards.

Visiting Doctors & Staff: Dr. Dhiraj Chhapara.

Dr. Neelesh Mittal

Dr. Anjali Gupta

Dr. Omprakash

Mr. Ram Kishore Lawaria

Mr. B.R. Yadav

Mr. Muneder Singh Choudhry

Visitors: 1. 24.04.08 DDM NABARD Mr. M.I. Khan, Mr. M.D. Agrwal, Ms. Neel Prabha

meeting with Manager Syndicate Bank Bajna and RDO.

2. 26.06.08 Meeting with Dr. Sanjay Nanda, Mr. M.D. Agrwal, Mr. B. Lal and visit to new OT building.

3. 27.06.08 Organized meeting and lunch for Mr. Ramesh Saraswat, Laval University students 4 girls + 1 boy

4. 26.07.08 Meeting with Syndicate Bank Bajna DDM NABARD Mr. M.I. Khan, LDM Syndicate Bank Mathura Mr. Prabhu Dayal Bajdolia, Ms. Neel Prabha and Mr. B.R. Yadav.

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5. 18.10.08 Dr. Sanjay Nanda, Mr. Mani, Mr. B. Lal, Dr. Dhiraj Chhaparia checked

Records before CBM visitors

6. 31.10.08 Dr. Sara Verghese and Mr. Vikas came from CBM Dr. Sanjay Nanda with Mr. B. Lal Dr. Dhiraj Chhaparia and said new OT building. Generator and records.

7. 11.11.08 Meeting with DDM NABARD Mr. M.I. Khan, Ms. Neel Prabha and Mr. B.R. Yadav in Bank Mr. Uma Shankar visited field Khanpur, Baghai to see SHGs.

8. 20.01.09 Three visitors from Curamerica – two ladies and one male with Mr. B. Lal, Mr. M.D. Agrawal meeting at PHC Naujhil MO s/c SHG meeting with women at Ajnanth.

9. 18.03.09 Mr. M.D. Agrawal, Mr. B. Lal went to CMO Aligarh, CMS Deen Dayal Hospital Aligarh and had meeting with Mr. B.N. Jha.

Savings account of 24 SHGs opened in Syndicate Bank Inter-loaning among groups

being done. Applications of 5 SHGs for Bank linkage have been approved.

Under the Eye Programme provision for Dalia, Khichri, milk, fruits, tea, bread and

biscuits have been made by the donor agency in camps in addition to medicines and black

spectacles.

In Deen Dayal Hospital Aligarh on every patient of operation one litre milk, a packet of

bread, four pieces of apple, khichdi, butter is given every day. This year the number of operation

was more than in the year 2007-08. Last year 2331 operations were done but this due to special

efforts of staff and surgeon of Aligarh and Mathura record operation of 2355 patients were

performed on 16.03.09 on the occasion of world women’s day the women of SHGs were taken to

Chhatikara NIRPHAD centre. They were accompanied by Board member Smt. Dayawati Gupta.

These women were from Bajna, Ajnanth and Prahladgarhi villages. One day Health Fair was

organized at NIRPHAD, Bajna Specialists of different diseases joined with the cooperation of

DIPFSA. Free lens were given in the camp organized by NIRPHAD. Eleven cases of

sterilization were done.

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Training for Staff: Mr. Reshu Gupta 1st January 2009 to 31st March 2009 “optical dispensing for three month

Arvind Eye Care System, Madurai.

Further Senior Director (Health and Family Welfare) Aligarh circle has said several times

to organize eye camps in two more districts – Mahamaya Nagar (Hathras) and Kashiram Nagar

(Kasganj) along with Aligarh by bringing the patients of cataract by bus to Deen Dayal Hospital

Aligarh and drop them back after operation.

Request has been made to Director Dr. Sanjay Nanda and Coordinator Shri B. Lal to

permit to take up the above work as requested by the Sr. Director as well as to organize a team

for awareness generation, propagation, selection of PHC and CHC and start the work.

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7. Dr. Rekha Tyagi- MBBS., In-charge Maternal and Child Health, MCH Centre- Chatikara Rubric: Any Public health programme is measured by the services of MCH, which is the gold standard of performance This is my 2nd year (2008) as an incharge MCH. 7.1. Staff =strength

- Lady Medical Officer incharge- Dr. Rekha Tyagi - Lady Medical Officer – Dr. Shakuntala Shrivastava (Part time) - Senior Nurse- Neetu , working as Nurse as a such not trained nurse - Lab technician-Anup Rauth - Registration in-charge-Bihari Lal - Dai- 4

7.2. Objective To provide a quality of health care to mother and child at a very low price ANC- Includes immunization and a physical check up in 10 rupees Registration and investigations like Hb, Blood grouping, V.D.R.L., HIV screening, at very low cost. Conducting deliveries PNC includes spacing, family planning counseling. Immunization for Mother and Child every Thursday.

Family planning camp at free of cost in which tubectomies was done. 7.3.Achievement in years

CMO recognized our Centre for Janani Surakasha Yojna and the contract was for 100 deliveries / year for BPL families. At our Centre 224 deliveries were conducted under this scheme in this year. In this scheme Govt. paid to NIRPHAD Rs. 1850 per delivery and 1400 to rural and 1000 to urban beneficiaries. The ANC and deliveries were done free of cost.

April, 2008 to 31st March,2009 Month New

Patients Old Patients

PV exam MTPs Deliveries

April,08 244 29 64 23 03 May,08 371 33 111 29 08 June,08 331 42 84 14 11

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July,08 338 35 96 11 20 August,08 297 35 77 17 47 September,08 316 33 92 17 33 October,08 235 22 62 19 25 November,08 315 33 78 27 31 December,08 357 36 115 19 32 January,09 305 33 104 13 31 February,09 283 26 87 23 33 March,09 344 37 93 29 37 Total 3736 394 1063 241 301 Total OPD =4130 New= 3736 Old= 394 Total MTPs = 241 Total Deliveries = 301 BPL Deliveries= 224 Non BPL= 77 7.4.Training I attended Ultra sonography training at St. Stephen’s Hospital on 14th to 29th March,2009. 7.5.Weakness

Every Tuesday, Friday and Saturday- USG facility at SJSH, despite of giving 50% rebate due to long distance from Chhatikara to SJSH only 2 patients from Chhatikara reached SJSH, so machine should be installed at Chhatikara.

Though it was mentioned in Janani Surakasha Yojna contract that we should have well equipped OT, but unfortunately it could not be completed due to shortage of funds.

Round the clock lab facility will give better services With the minimum facility staff works who lack of enthusiasm, compared to other hospitals, the Centre is providing facilities at very reasonable & low prices.

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7.6. Suggestions:

Rapid survey of adjacent areas, keeping this point in view, certain things should be improved as in couple of years this centre will be serving well with referral population.

OT should be upgraded Better trained staff is a must Lab facility round the clock Installation of USG PCO during night times, attendant struggles.

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8. Anup Baran Rauth, B.S.C, DMLT (Laboratory Technician), NIRPHAD Rural Eye Hospital, Chhatikara Rubric: A lab provides incontrovertible evidence to the clinician for diagnosis and guides in management of the patient. 1. Functions:

o A technician is responsible for the maintenance of Pathological laboratory and conducts various types of examinations or tests as required by the MCH and Eye section of NIRPHAD Growth Centre.

o Laparoscopic tubectomy camps were organized by and District Hospital, officials and technician conducted all tests pre-operatively. o Saubhagwati Surakshit Matratav Yojan programmes were implemented

by the State Govt. District Hospital. o The process involves collection of samples for testing hemoglobin levels,

total WBC, differential counts, HIV I & II, VDRL, blood grouping and urine routine examination (free of cost).

o Anemic patients & HIV+ reactive and any other finding, especially the latter, the District Hospital is informed.

o On account of work load, particularly on the days of Dr. Shakuntala Shrivastav (MCH) by the Eye Hospital on account of the huge number of patients, who request immediate testing and submitting of the reports the only Technician is under severe pressure.

8.2.Other responsibilities are Quality check of the chemicals and standardization of the equipment regularly. Maintenance of all the records of the tests. Proper disposal of laboratory waste Some times go to the Health Mela in village area to conduct Pathological tests. Sometime Manage the OPD

8.3. Strengths Lab possesses monocular microscope, colorimeter, fridge, centrifuge machine, incubator and all types of chemicals required for the tests.

We provided information to LAVAL students about various laboratory procedures.

Costs of all tests were affordable and inexpensive and the reporting was accurate and prompt.

Weakness Some difficulties are faced because of the out dated equipment like colorimeter and microscope.

There is no facility for special tests for hypertensive patients like serum, uric acid, serum cretin, blood urea or other special tests.

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8.4. Sr. No. Test Name Total tests Amount in Rs. 1. Hemoglobin 1187 11870.00 2. Blood sugar 986 24650.00 3. Urine Pregnancy 620 31000.00 4. Urine Sugar Albumin 1244 12440.00 5. Blood group 127 3175.00 6. Malaria parasite 167 5010.00 7. Total count 34 340.00 8. Differential count 39 390.00 9. ESR 27 540.00 10. Urine routine examination 428 12840.00 11. VDRL 541 21640.00 12. Blood sugar by glucometer 44 1760.00 13. Semen Analysis 30 1500.00 14. Vidal or Typhoid 15 7500.00 15. Mantoux OT 09 270.00 16. Platelets count 09 270.00 17. HIV I & II 454 27240.00 18. General blood picture 01 40.00 Total number of tests 6111 1,62,525.00

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9. Annual Report (1st April, 2008 to 31st March, 2009). HCDI PROJECTS Ms. Neel Prabha, MSW., Manageress, NIRPHAD Joining date: 13.08.1986 Narrative Report of Self help Groups. “Rubric : It does not matter what your intentions are or how high you set your goals; what you will be remembered for is what you accomplish” 9. I take this opportunity to present functions of the programmes during the reporting period in terms of planning, implementation strategies involved, success and challenges faced to achieve the set objectives of the programmes. 9.1 Presently I have the important role in the implementation and supervision of three major programmes: Micro-credit programme Child Focused Community Development Program Village Development Plan 9.1.1 Micro-credit Programme ♣NIRPHAD implemented a micro-credit programme in the year 1997 by consulting with FODRA (Fountain of Development and Research Action) with the objective of “Empowerment of Rural Women and graded self reliance by providing resources for socio economic development.” ♣NABARD played a significant role in formation and strengthening NIRPHAD’s micro credit programme. ♣Presently 120 SHGs covering 45 villages are functioning reasonably well in poor, interior and illiterate communities. The achievements of SHGs are encouraging and slowly moving towards graded self reliance. 9.2 Activities of SHGs consist of: 9.2.1 Monthly SHG meetings, joint SHG meetings, inter village SHG meetings, exposure visits, capacity building training programmes, 9.2.2 skill training programme. 9.2.3 Along with SHGs, SHG Supervisors capacity building was also one of the top priorities. During the reporting period two SHG supervisors attended training at Bhopal from 24th to 27th September on the subject “Empowerment of women through SHGs.”

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9.2.4 During the reporting period along with training, exposure visits with more emphasis was given on skill trainings and involvement of SHGs in social action programmes. SHG members were involved in the supervision of Anganwadi Centres and village Development. Potential SHG members are identified and schedule for their capacity building was prepared to strengthen SHG movement and organize women under one umbrella. 9.2.5 Skill training to SHG member is one of the special features of SHG programme, which creates avenues for Self employment for economic upliftment of the family. ♣In the month of July 13 day’s duration of candle making training program was organized at NIRPHAD Growth Centre Chhatikara for 30 SHG members. This programme was sponsored by National Bank for Agriculture and Rural Development (NABARD). ♣Along with women, male SHG members are taking interest in skill training programmes. During the reporting period, salty namkeen (making snacks) training was imparted to male SHG members of village Nagala Mauji who identified this activity and is keen for developing of individual IGP units. Market survey was completed. This is very encouraging which proved that SHGs are providing a platform for equal participation/opportunities for male and female members in skill training/income generation programmes. 9.6 Socio-economic Impact of Micro Credit Programme 9.6.1 Umang Mahila Bachat Sangh from village Kota is engaged in stone carving activity. 10 SHG members are involved in this trade and they are earning approximately Rs. 100 per day. The group has established good market at Vrindaban and Mathura, which is famous for stone carving work.

9.6.2 Gonda Atas Mahila Bachat Sangh (Gonda Atas), Aryamaan Mahila Bachat Sangh (Nagala Shivji) and Madhur Mahila Bachat Sangh (Ramtal) have established individual

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candle making units and they are earning a good profit, because of good market linkages.

9.6.3 Satyam Mahila Bachat Sangh from village Ramtal is involved in (Dona) makin paper saucers. 5 SHG members are involved in this activity.

1.6.3 Five Card Board Box manufacturing units are functioning in the villages Nagala Surir, Nagala Sumera, Bhartiya, Jonai and Nagala Mauji. 15 women are engaged in this activity. These women have proved as successful entrepreneurs and assisting their families to shoulder their economic responsibility.

9.6.5 Apart from these trades SHG members are also engaged in rearing of buffaloes (milch animals), goats and pigs. Grocery and bangle shops enhance family income. Two members from Gonda Atas Mahila Bachat Sangh (Gonda Atas) and Gola Mahila Bachat Sangh (Jonai) are selling bangles in the villages. The groups have availed credit from SHGs to start the business at micro level. 9.6.6 Along with female SHGs male SHG Members are also engaged in income generation programmes. Mr. Shankar Lal (Sadhana Bachat Sangh) who is SHG

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member acquired skill training from NIRPHAD and has launched out alone and started a box making unit. His wife who is also SHG member has received skill training and is now working with him. They are supplying card board boxes to the surrounding villages and are concentrating on local market. Mr. Sardar (Sadhana Bachat Sangh) one of the SHG members received skill training from NIRPHAD in making “Namkeen” (salty snacks) is supplying in the adjacent villages He is also running a petty shop (selling miscellaneous house hold requirements) in his village. 9.6.7 Apart from Income generation programmes SHG members are actively involved in village development, social activities. They are taking interest in Anganwadi’s (women’s groups) and involved in supportive supervision. They also motivate women to send their children at Aganwadis and utilize Govt. facilities. Women ensure supportive supervision of Aganwadi’s, quality education and supplementary nutrition programme. 9.6.8 Women are made aware about their rights and are trying to bring constructive social change in their respective communities. They have realized the importance of education and are practicing best health and agriculture practices. They have gained confidence and self respect. Women are fighting against blind beliefs (superstitions and taboos) and social evils. 1.6.8 Their participation in Panchayat (village council) is also an indicator for political awareness. In village Fenchari a woman is the village head ( Pradhan) who is a SHG member and some SHG members are acting as Gram Panchayat members in their village. Thus socio economic dependence of women is gradually decreasing SHG women are awakened as they are imparted information regarding Government schemes, Women’s- rights and right to information etc 9.2, Areas needing improvement

Record keeping Bank linkages for sustainability of SHGs Greater participation of bank Managers/officials in SHG monthly/joint

meetings. To establish rapport between Bank officials and SHG members to strengthen SHG movement.

Active involvement of SHGs in handling social issues, eradicating social evils and participation in Panchayati Raj.

Networking with Govt. departments, financial institutions and NGO’s working in the area.

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9.3. Celebration of Women’s Day

On 16th March, 2009 Women Day was celebrated at NIRPHAD Growth Centre Chhatikara. Three hundred women from the target villages participated in the celebration. Mrs. Simon graced the occasion as Chief Guest and Mrs. Dayawati- NIRPHAD Board Member was special guest of honor and Mrs. Nanda was the special invitee. ♥ Women presented cultural programme including folk songs, folk dance, individual and group dance, drama. The theme was illiteracy, drug abuse (alcoholism, smoking tobacco,) dowry, female feticide etc. ♥ Prizes to encourage were given to the women engaged in income generation programme and for best SHGs. Ranking of SHGs was done by grading. ♥SHG members shared experiences on achievement of SHG and, SHG as an instrument for charge etc. Days programme ended with special messages by guests. Mrs. Nanda who was special invitee stressed the need of women’s participation in the village development. She advised women to choose a goal in life to lead meaningful life; she appreciated the performance given by women and was very happy to see the enthusiasm of women. Mrs. Dayawati NIRPHAD Board Member, who is retired as a teacher and is very famous lady stressed the need of women’s education and advised women to provide co-education facilities to girls also along with boys. Mrs. Simon Chief Guest was overwhelmed to see the change that has occurred in the women due to NIRPHAD interventions through valuable support of donors and advised women to come forward and join hands for a bright future with NIRPHD. She said that these women are lucky to have a reputed NGO like NIRPHAD to assist them to enter the main stream of development. 9.4. Future Plans : Formation of Federation Steps taken

Identification of potential SHG leaders Monthly meetings of potential leaders to provide opportunity for collective

planning, decision making and capacity building. Formation of more SHGs (during the reporting period twelve SHG were formed)

9.5. Challenges

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Sustainability of micro-credit programme. 9.6.Child Focused Community Development Programme unit II 9.6.1. Introduction: CFCDP provided an opportunity to serve the neediest, poor, deserving children and their families for bringing them into the main stream of development. This was possible due to the foster parents’ generous support and concern for the poor children. This Annual Report is mainly focused on the activities implemented during the financial year and its impact on the target community. 9.6.2 NIRPHAD CFCDP has completed 6 years successfully by achieving pre-set objectives, reasonably well and is functioning along the critical path agreed upon. 9.6.3. In the fourth quarter of the year 2007-2008 four ECCEC centres were handed over to Aganwadi Centre for the sustainability of the project 9.6.3.1 A Supervisory Committee including SHG members was formed to provide supportive supervision and to ensure the daily attendance of children in the Aganwadi. This attempt was successful and presently children are attending Aganwadis. 9.6.3.2 Supervisory Committee is conducting informal meetings with Aganwadi teachers and there is a good coordination between Supervisory Committee Members and Aganwadi staff. Collective problem solving and decision making is practiced for the better functioning of Aganwadi 9.6.3.3.. On 24th February Supervisory Committee from village Bhartiya visited Aganwadi office (managed by the Govt.) and discussed the functioning of Aganwadi in their village. They demanded for better functioning of Anganwadi and improve quality of services. 9.6.3.4. Emphasis was given on capacity building of the Supervisory Committee members to ensure effective supervision and better results. 9.6.3.5 In the month of June, 2008 three SHG members attended a workshop on “Early Childhood Care” organized by HCDI at Raunchi. This training helped to promote understanding regarding the importance of Aganwadi, functioning of Aganwadi and role of Aganwadi in Early Childhood. The members shared their knowledge with other SHG members through discussion and presentation with the help of NIRPHAD staff.

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9.6.4. Govt. Aganwadi Centres are not well equipped with teaching, learning and play material. 9.6.4.1 NIRPHAD provided indoor and outdoor play material and educational material to the Aganwadi Centres, after conducting meetings with the staff. 6.4.2 Distribution was done in presence of the Officer in charge Aganwadi. CBOs were made responsible for the follow up and maintenance of the material along with Aganwadi teacher. 9.6.4.3 For continuation of education, educational material including note books, geometry box was distributed among school going children. Through village level Committee CBO representatives extended their cooperation in the Distribution activity conducted at village level. 9.6.5. Social development is one of the most important components in personality development. During the reporting period two picnics were organized for the Aganwadi Children. Supervisory Committee took imitative for arrangement of picnic at village level and accompanied children along with NIRPHAD Staff. 9.6.6. Involvement of CBO representatives in the implementation of different activities was one of the most important features. 6.6.1. During the reporting period to impart extra tuition, youth members were given priority for giving education to the students entitled for extra tuition. 9.6.7. Gender equality was practiced at the time of selection of teachers. Teachers were provided honorarium. This provided an opportunity for youth group members to realize their duty towards the children in their village and also to utilize their education to assists weaker children for better education.

6.8. Non formal education programme is progressing well and has proved to be a priority. Girls are happy to acquire basic reading and writing skills. 9.6.9. For gainful self employment vocational training facility is provided under CFCDP.

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9.6.9.1. CBO representatives of the target villages selected youth for undergoing vocational training and also identifying the trades. Seven youth from the target villages availed this facility. The result of this activity is quite encouraging, one trainee from village Bhartiya was appointed in the Computer centre located at Mathura. 9.6.9.2. To create mass awareness in community, awareness program/training program, health, animal husbandry, agricultures camps were conducted. Govt. official’s, experts were invited to participate in trainings as a resource persons. 6.9.3. Training was one of the most important factors for strengthening of SHGs. Continuing education programme was conducted for SHG members. During awareness camps and during continuing education programme, emphasis was given on networking with Govt. Department, resource mobilization, Govt. schemes, new techniques, legal knowledge and, human rights 9.6.9.4 Below poverty line families of target villages were provided facilities under “Saubhagwati Surakshit Matratav Yojna” which included free delivery and medical care at NIRPHAD MCH Chhatikara, NIRPHAD. 9.6.9.4.1. NIRPHAD ANM closely worked with Govt. ANM to provide health services to the community. 9.6.9.4.2 SHG members were informed about Govt. ANMs field visit schedule and were made responsible for follow up. 9.6.9.4.3. Good cooperation engendered between NIRPHAD ANM, Govt. ANM and Govt. health staff at grass root level (ASHA, DAI and Traditional Birth Attendant) was ensured. 9.6.10 During the reporting period more emphasis was given on strengthening of CBOs through adopting strategies like capacity building, identification of potential leaders and periodic assessment. 9.6.10.1 Regular monthly meetings, sports competitions were conducted for youth group members. SHG meetings, joint SHG meetings were emphasized to create interaction between the SHG members and share their experiences about SHGs. They were also motivated for their participation in village development and follow up of CFCDP activities implemented so far. 9.6.10.1.1 Training schedule for capacity building of potential leaders was jointly formed by Potential leaders and Project Manager NIRPHAD. 9.6.11.Through CFCDP visits were organized for visual perception and to adopt successful attempts done by others, 9.6.11.1 So far a number of exposure visits for farmers were organized to Agriculture University (Pant Nagar) Agriculture Research Centre, Krishi Vigyan Kendra etc. to enhance farmers knowledge regarding new agriculture techniques, concepts (viz organic farming). 9.6.11.2 Some farmers have adopted best agriculture practices. One farmer from village Bhartiya is growing vegetables on large scale. 9.6.11.3. During the exposure visit organized by NIRPHAD to Pant Nagar Agriculture University Mr. Mukut Bihari from village Bhartiya purchased seeds (Tomato, Cauliflower, Brinjal, Green Chilly etc.) and developed kitchen garden at his village. He

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utilized ½ acre land for growing vegetables. At present he is growing vegetables in 3 acres of land and is earning handsome profit. He has reduced wheat production, green fodder production and is concentrating on vegetable growing. During the year 2008 he has earned Rs. 33,000 as net profit. This has become a very successful activity and other farmers are trying to replicate it. 9.6.12 Formation and strengthening of Children’s Parliament was one of the important activities of the reporting period. 39 Children Parliaments were formed in all four target villages. Elections for Prime Minister and Cabinet Ministers were held and the role and responsibilities were briefed. This activity encouraged children to come under one umbrella and also provided opportunities for expression and their participation in the village development. Though it is a new concept community accepted the activity,

the results are encouraging. 9.6.12.1 Children have learned to express themselves. They are taking keen interest in education and village development activities. They are working efficiently in identifying school drop outs and motivating them to attend school regularly. 9.6.12.2 In village Bhartiya and Nagala Sumera, Children Parliament has submitted an application to village Pradhan regarding maintenance of hand pumps installed by Govt. to ensure potable drinking water. 9.7.Village Development Plan NABARD has sanctioned a project “Village Development Plan” to NIRPHAD for the duration of three years on 29th December,2008. Under this programme village Fenchari, of Mathura block was identified. The main objectives of the programme are as follows: 9.7.1 Objectives • To demonstrate holistic village development in the village Fenchari; serving as

a model to be emulated by other development agencies. • To promote sustainable natural resource management through interventions in

agriculture, animal husbandry, watershed development, water harvesting with an emphasis on building ownership and empowerment.

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• To ensure economic upliftment of the village through interventions and mass awareness programmes.

• To organize, educate and train villagers for their own development. • To increase livelihood options through promotion of micro enterprises

diversified agriculture, horticulture activities. 9.7.2 Activities • Awareness programmes for community health, livestock awareness health mela. • Promotion of women Self Help Groups • Exposure visits • Demonstrations of vermi compost, green fodder, horticulture / floriculture

7.2.1. Community Health Awareness camp o Community is empowered by creating awareness and enhancing their

knowledge through organizing awareness camps, capacity building training programmes, exposure visits etc.

o To utilize Govt. schemes through networking. o NIRPHAD has organized health awareness camp at village Fenchari,

which is adopted by NIRPHAD and NABARD under village Development plan.

o Before conducting health awareness camp, VDP programme coordinator conducted meetings with village level committee members and with community to find out priorities in health problems and their training needs.

o During meetings it was observed that common diseases like pneumonia, typhoid, malaria, diarrhea, and scabies are most common and villagers are ignorant about health facilities of Govt.

o Information regarding safe motherhood and child survival was one of the priorities.

9.7.2.2. Objectives:

o To create awareness regarding Govt. health schemes for rural community and develop strategies for networking to utilize health facilities/ schemes.

o To impart information regarding – most prevalent disease in children, skin diseases, safe mother hood, child survival and family planning.

9.7.2.3 Methodology/ techniques: Lectures, use of visual aids, discussions

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Day’s programme started with lightening of the lamp by the Chief Guest Mr. M.I.Khan, DDM NABARD

o Following participated in the Camp: Dr. S.E.Nanda, Director NIRPAHD & Swarn Jayanti Samudaik Hospital, Ms. Neel Prabha, Manageress NIRPHAD, Dr. Gupta, Medical officer in-charge Ral CHC, Dr. Rekha Tyagi, Lady Medical officer NIRPHAD. Mr. Yadav, Field program officer, SIFPSA, Mr. Ramesh Saraswat Agriculture officer NIRPHAD, Mrs. Durgesh – Village Pradhan participated in the programme. Camp was conducted in the community hall at Fenchari. After inauguration, self introduction was the next item.

o Director NIRPHAD Dr S.E Nanda gave a brief orientation about NIRPHAD and NIRPHAD’s association with NABARD.

o Ms. Neel Prabha, Manageress explained Village Development plan thoroughly and highlighted the contents of awareness camp.

o After delivering lectures interaction session was conducted between participants and resource persons. Participants cleared their doubts by asking questions. There was a good discussion on the following points.

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1. Corruption/ unemployment 2. Lack of awareness regarding health facilities 3. Utilization of CHC (Child Health Centre) 4. Role of community in utilization of Govt. services 5. Coordination/ Networking with Govt. health departments

9.7.2.4 Achievements: • There was a good networking with Govt. health structure (e.g. CHC Ral)-

Participation of MOIC Ral and his willingness to provide all the facilities to the villagers, they deserve from CHC Ral.

• Utilization of Govt. infrastructure for conducting the camp (Primary school) • Lively participation in the session. • Dialogue between Govt. officials and participants.

9.7.2.5 Suggestions need to be implemented • Joint meeting of ASHA, ANM, Aganwadi worker, NIRPHAD Manageress with

village Pradhan to review the work done by ASHA’s, Aganwadi worker, ANM and rectify.

• Monthly meeting with Pradhan to review the VDP project status. • Explore the possibility of joint meeting of Pradhan with Village Health

Committee, Grass root health workers and NIRPHAD Manageress. 9.7.3 Livestock Awareness Camp ♣In view of the rapidly changing social and economic scenario of the country, dissemination of knowledge has an important role to play. ♣ Farmers/ villagers can increase their profits by minimizing the cost of inputs for production of milk. ♣They will therefore have to discard the outdated traditional customs and traditions of animal rearing opting, for the new scientifically time tested techniques and systems. ♣Towards this direction NIRPHAD in collaboration with NABARD is committed to motivate the community for much needed change through implementation of village Development Plan. ♣An awareness camp is one of the main activities of VDP. ♣NIRPHAD organized one day livestock awareness camp at village Fenchari on 4th March, 2009 at community hall. ♣Experts from Veterinary Department Mathura having field experience were invited to participate, deliver talks and share best practices in the camp, so that the community benefited from their vast and rich experiences. ♣Talks on different topics were delivered at length. Questions and answer session by participants were discussed and possible practical solutions were provided. The lectures delivered by resource persons were instrumental in providing information to the grass root level villagers. ♣The topics covered were:

Most common diseases in animals and home remedies Immunization

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Balanced diet for milch animals Animal husbandry as an IGP Animal insurance and Govt. schemes Artificial insemination

9.7.3.1 Special features of the Program

• There was a good networking with Govt. Livestock Dept. (e.g. PHC Vrindaban and Ral). PHC provided vaccination and medicines for preventive and curative treatment.

• Participation of Veterinary Doctor and Livestock Extension officers as a resource person.

• Utilization of Govt. infrastructure • Need based awareness program • Dialogue between Govt. officials and participants to explore possibilities of

networking. • Govt. medicines contribution were distributed to 50 beneficiaries for animals • Examination of animals by doctors

9.7.4 Self Help Group Training Programme ♥NIRPHAD organized one day’s programme for SHG members at village Fenchari under Village Development Plan sanctioned by NABARD. ♣ 36 SHG members participated in the programme.

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♣Training program was conducted in the Panchayat Bhawan. ♣ DDM NABARD, District Coordinator SBI, Mathura, Manageress NIRPHAD, Field program officer NIRPHAD participated in the training program. ♣ Lectures, discussions, visual aids were used to impart training to the participants. 9.7.4.1 Objectives:

• To get insight in SHG Concept to function as women managed democratic and sustainable institutions.

• Capacity building of SHG members • Describe the role of SHG in village Development, community action programs.

9.7.4.2 Opening day The program started with prayer “Itne Shakti Hame Dena Data”, after prayer self introduction session was conducted. 9.7.4.2.1DDM NABARD emphasized the procedure for the formation of SHGs. He said minimum 40 SHGs should be formed in village Fenchari as there are 400 houses in the village i.e. one member from one house will become SHG member. 9.7.4.2.2 It was decided that all the new SHGs accounts will be opened at Mathura ADB/ SBI. 9.7.4.2.3. Requirement of NIRPHAD assistance in formation of SHGs and follow up of SHGs was discussed at length ♣ It was decided that NIRPHAD will provide inputs in record keeping. ♣ DDM suggested that as record keeping is one of the most important requirements of SHG for bank linkages, it should be ensured at village level. ♣ He emphasized involvement of family members/educated boy or girl/ volunteer in record keeping with some incentive from SHG. 9.7.4..2..4 The discussion regarding IGP was encouraged and following trades were identified:

- Tailoring - Candle making - Pickle/ masala preparation - Dairy- rearing milch animals and preparation of milk products

9.7.4.2.5. DDM asked whether women are interested in Dairy management. If yes he suggested that NABARD can provide assistance to NGO to organize one month training program. 9.7.4.2.6 The possibility of developing a proposal under MEDP for the above listed trades was discussed. ♣ The District Coordinator (SBI) had good interaction with SHG members. He assured the assistance of SBI in formation and strengthening of SHGs. There was very good interaction between the guests and SHG members.

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9.7.5. Health Mela

o NIRPHAD organized Health Mela at Fenchari on 20th March, 2009 under the able guidance of Mr. M.I.Khan, DDM NABARD, Dr. Sanjay Nanda, Director NIRPHAD and Mr. Banwari Lal, Coordinator NIRPHAD.

o CMO Mathura was invited to grace the occasion as a chief guest. Health Mela

was organized in the premises of Junior High School Fenchari. Village Pradhan , VLC members, NIRPHAD officials jointly planned the programme.

o Aganwadi teachers, ANM, ASHA was actively involved in the pre preparation of Health Mela.

o As Health Mela was organized for the first time villagers were very enthusiastic and participated, willingly in the implementation of the activity.

o Village level Committee and Village Pradhan shouldered the responsibility of village level arrangements for organizing the Mela. The advertisement regarding Mela was done well in advance through distribution of pamphlets, in Fenchari and surrounding villages.

o Following participated in the Mela. Dr. Shakuntala Shrivastava- Senior Lady Medical Officer, NIRPHAD Dr. Kristi- Medical Officer, Swarn Jayanti Samudaik Hospital

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Dr. Mishra- Eye Doctor Dr. Anant Vyas- General Physician CHC Ral Mr. Nizamuddin – health Supervisor CHC Ral Mrs. Santosh Gupta, Pankaj Kulshetra, ANM CHC Ral Dr. Gupta, MPIC CHC Ral extended his full cooperation in providing preventive and curative medical treatment to the villagers.

o Mr. M. I .Khan, DDM inaugurated the Mela. In his inaugural speech he highlighted the importance of organizing health mela and appreciated the cooperation given by RAL CHC staff. He also appreciated contribution of NIRPHAD an implementing Agency in terms of manpower, (doctors and Para medical staff)

o NIRPHAD Coordinator Mr. Banwari Lal expressed deep gratitude for NABARD’s assistance to organize the Mela and also for joining hands with NIRPHAD to serve the rural community through village Development Programme.

o A school premises was used as OPD by Doctors: - Registration - General Medicine - Eye Department - Pediatrics - Gynecology Department - Immunization - Family planning counseling and distribution of contraceptives - Medicine distribution. - A total 325 patients were registered. 26 eye patients were referred to NIRPHAD

Eye Hospital Chhatikara for free operations. 9.7.5.1. Exposure visit of farmers

- NIRPHAD organized visit of farmers on 19th March, 2009 to the Regional

Agriculture Testing and Demonstration Centre, Raya. 45 farmers participated in the visit.

DDM NABARD, Manager ADB Mathura, Manageress NIRPHAD, Agriculture officer NIRPHAD accompanied the farmers.

9.7.5.2. Objectives - To provide opportunity for to different varieties of crops, organic farming

demonstrations to adopt best agriculture practices to promote productivity. - To impart information regarding organic farming, soil and water testing, different

varieties of crops and advanced agriculture techniques to the farmers.

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- Networking with Govt. Department for utilization of Govt. facilities. - Establish a dialogue (interaction) between farmers and agriculture experts to

enhance knowledge.

Mr. Shyam Sunder Sharma, Research Assistant gave a detailed information regarding Vermi Compost and NADEP. He spoke at length on the pre preparation, process of formation and benefits of vermi compost.

Mr. Swaraj Singh Research Assistant Testing and demonstration Centre delivered a lecture on soil testing and water testing. He explained in detail the process of taking soil sample from the field and advised the farmers to test the soil to get good yield. Mr. Yogendra Singh, Farm Superintendent delivered lecture on varieties of seeds. He listed new varieties of wheat, mustard seeds. He emphasized on selection of seeds, seed treatment and places of purchasing good variety seeds. He advised farmers to purchase seeds from Govt. seed store or from the shops approved by Govt. to ensure quality of seed. His lecture was followed by question answer session. Mr. B. R. Yadav, Agriculture officer NIRPHAD did the recap of days programme. On behalf of NIRPHAD Mr. Yadav expressed thanks for fruitful participation of Mr. Mahendra Singh, Agriculture Development Bank Mathura and the staff of Raya Research Centre. As mentioned above sustainability is the challenge of on going programmes. NIRPHAD has taken some steps towards it as follows:

Networking with Govt. and NGOs Formation and strengthening of CBO’s Payment for services Fund raising from local resources Trainings Revolving Fund

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Child Focused Community development programme Unit 1st Project duration : 3 months (April 2008 to June 2008) Project area coverage : 5 villages:

(1) Gonda Atas (2) Nagla Surir (3) Nagla Sakaraya (4) Bobugarh & (5) Hanumangarhi.

Block : Mathura, Dist. Mathura 1.Programmes Objectives: • Community-based organization (CBOs) sustains different activities.

• Networking with Govt., NGOs, and private Institutions assist in identifying other

resources in the community for socio-economic development.

• Community knowledge about rights of children and women with legal information has

been enhanced.

2.Programme Components: 2.1 Strengthening of parents views: Village Total programme Work done 5 villages 151 15 programme 2.2 Strengthening of Community based Organisations (CBOs): Sl. No.

Village Total No .of programmes

Task Coverage

1. VSHGs 5 villages 10 programmes 10 programmes 2. Youth groups 5 villages 10 programmes 10 programmes 3. SHGs 5 villages 10 programmes 10 programmes 4. Farmers Groups 5 villages 5 programmes 5 programmes 2.3 Exposure Visit of CBOs: ♣HCDI Unit: After completion of TST programme it was felt that the community was not

informed that NIRPHAD HCDI programme had culminated.

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♣The Unit should help the community (CBO) to link with govt. departments and other

institutions so that after NIRPHAD’s tenure the CBO programme can continue.

♣ The CBOs were introduced to those departments from which they can get services/benefits

such as PHC and CHC, District hospital, CMO for health services, block office, KVK,

Agriculture Research Farm, CDO Office etc. These groups included SHGs, Youth Groups,

farmers groups. Exposure arranged for the members of VSHGs and linked with other

development agencies.

• Dairy Development programme.

• Veterinary Unit (Dairy Science Deptt.).

• Vermi Compost.

• Organic Farming, MP, Dewas District Mr. Deepak Suchaley Farm visit by 13 farmers.

• Monthly meeting for capacity building 15 monthly meetings in five villages.

3. Children’s Parliament:

5 villages, 22 children 3.1 Parliament:

Gonda Atas : 7 children Parliament

N. Surir : 3 children Parliament

N. Sakraya : 4 children Parliament

Babugarh : 6 children Parliament

Hanumangarhi : 2 children Parliament

Election of office bearers for 10 children’s Parliament and explained their roles and

responsibilities and the relevance of Children’s Parliament to community.

4. Networking community with Govt. Dep’t. and other Institutions: Cohesion and focusing of major issues was accomplished with good participation The

villagers began to be aware that collective action can solve some of their problems.

Some of the agencies whose collaboration was sought: Block-level activities: BDO Mathura . KVK Mathura District Training Institute.

District Agriculture and Horticulture Officers.

• District Development Officer, Primary Health Centre, Community Health Centre.

Agriculture Research Farm. And Private Dairy Unit.

♣ Dairy Farm, Animal Husbandry and Veterinary University Mathura.

• Officers of these departments were invited to share information among the villagers and

visit members of community, women SHGs and farmers groups.

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• Youth groups and village committees were organized to coordinate these activities.

Formation of SHGs in Bajna area of Nanjhil Block.

1. NIRPHAD had a target of forming 50 SHGs with the financial support of NABARD.

Prior to June 2008 only 14 Groups were formed.

2. From July to December 2008 three days in a week were fixed exclusively to visit

villages to explain the role and importance of SHGs and 10 SHGs were formed

in the following villages:

2.1.

Sl. No.

Name of Group Village No. of Members

Account in Bank

1. Gaurishankar SHG – Male Chindouki 11 Syndicate Naggarhi

2. Gauri Laxmi female SHGs Chindouki 12 Syndicate

3. Santosh SHG – Male Saddikpur 14 Syndicate Bank Bajna

4. Adrsh Prem – Male Barghar 12 Syndicate

5. Laxmi Mahila SHG Barghar 12 Syndicate

6. Shiv Ganesh SHG – Male Badons 14 Syndicate

7. Ma Durge SHG Badons 14 Syndicate

8. Upma SHG Joint Saddigpur 10 Syndicate

9. Mahila Kalyan SHG Khanpur 13 Syndicate

10. Jan Kalyan SHG Khanpur 13 Syndicate

o Two or three meetings of the groups were held to increase their motivation,

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By B.R. Yadav, B.Sc. (Agriculture)Field Programme Officer, NIRPHAD

Sobhagyawati Surakshit Matritwa Yojna (for households below poverty line) Rubric: “Yahi Bachan Hai Sabse Sachcha, Rahe Surakshit Jachcha-Bachcha”

“The children who are pure in thought, these children’s mothers had safe deliveries” 10.1. Introduction: 1.1. The mortality rate among women,, children and infants of UP is much above the

Indian average . It is necessary to promote institutional delivery to reduce this rate

but people’s faith in government services is declining because of lack of proper care,

carelessness of staff, timely care etc.

1.2. To regain faith of the community by participation in private nursing homes and

voluntary organizations, it has been decided launch a programme of ‘Janani

Suraksha Yojana’, which was established on 13 May 2008, but in the District this

programme started in July 2008 with the participation of four private hospitals

1.3. Under the Scheme the women belonging to BPL were provided free delivery

facilities in nursing homes/hospitals/voluntary organizations.

10.2. Details of Soubhagyawati Yojna: 2.1 Eligible beneficiaries: • All women belonging to BPL category in rural as well as urban areas are eligible. • Under this scheme the beneficiaries are given approved financial assistance. 2.2 .Provision of services: Under the scheme the selected hospitals which meet quality standards are

recognized.

2.3. Facilities available under the scheme Under this scheme following services were provided free of cost through recognized hospitals. 2.3.2 General Health Check Up This includes blood tests, (ultrasound if very necessary), BP, weight, vaccination-

two doses of TT, iron folic acid tablets etc.

2.2.3 Facilities for Delivery: Normal and if necessary caesarian, however no caesarian

section was reported as yet.

It was necessary to stay in the hospital for 24 hours, after normal delivery.

• Proper care of new born child and mother.

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• Referral advice before, during or of post delivery complications.

• To make available all necessary medicines required during delivery.

Other services: Based on consent of beneficiary, family planning services, however

no one

10.3.Dissemination as information of the programme details 3.1. To propagate the programme two meetings with ASHA workers in the block and

DNM in recognized nursing Homes were held and the information was shared

3.2 The scheme was also propagated at PHC & CHC levels, which included all staff.

3.3 Besides, pamphlets were distributed and information was also given to News

papers. Consequently many women utilized these services provided by NIRPHAD..

10.4. List of Recognized Hospitals in Mathura Dist.

♣ NIRPHAD Hospital Chhatikara, Rural areas of Mathura.

♣ Seema Hospital Mathura bypass.

♣ Brij Chikitsa Sansthan Davli Mathura.

♣ Surendra Nursing Home Chandanvan, Mathura.

10.5. Deliveries in NIRPHAD Hospital- coverage Women from Mathura, Choumuha, Govardhan, Chhatta , Mat Blocks and urban areas of

Mathura such as Vrindavan, Mathura and, Choumuha towns utilized the delivery

services..

10.6. Payments to Hospitals for Services: 6.1.The clients from different blocks of the district were provided free health services and

in return clients received Rs.1850/- per client from CMD Health Dept.

Total Deliveries Rate (Rs.) Total paid to clients (Rs.)

224 1850 Rs.4,14,400 (Four lakh

fourteen thousand four hundred)

6.2. The payments to the beneficiaries of Janani Suraksha Yojana were through bearer

cheques.

224 clients out of which: 219 were Rural @ Rs.1400 per client =Rs. 3,0, 6600.00

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5 cases urban @ Rs.1000/- per client = Rs. 5000.00

Total 224 clients =Total payments to clients= Rs. 3, 11, 600.00

6.3 Procedures: On the prescribed proforma the names of the patients were given to

ASHA by nursing home/organization/Hospital so that they are able to get their

honorarium from the relevant Health centre.

6.4 Total clients: 224

a) Clients brought by ASHA =185

b) Clients coming on their own =39

10.7. Regular Supervision and BPL household Ration Card: ♣ For availing the facilities of the Hospital proof of eligibility (Ration Card) has to be

produced before the organization.

♣ On the he basis of BPL Card the hospital provides free facilities and their eligibility is

to be supported by ASHA’S confirmation that the client belongs to BPL category.

♣ 10% of clients are physically examined by the hospital by visiting the villages to

ascertain eligibility of the cases. In the office:

(i) Copy of the BPL Ration card is made available.

(ii) Recent photograph of the beneficiary is submitted for identification.

10.8. Brief stratification of delivery clients: • Total clients (No.) : 224

• Rural Clients (No.) : 219

• Urban clients (No.) : 05

• Clients:: general population (No.) 31

• SC clients (No.) : 108

• OBC clients (No.) : 85

10.9 Gender at birth: Male : 128

Female : 96

9.1 Weight of infants at birth: Less than 2 kg. 2 to 2.5 kg 2.6 to 3 kg. Above 3 kg.

20 68 88 48

60

9.2 Still births : 05

Death within ½ hour of birth : 02

Women saved from death during delivery : 10

10.10.Staff component in Soubhagyawati Surakshit Matritwa Yojna Scheme: Medical Officer : One

Assistant ANM : One

Dais : Three

Programme Officer : One

10.11. Income Received from Soubhagyawati Surakshit Matritwa Yojna Scheme: Total payment from 224 deliveries @ Rs.1850/- = Rs.4, 14,400

Medicines and other expenses Rs.56, 440

Savings about Rs.3, 57,960

10.12.Challenges in Proper Implementation of the Programme: (i) OT facilities inadequate- needs to be updated.

(ii) Lack of staff nurse to help during Caesarian sections.

(iii) Non-availability of Pathological services round the clock.

(iv) Non-availability of Ration Card to the beneficiaries.

(v) Non-availability of Blood Bank and Oxygen facilities.

10.13.Suggestions: o If better facilities are available in OT Caesarian operations can be

performed and family planning services can be offered post-patum, which

will enhance the income of the Hospital.

o Trained staff nurse should be available in OT.

______

61

11. Ramesh Chandra Saraswat Since 1985

Working in the NIRPHAD Chhatikara as an Agriculture officer, since 1985 Rubric – Agriculture is the mainstay for the survival of humanity and food grain stocks are tumbling with drought and unprescredented population growth Following are the Responsibilities

1. Livelihood programme 2. Organizing Health Awareness Camps 3. Programme of Steel Authority of India Ltd. 4. in charge of mobile vans 5. medical store 6. vehicle maintenance

HCDI programme unit – II

Bunding of 250 bighas land was done in villages – Nagla Sumera, Nagla Moji,

Bhantys & Janai, a total of 119 femilies were covered 75% expenses of the four bunding

was borne by NIRPHAD and 25% contribution was shared by the beneficiaries in the

form of labour. These 119 families are poor farmers and land to 40 families has been

given by the government.

Farmers Training Programme Training was conducted in four villages Nagla Sumera. Janai is Bharty, Nagla

Moi. One training programme in each village, resource person was Raya Agriculture

research farm Ray and Devendra Singh farm Suptd and spoke about crop rotation & crop

insurance – bio fertilizer, watershed management.

Through CPCDP villagers are organized for visual perception and to adopt

successful attempts done by others. So far number of exposure visits are organized

Agriculture Research centre. Raya, Krishi Vigyan Kendra Mathura & Vet. College &

Research centre Mathura to enhance farmers’ knowledge regarding new agriculture

techniques concepts organic farming some farmers have adopted best agriculture

practices.

One farmer from village Bhartya is Growing vegetables on large scale, due to the

exposure visit organized by NIRPHAD to Pant Nagar Agriculture University, Nainital,

Uttarakhand.

62

Mr. Mukut Bihari from village Bhartiya purchased seeds (tomato, cauliflower,

brinjal, green chilly etc.) and developed kitchen garden at his village. He utilized half

acre land for growing vegetables and continued it. At present he is growing vegetable in

3 acre of land and its earning handsome profit. He has reduced wheat & mustard

cultivation, green fodder, jawar bajara, barsim, production and is concentrating on

vegetable growing during the year 2008. He has earned Rs.33,000/- as net profit this has

become a very successful activity and other farmers are trying to replicate this activity.

NADEP method compost pits & vermin compost were constructed in village.

Jonai, Bhartiya, Nagla Mauji and Nagla Summera to promote organic farming.

Under the drinking water scheme in village Bhartiya there was acute drinking

water problem although one community members Mr. Hukam Singh, since 2006 a total

of 120 families received potable water. For this facility the families are paying to Mr.

Hukam Singh Rs.100/- per month after three year. For this facility the families are

paying Mr. Hukam Singh Rs.50/- per stand post per month as rent.

After three year since March 2009 one community member Mr. Bhoja s/o Kanihya in village Bhartiya. 80 families contributed for laying pipeline (200 metre) and these families are getting sweet drinking water for their facility the families are paying Mr. Bhoj a Rs.50/- per stand-post per month as rent the rent is used for the maintenance of the tube well, settling the diesel and for paying the caretaker.

When the scheme was successful, other community members approached

NIRPHAD to extend it by Exposure & meeting, (VLC & SHG & Farmer Group youth

meeting).

To promote green vegetable concept for pregnant women NIRPHAD distributed

kitchen garden seeds, to 160 families in villagers (Radish, palak, methi)in village

Bharliya Janai Nagla Sumera, Nagla Mauji.

Exposure visit: Two exposure visit to 1. Koshi Kisan Mela. 2. Pandit Deen Dayal Viswavidyalaya

& Gau Anusandhan, centre Mathura.

63

Topics covered were:

a. New agriculture experiment.

b. new high yielding.

c. watershed (demorstation).

d. Soil test.

e. Plantation.

f. Crop and animal insurance.

Two exposure visit to Kosi and Mathura University was organized in this

exposure 200 farmers Benefited from the 4 villages where they were exposed to new

techniques agriculture implement, HY. Seeds & soil.

Testing and cropping patterns

In Mathura dist a new Mobile soil testing van so go to village. In Kosi fair the

govt. started a soil testing van which will test soils from house to house and farmer to

farmer. It was inaugurated by Agriculture Minister Shri Laxmi Narayan.

Animal Husbandry: Awareness camp at village Sumera, Janai, Nagla Moss Bharliya awareness camp

programmes were organized by NIRPHAD for animal husbandry.

1. Dr. Maheswari (VO) (Vet Hospital Vasundara) 2. Dr. R.S. Sharma (VO) (Vet. Hospital Vasundara) 3. Mr. Brjendra Pal Vet Asst. 4. Mr. Sohan Lal, Vet. Asst.

Topics covered were:

A. Vaccination, FMD, H.S. B. Animal insurance. C. Balanced Diet D. Green Fodder. E. Care of small and big animals.

64

In four villages H.S. vaccination of 700 animals, treatment of 150 animals by Dr.

& from Medicine Rs.5/- only charged for regsloatm.

Pass on the Gift scheme: 12 beneficiaries were given 24 goats, one unit consists

of two female goats. They will be crossed with healthy, berbery, on one berbery male

available in the village for insemination and near vet. Hospital, Vrindavan, Chhamuha

vet. Hospital. After two years two female of spring will be given to another widow, this

demino expect is known as pass on the gift.

Youth Groups – 72 members of 4 youth groups of four villages a attended 15

meetings. NIRPHAD arranged exposure to red fort Agra & Fatehpur Sikri Agra.

Youths were taken by bus as directed by Mr. B. Lal.

Inter village cricket tournament were arranged cricket set (kit bag) by NIRPHAD

team A. Jonai, Bhartiya Nagla Sumera, Nagla Moji, Sakaraya, Babugarh, Chaumha total

eight teams played.

Vocational training:

7 youths were identified from village (VLC holder’s) for receiving vocational

training in computer basic some of them have completed their training and now they are

interning on an honorary basis after sometime when they are well trained they will start

earning.

Mobile Van:

Provision of running of 02 Nos. of mobile dispensaries for Health Services to

surrounding villages of Mathura refinery.

Surrounding villages 1. Bhainsa 2. Bad 3. Dhana Teja 4. Aganpura 5. Azampur

6. Koyala 7. Ranchi 8. Mohanpur 9. Bhana Saasbad 10. Mohanpur.

The programme will be called community. Health programme sponsored by

MTR Refinery and implemented by NIRPHAD.

a. Diarrhia - 2752

65

b. Respiratary: Acute - 10517 Crime - 1717 c. Eye Problems - 1927 d. Skin discase - 2149 e. Malaria - 50 f. Water bone diseases - 08 g. TB - 05 Total - 19121 patients.

Farm Bunding – 315 families of four villages all poor and marginal farmers. The

beneficiaries borne 25 per cent of total cost and 75% by the NIRPHAD. Farm bunding

activity helps in watershed management programme.

SAIL (Steel Authority of India Ltd.) Central Marketing, organization 85/4 ispat Bhawan, Sanjay Place, Agra.

Title : Linking Drinking water & Sanitation and its impact on health (with

special emphasis on intersectorial development to reduce poverty).

5 low cost latrines were constructed in village Nagla Brahaman Nagla Pohapi. Under the sail project one submersible pump & small over head tank (villages Nagla

Pohapi) for drinking water.

Covered families 160 one village. Future Plans: Survey planning organization and selection of Pari panchayat for village Nagla Brahman

is in place the survey was AFPRO ground water investigation.

Future Plans: Under the HCDI project for irrigation purposes One community tube wells, benefited marginal farmers & poor family covered. In HCDI 4 villages 4 borewell for only women’s farms & SHG members. Under Pass on the Gift Scheme 2 goat for widow women & SHG members poor family.

66

12. Mrs.Vidya MacCunes

Nursing Superintendent

“Nurses are the hospitality of the hospital”

Carrie Latet

1. OBJECTIVE

Main– To provide quality nursing care, by assessing, the factors contributing to the

patient’s speedy recovery.

Subsidiary – To establish easy access and interaction with other departments and good

relationships involved in patient care.

2. MATERIAL AND METHOD (FOR 50 BED HOSPITAL + 25 SPECIAL BEDS)

• Staff strength: 35 nurses + 1 Night Supervisor 17 Male nurses & 18 Female. 22

Ward aides. Stationed in OPDs, Offices, Departments and Wards.

• Trained Nurses are recruited after they are assessed by written & viva voce

tests.

• After initial orientation they are exposed to independent nursing care.

• After a general medical check-up and performance evaluation conducted

during the 6 month’s probation period, the nurses are provided leave facilities

and other privileges as regular staff nurses.

• Nurses are rotated in the different wards and other department to gain

experience and hone their skills (hands-on training) under experienced and

senior nurses, who provide guidance, education and experience.

• Sufficient supply of medicines & equipment are provided so that nurses are

given specific responsibilities to maintain inventories.

67

• Nurse’s duties are categorized into three shifts and each nurse is responsible

for the total nursing care of 8 to 10 patients, along with help of ward aides to

provide direct or indirect patient care.

• Not sufficient but few equipments and reasonable help provided to utilize in

primary care of patients.

3. Processes Involved in Performance:

Nurses are provided with semi-furnished twin sharing accommodation in

hostel (male hotel is separate from female section.) with free water and

electricity. Food is provided from a mess with affordable charges. Staff

manage the mess and did not engage a contractor.

Nurses and ward aides can avail leave according to contract, standing

Orders and staff position.

Nurses are regularly supervised in working areas and in the hostel.

Disciplinary action is taken after counseling for any misdemeanor.

Suitable punishment is meted out for recalcitrant, repeated offenders. ,

act misconduct.

Social and cultural activities are arranged.

Regular in service-education is carried out to update the clinical and

theory knowledge of nurses.

Christmas, New year, Holi were celebrated with cultural activities, fun

and food

4. Challenges:

Swarn Jayanti Samudaik Hospital being situated on high way and also

reputed hospital receives mostly very high number of casualties to

provide emergency care, which become very difficult for assigned

number of staff. Unlimited attendants cannot be controlled by security

68

delays which, causes disputes between the patient and attending relatives

and hospital staff.

Nursing care is hampered by delays in making decisions, non-availability

of Doctors, poorly maintained equipment and inadequate supplies

contributes lowering of standard of care and causes in dissatisfaction

among patients and relatives.

Improper control of visitor’s crowded in the ward, which interferes in

maintaining cleanliness, nursing functions, creates frustration between

staff and patient’s relatives, which damages the image of the Hospital and

ends with threats, arguments and fights. The incidents are grist to the

media for cheap and yellow journalism.

5. Implementation & Suggestions:

Regular availability of Doctors for in patient care.

Provision of ward clerk to handle phone calls and to do paper work

providing nurses to have more time to be with the patients for care.

More supply of linen (Bed sheets, Pillows, Blankets) safe mattresses and

life saving equipments.

Urgent provision of ramp when elevator is not functioning.

Budget to provide professional activities to attend seminars, conferences.

This will improve the quality of nursing knowledge

Provision of having more earned leave to fulfill family affairs and to

refresh mind and spirit.

Emoluments as per market rate.

Provision of having picnic (Once in two years) or any outing to refresh

mind, body and spirit

69

6. Job Satisfaction:

Emoluments are given which provided some satisfaction.

Housing with clean environment, greenery with seasoning blossoms, full

time security, 24 hours availability of water and electricity fulfill basic

needs,

Provision for overtime solves the problem of over work and shortage of

staff.

Working environment is good until administration listens to the

problems, co-operates and encourages; instead of pointing always to the

short comings. Nurses like other staff who are under heavy stress needs

appreciation for good work and especially when work load is excessive

with critically ill patients.

In times of family distress Administration should depute some staff for

visiting the grieving families. This improves concern, togetherness,

empathy with the staff and improves relationships.

7. Personal Growth:

• Professional growth is encouraged by the Institution with the provision of a

good stock of books, cassettes, overhead/multiplex projectors and T.V&VCR.

These tools, hones skills and contributes to nursing education. Special sessions

are organized from time to time on personal growth. Newspapers updates are

available as to what is happening at the National and International level.

• Periodical in-service exercise is carried out to upgrade professional knowledge

• Department is managing well when there are short of staff due to any reason.

70

13. Dr. Rajesh Singh, Physician MD Date of joining : 14th April, 2009 Dr. Kartik Mishra, Physician MD Date of joining: 31st March, 2009 Rubric :- Indian Medicine has contributed for generations but must keep up with new standards of quality control and research to make a desirable mix with allopathy. 1.Objectives:- ♦ Qualitative and annual assessment of performance. ♦ To review the weaknesses and finding ways for improvement. ♦ Set goals for the future. 2.Man power & tools:- Two Physicians Inadequate staff in OPD Equipments used – Ultrasound Machine, ECG Machine, X-Ray Machine, Pathology services. 3.OPD :- ♦ Medicine Department acts as a feeder to different departments. ♦ Majority ofpatients who attend the medicine OPD suffer from of respiratory diseases. ♦ Pulmonary tuberculosis is on the rise, as more multi drug resistant tuberculosis patients are diagnosed. ♦ COPD cases also form the majority. Both COPD and pulmonary tuberculosis are concentrated in Mathura because of poverty and smoking. ♦ Due to change of life style diabetes and hypertension the incidence is also on the rise. ♦ To increase awareness regarding diabetes HTN and CADs the Department

started, by organizing the camps and educating the people about these lethal diseases.

♦ Even after 61 years of independence people don’t have the facilities for safe drinking water and excreta disposal. That is why infectious diseases eg enteric fever, gastroenteritis, hepatitis, malaria endemics occur regularly through out the year.

♦ In 2008-2009 there were 21669 patients against 21823 in 2007-2008 OPD patients. i.e net increase of 154 OPD patients.

3. IPD :- Due to the poor functioning of District Hospital, rising costs of treatment in Private Hospitals and inferior referral Govt. Hospital, more serious Patients are admitted in wards of our hospital.

There should be facility of central oxygen delivery and central suction vacuum Pump with cardiac monitors, at bed-side. In 2008-2009 1282 patients were admitted under medicine department against 1150 patients in 2007-2008 ie net increase of 132 patients.

71

4.Emergency :- In 2008-2009, 1802 patients were brought to emergency department against 986 Patients in 2007-2008 ie net increase of 816 patients. Emergency department

Should be updated with sufficient skilled manpower and better medical equipment.

Casualty medical officers and staff should be better trained in emergency Medicine, from time to time & general condition of emergency depts. Like AC/Fan and cleanliness also needs improvement 5. Challenges and issues :- There should be :- One Nursing Attendant in OPD who could measure BP, Pulse, Weight and check

the medicines prescribed and brought by the patients. Patients need care and explanations regarding dosage.. Schedule of taking medication, side effects, any restrictions and date of follow up.

Due to regular and continuous change of nursing staff, standard of nursing care is progressively diminishing.

Due to heavy patient load the staff have very little time to interact and plan for future activities.

Facilities for entertainment and to recharge one self will go a long way in improving efficiency.

Security should be tightened in hospital OPD/IPD so that outsiders should not create problems and disputes in the Hospital.

There should be only one attendant with each patient during IPD rounds. Every one should not be permitted to discuss with doctors, this job should be reserved for P.R.O.

The number of off day are less There should be a better canteen facilities for Staff. A OPD register should be maintained to know the exact trends and nature of

diseases from time to time in the community. It will also help in future annual report documentation.

Mess should be started soon by giving contract to a contractor. 6. Interesting Case :

Mahavir 23 year male was admitted on may, 5, 2009 in medicine ward with chief complaints of pyrexia with altered sensorium of acute onset. There was no history of trauma and relevant past history of illness. On examination patient had no altered vital signs or symptoms and was stable. Rest of the systemic examination was within normal limits. After investigations MP smear was positive P. Vivax and rest of investigations including CSF were within normal limits. Patient was treated as a case of pyrexia with altered sensorium causinge cerebral malaria. Was treated with parenteral artesunate antibiotics, mannitol and, IV fluids. Patient

72

partially improved showing signs of resistant malaria. Quinine and ceftazidime, mannitol were administered with, Iv fluids. Patient improved after 2 days, but patient sesorium partially improved, therefore a suspicion of intracranial space occupying lesion vs. stroke.Patient was advised CT. Scan of head, that revealed small intra-cerebral hemorrhage. Patient was given mannitol, phenytoin, antibiotics and IV fluids. Patient improved after 2 days for further evaluation and expert opinion patient was referred to higher centre Safdarjung Hospital New Delh, at attendant’s request.

7. Job description :- ♦ Emoluments: Since there is very steep increase in inflation and prices of essential

goods, salary scale needs to competitive. ♦ Salaries should be revised from time to time as per market rate. ♦ Job satisfaction good. ♦ Quarters are not well maintained 8.Contribution to the Community :- DOTs Program: - Govt. of India selected SJSH as a DoTs centre because of

patients load. Free anti-tuberculosis medicines to poor patients are distributed and to ensure complete treatment, a concrete action for the society to fight tuberculosis.

Respiratory Camps: - Respiratory camps were organized every month with the help of a Pharmacy Company. In which, spirometry is done of patients to assess the progress and to diagnose new cases. Also, to increase awareness of the hazards of smoking and motivate clients to quit smoking.

Ultrasound Scan: - USG avilable since Dec, 2006 but this should be done by expert radiologist for better reporting.

Final Impression: - As the no. of patients in OPD/IPD and emergency are increasing every year, this reflects good satisfaction of the services provided. In spite of insufficient skilled manpower and instruments reasonably good services are provided. there is scope for committed improvement for future challenges.

Dr. Rajesh Singh/Dr. Kartik Mishra Physician MD

Swarn Jayanti Hospital-Mathura

73

14. Dr.Ajay Jain, M.S., General Surgeon Date of joining : 10th November, 2005 Rubric:- Good, Better, Best, Never let it rest. Until our good is better and our better is best. 1. Objectives Evaluation and analysis of departmental and personal progress for the year 08-09 Evaluate the benefits provided to the poor community in terms of affordable and easily available healthcare means Documentation of departmental needs and achievements Self assessment for enhancing future performance 2. Material and methods

• OPD & OT registers, permanent case files as provided by medical record section

• Patient and community satisfaction as assessed from, interaction with village heads and pradhans

3. Infrastructure and manpower 3.1 Hospital has well trained staff working in good coordination

but needs to be more strengthened. Language problem is a main hindrance with the nursing staff from south Indian state.

3.2 There is paucity of trained staff in operation theaters. There are two well equipped OT with two trained assistants only with one nursing staff and one ward helper

3.3 A separate emergency section being looked by resident duty

doctors with the surgery department providing prompt emergency services

3.4 Separate burn unit is being run under the department of surgery with trained nursing staff for treating patients with all type of burn injuries. Burn unit at SJSH is being now one of premier referral centre of Mathura district and surrounding area for treating burn patients. All of plastic procedures such

74

as debridement and skin grafting are being performed at our centre.

3.5 Inter-departmental coordination and support from

paramedical staff is excellent. 4. ACHIEVEMENTS AND CONTRIBUTION 4.1 Total no. of OPD patients treated – 7452 4.2 There is a continuous increasing trend in last three years. There has been a

increase of 244 patients from previous year which reflects the increasing confidence and community relationship with the department

4.3 Total no of indoor patients – 924 – again an increase of 70 patients then previous year

4.4 Total number of general surgery patients attended to in emergency-1860, an

increase of 223 patients than previous year. 4.5 Total number of operations performed-483 an increase of 89 operations as

compared to previous year. 4.6 Satisfactory to good results with 0% complications rate for laparoscopic procedures (give numbers) 4.8 Several laparoscopic procedures have been performed in serious and critical

patients of abdominal trauma, perforation, peritonitis and intestinal obstruction etc with good results

4.9 Serious head injury patients are being managed conservatively without mortality till date. Only those requiring neuro-surgical intervention are being referred to higher centres.

4.10.A separate air-conditioned burn ward and surgery department is working as a premier referral centre for burn patients in this district.

75

7208

8541637

399

7452

924

1860

483

0

1000

2000

3000

4000

5000

6000

7000

8000

No. of patient

2007-08 2008-09

Statistics of General Suregry Dept. 2007-08 to 2008-09

OPDIPDEmergencyTotal No. of Oper.

6. Suggestions for improvement:- 6.1 In the OPD- the ward help should not be changed too frequently as the new

person takes time for adjustment and this creates hindrances.

6.2 In the ward- The staff should have strict directions to inform the consultant for newly admitted patients & also inform if the patient becomes critical or if he had asked for any urgent investigations

6.3 In the OT- 6.3.1 The practice of transferring the OT technician for ward duties should be

discontinued & if the OT technicians are free they should be helping both the Ortho/Gen. Surgery consultants in surgical work.

6.3.2 The air conditioning system in OT is not working & it definitely affects the performance & routine functions. New A.C should be installed as soon as possible. 6.4 In the Emergency section- 6.4.1 The duty Doctors/paramedical staff should inform regarding each & every critical patient of head injury & poly-trauma to the respective consultants.

76

6.4.2 The duty doctor/staff should also inform urgently if any of the patients become critical & should not discharge patients without informing the consultant 6.4.3 Necessary surgical instruments are lacking in emergency. 6.4.4 Administration/Security should be strict not to allow more than one attendant in casualty area as it hampers working. 6.5 In the Burn Ward- 6.5.1 Burn ward needs separate cubicles for patients, which will prevent cross-infection & also help in maintaining privacy of patients during dressings when both male & female burn patients are admitted. 6.5.2 Regular fumigation and change of mattresses is needed in burn ward. 6.5.3 Security should be strengthened and not allow more than one attendant for

each patient. Also discourage having lunch & dinner sitting on the floor besides the patients.

6.5.4 Cap/Masks/Footwear should be provided for staff & Doctors to enter the burn ward once or twice in a year.

6.6 Consultant should be allowed leave & help to attend surgical training courses. 6.7 Laparoscopic Instruments in OT needs to be changed as the camera & hand

instruments are totally malfunctioning & it has become hazardous for the patient if the surgeon is performing surgery with the poor instruments.

7. Academics With Laval University Students:- Laval University Medical Students from Canada come every

year and exposure is given to them in low cost health care & community programmes. All the students are taught clinical exams/basic surgical

procedures & trauma care in the emergency dept. They are allowed to assist in OT & do practical training wherever possible. All the past batches have provided a good feedback and appreciated the working of surgery dept. that they were exposed to, during their training period. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

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15. Dept. of Pediatrics

Dr.Sanjay Nanda (Bsc-MBBS .DCH.P.G Diploma Hospital Management,

Management Course on leadership and Management (ISHA) )

Date of Joining: 3rd February, 2003

Rubric : Real optimism is aware of problems but recognizes solutions; Knows about difficulties but believe they can be overcome; See the negative, but accentuated the positive; Exposed to the worst but expects the best; Reason to complain chooses to smile. William Arthur Ward 1. Objectives-

1. To document achievements of 2008-9. 2. For self assessment and improvement 3. To Share of information and also to get feedback regarding performance 4. To record achievement , failures and lesson learnt 5. To record contribution to the Organization 6. To list the services given to the community.

2. Material and method

i.e Source of data and information 1. Community ‘back ground noise’. 2. Interaction with satisfied and dissatisfied patients (Client) and their

attendants. 3. Data from medical record section 4. Discussion with the staff at every level 5. Reviewing Annual Reports of SJSH and other organizations 6. Actions taken at BOM, EC and FC and comments by Board Members of

NIRPHAD and District authorities. 7. Advise and feedback from Monitoring Committee of SJSH 8. Self assessment and verbal autopsy.

78

3. Manpower (see organogram)

4. Equipment & Tools:- Stethoscope, weighing machine, CPR kit, Torch, Oxygen supply, Pulse Oximeters, Monitors and, Defibrillator

SJSH

Medical Paramedical

Supporting Staff

Administrative

Pediatrics,Surgery, Orthopedic, Pathology, Medicine Gen Surgery, Physiotherapy, Emergency services(Casuality),

Ultrasound Facility.

Peadiatrics Consultant-Dr. Sanjay

Lab Technician, X-Ray Technician, Pharmacy, 35 Nurses

Ward aids, Housing dept, Electrical Dept.

Administrator, Office Incharge, Accountant

79

5. Requirement is for :- Pediatric ventilators, Phototherapy Unit, Warmers, Infusion Pump, New monitors and a separate ward for pediatric patients. 6. Daily activities

1. Daily OPD is conducted except Sundays and holidays (gazette holidays) 2. Round the clock emergency services 3. Evening OPD for Private patients 4. Vaccination services on every Wednesday 5. At least 2 ward rounds in morning and evening and also when needed in case

of critical patients 6. Attending any call from ward and from casualty department 7. apart from this Hospital administrative activities, looking after field program

in Mathura, Bajna and Agra of NIRPHAD and administrative inputs and responsibilities of NIRPHAD which also requires a major part of my time schedule

8. Respiratory Clinic held on every Thursday 7. Job satisfaction and Training I am getting a good exposure and experience in pediatrics but due to restriction of equipments, manpower, specialized wards (NICU), separate pediatric ward) I feel dissatisfied when patient needs to be referred to higher centre with better equipment and facilities. After the busy schedule still I could find sometime which I used to complete my PG diploma in hospital administration (1 ½ yr) and PG in management (2 yr course) from Indian Society of Health Administrator (ISHA), Bangalore. This year I qualified the open MAT. ( Management Aptitude Test) entrance test conducted at National level for getting admission in a 3 yrs course of MBA ( Human Resource) which will start from July, 2009 session. Last year in September as part of my exposure training I got chance to visit BRAC in Bangladesh, which is the largest NGO in World. Emoluments – as compared to private and government institution salaries are less but after the new contract which was signed in Oct, 2008 there is improvement in the salary structure. 8. Challenges:

1. Nursing staff and medical officers who acquire suitable skill to handle patients satisfactorily leave SJSH, may be due to low salaries and job uncertainty. Hence, long term planning is very essential

2. Some of the equipment are now outdated and some cannot be used as parts are not available. New equipment requirement is under consideration of IOCL/MOR.

3. For keeping abreast with improvements in medical care CME is essential. Exposure visits to suitable institution need to be arranged

80

4. Pediatric department require separate beds and equipment for general patients and especially for neonates

5. Availing leave is a problem as a substitute pediatrician is not available. 9. Comparison of Year 2007-08 to 2008-09 OPD 2007-08

OPD 2008-09

Increased

%

IPD 2007-8

IPD 2008-09

Increased

% Emergency 2007-8

Emergency 2008-09

Decrease %

6925

9764 2839 41%

325 408 83 25.53%

569 537 32

Total No. patient seen in OPD ( 1999-2009)

3699 4061

2864

7885 7872 7718 7494

5173

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

2000-01

2001-02

2002-03

2003-04

2004-05

2005-06

2006-07

2007-08

2008-09

No.

of p

atie

nts

9764

IPD Statistics

325408

0100200300400500

2007-08 2008-09

No.

of p

atie

nt

81

OPD Statistics

9764

6925

0

2000

4000

6000

8000

10000

2007-08 2008-09

No.

of p

atie

nts

569

537

520530540550560570580

2007-08 2008-09

Patie

nt

Emergency

82

10. Contribution of Pediatrics in Patient care:

IPD (Medi.,Ortho.,Surgery, Pediatric (2008-09)

1282, 40%

660, 20%

924, 28%

408, 12%

MedicineOrthopedicSurgeryPediatric

Pediatric

11.Two interesting patients:

83

Father of Gopal requested to get a photo graph with Dr. Nanda ( Treating Pediatrician) and wants to give in writing that his child who was having COUGH for last five years is now asymptomatic after being started on ANTI TUBERCULAR treatment. He took treatment for 9 months. One week after the treatment was started 2nd stage 1st stage

84

16. Dr. Adesh Sharma (MS-0rtho) Orthopedic Surgeon Date of joining : 30th January, 2009 Rubric : Trauma in India has been correctly called THE NEGLECTED DISEASE OF MODERN SOCIETY; but today it demands attention. 1. Objectives :

1. Qualitative & quantitative annual assessment of performance. 2. To review the weaknesses & finding ways for improvement. 3. Role of Orthopaedic department in fulfilling community needs 4. Set goals for the future.

2. Material & Methods: 9. Data from medical records section 10. Patient & community satisfaction assessment by interacting with village

Pradhans and hospital staff. 3. Manpower & Tools:

1.One Orthopaedic surgeon with good support from general surgeon, physician and anesthesiologist in dealing with surgical emergencies.

2. Causality medical officers are dealing with emergency trauma & helping in prompt care of critical patients. .

3. Nursing care by professionally skilled nurses is available. O.T. staff, including assistants, technicians & ward boys are very trained & helpful. 4, Round the clock laboratory services contributed for prompt clinical and most suitable management decisions...

5 Ancillary services like X-Ray (diagnosis) & Physiotherapy (follow up for quick rehabilitation) departments essential for care of patients.

4. Issues & Challenges: 1. To deal with increased number of road traffic accident emergencies, a better Spacious emergency department with availability of life saving instruments such as suction apparatus, cardiac monitors, defibrillator, ventilator, etc. 2. Improper control of visitors, leading to crowds in the wards is a big threat to spreading infection, especially for post operative patients.

11. One nursing attendant required in OPD to help in educating patients regarding precautions, exercises, medications etc. 4. Most of the equipments in OT are now outdated & require urgent replacement

especially image intensifier & fracture table. 5. Require more paramedical staff in the operation theatre & in assisting plasters

& dressings. 5. Statistics: Despite increased number of orthopedic surgeons practicing in Mathura, and ever increasing private & charitable hospitals in the city, the department performed exceptionally well. There was significant increase in indoor patients and number of operation being performed. The reasons being increased number of road traffic accidents & better acceptance of orthopedic services being provided at SJSH.

85

12758 1296911991 12300 12095

771 779 590 635 660

0

2000

4000

6000

8000

10000

12000

14000

2004-05 2005-06 2006-07 2007-08 2008-09

Patie

nts

Ortho statistics from 2005-2009

OPDIPD

317

732

420

697

306

949

334

1578

334

1772

0

500

1000

1500

2000

Opr.

2004-05 2005-06 2006-07 2007-08 2008-09

Operations- Major & Minor 2005 to 2009

MajorMinor

1892 1880

1598

1400

1600

1800

2000

Patients

2006-07 2007-08 2008-09

Emergency from 2006 to 2009

2006-07

2007-08

2008-09

209389

0

200

400

Patients

2007-08 2008-09

Evening OPD from 2007 to 2009

2007-08

2008-09

86

17. Pathology/Laboratory Department Dr. Pradeep Parashar, Pathologist Joining Date: 1st July, 2006 Rubric: “Health is not mainly an issue of doctors, social services and hospitals. It is an issue of social justice”

Dr. J.E. Park 1. Introduction: The purpose and function of laboratory through clinical pathology and laboratory medicine are to assist, the clinicians in confirming or rejecting a diagnosis and providing guidelines in patient’s treatment. 1.1 The department of pathology at SJSH consists of various sections namely haematopathology, clinical biochemistry, serology, cytopathology and transfusion medicine. 1.2 Each year the complexity of laboratory testing continues to increase e.g. bone marrow aspirations for diagnosis of various types of anemia, hematological neoplasm & malignant cell diagnosis of bone marrow aspirates for malignant cells. Changing trends of malaria presenting with thrombocytopenia’s, double infections and increasing trend of Dengue fever and HIV/AIDS. 2. Routine Activities: Among the various sections haematopathology comprises the main bulk of day-to day services and showed a significant growth in total number of patients and also increasing complexity. Clinical bio-chemistry plays an important role in providing rapid and highly reliable data to support prompt therapeutic decisions by consultants. Role of transfusion section consists of blood grouping its timely supply, after screening for various infectious diseases (HIV,HCV,HbsAg etc). This year the Department also started cross-matching before transfusion. blood brought from other labs. Cytopathology includes routine fluids examination e.g. (CSF, ascitic & pleural, any discharge like pus) and reporting various fine needle aspiration cytology and bone marrow aspiration. Providing lab services 24 hours for IPD and emergency patients and 9 AM to 5 PM for OPD patients. SJSH has been selected for RNTCP(Revised National Tuberculosis Control Program) under which laboratory is playing an important role in sputum examination (One of the technical staff is being trained under RNTCP). The department is attached with CMC Vellore for External Quality Control. 2.1. NO. OF TESTS [1999-2009]

87

Staffing: Department pf pathology staff comprises of one consultant pathologist, lab, blood bank, microbiology technicians and lab assistant cum ward boy. With the steady I Increase in total number of tests and limited manpower and high quality clinical services, have been very challenging. 3. Equipment: The lab is well equipped with fully and semi automatic bio-chemistry analyzer (functional), ELISA (Enzyme linked Immune Sorbet Assay) Analyzer, cell counter (not functional due to shortage of reagents). The old system of reporting e.g. hand written reports are being given to patients/consultants which are not presentable. High priority will be proper system (software and printer) for reporting in order to meet new standards. This will be less time consuming and staff can be utilized in other activities. 3. Financial Analysis: The department is one of the best in financial recovery, as expected. “The department tries to provide high quality, cost effective pathology services in a manner that supports patient care” 4. Planning/Challenges: Nursing staff needs to be trained regarding proper sampling techniques to be sent to the lab. Create more opportunities for staff to provide continuing education at higher centers. The laboratory desperately requires investment in capital for new hematology cell counter, reporting system and to replace aging, malfunctioning instruments to ensure a high quality service. Efforts are being made to develop a quality system in preparation for newer trends. The results are generally well within or better than accepted benchmarks. 5. Interesting Cases: Female patient aged 10 years came with progressive weakness for last one month her hemoglobin was 6.2gm% and peripheral blood picture showed

6875

26221 26885 2769130073

43606 4219238829 40069

38270

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

50000

99-2000

2000-01

2001-02

2002-03

2003-04

2004-05

2005-06

2006-07

2007-08

2008-09

88

immature cells. Her bone marrow aspiration was done and she was diagnosed as acute myeloid leukaemia. There are several patients being referred to pathology with complaint of cervical lymph nodes enlargement. The age of these patients is usually above 40 yrs. On FNAC most of them were diagnosed as metastatic aqueous cell carcinoma. 6. Personal Growth: CME enables interaction at District/National level so that interaction with other specialists is possible. A National conference sponsored by the hospital will enable staff to experience recent advances and newer trends. The department has one visiting consultant, Dr. R. Britt, FRC pathology, U.K a renowned hematopathologist who updated through his experience and also brings valuable study material and newer techniques to the dept. He also brings clinical specimens which provide an external quality assurance and dept is well within standard benchmarks. The department. has excellent work environment, free to explore newer dimensions, in respective areas. The dept. is trying to give of its best to the community by providing cost effective services, which are not available in the district, e.g. bone marrow examination. 7. Data of HIV/HCV/HepB./ Hbag from April, 2008 to March, 2009

S.No. Month HIV HCV Hep B. Total +ve -ve Total +ve -ve Total +ve -ve

Apr. 08 to Mar 09

1 Apr 08 66 1 65 59 1 58 70 2 68 2 May 08 86 1 85 72 1 71 87 8 79 3 Jun 08 87 87 71 1 70 85 3 82 4 Jul 08 92 92 49 49 91 2 89 5 Aug 08 63 63 56 56 64 4 60 6 Sept 08 84 84 66 66 89 2 87 7 Oct,08 67 67 40 1 39 60 2 58 8 Nov,08 91 91 55 55 88 5 83 9 Dec,08 66 2 64 58 58 59 3 56

10 Jan,09 49 1 48 41 41 45 6 39 11 Feb,09 58 58 36 36 48 48 12 Mar,09 80 80 64 1 63 76 4 72

Total 889 5 884 667 5 662 862 41 821 7.1 Data of Last Year Annual Report 2007-08 943 2 921 410 3 407 910 46 864

89

18. Dr. R.B. Sharma, M.S. (O)

Anaesthesiologist

Date of joining: Feb. 3, 2009

Rubric: Skills of a competent anaesthesiologist, who is a vital cog in the wheel of patient care, is paramount to the successful outcome of any surgery, especially in the high risk.

1. Objectives:-

1. Achievement of Department 2. Community response & benefits to community 3. Statistical evaluation 4. Comparison of different techniques of anesthesia 5. To find out the techniques of safe & balanced anesthesia

2. Duties & Roll of Anesthetist:-

( a) Pre anesthetic check up (PAC)

Apart from physical check up of the patient the anesthetist should try to remove the fear & anxiety of surgery & anesthesia from patients by polite, assuring conversation and counseling.

( b) To administer safest & balanced anesthesia under available facilities.

( c) To resuscitate critical patients in wards & ICU

( d) To attend emergencies when required

( e) To maintain complete record of type of anesthesia and events during surgery on standard documents..

( f) To manage unexpected accidents of anesthesia

( g) Pain Management

( h) To develop a staff training programme

Eternal vigilance of an anesthetist is imperative in the OT & ICU and failures of concentration can, which can be metaphorically, compared to an unconscious person who has been left on a high way, where many types of automobiles, at different high speeds hurtle dangerously.

90

3.Materials & Methods:-

I joined the Department on 3/2/2009 & tried my best to administer the safest anesthesia to different types of patients including high risk groups also, with pre-existing systemic disorders.

Anesthesia was administered to poly-trauma patients with maximum safety.

Anesthesia was also administered for emergency surgeries.

Post operative follow up was also conducted in wards.

When ever needed successful regional blocks were used with excellent results.

Since joining I administered 12 brachial blocks & not a single failed

Whenever needed I never hesitated to consult the Physician prior to

anesthesia in cases of pre existing systematic disorders.

Conducted one lecture to para-medical staff of SJSH on cardio pulmonary

resuscitation.

. I constantly enjoyed full co-operation with all consultants. Thanks to them.

O.T staff (Paramedical) are fully competent in discharging their duties.

High quality of medical services to the suffering community can

not be achieved without good team work & SJSH fulfills this criterion,

highly commendably.

4. Man Power & Tools:-

Trained permanent staff is a requisite in post op. wards.

At times the O.T staff is diverted to the wards & OPDs, which should not be a

regular practice.

For further improvements in the Dept. few drugs like Isoflurance, Fentanyl,

91

Morphine should be considered. Fibre optic laryngoscope has become necessary for difficult patients requiring intubation. One anesthesia machine requires replacements of its inbuilt valves & new circuits. The Central AC system is not providing regular & desired cooling in OTs. 5. Contribution : Expert opinions from other specialists always helped in better management of patients. Four OT ward staff did play a very significant role in managing the patients. 5.1 Achievements:- None of the regional blocks given so far was a failure. Anesthesia was administered to many geriatric patients after considering safety precautions with good results. Implemented quality of anesthesia, for which my training was a big factor. . Routine Staff training enabled efficiency in the Department Lecture on CPR to staff. Total no. of anesthesia for all age groups and all types of surgeries in SJSH for the period 2008-2009 is as follows:- General Anesthesia - 34 Short GA - 85 TIVA* - 05 Spinal - 266 Regional Blocks - 35 Grand Total - 425 *Total intravenous anaesthesia 6. Job Satisfaction:- The consultants should be encourage to attend at least one national conference & one of U.P. chapter, in a year, to enable interaction with and exchange of experiences with other specialists and update knowledge with the latest techniques and equipment.. . 7. Infrastructure of O.T. Ω The O.T complex is quite spacious which is essential for free movements of staff & better placements of all machines. Ω SJSH has completed 10 years of its services to the community and response of adjoining villages towards the Institution is quite encouraging. Ω The OT complex now requires maintenance & repairs along with purchase of new machines like- diathermy, suction machine, image intensifier, laparoscopes so that advanced expert services can be provided.

92

19. PHYSIOTHERAPY DEPARTMENT R. RAJKUMAR,BACHELOR OF PHYSIOHERPAY, MBBS (ALTERNATE

MEDICINE)-………. PHYSOTHERAPIST (HOD) JOINING DATE: 13.05.2002 RUBRIC: REHABILITATION IS TO RESTORE PARTIALLY ORCOMPLETELY TO FORMER OR BETTER CONDITION OF PHYSICAL, MENTAL AND SPIRITUAL WELL- BIENG. WHEN THESE ATTTRIBUTES DONOT EXIST, THE PHYSIOTHERAPIST CREATES AND ATTEMPTS TO BRING WHOLENESS AND THAT WAY HE BECOMES A PLAMATE WITH GOD.

- ADAPTED FROM WHO AND MICHAEL

SHEA

1. Performance of Department: Department is well maintained with well qualified professional

physiotherapist & trained female ward aid and 6 Canadian medical

students and two interns

Daily patients register entry is documented (OPD)

In patient register is available

Trainees and interns attendance records are maintained

Maintenance of physio-equipment.

Working hours 8 AM to 1 PM, and 2 PM to 4 PM

Non-ambulatory patients are treated at bedside

Department started functioning continuously for 8 hrs without break

for the convenience of patient’s treatment.

93

2. Narrative: All the patients of orthopaedic problems are dealt with care and

recovery rate is satisfactory..

Post-trauma of elbow & knee joint is mobilized as early as possible

to restore maximum range of motion.

3. Subsidiary: Good coordination & interaction with all the departments of the

Hospital is essential for the smooth & efficient functioning of the unit.

.

This is a VIP unit- and should be maintained properly.

3. Material & Methods: Thanks to the Management, Inventory controller & pharmacy

department who supply material to the department in time and the

amount required. There was no problem for adequate supply of

material.

4. Quantum of supplies: 6 Bottles of U.S. gel per month

1 cotton roll per month

Antiseptic solution 200 ml per month

5. Process Involved In Performance PHYSIO Department has a well planned strategy to provide

adequate services to the existing patient load.

Equipment is well organized and maintained in each cubicle.

Implementation of relevant techniques, have improved.

Coordination with other department heads and our peers was

satisfactory

All activities are supervised by the Administrative heads, with the

support of colleagues and peers

I thank all the departments involved like civil, bio-medical, electrical

departments who assisted in all emergencies.

94

5. Man Power / Tools Staffing Pattern

1 Male Physiotherapist

1 Female physiotherapist

1 Female ward aide

2 intern’s

6 Canadian trainees (2nd year medicos)

♦ Equipment Used

Electro Therapy Exercise Therapy

SHORT WAVE DIATHERMY

(S.W.D) (2 Nos.)

ULTRA SOUND (2 No.)

TRACTION (2 No)

(I.F.T)INTER FERENTIAL

THERAPY (2 Nos.)

ELECTRICAL STIMULATOR

WAX BATH

INFRA RED

HYDRO CLORATOR

TENS

SUSPENSION BED

MULTIPLE EXERCISER UNIT

HAND EXERCISER

HIP ROTATOR

ANKLE & WRIST EXERCISER

QUADRICEPS TABLE

ROWING MACHINE

PULLEY EXERCISER

STATIC CYCLE

SHOULDER WHEEL

GONIOMETER

FINGER EXERCISER

Note:- All the equipments are working efficiently:

Adequacy of the above

• LASER is a modern technology, (equipment required).

• CPM (Continuous Passive Mobilizer) is required

• Long wave diathermy

The above equipment are required to up-grade the Department.

95

6. DETAILS OF ACTIVITIES

7. MATHURA REFINERY HOSPITAL ♣PHYSIOTHERAPY DEPARTMENT – STATISTICS YEAR 2007-2008

MONTHS MALE FEMALE TOTAL

April ’07 63 70 133

May ‘07 50 45 95

June ‘07 122 121 243

July ‘07 79 130 209

Aug ‘07 74 134 208

Sept ‘07 97 83 180

Oct ‘07 139 85 224

Nov ‘07 109 89 198

Dec ‘07 61 80 141

Jan ‘08 121 134 255

Feb ’08 108 110 218

PHYSIOTHERAPY STATISTICS [1999-2009]

3011

4601

1218

5558

5624

4831

3455

3934 4011

5064

0

1000

2000

3000

4000

5000

6000

1999-2000

2000-2001

2001-2002

2002-2003

2003-2004

2004-2005

2005-2006

2006-2007

2007-2008

2008-2009

F.Y

Pat

ient

s

96

Mar, 08 105 169 274

TOTAL 1128 1250 2378

Year 2008 2009 Statistics Apr ‘08 80 99 179

May ‘08 76 98 174

June ‘08 40 57 136

July ‘08 92 63 155

Aug ‘08 100 79 179

Sept ‘08 110 88 198

Oct ‘08 31 61 92

Nov ‘08 58 109 167

Dec ‘08 84 86 170

Jan ‘09 75 94 169

Feb ‘09 54 93 147

Mar ‘09 86 108 194

TOTAL 886 ?? 1035?? ??1960

♣ Physiotherapy Department SJSH Statistics 2007-2008

Month Male Female Total

Apr ‘07 142 193 335

May ‘07 174 199 373

June ‘07 198 169 367

July ‘07 174 211 385

Aug ‘07 164 121 285

Sept ‘07 192 93 285

Oct ‘07 190 149 339

Nov ‘07 107 104 211

Dec ‘07 230 103 333

Jan ‘08 193 80 273

Feb ‘08 167 134 301

Mar ‘08 209 117 326

Total 2140 1673 3813

97

♣Year 2008-2009, -SJHS Month Male Female Total

Apr ‘08 270 232 502

May ‘08 262 238 500

June ‘08 198 187 385

July ‘08 186 158 344

Aug ‘08 179 228 407

Sept ‘08 132 213 345

Oct ‘08 152 144 296

Nov ‘08 163 153 316

Dec ‘08 202 155 357

Jan ‘09 227 148 375

Feb ‘09 144 132 276

Mar ‘09 89 97 186

Total 2204 2085 4289

N.B – Increase in no. of patients of physio in IOCL (Details

attached)

Patients coming from far distance couldn’t receive treatment

daily

8. Expenditure per Month

Male physiotherapist’s salary (HOD) – 13,000/-+

7000/month

Female physiotherapist salary 8,000/-

Ward aid 3,350/-

Total 24,350/- 9. Supplies

6 ultra sound gel

1 cotton roll

98

200ml Antiseptic solution

10. Equipment 1. 2006-2007 New Equipment like LASER should be

purchased

2. 2005-2006 New TENS machine purchased

3. 2006-2007 Hydro collator machine purchased

4. Micro wave diathermy should be purchased

5. CPM should be purchased

6. 2008-2009 window A/C is provided in new cubicles

7. Furniture for expended cubicles is provided

11. Increments: ♥ Revision of increment with the basic is necessary

♥ This year increments given is satisfactory

12 Perks

• Thankful for the books in the physiotherapy

Dept.

• We are very thankful to NIRPHAD for providing Medi-claim

(Insurance Policy) coverage/hoping that medi-

claim for

spouse and children should also be included..

• Thankful for residence in Mathura Refinery

Nagar.

• Thankful for the provision of DPS & KVS

education for our

children in MR Nagar Township.

• E.P.F provision should be provided

irrespective of grade

13. Comparison Most of the hospitals in Mathura are on

partnership with

99

physiotherapy department or on the

commission basis of

60:40 ( 60% physiotherapist, 40% hospital).

Some of the hospitals are :-

1. Mehta nursing home

2. Brij Chikitsa Sansthan

3. Vipin nursing home

4. Prayag nursing home

5. Life line hospital

6. L.R. Hospital.

The working conditions and emoluments are better in SJSH

With no housing or any other perks.

14. Challenges Planning

• Physio. Department staff has sufficient time to think, interact & plan

various aspects to improve treatment methods

• Proper records & census are maintained.

• Harmony and efficiency is maintained

• Expended cubicles is functional

Organization

• Department is well organized, discipline & work ethics are

maintained harmoniously.

Implementation

• Inter-personal relationship with the management & other

departments is satisfactory.

• Department working hours are extended to help reduce the waiting

time of the patients

Request to the consultants to refer the patient to physio from

pediatric, medicine and surgery departments.

As per the budget revision of salary should be regulated

100

15 . Dress Code should be implemented to give a professional touch to

the organization,

irrespective of grade in all departments. This year some

departments has given the

dress code & rest of departments needs the dress code.

Supportive supervision directly from the top is always beneficial and

encourages the staff to do better.

To improve accuracy and quality of results, the old, malfunctioning

machines, should be replaced with imported quality tested

equipment, which have a good track record and after sales service.

Renovated cubicles is functioning with 2 compressors and electric

fitting is completed.

Computerization is required in each department

Request to send for further training in higher centers to upgrade the

staff

16. Job Satisfaction Physio department staff have a sense of satisfaction and is working

without any pressure

Relationship with the seniors/juniors & peers is a happy blend of joy

and contentment.

Working area is great and challenging.

17. Contribution Department’s contribution to the Institution is to give quality

treatment to every patient & thereby give a good name to the

Hospital

• Department’s contribution to the community- is to provide quality

treatment & meet community’s needs for speedy recovery, with a

vision to develop long term positive relationships between the

community and the Hospital.

• VIP gentry (top officials from Mathura administration) also utilize the

services of the Unit.

101

• Positive response from hospital, community and patients coming

from far distances

• Counseling plays a key role

Successful training of 2 interns in physiotherapy department

this year

• Very successful and fully equipped department in Mathura zone.

• Demand for the Physiotherapy training in increasing for Student

internship

18. Attitudes ♦ This department is a high income generating unit. But treatment

is subsidized to meet the common & poor patient’s needs. So the treatment

rates are not commensurate with commercial organizations. Rural poor

patients are benefited.

♦ Staff is motivated to give the patients speedy recovery,

irrespective to their financial status

19. Personal Growth Continuing Medical Education for medical & paramedical staff plays

a vital role to updating/up-grading modern technology

Visiting specialists should be invited at regular intervals.

Availability of books & magazines in a library which can be used

regularly.

International magazines/journals & books should be issued to the

concerned department.

Recreation facilities should be available

20. Internet Browsing - Specific time should be allotted for each

department to get

exposure to the latest Education / Techniques / Technology and this facility is lacking

102

20-ray department Khalil Khan- Diploma in X ray and Radiology Joining Date : 1st April, 1999 Rubric: Roentgen revolutionized and is the first step in accurately diagnosing with the discovery of the roentgen rays (Xray) 1. The x-ray department plays a vital role as a diagnostic tool in the day to day functioning of Swarn Jayanti Hospital since the commencement of SJSH 2. X-ray department profile Senior radiographer – 1 Junior Technicians – 3 The department is open for 24 hours so that the staff is available for 24 hours, to attend to any emergency. 3. Regarding x-ray machine

o X-ray 500 mA machine (WIPRO GE) with a table and monitor o Portable machine (SIEMENS)- mobile unit o Auto film processor (PROMAX) made in India

4. Radiation protection (items)

1. Lead apron – 3 2. Lead screens (side screen) – 3 3. Lead goggles – 1 4. Gonads shield – 1 5. Ovarian shield – 1

5. BARC radiation badges are regularly worn by all employees of the x-ray department and sent to BARC for estimating radiation exposure of the staff 6. Activities Material requirements for the department is regularly indented and provided on monthly basis 7. Process involved in performance

o X-ray department plays a very important role in providing specific diagnosis and treatment to a particular patient.

o Thus planning of the department is done very meticulously. o Supporting staff and senior technicians work in coordination as per the

requirements of the patient.

103

8. Data: x-ray films used according to size S.No. Size Last

month balance

Issue of total film

Total Used films

Balance in Dept

1. 14 x 17 10 50 60 40 20 2. 14 x 14 20 150 170 165 5 3. 12 x 15 10 100 110 105 5 4. 12 x 12 30 50 80 75 5 5. 10 x 12 50 300 350 330 20 6. 8 x 10 20 50 70 60 10 7. 6.5 x 8.5 30 100 130 120 10 Evaluation of activity regarding number of x-ray performed on a day to day basis as per doctor wise requirement is done regularly.

o Organization/implementation/coordination/control after receiving the patient from requisition centers are documented in the register as per the format. X-ray department serial number is allotted to the patient.

o In between if any other information is required the concerned doctor is consulted.

o Since the department is well equipped with state-of-the-art equipment and the services are quicker than the services provided by any outside hospital.

9. Impact on the community o Since x-ray department is well equipped with sophisticated equipment like

auto film processor, which enables faster and better services to the patient. o The department usually provides = a developed plate in just 10 minutes, thus

patients can return quickly to the concerned doctor for the diagnosis. o Community at large appreciates the competence and superior quality of

services by the Department. 10. Work environment

o Radiation hazards reduced and monitored after the inspection visit of senior scientists from BARC.

o Specific protective measure advised to check radiation hazards were implemented which included lead lining of the walls and increase thickness to prevent rebound and scattering of x-rays.

o The pre-existing glass window outlet from x-ray room has been closed completely.

104

o The registration staff / technician chamber has been changed from inside the x-ray room to a safer outer room. The pre-existing dark room was shifter to outlet x-ray room.

11. Suggestions In the growth of a organization, the post played by all employees from class-1 to class-4 is vital and good relationship among them is necessary.

12. Contribution x-ray department was organized by a senior radiographer who organized and planned and also trained the supporting staff. The performance of the x-ray department achieves the vision of providing services to the community at large, with the best that the department can provide.

13. Total No. of X-Rays used (per m month) X-Ray Film Size S.No. Month 14x17 14x14 12x15 12x12 10x12 8x10 6x8 Total

1 Apr 08 105 39 227 82 46 156 50 7052 May 08 106 28 264 87 133 156 43 8173 Jun 08 109 29 258 52 173 124 64 8094 Jul 08 100 43 296 46 141 134 36 7965 Aug 08 166 56 153 96 166 130 40 8076 Sept-08 65 59 240 78 136 134 39 7517 Oct.08 74 54 212 97 77 116 25 7388 Nov.08 106 74 197 45 131 118 35 7069 Dec-08 181 54 99 110 139 130 25 73810 Jan-09 70 69 120 9 190 109 27 59411 Feb-09 126 18 347 66 106 153 47 86312 Mar-09 141 14 322 74 145 133 42 871

TOTAL 1349 537 2735 842 1583 1593 473 9112

105

14. Bar diagram of Total no. of X-Rays ( 2008-2009) OPD,IPD

No. of X-Rays

782 805 795 782 788 736646 690 722

583

850 860

0200400600800

1000

Apr,08

May,08

Jun,0

8Ju

l,08

Aug,08

Sep,08

Oct,08

Nov,08

Dec,08

Jan,0

9

Feb,09

Mar,09

671 693 707 666 688 644552 620 596

517

710 755

0100200300400500600700800

No. of Patients

106

21. Mr.Sriniwasa Babu

Head: Pharmacy Dept.

DOJ – 9th June 2003.

Rubric: Pharmacy is the life line of the Hospital, but also directly serves the

community. Promotional, preventive, curative drugs must be used judiciously and be

affordable. even to the poorest .

1. OBJECTIVE

Good cooperation with all the departments of the Hospital to ensure proper

functioning.

2. PERFORMANCE OF THE DEPARTMENT-

• Department is well maintained with fully qualified pharmacist

• Maintenance of stock register, poor patient register and document filing

• Medicines distributed to RNTCP (DOTS) patients regularly

3. WORKING HOURS-

• From 1st April to 31st October timings are: 08:00 to 04:00 PM with one hour

lunch break at 01:00 to 02:00 PM every year. From 1st November to 31st March

there is 09:00 to 05:00 PM with one hour lunch break at 01:00 to 02:00 PM every year

4. MATERIALS AND METHODS

• All records provides sufficient information to write the Report

• All materials including medicines were sanctioned by the Purchasing

Committee. Previously the same procedure was followed.

• Vaccines and RNTCP (DOTS) medicines were available from Government

Hospital, Mathura

5. PROCESS INVOLVED IN PERFORMANCE

• Planning– to plan as a computerized pharmacy and preserve data for retrieval.

• Organization–to organize pharmacy and pharmacist requires one assistant

pharmacist.

107

• Implementation – to issue materials to all the department and maintain

consumption record for filing

• Coordination – good coordination with store for issuing materials as the

pharmacist is involved in his work and coordinates well with all employees

• Control – to control consumption to all departments

6. STEP-WISE EVALUATION

• Mid term – On assessment the Departments are more than satisfied with the

procedures and processes of the functions..

• Final – the above procedures were satisfactory and will be reviewed every 12

months.s

7. MANPOWER / TOOLS

• Staffing pattern – one qualified pharmacist managing entire pharmacy-

including record maintenance, issuing medicines to staff /poor patients,

purchasing, issuing medicines to RNTCP (DOTS) patients, issuing vaccines to

other departments.

• Equipment used- one refrigerator and computer

• Adequacy of above – pharmacist require a computerized programme and

software to keep data (code drugs / supplies, consumption details of various

sections of hospital)

8.DETAILS OF ACTIVITIES

• Issuing medicines to staff / poor patients

• Issuing medicines to RNTCP (DOTS) patients

• Issuing vaccines children immunization.

• Daily ward rounds for checking oxygen supplies and instruments.

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9. FINANCIAL STATEMENT

Salaries –

• Salaries are adequate and I am happy with what I receive previously and

presently.

• Increment – in previous year there was slight increment was provided and in

current year pharmacist received better increments

• Perks:. Family accommodation provided to me in SJSH hostel but presently I

required quarter in Mathura Refinery Nagar because of family considerations.

10. Supplies.

Medicines are supplied to the pharmacist from the whole sale market. The

pharmacist acquires three quotations from the same brand from different parties

and best of the three is sanctioned by Purchasing Committee, after scrutiny and

purchase order is placed. Vaccines and RNTCP (DOTS) medicines are available

from the District Hospital, Mathura. Since these items are sanctioned by

Government, the supply of the same is erratic and SJSH has to purchase from the

open market.

Drugs – drug stock and documentation are maintained properly in the

department

Equipment – refrigerator, computer and maintained regularly.

11 CHALLENGES

• Planning – pharmacist has sufficient time to think and plan

• Organization – pharmacist require one assistant for pharmacist department to

help in the various activities. In absence of pharmacist, assistant will be able to

manage pharmacy, if properly trained.

• Implementation – inter-personal relationship is good with all the departments.

Discipline of the staff is good and sometimes pharmacist gets support from

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seniors. Working condition and quality of equipment are satisfactory but some

times staff requirement (medicines) is not available in the pharmacy.

12. JOB SATISFACTION

• Emoluments – the work load is gradually increasing. The pharmacist receives

according to the rules of SJSH but I am happy with what I receive

• Housing and furniture – I am happy to get housing and furniture in SJSH

campus but presently I am planning to shift in Mathura Refinery Nagar.

• Work environment – work environment is good but the room needs one

ventilator because the refrigerator cannot work properly with poor ventilation

• Leadership qualities / problem solving – under RNTCP (DOTS) immunization

programme (trouble shooting), some patients and staff have some queries and

pharmacist clarifies regarding their queries.

• Relationship with seniors / juniors and peers – coordination and relationship

with seniors, juniors and peers are good.

13. PERSONAL GROWTH

• Continuing medical education – pharmacist requires some basis health care

training

• Routine schedule for ward, classroom, visiting – the pharmacist visits wards to

find out if they have any problems. If the ward staff has any doubts, the

pharmacist clarifies. Regular visit to external pharmacy are made to check the

quality, expiry date and prices of stock.

• Availability of books and magazines – books and magazines are available in the

library

• Presentation of papers at conference – pharmacist needs training in writing

and presenting papers for conference. But first will have to become a member

of some National Pharmacy Organization.

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22. Vincent Raj

Medical record officer

Joining dates:

REJOINED:

“LIFE IS LIKE A SHEET OF FRESHLY FALLEN SNOW, REMEMBER, HAVE YOU

STEP ON IT EVERY MARK WOULD SHOW.”

(PADMA RAJAN), FILM DIRECTOR

Swarn Jayanti Samudaik Hospital completed its 10th year of success in March 2009.

NIRPHAD and Indian Oil Corporation Limited have helped Swarn Jayanti Hospital to

cross the milestone.

1.PERFORMANCE

During the year under review of a total of 50,980 patients were seen in the

various out door clinics (Medicine, Orthopedics, Surgery, and pediatrics) , this

represented as increase of 4% over the previous year 2008. ( Previous year was

48835)

Total number of inpatients admitted under various departments was 3274.

This represented as increase of 9% over the previous year. ( Previous year was

2964)

The total cash recovery all the services provided (Out patients and in patients)

was Rs. 5299430/-. This is 9% increase the previous year. ( Previous year was

4855300)

The X-Ray department performed 10880 X –Rays on 9370 patients. The

number of X-Rays later this year was 9.7% increase the previous year.

(Previous year was 9276 X –Rays on 9065 patients)

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The Laboratory which provided Biomedical, Hematology and Microbiology

services performed 38,270 test on 8935 patients this was 8% less than previous

year. ( Previous year 40069 test on 9471 patients)

The Physiotherapy department: total patients was treated 4262. This was 7.6%

increase over the previous year( previous year was 3934)

The number of Ultrasounds performed was 61(Previous year was 174).

A total of 6828 patients were seen and treated at the Emergency room which is

operational 24 hrs a day. This was 7.4% increase over the previous year(

previous year was 6353).

A Total number of major operation is 423 (both general surgery and ortho

surgery) this was 1% less than previous year (previous year was 445).

Total number of minor operations was 2166 ( general surgery & ortho.

surgery) this was 13.8% increase for the previous year(previous years was

1866)

The bed occupancy averaged it 78.4% this was 9% increase over the previous

year.

The average annual mortality rate for inpatients was 3.1%.

A total number of 450 critical patients (Ward/Emergency) referred to higher

treatment.

In summary, the year gone by was a mixed year for Swarn Jayanti Hospital. In

some areas did see significant growth whilst in other areas remained statistics

or even saw negative growth. The important thing is to analyze the results and

see what we can learn and how we can achieve greater growth and contribute

to the well being of the community we serve.

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2. Suggestions:-

Computerize all departments

Need technically qualified staff for ultrasound, TMT, Endoscope and blood

bank.

Increase bed strength

A blood bank must be opened

Required more Ambulance

Replacement for all old equipment..

3. Finances at a glance

Cash recovery 2007-08 2008-09

OPD 1969020/- 1968705/-

IPD 2886280/- 3330725/-

TOTAL 4855300/- 5299430/-

Poor (free Rx) 514210/- 300300/-

Staff (free Rx) 127865/- 79635/-

4.STATISTICS FOR THE YEAR 2007-08

Year 2007-08 2008-09

OPD 48835 50980

IPD 2964 3274

4.1. OPD (DEPARTMENTAL STRATIFICATION)

YEAR 2007-08 2008-09

Medicine 21823 21669

Ortho 12300 12095

Surgery 7208 7452

Peadritic 7504 9764

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4.2 .IPD (DEPARTMENTAL STRATIICATION)

YEAR 2007-08 2008-09

Medicine 1150 1282

Ortho 635 660

Surgery 854 924

Paedritics 325 408

4.3. Operations performed (according to Departments)

Year 2007-08 2008-09

Gn. Surgery (major) 111 89

Gn. Surgery (minor) 288 394

Ortho Surgery (major) 334 334

Ortho surgery (minor) 1578 1772

4.4 X-rays consumed:

Year 2007-08 2008-09

Used films 9276 10880

No. of OPD / IPD pts 9065 9370

4.5 Laboratory tests:

Year 2007-08 2008-09

Total test 40069 38270

No. of patients (OPD / IPD) 9471 8935

4.6. Physiotherapy

Year 2007-08 2008-09

OPD / IPD 3934 4262

RTA (Road Traffic Accident) 707 1275

4.7 . IPD PATIENTS (ORIGIN)

YEAR 2007-08 2008-09

In Mathura 2466 2387

UP (other district) 396 412

Other state 34 28

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4.8 OPD INVESTIGATIONS

(NO. OF PATIENTS)

YEAR 2007-08 2008-09

1. Laboratory 6316 7148

2. X-ray 6731 6649

3. Physiotherapy 3752 3964

4. Ultrasound 174 61

5. ECG 1035 830

6. Dressing 2284 2835

7. POP 717 433

8. Plaster 362 630

9. Ambulance 539 567

10. Trauma cases 479 688

11. MLC (Medico Legal Case) 628 701

12. Others 1537 1868

(Others:-Medical certificates given, catheterization, gastric lavage, oxygen administered,

enemas, nebulization administered, ryles tube inserted, cut down done, injections given

and stomach wash procedures)

4.9 Admissions in wards 2007-08 2008-09

Gn. Ward G.floor 1841 1957

Gn. Ward 1st floor 802 1020

Pvt rooms 195 154

Burns unit 122 126

ICU 04 17

4.10 Discharges and deaths (ward wise) 2007-08 2008-09

Discharges-Deaths Discharges-Deaths

Gn. Ward G.floor 1758 91 2001 52

Gn. Ward 1st floor 778 12 917 11

Pvt rooms 187 14 161 07

Burns unit 79 41 83 32

ICU 0 0 15 0

Emergency 0 37 0 43

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4.11 RESULTS ON DISCHARGE

2007-08 2008-09

Improved - 1346 1063

Cured - 114 42

Discharged on request - 878 1479

Referred - 156 254

LAMA - 285 324

Death - 158 102

Absconded - 23 15

4.12. HOSPITAL DAYS

2007-08 2008-09

Gn. Ward G.floor 6989 7321

Gn. Ward 1st floor 4427 5447

Pvt rooms 780 730

Burns unit 730 810

ICU 04 0

4.13 REPORTS / CERTIFICATES

2007-08 2008-09

Injury reports 587 612

X-ray reports 89 88

Medical certificates 210 201

MLC reports 619 701

Medical bills 108 110

LIC forms 22 18

Court cases 13 11

Bodies kept in mortuary 84 70

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4.14. ADOPTED VILLAGES- PATIENTS RECEIVING FREE RX

2007-08 2008-09

2. Azampur 75 66

3. Aganpura 49 18

4. Mohanpur / Adooki 167 89

5. Baad 265 216

6. Bhainsa gaon 71 32

7. Chad gaon 49 40

8. Dhana teja 46 28

9. Dhana samsabad 57 15

10. Koyla – alipur 52 37

11. Raunchi Bangar 305 361

4.15.

Vehicle used / expenditure 2007-08 2008-09

Tata Sumo (Km) 19842 Km 21202 Km

Expenditure Rs. 105732 Rs. 108400

Ambulance – Reg, No.9806 25112 Km 32801 Km

Expenditure Rs. 98, 803 Rs.1, 28,930

Ambulance –9721 Reg, no) 21400 Km 22,966 Km

Expenditure Rs. 1, 06,285 Rs. 1, 22,065

Swarn Jayanti Hospital is committed to constantly improving its service to the

community under “NIRPHAD” management and is confident that sustained growth will

take place, with SJHS becoming an integral and vital part of the local community.

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23. Electrical and Heavy Equipment Department Mr. Tej Singh, Qualifications: Electrical Engineer Date of Joining:- Rubric: Un-interrupted, balanced (without fluctiations), power supply for all equipment and machinery is vital for the efficient functioning of any Hospital Introduction 1. The electrical equipment installed in SJSH with the best and latest technology require meticulous checking daily- D.G. set (437 KV), Water treatment plant, Sewage Pump, Fire system and EPABX etc. Most function automatically. The Central AC facility is provided in OT and Burns department. 2. Department Profile:-

1. Mr. Tej Singh, Electrical Engineer 2. Mr. Bishamber Dayal, Electrician 3. Mr. Mohan Pandit, Electrician 4. Mr. Ajay Matto, Electrician 5. Mr. Rajendra, Ward Aid

3. Responsibilities:- Maintenance of the following equipments:

1. Electrical Sub Station 11 KV/415KV, 1.6.MVA 2. D.G. Set 437.5 KVA 3. Water Treatment Plant 4. Lift 26 person capacity 5. EPABX 6. Air Conditioning 7. Central AC 8. Street Lights & other general maintenance. 4. Challenges :- 4.1 In Central AC- 5 Compressors and two chillers are not working 4.2 D.G. Water leakage normal 4.3 Fire engine not working 4.4 Water Treatment Plant not working

4.5 There is no foundation for water distribution motor pumps 4. Suggestions: 4.1 Pending work order should be completed without delay. 4.2 MOR should take action expeditiously to requests made by SJSH . 4.3 Street lights need repairs 4.4 One additional electrician should be engaged in electrical dept. The End

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24. Accounts Department

Ms. Girijesh Goyal- M.A (economics). Sr .Accountant

Joining date: 6 JANUARY, 2003

1.Profile Rubric:- Any community that espouses fair, balanced,

transparency and accountability will never see a disaster.(N.R

Narayana Murthy-Infosys)

2. Current Duties: ♦ preparing all vouchers

♦Maintaining cashbook

♦preparing all vouchers

♦preparing all vouchers

♦Maintaining cashbook

♦Collecting all recoveries made by SJSH on behalf of IOCL and maintaining

accounting records of such recoveries, both in manual and computerized form

♦Liaising with the State Bank of India branches both at the Refinery and at the

Refinery Township

♦Ensuring payment of all statutory dues, including TDS & PF, within the

deadlines prescribed.

♦Prompt payment of bills, including electricity bills & telephone bills, subject to

availability of funds

♦Liaising with Mathura Refinery Officers for receiving installments of grant from

time to time and furnishing both orally and in writing, with the clarifications

required, if any

♦Holding SJSH’ cash balance in single personal custody and making all cash

payments

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♦Maintaining and holding all files of Finance Department in personal custody

♦ Maintaining record of PF remittances, collecting PF withdrawal applications

from the employees

who leave service of SJSH, forwarding these applications to PF Department

and liaising with

Mr.Manoj Rastogi, Consultant to SJSH on PF matters.

♦Assisting Asst. Administrator/Finance officer in his weekly voucher audit of

SJSH and appropriately communicating instructions to the concerned officials

♦Assisting the statutory auditors in the quarterly audit of SJSH

♦Liaising with NIRPHAD staff on all financial and accounting matters relating to

SJSH

♦Preparation of salary statements, disbursement of salary and distribution of pay

slips to all employees

♦Liaising with Mathura Refinery Officers for receiving installments of grants

regularly and furnishing them, both orally and in writing, with the clarifications

required, if any

♦Holding SJSH’ cash balance in single personal custody and making all cash

payments

Ensuring prompt payment of bills, including electricity bills & telephone bills,

subject to availability of funds

3. Strengths: ♥I am well qualified and quick at learning new skills, and sincere and hardworking as can be seen from my performance. Being a native of Mathura, I

am attached to this place. Therefore, look at SJSH as a long-term employer and have no intentions of job-hopping. Benefits of any investment for training

will accrue to SJSH.

Relationship with all employees is excellent, barring one or two. I have

excellent rapport with all the employees of State Bank of India, Refinery

Township Branch and excellent rapport with the concerned officers of the

Mathura Refinery.

4. Weaknesses:

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I am generally not outspoken (introvert). Therefore, I have not been able to

properly communicate to the top management of SJSH about my performance.

5.,Opportunities: ♣I have taken over the complete charge of Finance Department after the

resignation of finance officer.

♣Regular interactions with the bank officials, refinery officials, statutory auditors

and employees of SJSH, at all levels, have been leading to continued

improvement in my knowledge and skills.

♣Thanks to SJSH Management for allotting a residence ‘B’ type in M.R Nagar and

grateful and satisfied with the salary increment.

Obliged being upgraded from Jr, Accountant to Sr. Accountant 6.Threats: Ω I hold and handle large amounts of cash in single personal custody. May need

greater .protection.

ΩContract with M/s Mohini Filling Station for the n restarted.

♣ Finance Department is always short of cash and due to regular power failures

there is a huge consumption of diesel is purchased by paying cash.

♣Most of the time Department was unable to disburse salaries on time because

IOCL / MR takes time to release the grant and this irregularity makes the Staff disgruntled, which causes unnecessary and avoidable problems in dealing with

the staff.

7. needs: 7,1 Salary bonus -Performance bonus should be encouraged and there should be salary grades

according to skill required for performing a defined task,

7.2 Insurance for the family

8. Suggestions a. On line banking service. b. Regular Regular Purchase Committee meetings should be

conducted so that needs of departments can be reviewed.

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c. In the next contract, efforts will be made to get a new ambulance

for SJSH.

d. Computerization of data available.

9. Achievements 1. Repair of HTVCB- costing Rs.4,71,569/-

2. Repair & Maintenance of Central AC- Rs. 7,67,149/-

3. Boring of tube well – Rs.3,45,831/-

4. In order to make SJSH a self-sustainable, evening OPD has been

started from Sept 2007. Till date recovery of Rs.36,150 has been

received from evening OPD that is distributed among doctors and staff

in the ratio of 50:50.

5. Annual increment of 8% has been given to the staff of SJSH for the

financial year 2009-2010.

6. Grant of Rs.13, 49,65,486/- have been sanctioned from IOCL / MR for

the period of 01.10.08 to30-09-2013 (Five years)

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25. Mr. Charan Massey Office Secretary Joining Date : 22nd Nov, 2008 Rubric: “Honesty & Hard work is the best key of success”. adapted ( Massey ) 1. Introduction : Name of Swarn Jayanti Hospital is a very beautiful Hospital in Mathura City. It is situated on High way-2, Delhi-Agra Road. According to name it is working satsfactorily in this area since last 10 years 1999 under supervision of Dr. E.B. Sundaram, FRCSC Advisorbto Director & Dr. Sanjay Nanda, Director. The latter is getting good experience to run this Institution by having qualified and experienced staff. 2. Profile Job Description:- → Maintaining the Swarn Jayanti Samudaik Hospital Library → Maintaining attendance, leave record as Casual leave/Medical leave/Earned leave/compensatory off/Leave without pay etc. → Service records of all SJSH employees and holding them in personal custody → Maintaining all types of files, correspondence

and other non-medical records, including confidential documents and holding them in personal custody.

→ All types of correspondence in English and Hindi. → Documenting all the reports and minutes of meetings → Attending to telephone calls on behalf of all senior staff of SJSH → Dispatching lettes & maintaining telephone register for calls. → Verification of bills relating to photocopies, STD calls, couriers etc. → To make the arrangements for meetings → Organizing appointments, meetings and communicating with all concerned → To prepare Duty Roster for each department → Making photocopies. → Entries of all statistical data of Lab, X-Ray & physiotherapy every month. → Ensuring circulation of circulars, memoranda and notice to all staff. → Distributing tea coupons to staff. → Distributing uniforms to staff and maintain all records → To prepare duty roster for doctors, drivers, reception and other departments. → Supports in Court Cases dates and prepare data (briefs) for court cases. → And other Official work accordingly and field work field work Assisted Canadian Medicos with their domestic, internet, travel and other miscellaneous requirements.

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3.Strengths: Supportive/capable/cooperative nature with all colleagues and displayed my ability to work as a team member and to make an effective contribution to team work My capacity to work for long hours daily, including on holidays, whenever there is need. Duty hours is 8:00 AM to 4:00 PM but mostly I stay in office up to 6/7 PM while there is no overtime or extra payment, but I never requested. Useful attribute, “Good fighter in Judo & Boxing” and it helps in my security and security for other staff. Good knowledge of Court procedures & also fully support the Administration regarding court case of Dr. Brijesh Sharma, (case pending at High Court Allahabad). The cases of Mr. Nadeem Sidaqi & Mr. Ravindra Kumar to be heard at Civil Court-Mathura Mr. N.L. Mishra (P.R.O), assists during hearings and in the preparation of the affidavits and other legal documents required by the courts. 4. Weaknesses:-

• Weaknesses of short hand language • Having the good knowledge of english but I feels hesitation in

english speaking • Feels problem in tally version.

4.a Opportunities:- Opportunities afforded by SJSH, to work with people of varied backgrounds has enlarged my horizons and has helped me in improving my knowledge and skills. 5. Needs:- →There is only one USB modem and most of the time it is difficult to get for office use, as the same is used by Director and Administrator. There fore separate Internet connection should be provided. →Need one big almirah for storing the files. 5. Suggestions for improving SJSH performance:- Conduct monthly meeting with staff for their feedback & performance Prompt action should be taken to solve patient’s problems Staff problems also should be given priority Security of SJSH and Staff should be strictly enforced to and greater emphasis given to public relations so that they cooperate with the Staff. Entrance of outsiders should be better controlled. 6. Problems: Very low salary not commensurate with the work load. Besides official work , court cases, other duties such as field work, Refinery/Estate office/staff room/ conference room arrangements responsible for ‘take over and hand over charge’ of Staff

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26. Mr. Ramesh Kaul, inventory Officer

Date of joining: 1-4- 2002 Rubric: The beginning of knowledge is the discovery of something we do not understand -Frank Herbert It is my pleasure to present this annual report for the year 2008-2009. This opportunity will present the departments activities. 1.Objective:- qualitative and quantitative assessment of performance. 2.Working hours;- 1st April to October, timings are 8.00 to 4.00 with one hour lunch break. 1st November to March timings are 9.00 to 5.00 with one hour lunch break. 3.Materials and methods ♣All supplies are sanctioned by the purchasing committee. The purchasing committee examines every tender and instructs the inventory officer the best purchasing procedures. ♣Each and every item is documented manually as per the instructions given by Asst. Administrator and PRO during their audit of the store. 4.Man power One-part time ward aide. 5.Responsibilities: ♣ Interact with external suppliers-sourcing, purchasing and receiving goods. ♣ Ensuring correct type and quality of goods are received from suppliers and issued to internal departments on request. ♣ Arrange stocks in accordance to specifications. ♣ Be vigilant that an adequate stocks level is maintained for all items in the stores.

♣ Maintain uninterrupted supply of materials and maintain high quality, competitive price and prompt delivery of goods.

♣ Identify new sources of supplies and new products.

♣ Coordination with accounts department.

♣ Cost reduction by introducing new vendors/products.

♣ Follow up with submission of accounts for timely release of payments.

♣ Follow up with timely delivery of materials/supplies.

♣ Preparing reports like pending indents and purchases

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♣ Cost comparison of different sources and analysis the market trend and then decide best the price.

♣ To monitor continuous improvement and quality of supplies.

♣ Create purchase orders based on material requirements.

♣ Coordinate with vendor's for quality issue.

♣ Maintain optimum level of inventory.

♣ To develop good relationships with vendors.

♣ Administration functions.

6. Job satisfaction

Interpersonal relationship is good with all the departments.

The IO receives a salary according to the rules of SJSH.

Housing–We are happy to get housing in the Township and assistance in getting my child admitted in the School.

Work Environment is good.

7.Personal Growth

♦Books and magazines are available in the library, but not related to my Department.

♦Internet browsing – If internet browsing is available to IO, it will be helpful to improve knowledge and skills.

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