Annual Report Karuna-Shechen 2013

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ANNUAL REPORT

2013

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CONTENTS

PAGE NUMBER

Main Achievements 4

Main Events and Activities 6

Introduction 7

Health

An Overview of Medical Activities 13

Access to Primary Healthcare in Urban Area: Shechen Medical

Centre in Bodhgaya, Bihar

18

Mobile Clinics 22

Medical Camps for the Poor and Needy

24

Health Education Program (HEP)

27

Malnutrition 29

Education

Strengthening Basic Education 34

Early Childcare and Development 35

Non-Formal Education (NFE) 36

Environment

Solar Electricity

37

Rainwater Harvesting 38

Bodhgaya Clean Environment, Hygiene and Sanitation Programme 39

Social

Small money, BIG CHANGE 41

Kitchen Garden

43

Vocational Training for Underprivileged Youth & Women 44

Networking with other Local NGOs

46

Other Important Informations

Finances 47

International Audit 48

External Visitors 48

Orientation on Programme Activities 48

Upcoming Activities 49

Our Partners 49

Annex-Success Story 50

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Message from Director

Greeting from Karuna-Shechen, India!

It is my privilege to present the Annual Report of Karuna-Shechen, India for the financial year 2013.

This year, Karuna-Shechen, India made some important contributions in holistic community

development efforts through the launching of new programmes like Kitchen Gardening,

Rainwater Harvesting, small money, BIG CHANGE, Vocational Training, Strengthening Basic

Education and Menstrual Health and Hygiene, and scaling-up of some existing ones- Non-

Formal Education and Solar Electricity. With the aim to increase and reach out to more

underprivileged people we expanded our geographical area of operation to 6 new villages in Gaya

district.

In 2013 our approach to development activities was entrenched in Community Participation, as

we believe it to be the key to Community Development and Empowerment. Therefore, we made

sure that we tap into the local needs, conditions and dynamics of a village through active

community involvement at each stage of all our outreach programmes, right from planning to

implementation to management. The focus of our work has been increasingly looking at the

importance of participatory approach for sustainable development.

Our main objective to use participatory approach has been our endeavour to restore the

community bonding and confidence that have weakened over the years due to several factors like,

outward migration and urbanisation. Besides, active participation of villagers in development

programmes will promote transparency in transactions as the community will have knowledge

about the exact amount of money invested by our organisation for the project and the amount

contributed by them in terms of labour and locally available raw materials.

With our new community-planned, community-managed programme, popularly known as ‘small

money, BIG CHANGE’ has been shown positive impact. It is important to mention that in Kadal

38% contribution came from the community. Total expenses INR 1,57,358 = USD 2623, where

community contributed INR 59,310 = USD 989.

For the past 13 years, Karuna-Shechen, India has been working with the underserved and

marginalised population of Gaya district adopting a holistic approach in responding to the specific

needs and aspirations of the communities. Now as we move ahead on the path of humanitarian

development, I would like to extend my sincere thanks and gratitude to Matthieu Ricard, the Board

President, the Board members, Management and the staff for transforming our vision and dreams

into reality. I would also like to express my gratitude to our donors (Shining Hope Foundation,

Foundation Chanel and many small donors for being a pillar of support in all our endeavours. We

look forward to accomplishing our goals with your continued support. I must appreciate all your

effort towards making a better life and society.

I do believe this year will bring more visible change and fulfil our dreams which will contribute

towards making our society better than yesterday. Let’s pray together we can make a BIG CHANGE

through our small effort. And will remain Humble.............

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MAIN ACHIEVEMENTS

Health

48,232 patients availed healthcare services provided by our Outreach Patients Department

(OPD), Mobile Clinic and Medical Camps.

Our outreach healthcare service was extended from 12 villages to 18 with the introduction

of a second Mobile Clinic.

4,714 medical tests were conducted at our Pathology laboratory.

Refresher training was given to our Doctors by Dr. Jaya Maitra from the Red Cross Society in

Jamshedpur, Jharkhand.

A DOT training was conducted for all staff members, especially our DOT providers at OPD

and the villages. Training on malnutrition was conducted in February for the entire staff as

a preparatory stage for our upcoming Malnutrition programme.

Our Menstrual Hygiene program commenced in June with the starting of distribution of cheap sanitary napkins to poor girls and women in our 18 adopted villages and Bodhgaya town. A total of 6679 sanitary pads were sold in 7 months (June-December). Appointment of Female Medical Officer to better serve the women and child patients.

Education Non-formal Education (NFE) was scaled-up from 6 villages to 16.

Currently 447 women are enrolled in the programme.

Support faculties have been recruited for primary schools in Dema and Gopalkhera in an effort to ameliorate the otherwise low teacher-student ratio. Parent-Teacher Associations (PTAs) have been formed in 5 schools and parent-teacher meetings are organised on a regular basis. We have started Yoga classes for school children in the villages.

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MAIN ACHIEVEMENTS

Environment

3 women have successfully completed their 6 month training in Solar Engineering from

Barefoot College in Rajasthan.

In 27 schools drawing and speech competitions were conducted in order to raise awareness

on environmental cleanliness, hygiene and sanitation.

32 households have installed rainwater harvesting system in their houses under the

Rainwater harvesting programme.

4 Rainwater Harvesting systems have been installed in 4 Schools (Chando, Barsuddi, Dema

and Gopalkhera)

Social

1000 households and 4 schools (Chando, Barsuddi, Dema and Gopalkhera) have been benefitted by

our Kitchen Gardening programme across 18 villages.

108 NFE students participated in vocational training workshops on candle and incense stick

making, snacks, phenyl and chalk. 7 women from amongst those learning candle-making

were sent to Jamshedpur, Jharkhand for a seven day advanced course.

36 students are taking free computer courses under our vocational training programme

targeted at the underprivileged youth.

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MAIN EVENTS AND ACTIVITIES

Health

Generic medicines were introduced in January 2013.

Identity Cards are issued to all Patientsat the OPD and Mobile Clinics in an effort to keep a track

of the medical history of the patients. 16,373 identity cards were issued this year.

On the basis of the training imparted during our training on Malnutrition our able staff members

conducted a baseline survey on children below 5 years of age in the 6 newly added villages in

order to know the nutritional status of these children.

Education

Bright and enthusiastic women from within the community have been recruited as faculty for the new NFE centres.

A temporary candle-making unit was opened within our office premises in Bodhgaya in October

with our NFE students who had gone to Jamshedpur for an advanced training in the vocation.

Now those working at the candle-making unit are now visiting all the NFE centres, providing

advanced training and guidance to the students.

A member of Iner’Lude, France has come down to Bodhgaya in December to give a 4-month

training, workers on child development through games and play the ground work for which has

started the same month Anganwadi.

Environment

Several meetings were held with stakeholders regarding our Bodhgaya Clean Environment,

Hygiene and Sanitation programme.

Household Survey was conducted in the villages where solar lights were installed in 2011 and in

the villages where it will be installed in 2014. The intensive survey formed a

feedback/evaluation of the progamme that has been running in the 3 villages and was also a

feasibility test for the new villages.

The Green Schools Programme (GSP) audit was conducted in all our operational villages.

Other Events and Activities

New staff members were recruited for various positions starting from medical officers and nurses to village motivators. A one-day Orientation was conducted for all the staff members. An international Audit for the financial year 2012-2013 successfully took place during the last

quarter of the year.

We had the honour of welcoming several external visitors including Matthieu Ricard, President

of Karuna-Shechen; Tarek Toubale, Chief Operating Officer of Karuna-Shechen; Anne Oliver,

Chief Financial Officer of Karuna-Shechen Sanjeev Pradhan, Director of Shechen Clinic, Nepal;

and Serge, Astrid and Marie Saint-Arnoult from Shining Hope Foundation.

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The year 2013 can be considered as a watershed for Karuna-Shechen, India as we launched several

new programmes, such as Kitchen Gardening, Rainwater Harvesting, small money, BIG

CHANGE, Strengthening Basic Education, Vocational Training and Menstrual Health and

Hygiene as well as added a fourth area of intervention, ‘Social’ to the existing three areas- Health,

Education, Environment. Besides, we scaled-up some existing project, like Non-Formal

Education and Solar Electricity. Continuing with our sincere effort towards holistic community

development we began the year with the expansion of our outreach services from 12 villages to 18.

These villages were selected primarily on the basis of their need for intervention in the areas of

health, education, environment and social factors.

This report, apart from providing the details of various events, programme activities and

achievements of Karuna-Shechen, India in the year 2013, will also give a comparative analysis of

the achievements in 2012 and 2013.

INTRODUCTION

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Table 1:Update on Programme Activities of 2013 and their Comparison with 2012

AREAS OF

INTERVENTION

INDICATORS

2012 2013 RESULTS/ACHIEVEMENT

S OF 2013

HEALTH

Healthcare Services

OPD/Medical Centre Number of

Consultants

17,953 20,535 There has been a 14.38%

increase in the number of

patientsvisiting our OPD,

showing a growing

satisfaction among the

patientsand a consequent

spread of word through

them.

DOT Total Number of

Sputum tests

conducted

303 465 53.47% increase in the

total number of Sputum

tests conducted compared

to 2012. It is testimony to

the rising confidence in the

Shechen Clinic and

increasing awareness about

Tuberculosis.

Number of People

diagnosed with TB

38

27

Pathology Laboratory Number of Patients

who came for

medical tests

722 1665 A 130.61% increase in the

number of people

approaching our pathology

laboratory for conducting

medical tests as compared

to 2012 clearly

demonstrates the immense

satisfaction and success of

our services.

Total Number of

Medical Tests

conducted

2179 4714 116.34% increase in the

total number of medical

examinations done

compared to 2012

Mobile Clinic Total Number of

Patients

16587 24550 48.01% increase in the

number of patientsat

mobile clinics primarily

due to extension of our

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outreach healthcare

services from 12 villages to

18.

Medical Camp Total Number of

Patients

2167 3147 45.22% increase in the

number of patientsat

medical camps for the poor

and needy including monks

Health Education

Programme (HEP)

Number of Health

Groups

87 87

Total Home visits by

Village Coordinators

(vc) and Motivators

(m)

4262(vc)

+ 9165

(m)

2502 (vc)

+ 8010

(m/0

There has been a slight

decline in the number of

home visits under HEP

programme.

Total Number of

Sanitary Napkins

distributed

----

6679

We have started a new

programme on menstrual

health and hygiene under

HEP where we are

providing sanitary napkins

to underserved women and

girls.

Percentage of

Pregnant Women

Followed-up by

Village Coordinators

and Motivators

27.06

57.78

An 30.72% rise in the

number of pregnant

women followed-up by

Village Coordinators and

Motivators in 2013.

Percentage of

Pregnant Women

having Institutional

Delivery

58.50

61.34

2.84% rise in institutional

delivery cases,

demonstrating a clearly

positive impact of our

health education

programme on the target

populations.

Percentage of Neo-

natal deaths

5.43

2.10

A 3.33% decline in the

number of neo-natal

deaths, a result of increased

awareness through HEP

among the rural

communities.

Percentage of new-

born children

immunized with BCG

73.77

59.23

A slight decline (14.54%)

compared to the 2012

figures.

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and 1st DPT

Total number of

children surveyed in

phases I and II of the

Baseline survey for

Malnutrition

programme

---

460

children

in Phase I

and 193

children

in Phase

II

A baseline study was

conducted for our

upcoming programme on

Malnutrition

EDUCATION

Non-Formal Education

(NFE)

Total number of

women enrolled in

NFE

180

447

NFE programme was

scaled-up from 6 villages to

16 villages (18 centres) in

2013

Total number of

villages where NFE

programme is

running

6

16

Strengthening Basic

Education

Total number of

schools where

Parent-Teacher

Association (PTA)

has been formed

---

5

Under our new programme,

Strengthening Basic

Education, we have formed

PTAs in 5 schools

Total number of

villages where Yoga

classes are held

----

9

Yoga classes have been

introduced in all schools

across our 18 villages to

better the physical and

mental health of the school

children.

ENVIRONMENT

Solar Electricity Total number of

villages where solar

lights have been

installed

0 0 This year we did not

provide solar lights to any

village although through

the year we prepared the

ground for such

installations early next year

like conducting feasibility

studies and sending women

to Barefoot college for

training in Solar

Engineering.

Total number of This year 4 rural, illiterate

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women who have

been successfully

trained as Solar

Engineers at the

Barefoot college,

Rajasthan

----

3

women were sent to

Barefoot college to learn

Solar Engineering. Apart

from one woman who had

to return to her family in

the middle of the course for

personal reasons, the rest

have successfully

completed the training.

Rainwater Harvesting Total number of

households where it

has been installed

----

32

We have started a new

programme, Rainwater

Harvesting, as an outreach

Environmental activity.

Total number of

households where it

is in the process of

being installed

----

277

Households that have

started constructing

platform for installing the

tank.

Total number of

schools where it has

been installed

----

4

Chando, Barsuddi, Dema

and Gopalkhera

Clean Environment,

Hygiene and Sanitation

in BodhGaya

Number of food

covers distributed

ordered by vendors

-----

30

Street vendors and snacks

shop-owners have placed

orders with us for covers

to protect food on display

from dust and germs.

Number of schools

where various intra-

school competitions

were organized as a

part of our

environmental

awareness campaign

------

27

We had organised drawing

and speech competitions in

27 schools in Bodhgaya and

our operational villages;

the purpose being

awareness generation

among the children

regarding environmental

cleanliness, hygiene and

sanitation.

Number of schools

where audit for the

Green Schools

Programme was

conducted

------

17

SOCIAL

Vocational Training Vocations taught to

NFE students

--- 6 Candles, incense-sticks, 2

types of snacks, phenyl and

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chalk

Total Number

participating in the

workshops

----

108

Total Number of

Students in Computer

training classes

---

36

As a vocational training for

the young underserved

populations we started free

computer training courses

in 2013.

Kitchen Garden Total number of

households to whom

fruit and vegetable

seeds/plantations

were distributed

---

1000

Total number of

schools where fruit

and vegetable

seeds/plantations

were distributed

----

4

Dema, Gopalkhera, Kadal

and Chando

small money, BIG

CHANGE

Number of villages

covered under the

programme

----

5

Kadal, Barsuddi, Chando,

Banai and Gopalkhera

Community

development projects

undertaken

--- Pond

digging,

reconstru

ction of a

well and

a check-

dam,

levelling

of

undulatin

g

agricultu

ral land

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AN OVERVIEW OF MEDICAL ACTIVITIES

OPD & MOBILE CLINICS

In the year 2013, the total number of Patientswho availed the healthcare services of our OPD

(Outreach Patients Department) Mobile Clinic and Medical Camps was 48,232. New patients(for

OPD and Mobile Clinics) constituted 19,073 people.

We can see from the graph that during the summer the number of patientshas been less

compared to the monsoons and winter due to the scorching heat.

From June to December the total number of patientsshow an upward trend. However,

during the festive season in November there is a a slight drop.

The number of patients referred to PHC & Government Hospitals was 204 (0.45% of total

patientsat OPD and Mobile Clinics).

The total patients who were treated “Free of Cost” (Pregnant women, children and aged people

above 60 years) in the OPD Clinic and by our Doctors were 26,098 ( 57.89% of total patientsat

OPD and Mobile Clinics).

HEALTH

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DOT

Out of 4,718 medical examinations conducted in our pathology laboratory 465 were Sputum tests

(for Tuberculosis). Out of these the number of people who were diagnosed with TB was 27.

Currently, the total number of TB patients undergoing treatment at the DOT centre within our OPD

and DOT services provided in the villages is 40.

Table 2: Details of DOT Program

Indicators Total

Total number of medical tests conducted In laboratory 4718

Total number of patients coming for medical tests 1665

Sputum Test(AFB) 465

Sputum Positive 27

Total number of TB patients who started medicine 57

Refer TB Patients 9

Completed TB Medicine 4

Total No. Of TB Patients are undergoing treatment 40

DOT Training

DOT Providers’ Training

A one-day DOT Providers’ Training was conducted in July for the motivators of the 6 newly added

villages as they are responsible for administering DOT services to TB patients within their

communities. The training also served as a refresher for our laboratory technicians and motivators

of the rest of the villages who act as DOT providers at our medical centre in Bodhgaya and in our 12

villages respectively.

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Meeting with TB Patients

Lab Technician and Director with the TB Patients who attended the Meeting

As tuberculosis leaves a person weakened and fragile, leading to loss of several days of work which,

in turn, hampers their socio-economic lives we realised that medical treatment and cure form just a

part of restoring them to normalcy. Therefore, we plan to invest the money collected as registration

fees from our OPD and Mobile health services, for the improvement of the livelihood opportunities

of our TB patients. To discuss this, a meeting was organised with those people who have recovered

completely from TB under our DOT treatment and those on their road to recovery. At the meeting

we discussed our plans with the TB patients, seeking their opinion and feedback.

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TYPES OF DISEASES OBSERVED AMONG PATIENTS IN OPD AND MOBILE CLINICS

The following table gives us information about the various types of diseases observed among the

patients in our OPD and Mobile clinics.

Table 3: Types of Diseases

Diseases Total

Diarrohoea/children 91

Diarrhoea / dysentery adults 1167

Amoebiasis 583

Typhoid 508

TB 705

Gynecological patients 2100

Bone & joints patients 7868

Burn patient 375

Worm manifestation 73

Skin diseases of all kinds 3482

Ophthalmologic infections 160

Malnourished children 2

Cardiac Inf. 74

HTN 2150

Diabetes 278

Asthma & COPD 1982

Cough & Cold 9017

Epilepsy 295

ENT patient 4125

Lymphadenopathy 67

I&D Dressing 416

Other Patients 8739

The table and graph show that the most common health problems observed among our OPD and

Mobile clinic patients were Cough and Cold, Bone and Joint pain, Skin diseases and ENT problem.

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Refresher Training for our Medical Officers

In February a Refresher Training was given to our Medical Officers by Dr. Jaya Maitra from the Red

Cross Society in Jamshedpur, Jharkhand.

Identity Cards for Medical Consultants

In order to maintain the patient history we started issuing Identity Cards to all medical

patientsvisiting our OPD in Bodhgaya and mobile clinics in the villages. A total of 16,373 identity

cards (8721 for OPD and 7652 for Mobile Clinics) were issued.

Appointment of New Staff

With the expansion of our outreach activities from 12 villages to 18 and the launch of several new

programmes Karuna-Shechen (India) expanded its team to incorporate new staff members,

including 2 female and 1 male doctor, 1 laboratory technician, 2 nurses, 1 pharmacist, 1 driver and

1 research and documentation officer; and village motivators for our 6 new villages, instructors for

our new NFE centres and 2 Computer teachers for our computer training courses. Besides, we have

hired 4 interns from the Department of Rural Development and Management of the Magadh

University to assist us in various programme activities.

Till 2012 only male doctors served the patients at OPD and mobile clinics but in February 2 female

medical officers were appointed to better serve the women and children who form majority of our

medical consultants. Unfortunately, both of them had to discontinue after a few months of service

due to personal reasons. However, in July we hired a sincere and dedicated female doctor.

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ACCESS TO PRIMARY HEALTHCARE IN URBAN AREA: SHECHEN MEDICAL

CENTRE IN BODHGAYA, BIHAR

The total number of people who came to the Medical centre in Bodhgaya for Consultations in 2013

was 20,535. Out of this total 9621 were new consultants, representing 46.85% of total

consultations in OPD.

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Table 5: Details of Patientsin OPD

From the table and graphs we see that the number of patientsat OPD show a decline in

the months of March through May compared to the January-February. This may be

primarily attributed to the scorching summers as majority of our consultants, both at

OPD and Mobile clinics, travel considerable distances (often on foot) from the

neighbouring villages to come for medical check-ups.

June onwards until December the number of patientsshow considerable increase,

except for November when there is a slight drop in the number of patientsas it is the

month of festivals.

Months Total

Consultants

New

Consultants

January 1360 872

February 1321 864

March 1153 674

April 1092 520

May 1085 674

June 1585 760

July 1851 858

August 1904 881

September 2218 907

October 2398 913

November 2002 788

December 2566 910

Total 20535 9621

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The above graphs demonstrate clearly that women and children constitute majority of patientsat

OPD (71% of the total patientsat OPD).

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Pathology Laboratory

Total number of patients who came in 2013 for different medical tests was 1665 and total analysis

done was 4718. The number of patients and tests are different because one patient may go for

several tests. Patients tested Free of Registration Charges was 195.

Table 6: Types of Medical Tests conducted in our Laboratory

From the above table and graph we see that the highest number of medical tests conducted are

TC/DC, ESR, Blood Sugar, HB% and Sputum Test.

Types of Medical Tests

Conducted

Total

Number of

Tests

TC/DC 862

ESR 732

HB% 537

Malaria 162

Uric Acid 126

Blood Sugar 530

Serum Blirubin 82

AFB (Sputum test) 465

ECG 51

Urine routine

examination

274

Urine culture sensitivity

test

126

Other Tests 771

Total 4718

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MOBILE CLINICS

Till January 2013 our outreach health services were provided to the rural population of our 12

operational villages through a mobile clinic that functioned 6 days a week. With the objective of

providing comprehensive healthcare to a larger number of the underserved communities we

expanded our services to 6 new villages from February 2013 by launching a second Mobile clinic.

In 2013 the number of patients who came for the consultations in mobile clinic from 18 village was

24,550, out of which 9452 (38.50% of total patientsat Mobile Clinics) were new patients

The total patients who were treated Free of Registration Charge (Pregnant women, children and

aged people above 60 years) in the Mobile Clinic was 17,375 (70.77% of the total patientsat

mobile clinics).

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Table 7: Patientsat Mobile Clinics

Months Total

Consultants

New

Consultants

January 632 237

February 1511 915

March 1381 659

April 1425 618

May 1360 659

June 1605 648

July 2572 1040

August 2311 853

September 3012 1068

October 2909 1018

November 2652 865

December 3180 872

Total 24550 9452

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Women and children constitute 74% of the total patientsat Mobile clinics, which is similar to the

trend in OPD where they form more than 70% of consultants.

MEDICAL CAMPS

With the objective of extending our healthcare services to the maximum number of underserved

people, every year we organise free medical camps for the poor and needy. In 2013 the medical

camps were organised in the months of January, February, November and December not only for

the underprivileged populations in and around Bodhgaya but also for the Buddhist monks at

Nyingima Monastery.

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Table 8: Number of Patients at Medical Camps

Of the 3147 patientsat the medical camps, 748 were registered at the camp

exclusively for Buddhist monks at Nyingima Monastery. The camp at Nyingima Monastery

had run for a greater number of days in the month of February compared to that in January,

hence the larger number of patientsregistered in that month.

Medical camps for the poor and needy registered the highest number of patientsin

December as 2 camps were organised that month, instead of the usual 1 camp per month

schedule that had been followed for January, February and November.

Months Total Number of

Patientsat Medical

Camps for Poor

and Needy

Total Number of

Patientsat Medical

Camp in Nyingima

Monastery

January 500 148

February 359 600

March 0

April 0

May 0

June 0

July 0

August 0

September 0

October 0

November 523

December 1017

Total 2399 748

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The following table and graph show the number of male, female and child patientsat the medical

camp for the poor and needy.

Table 9 : Men, Women and Children at Medical Camp for the Poor and Needy

Month Male Female Children Total

January 78 325 97 500

February 116 203 40 359

March 0 0 0 0

April 0 0 0 0

May 0 0 0 0

June 0 0 0 0

July 0 0 0 0

August 0 0 0 0

September 0 0 0 0

October 0 0 0 0

November 158 198 167 523

December 264 419 334 1017

Total 616 1145 638 2399

From the above table and graphs we see that, just like in OPD and Mobile Clinics, at medical camps

too women and children for majority of the patients( 74% of total consultants).

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HEALTH EDUCATION PROGRAMME (HEP)

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Our Health Education Programme continues to run successfully as can be seen from the following

tables:

Table 10: Some Details of HEP

Indicators

Total Population reached 9449

Total Households reached 1285

Total Families reached 1936

Total Number of Health Groups 87

Total Number of Members in Health Groups 340

Total Number of Home Visits by Village Coordinators (vc) and

Motivators (m)

2502 (vc) and

8010 (m)

Table 11: RCH Programme Details

Indicators

Total Number of Sanitary Napkins distributed 6679

Total Number of Pregnant women benefitted from the awareness generation

and information dissemination under our sage pregnancy programme.

500

Total Number of Pregnant women received minerals and vitamins and were

followed-up by our village coordinators and motivators.

193

Percentage of Pregnant Women Followed-up by Village Coordinators and

Motivators

57.78

Percentage of Pregnant Women sent for Immunisation by Village Coordinators 41.32

Percentage of Pregnant women immunized with TT1& TT2 53.89

Percentage of Pregnant Women having Institutional Delivery 61.34

Percentage of new-born children immunized with BCG and 1st DPT 59.23

Percentage of Neo-natal deaths 2.1

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MALNUTRITION

Considering health programs as a critical component of our endeavour to reach out to the

underserved populations we recognise malnutrition as a major impediment to welfare of the poor

and needy. According to the Global Hunger Index 2011, Bihar’s child malnutrition rate is higher

than any country in the world1. Gaya district, like other parts of Bihar, has a high incidence of

malnutrition. Therefore, keeping in tandem with our vision and mission we intend to start a child

malnutrition program in the 6 villages that have been brought under the aegis of Karuna-Shechen’s

support early this year.

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In February, one-day training on Malnutrition was conducted by Dr. Nadine Donnet, the

organisation’s malnutrition consultant, for the entire staff of Karuna-Shechen India, where apart

from imparting knowledge on the various aspects, problems and policies of malnutrition the use of

a tools for measuring it, MUAC (Mid-Upper Arm Circumference) and Weight for Height were

demonstrated.

A baseline survey was conducted to guage the intensity of the prevalence of acute and chronic

malnourishment among children under 5 years of age in the target areas so as to evaluate the

relevance of a nutrition programme in the chosen villages. As acute malnutrition is seasonal in

nature the survey was conducted in two phases to get a clear picture of the prevalence and

intensity of the problem; the first phase was conducted in February, the time of the year when food

shortage does not usually take place and so chances of finding severe acute malnutrition is much

less. The second phase was conducted in the third quarter, during the monsoons when people,

especially children are susceptible to water-borne and other diseases. It is also the season of food

scarcity.

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Results of the Survey2

Phase I of Baseline Survey

Table 12: Phase I Results

Village Total

Number of

under-five

Children in

the Village

Number of

Children

Absent

Number of

Children

Measured

MUAC>11.5

cm

Severe Acute

Malnourished

(SAM)

MUAC>12.5cm

Moderate

Acute

Malnourished

(MAM)

Dema 283 85 198 1 17

Chando 110 27 83 0 0

Barsuddi 30 6 25 0 1

Kadal 45 8 37 1 2

Nawatari-

Meghubigha

44 17 26 0 3

Meghubigha 43 13 30 1 1

Bandha 95 34 61 0 7

Total 650 190 460 3 31

The above table shows that Severe and Moderate Acute Malnourishment was found to be 7.39% in

Phase I of the baseline survey where Severe Acute Malnutrition (MUAC >11.5cm) was 0.65% and

Moderate Acute Malnutrition (MUAC >12.5cm) was 6.74%.

Phase II of Baseline Survey

A second phase of survey was conducted during the monsoons for the following reasons:

People, especially children are susceptible to water-borne diseases during the rainy season

which highly increases the risk of falling into malnutrition.

The monsoons are usually plagued by food shortage

We wanted to measure the children who were absent during Phase I and also those who

were found to be SAM or MAM.

In June our Malnutrition team visited the villages to conduct the second round of survey but out of

224 children to be measured (190 absent during Phase I and 3 SAM and 31 MAM children) only 60

were present. Therefore, we had to conduct the survey again in the months of August-September

when 193 children were measured, 31 being absent.

2 Malnutrition Baseline Survey Report, 2013, Karuna-Shechen (India)

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The following table gives the results of Phase II of the survey:

Table 13: Phase II Results

Village Number of

Children

Measured

Number of

Children

Absent

MUAC>11.5 cm

Severe Acute

Malnourished (SAM)

MUAC> 12.5cm

Moderate Acute

Malnourished (MAM)

Dema 74 18 2 7

Chando 24 5 1 0

Barsuddi 15 2 0 1

Kadal 18 0 0 3

Nawatari 19 1 0 3

Meghubigha 15 2 0 1

Bandha 28 3 1 2

Total 193 31 4 17

The above table shows that Severe and Moderate Acute Malnourishment together was found to be

10.88% in Phase II of the baseline survey. Severe Acute Malnutrition (MUAC >11.5cm) was 2.07%

and Moderate Acute Malnutrition (MUAC >12.5cm) was 8.81%.

Table 14: Phases I and II Comparison

Baseline Survey

Percentage of

Children with

Severe Acute

Malnourishment

(SAM)

Percentage of

Children with

Moderate Acute

Malnourishment

(MAM)

Percentage of

Children with

Acute Malnutrition

(SAM + MAM)

Phase I (February) 0.65 6.74 7.39

Phase II (August-

September)

2.07 8.81 10.88

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In both the phases of the baseline survey we find more children afflicted by MAM compared to

SAM. Phase II has recorded 218.46% higher SAM and 30.71% higher MAM. Phase I of the Baseline

Survey shows a lower prevalence of acute malnutrition among children below 5 years of age

because of the following reasons:

All children in the target villages were measured. So, compared to the total number of

children measured the number suffering from acute malnutrition was very low However,

the Phase II of the survey measured exclusively those who were found to be acute

malnourished in Phase I. Thus, the percentage of Acute Malnutrition (both SAM and MAM)

among those measured in the second phase was higher than the first.

Secondly, Phase I was conducted when the villages are not plagued by food scarcity

whereas Phase II was carried out in the rainy season when there is food shortage and high

susceptibility of the villagers, especially children to various infections and diseases.

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STRENGTHENING BASIC EDUCATION

Yoga classes

Support Faculty at Dema School PTA Meeting

With the aim to establish a strong foundation for a child’s proper all-round development through

the strengthening of primary education we launched our ‘Strengthening Basic Education’

Programme in early 2013.

The first step was to visit schools in all our operational villages, engage in discussions with the

school principal, faculty members, students and their parents in order to identify the problems

facing basic education system in those schools.

As the teacher-student ratio was found out to be a major problem in all the schools our next step

was to recruit bright and enthusiastic teachers from within the community who would make

learning an interesting and joyful experience. We thus provided support faculty to the schools in

Dema and Gopalkhera. However, we were unable to get well-educated and bright support faculty

EDUCATION

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for schools in the rest of the villages due to dearth of such people in the communities. This has

made our progress on the Education front tardy due to lack of expected development in this area.

Parent-Teacher Associations (PTA) have been formed in Dema, Gopalkhera, Lohjhara, Kadal and

Chando. Regular PTA meetings are held in these schools. Our aim of forming PTA in schools is to

sensitise the target communities about the various governmental schemes and programs related to

education. This knowledge will make the children and parents aware of their right to good

education, enabling them to better judge the existing education standard and facilities at school.

Looking at the importance of physical and mental fitness we introduced Yoga classes at schools in

all our operational villages in June this year.

We have started supplying Teaching-Learning Materials (TLM) to schools in an effort to fulfil the

basic requirements of teachers and students and help ameliorate the basic education standards

there. The TLMs also include indoor and out-door game materials like carom board, badminton

racket and shuttle cork, cricket bat and ball, etc which would encourage extra-curricular activities

thereby helping the overall growth of the children.

EARLY CHILDCARE AND DEVELOPMENT

Our volunteer from Inter’Lude with children at Anganwadi Centre in Dema

A child’s development in his early years forms the foundation for his future learning, well-being

and success. Integrated Child Development Scheme (ICDS), India’s programme on early childcare

and development responds to the inter-related needs of children below 6 years, through various

services like provision of supplementary nutrition, immunization, health check-up, referral

services, health education and non-formal education. These services are delivered to pregnant and

nursing mothers and preschool children (up to 6 years) through Anganwadi Centres (AWCs) set up

at the community level. Thus, recognising the vital role that Early Childhood Care and Development

(ECCD) plays in ensuring proper physical, emotional, cognitive and social growth of a child, we

have introduced an ECCD programme. In 2013 the base of the programme was formed through

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meetings and discussions with the District Programme Officer for Integrated Child Development

Services (ICDS-India’s programme on early childcare and development) and the District Magistrate

of Gaya district regarding our new intervention in Anganwadi centres.

We expect to start our ECCD programme on children’s games and play from early 2014. The

project will be conducted on a pilot basis in four villages (Gopalkhera, Dema, Chando and Banahi).

We have had the honour of welcoming a volunteer from Inter’Lude, France for imparting 4- month

training to the Anganwadi workers on the importance and organisation of various types of games

for children. Besides, we will be designing different in-door and out-door games from locally

available resources and providing the same to the children at Anganwadi centres.

NON-FORMAL EDUCATION (NFE)

Our NFE programme that had been running in 6 villages (Banahi, J.P Nagar, Karhara, Trilokapur,

Kharati and Gopalkhera) since 2011 was scaled-up to cover 10 more villages in response to the

demand of their rural illiterate female populace. 487 women are currently enrolled in our NFE

classes running in 18 centres across 16 villages. Apart from teaching the students basic alphabets,

simple sentence construction and numericals, different important national and global geographical

locations are shown on the map. Besides, daily newspapers are used as a learning tool not only to

improve the students’ reading abilities but also to expose them to current affairs.

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SOLAR ELECTRICITY

This year saw a new step taken towards the scale-up of our solar electricity programme that has

been running in 3 of our villages, J.P. Nagar, Banahi and Kharati. 4 women (three from Chando and

1 from Kadal) were selected for the 6-month training at Tilonia, Rajasthan’s Barefoot College in

Solar Engineering. Unfortunately, one woman had to return to her village mid-way due to family

reasons but the rest 3 successfully completed it and went back home in December 2013, equipped

with the designation of Solar Engineers. While these women were away in Tilonia we conducted ty

2 surveys, one in April and another in October-November in the villages of Chando, Kadal and

Barsuddi as a feasibility study; in order toknow the total number of households willing to pay a

one-time installment, specifying the amount they are willing to pay; how much, if any, do they want

to pay on a monthly basis for light maintenance and battery replacement; the number of lights

required per household, etc.

ENVIRONMENT

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RAIN WATER HARVESTING

All our operational villages, located in the drought-prone agro-climatic zone of southern Bihar face

water shortage problem for large parts of the year, especially during summers when there is severe

dearth of water for irrigation, washing etc. In order to combat this problem we have started our

new water harvesting programme in the villages where rain water is collected from roof-tops and

stored in water tanks. The stored water can be used for various productive purposes like washing,

cooking, sanitation requirements and watering of kitchen gardens in the household backyards.

We started the project by conducting several meetings and discussions with the village

communities, explaining to them the concept, uses and advantages of rain water harvesting. Those

interested were instructed to build platforms for the installation of water tanks and to fit pipes that

would carry water from roof-tops to the tank. While some households have already completed the

process of installing the whole system and are ready to use the system, several are yet to

accomplish the task. This project, which began in the last leg of the year, has already managed to

have 32 households and 4 schools (Dema, Gopalkhera, Chando and Barsuddi) install the whole

rainwater harvesting system while several others are in the process of installing it. By the end of

this project we expect our villages to boast of household level water harvesting.

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BODHGAYA CLEAN ENVIRONMENT, HYGIENE AND SANITATION

Drawing Competition Participants with Jute bags

Meeting with Stakeholders of the Programme

With the mandate to create a clean and hygienic town we launched the Bodhgaya Clean

Environment, Hygiene and Sanitation Program early this year.

In order to create awareness about the importance of cleanliness and hygiene and, in the process,

make it an integral part of the lives of the local people we have taken the following steps through

2013:

We have held several meetings and discussions with various stakeholders ; food-shop

owners, street vendors, local communities and school prinicipal and faculty members, to

make them understand the important nexus between health and clean environment and to

achieve awareness genration through constant interaction with them.

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Prior to community-level meetings we conducted an extensive household survey in 142

households in Bodhgaya town to get an idea about the level of awareness, problems and

practices related to sanitation and hygiene at household and locality levels.

We have organised intra-school drawing and speech competitions, in 27 schools (15

schools in Bodhgaya and 12 in our operational villages) in order to create awareness on

Environmental Cleanliness and Hygiene among young students ; and have received

appreciation for our initiative.

Three of our staff members (the Director, a Village Coordinator and the Research and

Documentation Officer) attended a 2-day intensive training program (Green Schools

Program) at the Centre for Science and Environment (CSE), New Delhi. On the basis of the

training we successfully conducted Green Schools audit in all schools within our

operational villages.

In a bid to discouraging the usage of plastic bags and motivate people to use substitutes we

have ordered jute bags of different sizes to serve various pruposes. These bags have our

organizational logo and a message pertaining to our programme. In order to promote the

use of bio-degradable alternatives to plastic bags we are distributing these jute bags for free

among participants of school competitions, our medical consultants, staff members, and

others.

We will be providing food covers to the vendors and sweet-shop owners in Bodhgaya and

at Gaya station. Till now we 30 vendors have placed orders with us for the covers that will

protect the food on display from roadside dust and germs.

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SMALL MONEY, BIG CHANGE

Village Scan in Dema and Bandha

Levelling of Agricultural Land in Chando After the Land was Levelled

The repaired well at Kadal The newly dug pond at Kadal The Bathroom at Kadal

Recognising the imperative role that active participation of underprivileged target communities in

development projects play in empowering them, we launched our new programme- ‘small money,

SOCIAL

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BIG CHANGE’ early this year. Community participation ensures effectiveness as communities bring

understanding, knowledge and experience integral to the development process. Besides, the

community is best informed about the needs, attitude and socio-economic conditions of its

members.

We conducted a Village Scan in our 6 new villages, Chando, Bandha, Kadal, Barsuddi, Dema and

Gopalkhera. This step, by helping us identify the specific needs and aspirations of the local

communities, formed the base for determining what projects will be introduced in the villages. The

community development work under ‘small money, BIG CHANGE’ started in Chando and Kadal

from June this year. Eventually the programme was extended to two more villages, Gopalkhera and

Banahi.

In Kadal, the community’s primary source of water for drinking, washing and bathing

purposes; a well was reconstructed. Perviously it was in such a deplorable condition that

the water used for various purposes would flow back into it, polluting the water inside the

well and making it unfit for drinking. Through small money, BIG CHANGE not only was the

well renovated for proper use by the villagers but also made provision for water outlet for

domestic animals and livestock. Apart from a private bathing space or bathroom was built

exclusively for the women. The waste water from the bathrooms are channeled to a nearby

land which we have turned into a Kitchen Garden. Also a pond has been dug nearby where

pisciculture is being cultivated in order to add to the livelihood opportunities of the

community.

In Chando the undulating agricultural lands that adversely affected both crop yield and

quality, were levelled. This is expected to enable better weeding and increased crop

production and productivity. Besides, the ground within Chando school premises was also

levelled and turned into a playground for children.

In Gopalkhera, an existing check dam which had been broken and had remained

dysfunctional for long, was successfully repaired. This has enabled rainwater to flow

straight into the village pond which will not only allow the villagers to perform their daily

activities but also provide water for the agricultural fields, increasing crop productivity and

consequently improving the villagers’ livelihoods.

A small pond was dug in Banahi village, thereby giving the community access to an

additional source of water which was a basic requirement and demand of the community as

it faces serious water shortage during summers.

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KITCHEN GARDEN

Looking at the abysmally high incidence of malnourishment in Bihar (around 80% of children

below five years of age and 68.2% of women in reproductive age group (15-49 years) in Bihar are

malnourished) and the extreme poverty of small and marginal farmers we have started a

programme on Kitchen Gardening. Contrary to commercial farming which encourages mono-

cropping, we practice multiple-cropping in the kitchen gardens in order to ensure a sustained

supply of fresh vegetables and fruits throughout the year.

The success of our new programme can be gauged from the fact that, in contrast to our initial

estimation of covering 100 households across 18 villages, 1000 households showed interest in the

project and are now practicing kitchen gardening with the fruit seeds and vegetable plants

provided by us. Our Kitchen Garden programme is also going on in 4 schools (Dema, Gopalkhera,

Chando and Kadal)

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VOCATIONAL TRAINING FOR UNDERPRIVILEGED YOUTH AND WOMEN

With the objective equipping the underprivileged youth with adequate digital skills so as to provide

them with better employment opportunities and socio-economic empowerment we have started

free computer training programme from July this year. Two types of computer courses are being

taught at our Bodhgaya office namely, Office Management (which will teach MS Office) and DTP

(Page maker, Coral Draw and Photoshop). The duration of each course is 6 months. While the

trainings are imparted free of charge it is mandatory for the students to devote 5 hours per week

towards voluntary services in their respective villages. This provision will fulfil the twin objective

of promoting computer literacy amongst the marginalised communities and serving the rural poor.

36 enthusiastic youths are pursuing the courses with great dedication.

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With the aim to empower the NFE students with both educational and skill enhancement services

we introduced vocational training for them. Under this programme NFE we organised 3 vocational

training workshops in July. Conducted by an eminent vocational trainer from Jamshedpur,

Jharkhand the workshops, attended by our NFE students from all 18 centres and by village

motivators, taught the making of incense sticks, candles, 2 types of popular snacks, Phenyl and

chalk. The vocations were selected on the basis of their market demand, income-earning

capabilities and interests of the NFE students.

All the workshops saw much greater turn-out than the expected 40 (90 participants at candle and

incense stick-making workshop, 41 participants for snacks and 54 for the workshop on phenyl and

chalk). 7 participants from the candle-making workshop were chosen on the basis of their ability to

produce what they had leant. They were sent to Jamshedpur in August for a week-long intensive

advanced training. The next step was the economic empowerment of these women through the

opening of a temporary candle-production unit within the premises of our medical centre at

Bodhgaya. These women were assisted by 4 others who had attended the candle-making workshop

that we had organised.

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NETWORKING WITH OTHER NGOS

We have collected detailed information on all the non-governmental organizations working in Gaya

district. This is the first step towards our goal of creating a network of like-minded NGOs so that

instead of working in isolation, organisations with similar views and mission would be able to work

collectively towards the realisation of their common aspirations.

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FINANCES

The budget and expenses for the year 2013 are as follows:

Table 16: Budget and Expenses

Budget in USD ($1=INR 58)

Expenses in USD ($1=INR

58)

Administration, transportation and functioning cost 51719 43448

OPD , Mobile Clinics and Medical Camps 1,57,858 80,137

Education direct benefit to population in 18 villages 39714 23536

Environmental Program 42355 11393

Social Program 59441 39202

Program Support and Investment 54,590 28,430

Total 405678 264314

OTHER IMPORTANT

INFORMATION

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INTERNATIONAL AUDIT

An international Audit for the financial year 2012-2013 successfully took place during the fourth

quarter of this year.

EXTERNAL VISITORS

We were honoured to welcome our guests who took out time from their busy schedules to pay us a

visit. Our list of esteemed visitors included Matthieu Ricard, President of Karuna-Shechen; Tarek

Toubale, Chief Operating Officer; Anne Oliver, Chief Financial Officer of Karuna-Shechen, Sanjeev

Pradhan, Director of Shechen Clinic, Nepal, Vanessa Challinor, Serge, Astrid and Marie Saint-

Arnoult from Shining Hope Foundation. Besides, our ex-Field Operations Director, Dr. Nadine

Donnet, Dr. Jaya Maitra from Red Cross Society in Jamshedpur and Sebastien, our volunteer from

Inter’Lude, France also graced us with their presence.

ORIENTATION ON PROGRAMME ACTIVITIES

In March, a one-day Orientation on our programme activities was organised. It was attended by the

entire staff of Karuna-Shecehn, India with our Director acting as the Facilitator.

The objectives of the Orientation were:

To give a clearer understanding about the organization

To give a clearer understanding of the program activities

To make all new colleagues feel as part of the team and enable them to do their best to help

the organization achieve its goals.

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ACTIVITIES -2014

A 4-month training imparted to Anganwadi workers in our villages by a volunteer from

Inter’Lude, France. The primary focus of the training will be child development through

games and activities.

A pathology laboratory expert will join us from France for a 6-month training and

supervision session at the laboratory in our medical centre, Bodhgaya.

Solar lights to be installed in the villages of Chando, Barsuddi, Kadal and Banahi by our

newly trained Solar Engineers.

Rainwater harvesting to be completed in the households and/or schools where the process

of installation has begun. Also, as there is a gradual increase in interest regarding the

project amongst the communities in our operational villages more households are likely to

install rainwater harvesting system in the coming months.

We may conduct the Green Schools Programme in schools in and around the town of

Bodhgaya.

This year we envisage extending our services to Aurangabad, Jehanabad, Nalanda and

Nawada, i.e., the districts neighbouring our present area of intervention; Gaya district.

Besides, we intend to expand our geographical area of operation to the neighbouring State

of Jharkhand.

OUR PARTNERS

Current Partner: Barefoot College in Tilonia, Rajasthan

Prospective Partner: Centre for Science and Environment, New Delhi.

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THE BENEFITS OF PRACTISING KITCHEN GARDENING WITH HELP FROM KARUNA-

SHECHEN, INDIA: EXPERIENCE OF SAKER MANJHI FROM BHUPNAGAR

Saket Manjhi, a rural youth from the village of Bhupnagar is extremely happy to have started a

Kitchen Garden in his backyard with fruits and vegetables provided by our organisation. 4 months

since he began growing brinjals, tomatoes, green chillies, bitter gourd, pumpkin, potatoes, etc in

August 2013, his family has not had to worry about market availability and prices of food as he now

cultivates them in their own backyard. The biggest satisfaction is that Kitchen Garden contributes

to his household food security by providing direct access to food that can be grown, prepared and

fed to family members, on a regular basis. Saket Manjhi believes that the primary benefits of

practicing kitchen gardening is increased direct access to nutritious foods by the otherwise, often

food insecure rural communities like theirs. Talking about the economic benefits that his family

enjoys due to this programme Saket Manjhi says that he has been growing vegetables worth INR

700 per month.

He sincerely thanks Karuna-Shechen, India for coming up with such a dynamic programme which

will provide his family and other community members with steady source of nutritious food and

income. He is especially satisfied with our regular follow-ups with the participants of this

programme where we guide them regarding protection of the plants from animals, proper watering

and maintenance of the plants, the use of composting, proper use of pesticides, etc. Saket Manjhi

expects to expand his Kitchen Garden by planting greater varieties of crops next year.

ANNEX-SUCCESS STORY

Annual Report Karuna-Shechen 2013

Documents

Transcript of Annual Report Karuna-Shechen 2013