Reported by Carol D’Souza
Samman Association (Indian Epilepsy Association, Mumbai Chapter) has been looking after epilepsy patients in rural areas since 2007. Our work in this regard started with clinics in Pen, a village nearer to Mumbai where we are based. We held a clinic there every 3 months, till January 2020. Simultaneously in 2016, we started a rural clinic in Palghar District. These physical clinics continue to date with about 100 patients attending each and 3 months’ medication given free of charge. Sometime in April 2021, JM Financial Foundation (JMFF) approached us to support them with their health care project in rural Bihar, and our Past President, Neurologist Dr. Pravina Shah readily agreed.
JM Financial Foundation (JMFF) has a Mobile Health Unit (MHU) that provides primary, curative and preventive healthcare to 14 villages covering a population of approximately 10,000 in Sikandra & Khaira in the Jamui district of Bihar. One MHU caters to approximately 1,700 patients per month. The villages are inhabited by tribal and backward communities, whose livelihood depends on the maintenance of small farmlands, or collecting minor forest produce like jaggery and toddy, pig rearing or working at brick kilns. Most male members migrate to cities, leaving the elderly, mothers, infants and kids to fend for themselves. To access specialized healthcare centres and have investigations done, villagers need to travel for 180km! This leaves them stranded and vulnerable to take up whatever is provided by local quacks or use available homely remedies. The JMFF team consisting of three doctors (1 Allopathic and 2 Ayurvedic), two public health professionals, and one nurse, observed about 40 cases of epilepsy at their clinics mostly among children and adults. As they did not have the expertise to care for these patients, they approached Samman for help.
JMFF informed that the work would involve:
- Capacity building of the team of health care workers
- Content for raising epilepsy awareness and
- Online consultation with the Doctors on case-to-case help for the patients.
After a few epilepsy education sessions were held online Dr. Pravina Shah had 6 sessions (1st was held in Oct 2021) with the JMFF health care team, wherein over 50 specific cases were discussed. 6 patients were asked to have CT scans and 5 had to have their details taken again, after which their treatment was started. So far 39 patients have started treatment.
When asked about her experience, Dr. Shah says she is very happy to work with the very enthusiastic and dedicated Health Care team who are trying to improve, especially in history taking from both patients and eyewitness. They have also managed to obtain video recordings of seizures of a few patients. The team tries their best to explain how the anti-seizure medication (ASM) works and the dosages one needs to take to make sure that compliance is maintained. Only primary ASMs have been used so far. Heartening to note is that earlier patients did not come forward easily, but as they are seeing improvement in the neighborhood of people who attend the clinic, they are motivated to come forward and comply with medications as well. Dr. Shah looks forward to continuing the online training as she says, the work overall has indeed been heartwarming and satisfying.
