HELPAGE INDIA-ONGC MMU PROJECT FIELD REPORT FROM ONGC ... Region.pdf · The HelpAge India-ONGC...

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HELPAGE INDIA-ONGC MMU

PROJECT

FIELD REPORT FROM ONGC

OPERATIONAL AREAS

IN

ANDHRA PRADESH AND

TAMIL NADU

91

CCCContentsontentsontentsontents

SectionsSectionsSectionsSections DetailsDetailsDetailsDetails Page No.Page No.Page No.Page No.

Section-I Project Backdrop in South India 93

Section-II Project Initiation 93

Section-III The Gram Panchayat Identification Process 94

Section-IV Consultation with Gram Panchayats for Mapping

Basic Infrastructure, Collection of Demographic and

Other Basic Information, Identification Of MMU

Parking Locations and Relationship Building for

Smooth Project Operation

99

Section-V Conducting Baseline Survey for Mapping Elderly

Population, their Health, Psycho-social, and Family

Related Issues

104

Section-VI Suggested Office Locations for MMU Units and

Search For Prospective Candidates

105

Section-VII Linkages Established with Government and Private

Health Resources

107

Details of Parking Locations 109

List Of ONGC Officials Met During Project & Field

Visits

113

Field Observations from Andhra Pradesh & Tamil

Nadu

114

93

Section I. Project Backdrop in South IndiaSection I. Project Backdrop in South IndiaSection I. Project Backdrop in South IndiaSection I. Project Backdrop in South India

The HelpAge India-ONGC collaborative Mobile Medicare Unit (MMU) project is designed

to provide basic health care to services to the elderly at their doorsteps in selected Districts

of two states of South India (Andhra Pradesh and Tamil Nadu). The following ONGC

project locations were to be mapped as per the information provided by the ONGC and

HelpAge India (HI).

1. Rajahmundry Asset4

2. Kakinada Asset

3. Karaikal Asset

4. Chennai Asset

Section ISection ISection ISection II. ProjectI. ProjectI. ProjectI. Project IIIInitiationnitiationnitiationnitiation

The field team of FourX4 was further suggested by HAI to start the baseline and project

operational process at Rajamundry Asset. Accordingly, the General Manager, Human

Resources Department, Rajahmundry Asset, who is responsible for Corporate Social

Responsibility (CSR) activities, was contacted and the FourX4 field team called on the

official at Rajahmundry. It was learnt during the meeting with GM-HR at Rajahmundry that

Kakinada Asset is a separate administrative unit which has been allotted one MMU. A

meeting was organized with the Top Management of Kakinada Asset led by its Executive

Director (ED). It was very aptly articulated by the ED of Kakinada Asset the MMU project

must focus on villages in and around its soon-to-be-functional permanent Gas Collection

Station (GCS) at Odalarevu Village in the Allavaram Mandal of East Godavari District.

Accordingly, villages (village Panchayats) were identified in and around Odalarevu with

the help of ONGC field officials where ONGC is presently having Drilling Units, oil and

gas producing Wells, etc. Table-1 reflects the number of village panchayats selected for

the operation of MMU.

In the meeting with the GM-HR of Rajahmundry Asset, it was made clear by ONGC

officials that their established operations are mostly concentrated in Malkipuram,

Sakhineti Palli, Razole and Mamidi Kuduru Mandals of East Godavari district and there is

great potential for future operations in Penugonda, Poduru, Achanta and Elamanchili

Mandals of West Godavari district. Therefore, it was decided to map these Mandals for

identifying the specific focus villages (village Panchayats). Table-1 reflects number of

village panchayats selected for the operation of MMU for Rajahmundry Asset.

Similarly, in the meeting with the GM-HR of Karaikal (Cauvery Basin) Asset it was

suggested by ONGC officials that villages belonging to two separate districts may be

mapped for MMU operations. After a thorough discussion with the field team it was

4 An operational unit is referred to as an Asset in the ONGC lexicon.

94

decided to limit the operations to one district only, i.e. Nagapattinam. The neighbouring

district of Thiruvarur was the other operational location which was suggested by ONGC to

be included in the same MMU operation. However, this was dropped later on because of

lack of feasibility which is discussed in Table-2. Table-1 reflects the number of village

panchayats selected for the operation of MMU for Karaikal (Cauvery Basin) Asset.

The field team also met the Deputy General Manager-Field Operations of the Karaikal

forward base of Chennai Asset and after a discussion with the field team a number of

villages were suggested by ONGC officials for inclusion in the MMU operations. Table-1

reflects the number of village panchayats selected for the operation of MMU for Chennai

(Karaikal Forward Base) Asset.

TableTableTableTable----1: 1: 1: 1: Details of village panchayats selected for the operation of MMU for Chennai (Karaikal Forward Base) Asset

Sl. Sl. Sl. Sl. No.No.No.No.

StateStateStateState ONGC Field ONGC Field ONGC Field ONGC Field UnitUnitUnitUnit

MMU MMU MMU MMU Units Units Units Units AllocatedAllocatedAllocatedAllocated

Operation Operation Operation Operation DistrictDistrictDistrictDistrict

Operation Operation Operation Operation Mandal/BlockMandal/BlockMandal/BlockMandal/Block

No. of No. of No. of No. of Village Village Village Village Panchayats Panchayats Panchayats Panchayats SelectedSelectedSelectedSelected

1. Andhra Pradesh

Kakinada Asset 01 East Godavari Allavaram 08

2. Rajahmundry Asset

02 East Godavari Razole 01

Sakhinetti Palli 07

Mamidi Kuduru 01

Malkipuram 06

West Godavari

Poduru 01

Achanta 01

Elamanchili 02

3. Tamil Nadu

Karaikal (Cauvery Basin) Asset, Neravy

01 Nagapattinam Kilvelur 04

Thirumarugal 04

4. Tamil Nadu

Karaikal Forward Base, Chennai Asset

01 Cuddalore Bhubanagiri 07

Keerapalayam 02

Katumanarkovil 07

Together with the focus village identification, the focus was also to establish initial contacts

with key stakeholders of the MMU project, collect basic demographic information and

initiate survey process for establishment of baseline. The key stakeholders with whom

communications were established were:

• ONGC’s HR/Corporate Social Responsibility Lead Representatives at different

Assets

• Elected Gram Panchayat Leaders & functionaries

• Government Health Centres – Primarily NRHM facilitated health bodies like PHCs

& CHCs

• Local Government Administration (Block/Taluka/Mandal/District)

• Non-government Organisations

Section III:Section III:Section III:Section III: TTTThe ghe ghe ghe grrrram panchayat identification processam panchayat identification processam panchayat identification processam panchayat identification process

Since almost all the operational areas of ONGC in the two focus states of South India are

located in villages, village identification was one of the most crucial steps in the whole

95

exercise. Since ONGC has arguably the highest stake in this process to highlight its

corporate image and augment its visibility in its operational areas, the village

identification process had to initially begin with a consultation with the ONGC team at all

concerned Assets or Forward Bases. The HR/CSR departments of concerned operational

locations of ONGC were informed before-hand about the team’s visit and its purpose.

They were requested to prepare a list of the villages, which from the ONGC’s point of

view would best suit their CSR objectives and its corporate visibility. The ONGC team

usually shared a list of villages with the FourX4 team which did not have any other

associated details like demography, distance of villages from one another, the

corresponding administrative structure details like Gram Panchayat or Block or Taluka,

etc. the list was to be further decoded for developing finer operational details for the

project.

Therefore, on the basis of the list of the villages provided by the concerned HR/CSR

department of ONGC, a mapping of the Gram Panchayats was done. This helped in

identifying the GPs which contained the suggested names of the villages. The mapping

was important because of four reasons, which were:

• The MMU operation needs to align itself with the local governance bodies,

especially Gram Panchayats as it would require the sustained availability its

resources for successful operation. The basic information that will feed into the

operation of MMU will come from Gram Panchayats. The locations for parking of

the MMU vehicle can be best identified in consultation with GP functionaries. As

per the mandate of the MMU project, the parking locations need to be public

places (Schools, Community Halls, Anganwadi Centres, Health Sub-centres, etc.)

thereby guaranteeing uninhibited access by the target group. These locations in a

village are essentially under the jurisdiction of Gram Panchayat and therefore, it

becomes important that its consent and participation are elicited at the beginning

itself.

• The GP mapping helped in assessing the operational feasibility in terms of

distance coverage for the MMU. Here factors like contiguousness of Gram

Panchayats, travel distance between the GPs and location for MMU office were

looked upon. The second important factor that was looked into was population

strength of GP and the corresponding potential patient load that it will be borne by

any one MMU. Based on the patient carrying capacity of the MMU and the

suggested operational areas by ONGC, coverage of GPs in the project was

assessed.

• For determining the exact patient load and generating the corresponding baseline

a door-to-door survey was envisaged from the very beginning. The in-principle

support of the Gram Panchayat leadership was considered crucial to conduct the

survey smoothly and gather the relevant information.

• The ONGC team does not make any differentiation between natural

villages/habitats and village Panchayats or Gram Panchayats (GP). If one or two

villages appear on the list of villages given by ONGC the MMU operation cannot

stop at just reaching out to only these one or two stand alone villages. The services

have to be made available to the whole GP in order to make it relevant and

96

participatory. Therefore, GP mapping was essential for making the entire process

meaningful.

The mapping of the Gram Panchayat was done by locating a field contact, primarily a

Gram Panchayat leader. Supporting help from the field contact was then taken in

mapping the names of the Gram Panchayats corresponding to the names of the villages

suggested by ONGC. In all cases the information on matching the list of villages with

corresponding GPs and other associated conditions like contiguity, operational feasibility

keeping the distance factor in view, etc. were collected from more than one source in

order to ensure its correctness and reliability. ONGC personnel helped in locating some

of the field contacts.

Table-2 below depicts the names of the villages suggested by ONGC representatives and

its corresponding GP Mapping.

TableTableTableTable----2: 2: 2: 2: List of villages suggested by ONGC representatives and its corresponding GP Mapping.


StateStateStateState ONGC AssetONGC AssetONGC AssetONGC Asset Villages Suggested by Villages Suggested by Villages Suggested by Villages Suggested by ONGCONGCONGCONGC

Finally Mapped GPs and Excluded Finally Mapped GPs and Excluded Finally Mapped GPs and Excluded Finally Mapped GPs and Excluded GP DetailsGP DetailsGP DetailsGP Details

1. Andhra Pradesh

Kakinada Odalarevu Odalarevu

Bendamurilanka Bendamurilanka

Komaragiripatnam Komaragiripatnam

Thumalapalli Thumalapalli

Mogalamuru Mogalamuru

Godi Lanka Godi Lanka

Godi Godi

Godithipa Godithipa

S. Palli Pallam These two GPs along with Rameswaram hamlet of Komaragiripatnam GP were dropped from the list because of their distance beyond 25 kilometers from the MMU central location -Odalarevu. Rameshwaram is 33 kms away from its GP.

Samanthakuru

2. Andhra Pradesh

Rajahmundry-I (East Godavari)

Karvaka Karvaka

Tatipaka Tatipaka

Antarvedi Palli Pallem Antarvedi Palli Pallem

Gondi Gondi

Kesavadasu Pallem Kesavadasu Pallem

V.V. Mereka V.V. Mereka

Mori Mori

Gudapalli Pallipallem (+Gudapalli)

Gudapalli Pallipallem

Chintala Mori Chintala Mori

Sankaraguptham Sankaraguptham

Kesanapalli Kesanapalli

These 5 GPs were included to maintain contiguity between the ONGC proposed GPs

Antarvedi Devasthanam

Pademati Pallem

Antarvedi Kara

Golla Pallem

Toorpu Pallem

97




3. Andhra Pradesh

Rajahmundry-II (West Godavari)

Vadali Vadali

Deva Deva

Soma Raju Cheruvu Soma Raju Cheruvu

Manimanchilipadu Manimanchilipadu

A. Vama Varam A. Vema Varam

Badava Badava

Yenugovani Lanka Yenugovani Lanka

These 3 GPs were included to maintain contiguity between the ONGC proposed GPs

Monamaru

Kotala Parru

Tamarada

4. Tamil Nadu

Karaikal (Neravy)

Narimanam Narimanam

Kuthalam Kuthalam

Gopu Raja Puram Gopu Raja Puram

Eravanchery Eravanchery

Okkur Okkur

Kurumanangudi Kurumanangudi

Venkatangal Venkatangal

A single hamlet under this GP was proposed by ONGC and therefore, the GP was included in the list

Anaimangalam

Additionally, some operational areas of Thiruvarur district was being proposed by ONGC.

It was placed before ONGC that one MMU unit can only cover a distance of 15-20 kms. Since the listed GPs are already covering this distance and have good patient load it would not be possible to cater to other operational areas of ONGC in the neighbouring district with the same MMU.

5. Tamil Nadu

Chennai (Karaikal Forward Base)

Adivarahanattam

Alisikudi

Vattrayntethu

Miralur

Manja Kollai

Kilavadinattam

Pinnalur

Orathur

Sathamangalam

Kandamangalam

Kurungudi

Chettitangal

Kil Kadambur

Mel Kadambur

Veerandapuram

Nattar Mangalam These two GPs were not included because of these are situated 25 kms away from the proposed MMU central location

Kalladikuttal

Additionally, ONGC also proposed several villages in Andimatam

This area was more than 35 kms away from the proposed MMU central location. Moreover, one

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area in Cuddalore district.

MMU couldn’t have taken more patient load than what has already been included through the finalized GPs.

The Rajahmundry Asset in Andhra Pradesh has three operational districts – East Godavari,

West Godavari and Krishna. Since Krishna was far away from the other two districts it was

excluded from the mapping exercise from the very beginning. However, as per ONGC’s

own assessment East Godavari has a higher stake for the organization’s CSR activities

and the Asset’s top management initially thought of the idea of running both the MMU

units allocated to this Asset in East Godavari’s operational areas. West Godavari, which

has future potential, was being considered for included in future scale-up projects.

However, the management later on decided to run one MMU in 10 GPs exclusively from

East Godavari district and the second MMU to be operational by including 06 GPs from

East Godavari and 04 GPs from West Godavari. But it was decided that both these units

would run from Malkipuram.

Consequent upon the finalized GPs and the facts presented above, the five MMUs are to

be deployed in the following GPs as the constituent units as depicted in the table below.

TableTableTableTable----3 3 3 3 Detailed MMU operational areas Sl. Sl. Sl. Sl. No.No.No.No.

StateStateStateState MMU Unit MMU Unit MMU Unit MMU Unit Constituent Gram Constituent Gram Constituent Gram Constituent Gram PanchayatsPanchayatsPanchayatsPanchayats

Proposed MMU Central Location and its Proposed MMU Central Location and its Proposed MMU Central Location and its Proposed MMU Central Location and its DetaDetaDetaDetailsilsilsils

1. Andhra Pradesh

Kakinada Asset MMU-1

Odalarevu Odalarevu Village of Allavaram Mandal. This location is highly suggested by the ONGC to make it the central point of operation since its GCS is located at this place. The farthest MMU parking location would be 12 kms from Odalarevu

Bendamurilanka

Komaragiripatnam

Thumalapalli

Mogalamuru

Godi Lanka

Godi

Godithipa

2. Andhra Pradesh

Rajahmundry Asset-I MMU-2

Karvaka Malkipuram. This location has all necessary infrastructure and all the GPs are within 15 kms from this location. The farthest MMU parking location is 16 kms from Malkipuram.

Gudapalli (+Gudapalli Pallipallem)

Chintala Mori

Sankaraguptham

Kesanapalli

Golla Pallem

Pademati Pallem

Toorpu Pallem

Tatipaka

Kesavadasu Pallem

3. Andhra Pradesh

Rajahmundry Asset-II MMU-3

Antarvedi Palli Pallem

Malkipuram. This location has all necessary infrastructure and all the East Godavari GPs are within 15 kms from this location. However, the 04 West Godavari GPs are 35-40 kms from this location. The farthest MMU parking location is 40 kms from Malkipuram.


Antarvedi Kara

Gondi

V.V. Mereka

99


StateStateStateState MMU Unit MMU Unit MMU Unit MMU Unit Constituent Gram Constituent Gram Constituent Gram Constituent Gram PanchayatsPanchayatsPanchayatsPanchayats

Proposed MMU Central Location and its Proposed MMU Central Location and its Proposed MMU Central Location and its Proposed MMU Central Location and its DetaDetaDetaDetailsilsilsils

Mori

Yenugovani Lanka

Badava

A Vama Varam

Manimanchilipadu

4. Tamil Nadu

Karaikal Asset (Neravy)

Narimanam Nagapattinam. It’s the district headquarters and has all necessary infrastructure. The farthest parking location would be 20 kms from Nagapattinam.

Kuthalam

Gopu Raja Puram

Eravanchery

Okkur

Kurumanangudi

Venkatangal

Anaimangalam

5. Tamil Nadu

Chennai Asset (Karaikal Forward Base)

Adivarahanattam Shetiatopu. It’s a small town which is the central point to all 15 focus GPs. All necessary infrastructures are available in this town. The farthest MMU parking location would be 20 kms from Shetiatopu.

Alisikudi

Vattrayntethu

Miralur

Manja Kollai

Kilavadinattam

Pinnalur

Orathur

Sathamangalam

Kandamangalam

Kurungudi

Chettitangal

Kil Kadambur

Mel Kadambur

Veerandapuram

All the finalized GPs for programme intervention and the ones that were declined because

of combination of distance as well as patient load factors were visited by the team gain a

first-hand impression of the situation. The facts were shared with the ONGC officials at all

locations. The GP finalization process also involved simultaneous consultation with the GP

leadership.

Section Section Section Section IVIVIVIV:::: Consultation with gram panchayConsultation with gram panchayConsultation with gram panchayConsultation with gram panchayats for mapping basic infrastructure, ats for mapping basic infrastructure, ats for mapping basic infrastructure, ats for mapping basic infrastructure,

collection of demographic and other basic information, identification of collection of demographic and other basic information, identification of collection of demographic and other basic information, identification of collection of demographic and other basic information, identification of

mmu parking locations and relationship building for smooth project mmu parking locations and relationship building for smooth project mmu parking locations and relationship building for smooth project mmu parking locations and relationship building for smooth project

operationoperationoperationoperation

Establishing contacts with the Panchayats was the second most crucial step in the project

initiation process. There were many objectives for establishing this contact. They are as

follows:

• Appraising the Panchayat leadership on the MMU project and develop a

consensual understanding among the local leadership and general population on

the need of the project and the health as well as psycho-social benefits that it is

going to accrue to the elderly population

• Mapping of basic infrastructure was another requirement which would help the

project run from those points. Resources like government school, Anganwadi

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Centre, Health Sub-centre, Self Help Group Building, Village Community Halls,

Temple, Mosque, Church, Cyclone Shelter, etc. are counted as basic infrastructure

available in the villages or habitats. Usually all people in the village have access to

these resources and these would serve as the parking place for the MMU. The

MMU would park at these locations at pre-determined time slots and would offer

the health and counseling services to the elderly of the nearby villages/hamlets

within a particular GP. Since Gram Panchayats have many such hamlets the MMU

would need to park at more than one location within the GP.

• A basic understanding of the constitution of the Gram Panchayat, its geographical

spread, number of hamlets/natural villages, population with necessary

disaggregation (male/female, BPL/APL, no. of elderly persons, etc.), etc. is

required to address the health needs through this programme

• Unless it is known as to how many elderly persons (for this project an elderly

person is one who is 55 years old and/or above) live in a village, how many

households have elderly people, their habits, their disease history, etc. it would be

imprudent to start the project because the benefits that accrued to the elderly

people because of this intervention cannot be measured or evaluated at a later

point in time. Monitoring would also not be possible without a baseline. Moreover,

individual cards would be issued to each elder for tracking his/her individual

health status at the time of his/her visit to the MMU. The consent and cooperation

of the GP leadership to conduct this baseline survey is considered essential.

• Since the project will run for a period of five years sustained support and

assistance would be required from the GP leadership for its smooth operation and

conflict resolution in case of any eventual need. Therefore, a relationship building

exercise is also at the core of establishing contact with the GP leadership.

The first point of contact was usually the Gram Panchayat offices and meetings with

Panchayat President, Vice President, Secretary and other key people of the village was

held. In such meetings the participants were introduced to HelpAge India’s organizational

objectives and operation. Thereafter, they were appraised in-detail about the objectives

and operational aspects of the MMU project. Their views on the project were also elicited.

In all the cases the Panchayat leadership welcomed the initiative undertaken by HelpAge

India and appreciated the working model of project and assured their continued support

for smooth running of the project. Immediate support was also available in the following

ways:

• Provision of demographic and other basic information

• Information on possible MMU parking locations and guidance as well as help to

inspect the locations to examine their suitability in terms of accessibility, physical

condition of the building, distance from nearby hamlets, sitting arrangements for

Doctor and paramedical staff, etc.

• Provision of names of suitable candidates from the village for the MMU project,

i.e. for Doctor, Project Coordinator, Nurse and Driver candidates

• Assistance to locate field investigators to conduct the baseline survey in the GP

101

Table-4 gives the information of GP leadership with regard to each MMU unit.

TableTableTableTable----4: 4: 4: 4: Details of GP Leadership in the project operational areas MMU MMU MMU MMU UnitUnitUnitUnit

StateStateStateState Block / MandalBlock / MandalBlock / MandalBlock / Mandal Name of GPName of GPName of GPName of GP GP PresidentGP PresidentGP PresidentGP President Mobile No.Mobile No.Mobile No.Mobile No.

MMU-1

Andhra Pradesh

Allavaram Odalarevu

Bendamurilanka

Komaragiripatnam

Thumalapalli

Mogalamuru Suryanarayana 9989483724

Godi Lanka

Godi

Godithipa

MMU-2

Andhra Pradesh

Mamidi Kuduru Karvaka K. Balakrishna 9908853797

Malkipuram Gudapalli S. Ramachandra Rao

9866288363

+Gudapalli Pallipallem

V.S.Prasad 9912576099

Chintala Mori K.V. Raju* 9866067964

Sankaraguptham O. Durga* 9951452607

Kesanapalli A. Narayan Swami 9849251199

Pademati Pallem

Golla Pallem GP Secretary* 9849555376

Toorpu Pallem V. Satyanarayana* 9441563024

Razole Tatipaka T. Uma. R. Rao 9440413413

Sakhinetipalli Kesavadasu Pallem

Srinivasa Rao* 9441563026

MMU-3

Andhra Pradesh

Sakhinetipalli Antarvedi Palli Pallem


Nalli Mariama 9963948041

Antarvedi Kara

Gondi

V.V. Mereka B. Laxman Rao 9490186249

Mori J. Shankara Rao 9849566324

Elemanchali Yenugovani Lanka V. Rataiya 9848844555

Badava I. Narasimha Rao 9705557288

Achanta A Vama Varam R. Naga Raju 9989982458

Poduru Manimanchilipadu B.V. Satyanarayana

9849287436

MMU-4

Tamil Nadu Thirumarugal Narimanam Mrs. Neelawati 9965185209

Kuthalam R. Sekhar 9865326647

Gopu Raja Puram Mrs. Indira 9842091787

Eravanchery Shiva Kumar 9524584005

Kilvelur Okkur Balasubramaniam 9443974390

Kurumanangudi Mrs. Revathi 9943289430

Anaimangalam A. Durai Raj 9942676820

Venkatangal Thyagaraj 9842965774

MMU-5

Tamil Nadu Bhubanagiri Adivarahanattam S. Usharani 9443212854

Alisikudi S. Ramachandran 9976867021

Vattrayantethu V. Gunasekaran 9965328933

Miralur Balasubramaniam 9751026567

Manja Kollai Ramanujam 9786734605

Kilavadinattam Mr. Kumar 9710680768

Pinnalur K.G. Krishnamurthi

9842344845

102

MMU MMU MMU MMU UnitUnitUnitUnit

StateStateStateState Block / MandalBlock / MandalBlock / MandalBlock / Mandal Name of GPName of GPName of GPName of GP GP PresidentGP PresidentGP PresidentGP President Mobile No.Mobile No.Mobile No.Mobile No.

Keerappalayam Orathur R. Silvarajan 9842890153

C. Sathamangalam

Mrs. Devi 9865672336

Kattumannark-ovil

Kandamangalam Mr. Annadurai 9787436576

Kurungudi K.Kannan 9865360182

Chettitangal Sri Arivalagan 9486457134

Kil Kadambur Mrs. Jyoti Bhanu 9443666088

Mel Kadambur G. Devadas 9842750898

Veerandapuram Radha Ravi 9942369636

NoNoNoNote:te:te:te: * = GP Secretary

After initial discussion with GP leadership basic information on demography and infrastructural

facilities were collected. The parameters on which information were collected were:

• Population – with necessary disaggregation

• No. of Households (HHs) in the GP

� No. of BPL HHs

� No of HHs with M-NREGA Job cards – Discussion was held on elderly

people’s participation in M-NREGA work

� No. of HHs enrolled under any government Health Insurance scheme

• No. of old Age pensioners (& pending pension applications, if any)

• Administrative arrangement – District, Sub-division, Tehsil & Block

• Basic Infrastructure facilities in GP

� Bus Services, Auto & Taxi services

� PCO, Mobile Service and Internet

� Community hall

• Health & Sanitation

� No. of HHs with Toilet facilities

� Cooking facilities – LPG & wood based chulha

� Drinking water facilities

• Health Infrastructure

� NRHM facilities – Sub-center to District Hospital related information

� Private Clinics operation

� Access to Health facilities

• Any NGO operating on Health issues or on old age care in the GP

All the above information is being consolidated into a Gram Panchayat information

format for future references. After collection of aforementioned information, discussion

was held on identification of MMU parking locations in the GP. The GP functionaries were

advised to select minimum number of locations that would be required to cover all the

constituent hamlets/villages of the GP effectively, i.e. all the elderly people can access it

without many problems. While suggesting MMU parking locations, the GP functionaries

were also asked to keep two important factors in mind, which were:

• The locations should be public places thereby assuring access to all elderly

persons irrespective of their caste, faith or class.

103

• All the location can be accessed by four wheel medium size vehicle (Tata Sumo,

Tata Winger, Mahindra Bolero, etc. type models) throughout the year (irrespective

of seasonal damages to the road conditions).

Based on the above criteria and the size (guessed or projected) of elderly population, each

GP suggested the minimum number of locations that they would require. Table-5

presented below depicts the detail of the GP population and the corresponding number of

locations identified.

TableTableTableTable----5: 5: 5: 5: Details of the GP population and the corresponding number of MMU parking sites


StateStateStateState Gram PanchayatGram PanchayatGram PanchayatGram Panchayat Total Total Total Total PopulationPopulationPopulationPopulation

Approximate Approximate Approximate Approximate 55555555++++ PopulationPopulationPopulationPopulation

No. of MMU No. of MMU No. of MMU No. of MMU Parking Parking Parking Parking LocationsLocationsLocationsLocations

MMU-1 Andhra Pradesh

Odalarevu 3,700 1,000 03

Bendamurilanka 5,000 1,000 03

Komaragiripatnam 13,800 3,000 03

Thumalapalli 2,100 600 03

Mogalamuru 2,700 600 02

Godilanka 1,700 550 01

Godi 2,400 850 03

Godithipa 1,700 450 02


Karvaka 2,500 400 02

Gudapalli (+Gudapalli Pallipallem)

6,500 700 02

Chintala Mori 4,300 450 04

Sankaraguptham 6,500 750 03

Kesanapalli 5,500 500 04

Pademati Pallem 1,500 200 01

Golla Pallem 1,500 150 02

Toorpu Pallem 5,200 900 01

Tatipaka 9,000 1,500 04

Kesavadasu Pallem 6,000 800 02


Antarvedi Palli Pallem 2,700 300 02


2,300 225 01

Antarvedi Kara 5,000 500 02

Gondi 5,800 600 05

V.V. Mereka 8,000 850 03

Mori 5,000 600 02

Yenugovani Lanka 5,000 1,000 03

Badava 2,600 300 02

A Vama Varam 10,000 2,000 04

Manimanchilipadu 1,000 150 02

MMU-4 Tamil Nadu

Narimanam 2,000 250 02

Kuthalam 1,500 100 02

Gopu Raja Puram 1,200 75 01

Eravancherry 3,500 300 04

Okkur 2,200 200 03

Kurumanangudi 1,300 150 02

Anaimangalam 2,000 125 03

Venkantangal 1,300 350 03

MMU-5 Tamil Adivarahanattam 5,000 2,000 03

104


StateStateStateState Gram PanchayatGram PanchayatGram PanchayatGram Panchayat Total Total Total Total PopulationPopulationPopulationPopulation

Approximate Approximate Approximate Approximate 55555555++++ PopulationPopulationPopulationPopulation

No. of MMU No. of MMU No. of MMU No. of MMU Parking Parking Parking Parking LocationsLocationsLocationsLocations

Nadu Alisikudi 2,700 170 02

Vattarayantethu 2,000 150 01

Miralur 4,700 1,000 02

Manja Kollai 2,500 800 02

Kilavadinattam 1,500 80 01

Pinnalur 2,500 250 02

Orathur 1,500 150 01

C. Santhamangalam 2,700 135 02

Kandamangalam 4,500 500 01

Kurungudi 5,300 450 03

Chettitangal 1,200 250 01

Kil Kadambur 3,500 300 01

Veerandapuram 5,500 900 03

Mel Kadambur 2,650 150 01

MMUsMMUsMMUsMMUs----5555 StatesStatesStatesStates ---- 2222 GPsGPsGPsGPs----51515151 191,750191,750191,750191,750 29,76029,76029,76029,760 117117117117

Section Section Section Section VVVV:::: CCCConducting the baseline survey for mapping elderly population, their onducting the baseline survey for mapping elderly population, their onducting the baseline survey for mapping elderly population, their onducting the baseline survey for mapping elderly population, their

health, psychohealth, psychohealth, psychohealth, psycho----social, and family related issuessocial, and family related issuessocial, and family related issuessocial, and family related issues

As has been briefly discussed above conducting a baseline survey is considered very

important and elementary for the intervention to become effective, monitoring its core

elements and evaluation of the differences the project has brought about to the elderly

populace of the focus GPs.

In order to carry out the baseline survey exercise support of the GP leadership was sought

to help identify educated youth from their respective GPs. The identified educated youth

was motivated to conduct the survey within a given time period in order to facilitate timely

launch of the project. The GP leadership was requested to ensure conduct of the survey in

the interest of the health care of the elderly persons of their respective GPs. They were also

requested to ensure that the survey is conducted in all the constituent habitats/natural

villages of their GPs.

The identified candidates were given appropriate training for collecting accurate and

complete information as per a pre-determined survey schedule. They were provided with a

detailed instruction-cum-guidance sheet in order to ensure a flawless survey.

One of these candidates was later on identified to supervise the survey process and was

delegated required responsibility and was supported with required resources. Except the

MMU-4 unit, in rest 04 MMU units this model was put into use. In order to conduct survey

in the GPs falling under MMU-4 unit services of a local NGO was roped in to help in

conducting the survey through its field staff. But in this case too, a survey supervisor was

appointed to ensure timely and accurate completion of survey.

105

Section VISection VISection VISection VI:::: SSSSuggested office locatiouggested office locatiouggested office locatiouggested office locations for mmu units and search for prospective ns for mmu units and search for prospective ns for mmu units and search for prospective ns for mmu units and search for prospective

candidatescandidatescandidatescandidates

It is quite obvious that an MMU unit will need an office to locate itself and its staff. Each

MMU has approved staff strength of four – a doctor, a project coordinator, a nurse and a

driver. The MMU needs a space to park during non-working hours and on days when it

does not operate. The staff needs to sit down and plan for the finer operational details,

programme records need to be kept and continuously updated, medicines to be stored,

patient records are to be maintained, etc. This location obviously has to be a place which

has minimum infrastructure that enables the office to operate efficiently, allows staff to

find accommodation, etc. This office has to be at a place that is located not too far from

the areas of operation, i.e. maximum within 10-20 kms so that it can reach the focus

villages within 15-20 minutes. The less time the vehicle spends on road more time will be

available to take care of the patients which is the core objective of the MMU operation.

Keeping these factors in view the following locations are being suggested for location of

the offices of different MMU units. The information is presented in Table-6.

TableTableTableTable----6: 6: 6: 6: Suggested MMU Offices MMU MMU MMU MMU UnitUnitUnitUnit

StateStateStateState Operational Operational Operational Operational DistrictDistrictDistrictDistrict

Proposed LProposed LProposed LProposed Location for ocation for ocation for ocation for MMU OfficeMMU OfficeMMU OfficeMMU Office

Maximum Distance of Maximum Distance of Maximum Distance of Maximum Distance of Operational Areas from Operational Areas from Operational Areas from Operational Areas from

Office LocationOffice LocationOffice LocationOffice Location


East Godavari Odalarevu 12


East Godavari Malkipuram 16


East Godavari Malkipuram 16

MMU-4 Tamil Nadu

Nagapattinam Nagapattinam 20

MMU-5 Tamil Nadu

Cuddalore Shetiatope 20

As regards identifying potential staff for the project, the approach was to find out local

candidates in order to avoid situations of higher staff turnover. During the consultation

with GP leadership, information related to the vacancy available with MMU units were

shared in all the GPs. Other stakeholders like Primary and Community Health Centers

(PHC and CHC), local administrative officials, professionals working in social sector were

also informed of the vacancies. As a result, discussion with interested candidates was held

at various locations related to all the positions. Finding driver candidates was the easiest

of all and locating doctor candidates was the toughest. Even after searching all the GPs

Allavaram Mandal did not have a single MBBS candidate available for the MMU-1. A

candidate was located in Amalapuram which is 25 kms away from the suggested office

location for MMU-1. The quantum of salary and the timing of the MMU operation (from

morning till late afternoon) were issues that need to be addressed properly in Allavaram

Mandal. Many doctor candidates were available for the Malkipuram office location which

is the location for two MMU units, i.e. MMU-2 & MMU-3. The quantum of salary was not

an issue at this location.

106

Availability of doctor candidates has been very much a matter of concern at

Nagapattinam and Shetiatope, the suggested office locations for MMU-4 and MMU-5

respectively. The quantum of salary and the timing of the MMU operation (from morning

till late afternoon) were also issues that need to be properly addressed at this location as

well.

Salary for project coordinator, nurse and driver was considered satisfactory at all

locations. No issue was raised regarding the timing of MMU operation too.

Since Malkipuram has to locate two MMU units at one office, it is suggested that the staff

structure may be modified to function efficiently as well as effectively. A Senior Project

Coordinator/Officer may be appointed with two project officers (PO) to take care of the

field operations of one MMU each. The Senior Project Officer /Coordinator will have the

supervisory responsibilities for both the units. The proposed structure may be arranged as

follows:

Figure-1: Proposed Staffing Structure at Malkipuram Office

The Project Coordinator or Project Officer may also be asked to play the role a social

mobilizer and counselor in order to create demand for health services among the elderly

population by conducting door-to-door visits and also working along with the available

government health infrastructure and the GP system. All the elderly persons may be

motivated and counseled to seek timely health intervention which would play a very

significant role in making the project inclusive and more participative.

Last but not the least, enough care may be taken while purchasing the vehicle to operate

as MMU. In East Godavari district village roads are usually wider as well as in good

condition. Therefore, purchase of any vehicle would not create any problem for the first

three MMU units. However, village roads in Nagapattinam and Cuddalore districts of

Tamil Nadu are not wide enough and are not in good condition. Therefore, a sturdy

vehicle with good ground clearance may be deployed for smooth operation.

107

Section Section Section Section VIIVIIVIIVII:::: LLLLinkages established with government and private health resourcesinkages established with government and private health resourcesinkages established with government and private health resourcesinkages established with government and private health resources

The proposed HI-ONGC collaborative MMU operation will primarily address primary

health issues of old age people. Therefore, it becomes important that effective referral

links are established with the mainstream health system. The mainstream health system

functions as under in both the states of Andhra Pradesh (AP) and Tamil Nadu (TN):

Therefore in all the MMU locations a mapping of the Health center starting from Sub-

center to District hospital was done. This helped in identifying the following:

• No. of Sub-centers operating in a Gram Panchayat

• Names and location of PHCs catering to the population of respective GPs

• Names and location of CHC (in AP) or Block PHC (in TN) under whose area of

operation the operational GPs of the MMU project falls

• Names of Sub-division level Hospitals (if any) for the concerned project locations

• District Civil Hospitals

Information on Private Nursing Homes and Clinics was also collected at each location.

Names of all the government health centers visited by the team along with their contact

details are given below in Table-7. When visits to the PHCs/CHCs operating in all the

project locations were made the team members met the Medical Officer’s In-charge

(MOIC) or the available Medical Officer (MO) and they were was appraised about the HI

MMU project. All the MOICs/MOs expressed happiness about the initiative in the area of

geriatric care and assured necessary help in this context. It was underlined by them that

once the project starts they should be intimated about it so that the necessary coordination

and collaboration for providing better health care to the elderly persons could be

facilitated.

TableTableTableTable----7777: : : : Name and contact details government healthcare institutions MMU MMU MMU MMU UnitUnitUnitUnit

Concerned PHCsConcerned PHCsConcerned PHCsConcerned PHCs Concerned CHC or Concerned CHC or Concerned CHC or Concerned CHC or Block PHCBlock PHCBlock PHCBlock PHC

SubSubSubSub----divisional divisional divisional divisional HospitalHospitalHospitalHospital

Civil HospitalCivil HospitalCivil HospitalCivil Hospital

MMU-1

PHC Godilanka Dr. V. Venkata Rao Medical Officer Mobile:9885088895

CHC Allavaram Dr. Chenchayya MOIC Mob:9849474761

Area Hospital Amalapuram

Civil Hospital Kakinada

MMU-2

PHC Lakavaram Dr. M.R. Rao Medical Officer 9949049904

CHC Razole Area Hospital Amalapuram


PHC Tatipaka/Nagaram

PHC Sakhinetipalli Dr. J. Swarup Medical Officer Mobile: 9989594892

MMU-3

PHC Mori Dr. S. Ram Babu Medical Officer Mobile: 9030161860

CHC Razole Area Hospital Amalapuram


PHC Sakhinetipalli Dr. J. Swarup

108


Concerned PHCsConcerned PHCsConcerned PHCsConcerned PHCs Concerned CHC or Concerned CHC or Concerned CHC or Concerned CHC or Block PHCBlock PHCBlock PHCBlock PHC

SubSubSubSub----divisional divisional divisional divisional HospitalHospitalHospitalHospital

Civil HospitalCivil HospitalCivil HospitalCivil Hospital

Medical Officer Mobile: 9989594892

PHC-A. Vama Varam Dr. Venkata Rao Mobile: 09849294024

CHC-Achanta Dr. Venkata Rao Mobile: 09849294024

N.A. Civil Hospital Eluru

PHC-Poduru Dr. Namagiri Mobile: 09247226833

CHC-Palakol Dr. Prabhakar Rao 9440866248

PHC-Elimanchali

MMU-4

PHC Thitachery Dr. M. Hasan Medical Officer Mobile: 9941468064

Block PHC, Thirumarugal Dr. Liaquat Ali MOIC Mobile: 9442986710

N.A. Nagapattinam Civil Hospital Dr. Kashiraman Civil Surgeon Tel: 04365-242459

Govt. Hospital Kilvelur Dr. S. Arutchelvan Medical Officer Mobile: 9790629486

MMU-5

PHC Bhubanagiri Dr. Sashikumar Medical Officer Mobile: 9944312450

Block PHC Krishnapuram Dr. M. Shiva Kumar MOIC Mobile: 9443586546

Taluka Hospital Chidambaram

Cuddalore Civil Hospital

PHC Orathur Dr. Arul Anand Medical Officer Mobile: 9994682695

Additional PHC Veerandapuram Dr. M. Shivanandan Medical Officer Mobile: 8012115747

PHC Shetiatope Dr. Henry Medical Officer Mobile: 9443282791 Tel.: 04144-244545

Information on the ailment profile of the aged was also collected from the PHCs/CHCs.

Table-8 below depicts the major aliments that are afflicting the old age people in the

respective PHC areas corresponding to the MMU operation locations as cited by the

MOICs/MOs.

TableTableTableTable----8: 8: 8: 8: Major ailments of people in the project operational areas MMU MMU MMU MMU UnitUnitUnitUnit

StateStateStateState Old AgOld AgOld AgOld Age Ailment Profilee Ailment Profilee Ailment Profilee Ailment Profile


Ulcers, Joint pains, Sugar, BP, Skin allergies, Leuko derma, Filariasis, TB, Deafness, Arthritis /Osteoporosis, Respiratory problems

MMU-2 Dental problems, gastritis, BP, sugar, skin allergies

MMU-3 Diabetes, Hypertension, Joint-pains, low backache, elephintis, Dementia, UTI, Prostrate, Ulcer Diseases, Gastritis, Gastroenteritis

MMU-4 Tamil Nadu

Arthitis, Hypertension, Diabetes, Gastritis/ ulcer diseases, skin diseases / fungal infections, bronchial asthma, Anemia, neurological problems

MMU-5 Hypertension, body/ joint pain, diabetes, osteo arthritis, back pain, bronchial asthma

109

The field visit team also collected names and contact details of private nursing homes or

clinics operating in the operational areas of various MMU units. The team met many

private practitioners at these hospitals or clinics. The information so collected is produced

in Table-9 below:

TableTableTableTable----9: 9: 9: 9: Details of private doctors in the vicinity MMU MMU MMU MMU UnitUnitUnitUnit

StateStateStateState Concerned Block/MandalConcerned Block/MandalConcerned Block/MandalConcerned Block/Mandal OperationOperationOperationOperational Private Nursing Homes or al Private Nursing Homes or al Private Nursing Homes or al Private Nursing Homes or ClinicsClinicsClinicsClinics


Allavaram Dr. Varahala Rao; Mangayamma Nursing Home; Tel.: 08856-259468


Mamidi Kuduru, Malkipuram, Razole and Sakhinetipalli


Sakhinetipalli

Poduru, Achanta and Elimanchali

Vijayalaxmi Nursing Home, Achanta; Surya Nursing Home, Sai Krishna Hospital-Palakol

MMU-4 Tamil Nadu

Thirumarugal & Kilvelur Sivabalan Hospital, Kilvelur Dr. Murugesan Mobile: 0-9245963688 Tel.: 04366-275545

Periyar Hospital, Solinganalur, Nagapattinam

Dr. Haja Abudul Nazeer’s Private Clinic Thitachery Mobile: 0-9865025989

MMU-5 Tamil Nadu

Bhubanagiri, Keerapalayam & Kattumanarkovil

Shravana Poly Clinic, Bhubanagiri Dr. Venkatachalam Mobile: 0-9486632923

MMU parking locaMMU parking locaMMU parking locaMMU parking location detailstion detailstion detailstion details

MMUMMUMMUMMU----1111

Allavaram Mandal, East Godavari District, Andhra Pradesh (ONGC Kakinada Asset) Allavaram Mandal, East Godavari District, Andhra Pradesh (ONGC Kakinada Asset) Allavaram Mandal, East Godavari District, Andhra Pradesh (ONGC Kakinada Asset) Allavaram Mandal, East Godavari District, Andhra Pradesh (ONGC Kakinada Asset)

Sl. Sl. Sl. Sl. VillageVillageVillageVillage LocationLocationLocationLocation Nearest LandmarkNearest LandmarkNearest LandmarkNearest Landmark

1. Odalarevu i. At/In front of Ramalayam Temple Ferry Point

ii. At Ambedkar Community Hall, Ambedkar Colony

ONGC Gas Collection Point

iii. At Anganwadi Centre, Fishermen’s Colony (Manna Colony)

Water Tank & Post Office

2. Bendamurulanka iv. At Ambedkar Community Hall, Ambedkar Nagar

Ramalayam Temple & Ambedkar Statue

v. Besides Jambaban Peta Primary School

Sub-centre, Bendamurulenka

vi. In front of Church, Palagunta Cheruvu Dalit Colony

Private Well (Opposite Church)

vii. At Kali Temple Centre, Argatalapallem

Anganwadi

3. Komaragiripatnam viii. At Primary School, Daivalapallem-Raju Pallem Colony Intersection

Ayyappa Temple & Byraju Foundation Building

ix. In front of Kodappa Church, Mannanagar Colony

Primary School

110

Allavaram Mandal, East Godavari District, Andhra Pradesh (ONGC Kakinada Asset) Allavaram Mandal, East Godavari District, Andhra Pradesh (ONGC Kakinada Asset) Allavaram Mandal, East Godavari District, Andhra Pradesh (ONGC Kakinada Asset) Allavaram Mandal, East Godavari District, Andhra Pradesh (ONGC Kakinada Asset)


x. In front of Ramalayam Temple, Military Colony

Primary School & Church

xi. At Open Space opposite Revenue Office (Saturday Haat Venue)

Ramalayam Temple

4. Thumalapalli xii. At Prahlad Swami Ashram, Twatalu Pandari

-

xiii. At Primary School, Thumalapalli Main Village

-

xiv. At Laxmaneswaram Temple Primary School

5. Mogalamuru xv. At Primary School, Sirgatalapalli Ramalayam Temple & Big Pond

xvi. At Ambedkar Statue Toorpucheruvugattu Crossing

Canal in front of the location

6. Godilanka xvii. At Ramalayam, Ambedkar Nagar Ambedkar Statue

xviii. At Zilla Parishad School Sri Lakshmi Venkata Rice Mill

7. Godi xix. At Anganwadi Centre, Godi Main Village

Big Water Tank & Primary School

xx. At Kattavari Pallem Primary School, Godi

Ramalayam Temple

xxi. At Indira Colony Primary School, Godipallem

Indira Colony Anganwadi Centre

8. Godithipa xxii. At Mandala Primary School, Opp. Fishermen’s Colony

Water Tank, Panchayat Office

xxiii. At Mandala Parishad Primary School

Gopailanka

Note: All the above villages belong to Allavaram Mandal. MMU office for the above listed villages proposed to be based at Odalarevu. MMUMMUMMUMMU----2222

Mamidi Mamidi Mamidi Mamidi Kuduru & Malkipuram Mandals, East Godavari District, Andhra Pradesh (ONGC Kuduru & Malkipuram Mandals, East Godavari District, Andhra Pradesh (ONGC Kuduru & Malkipuram Mandals, East Godavari District, Andhra Pradesh (ONGC Kuduru & Malkipuram Mandals, East Godavari District, Andhra Pradesh (ONGC Rajahmundry Asset)Rajahmundry Asset)Rajahmundry Asset)Rajahmundry Asset)

Sl.Sl.Sl.Sl. VillageVillageVillageVillage LocationLocationLocationLocation Nearest LandmarkNearest LandmarkNearest LandmarkNearest Landmark

1. Karvaka i. Besides Panchayat Office High School

ii. Water Distribution Point, Indirama Colony

-

2. Toorpu Pallem iii. In front of Panchayat Office Primary School

3. Golla Pallem iv. In front of High School Primary School

v. In front of Panchayat Office Shiva Temple

4. Kesanapalli vi. Near Prarthanamandir Church, Rajiv Nagar, West Pallem

Ambedkar Statue (nearing completion)

vii. Near Primary School, Yedla Tatya Group Colony

Anganwadi Centre, Ambedkar Statue

viii. At Kanakaya Bus Stop, Rapakawari Group Colony

Ambedkar Statue

5. Pademati Pallem ix. Near Zilla Parishad High School, Pademati Pallem

Panchayat Office, Water Tank

6. Gudapalli (+Palli Pallem)

x. Near Cyclone Shelter Building, Gollamandala Vari Colony

Primary School, Anganwadi Centre

xi. In front of Panchayat Office, Godapalli Palli Pallem

Water Tank (200 meters away)

7. Chintala Mori xii. Poduthota Crossing, Near Ambedkar Statue & Ambedkar Community Hall

Goparaju Temple

xiii. At Post Office Panchayat Office

111

Mamidi Mamidi Mamidi Mamidi Kuduru & Malkipuram Mandals, East Godavari District, Andhra Pradesh (ONGC Kuduru & Malkipuram Mandals, East Godavari District, Andhra Pradesh (ONGC Kuduru & Malkipuram Mandals, East Godavari District, Andhra Pradesh (ONGC Kuduru & Malkipuram Mandals, East Godavari District, Andhra Pradesh (ONGC Rajahmundry Asset)Rajahmundry Asset)Rajahmundry Asset)Rajahmundry Asset)


xiv. At GDM Church, Molla Pallem (on way to Palli Pallem)

-

xv. At Beach Nagar Entrance Point (in front of Water Tank)

Ramalayam Temple

8. Sankaraguptham xvi. IPC Church, Beach Road (on way to NABARD SC Colony)

-

xvii. Panchayati Crossing Bus Stop Electric Transformer

xviii. In front of Bethel Church Main Commercial Centre, Sankaraguptham

9. Kesavadasu Pallem xix. Primary School Panchayat Office

xx. Besides Sai Baba Temple Ambedkar Bust

10. Tatipaka xxi. Opp. Anjaneyaswami Temple Maria Montessori School

xxii. At Monday Market Gram Panchayat Office, Ramalayam Temple

Note: Karvaka is in Mamidi Kuduru Mandal. All other villages are in Malkipuram Mandal. Office

location for this MMU Unit is proposed at Malkipuram.


Razole & Sakhinettipalli Mandals, East Godavari District, , Andhra Pradesh (ONGC Rajahmundry Razole & Sakhinettipalli Mandals, East Godavari District, , Andhra Pradesh (ONGC Rajahmundry Razole & Sakhinettipalli Mandals, East Godavari District, , Andhra Pradesh (ONGC Rajahmundry Razole & Sakhinettipalli Mandals, East Godavari District, , Andhra Pradesh (ONGC Rajahmundry Asset)Asset)Asset)Asset)


1. V.V. Mereka i. Ambedkar Community Hall, KV Podu SC Colony

Primary School

ii. In front of Weavers’ Colony Community Hall

Lion’s Club Community Hall

iii. Besides GDM Centenary Church, St. Paul Nagar

Primary School

iv. GDM Church (in front of Canal; other side of the canal is Antarvedi Pallem Village)

Ambedkar Statue

2. Antarvedi Kara v. Behind Primary School, B.V. Kodappa Colony

Small Pond

vi. At Quota Peta Ramalayam Bus Stop

3. Antarvedi Palli Pallem

vii. In front of Cyclone Centre Building, Ishiko Tota Colony

Big Pond

viii. At Muchallama Mariamma Temple Panchayat Office

4. Antarvedi Deva Sthanam

ix. Near Panchayat Office Zilla Parishad High School

5. Gondi x. Adiveerlamma Temple Elementary School

xii. At Anganwadi Centre, Near Panchayat Office

Kanak Muchallama Temple

xiii. Madhya Gunta Pamulawari Centre, Ambedkar Nagar

Ambedkar Statue

xiv. GDM Church, Jai Bhim Nagar Big Pond

6. Mori xv. In front of Panchayat Office Mahalaxmi Temple & Sai Temple

xvi. Primary School, Mori Pademati Pallem Ambedkar Statue

7. Yenugovanilanka xvii. Panchayat Office Anjaneya Swami Temple

xviii. Elementary School, Quota Harijan Peta Ambedkar Statue

xix. Pallavaram Elementary School Anjaneya Swami Temple

8. Badava xx. Ramalayam, Main Road, Badava Primary School

112

Razole & Sakhinettipalli Mandals, East Godavari District, , Andhra Pradesh (ONGC Rajahmundry Razole & Sakhinettipalli Mandals, East Godavari District, , Andhra Pradesh (ONGC Rajahmundry Razole & Sakhinettipalli Mandals, East Godavari District, , Andhra Pradesh (ONGC Rajahmundry Razole & Sakhinettipalli Mandals, East Godavari District, , Andhra Pradesh (ONGC Rajahmundry Asset)Asset)Asset)Asset)


xxi. Hope Ministry Church Primary School

9. A. Vama Varam xxii. Ramalayam Temple Anjaneya Swami Temple

xxiii. Panchayat Office Kanakadurga Temple

xxiv. Elementary School, Ishuka Garudu Kanaka Durga Temple

xv. RCM Church, Pasala Peta Elementary School

10. Manimanchilipadu xvi. Primary School, Chhinna Harijan Peta Anganwadi Centre

xvii. Primary School Panchayat Office

Note: Tatipaka is in Razole Mandal and all other villages are in Sakhinettipalli Mandal. Office

location for this MMU Unit is also proposed at Malkipuram.


Thirumarugal, and Kilvelur Mandals, Nagapattinam District, Tamil Nadu (ONGC Karaikal Asset) Thirumarugal, and Kilvelur Mandals, Nagapattinam District, Tamil Nadu (ONGC Karaikal Asset) Thirumarugal, and Kilvelur Mandals, Nagapattinam District, Tamil Nadu (ONGC Karaikal Asset) Thirumarugal, and Kilvelur Mandals, Nagapattinam District, Tamil Nadu (ONGC Karaikal Asset)


1. Narimanam i. In front of Farmers’ Society Office Perumalkovil Temple, Panchayat Office

ii. In front of new Anganwadi Centre Community Toilet, Water Tank

2. Kuthalam iii. In front of Panchayat Office (Meletheru) Middle School, Mariama Temple

iv. Vinayaka Temple, Pullavar Nallur Panchayat TV Room

3. Gopu Raja Puram

v. Panchayat Office (Sanyasi Panamgudi Hamlet)

Elementary School

4. Eravanchery vi. Opposite Old Elementary School, Devemgudi Main Road

Present Panchayat President’s Residence

vii. In front of Library Building, Nattar Mangalam

Primary School, Mariama Temple

viii. At SHG Building, Madhya Gudi Community Toilet

ix. In front of Panchayat Office Elementary School

5. Okkur x. At Community Hall, Okkur Village Administration Office

xi. In front of Perumal Temple, Kadambangudi

Shivam Temple

xii. In front of Primary School, Vilambakam (this location is not presently easily approachable because of bad road)

Singha Mahakali Amman Temple

6. Kurumanangudi xiii. In front of DMK Library Building (Periyar Hall), Road Theru

-

xiv. At Middle School, Melatheru Shri Ganesh Temple, Water Tank

7. Anaimangalam xv. At Community Hall, Anaimangalam Aiyanar Temple, Panchayat Office

xvi. At Aiyanar Temple, Orgudi Water Tank, Pond

xvii. Elementary School, Kulangudi Kaliamman Temple

8. Venkatangal xviii. Near Panchayat Office, Venkatangal Anganwadi Centre

xix. Primary School, Porkalakudi -

xx. Panchayat TV Room, Senbia Nadi Medium Size Plastic Water Tank

Note: Villages from 1-4 belong to Thirumarugal Block and those from 5-8 belong to Kilvelur Block.

The office for the MMU Unit should be located at Nagapattinam.

113

MMUMMUMMUMMU----5555 Bhubanagiri, Keerapalayam and Katumannarkovil Mandals, Cuddalore District, Tamil Nadu (Forward Bhubanagiri, Keerapalayam and Katumannarkovil Mandals, Cuddalore District, Tamil Nadu (Forward Bhubanagiri, Keerapalayam and Katumannarkovil Mandals, Cuddalore District, Tamil Nadu (Forward Bhubanagiri, Keerapalayam and Katumannarkovil Mandals, Cuddalore District, Tamil Nadu (Forward Base at Karaikal, Chennai Asset) Base at Karaikal, Chennai Asset) Base at Karaikal, Chennai Asset) Base at Karaikal, Chennai Asset)


1. Adivarahanattam i. In the premises of Middle School for Boys, Adivarahanattam

-

ii. At Vem Vadi Amman Temple, Rattaikulam

Water Tank

iii. At Balakrishna Temple, Sutukuli Anganwadi Centre, Tubewell

2. Alisikudi iv. Near Panchayat Office Sub-centre

v. Sri Cheliamman Temple, Vandarayanpethu

Water Tank

3. Vatarayanthettu vi. At Panchayat Office Common Water Distribution Point

4. Miralur vii. At Pillayar Temple Water Tank

viii. At Sub Centre Shivan Temple, Water Tank

5. Manja Kollai ix. At Panchayat Office Panchayat TV Room, Murugan Temple

x. In front of TV Room Water Tank, Pond

6. Kilavadinattam xi. At Old Primary School Anganwadi Centre, Water Tank

7. Pinnalur xii. In front of Water Tank, Ambedkar Nagar Colony

Mariamman Temple

xiii. At Sub-centre, Main Road, Pinnalur Veterinary Hospital (across the road)

8. Orathur xiv. At Panchayat Office BSNL Office (across the road)

9. C. Sathamangalam

xv. At Primary School, Sakhti Vilaham Anganwadi Centre

xvi. Adi Dravida Welfare School Panchayat Office, SHG Building

10. Kandamangalam xvi. At Panchayat Building Primary School, Water Tank

11. Kurungudi xvii. At Panchayat Office -

xviii. At Ration Shop Pilliyar Kovil Temple

xix. Kali Amman Temple, Puliyadi

12. Chettitangal xx. Near Community Hall (Ranganathapuram)

-

13. Kil Kadambur xxi. Adi Dravida Welfare Primary School -

14. Mel Kadambur xxii. In front of Panchayat Office -

15. Veerandapuram xxiii. At SHG Building, Veerandapuram -

xxiv. At Panchayat Office, Vivakulam -

xxv. Kalyana Madapam , Peria Ponga Nadi

Aiyanar Kovil Temple

Note: Villages from 1-7 belong to Bhubanagiri Block; 8 & 9 belong to Keerapalayam Block and

10-15 belong to Kattumanarkovil Block of Cuddalore district. The office location is proposed at

Shetiatope.

DDDDetailsetailsetailsetails of of of of ONGCONGCONGCONGC officiofficiofficiofficials met during field visit of als met during field visit of als met during field visit of als met during field visit of AAAAndhra ndhra ndhra ndhra PPPPradesh and radesh and radesh and radesh and TTTTamil amil amil amil NNNNaduaduaduadu


StateStateStateState ONGC AssetONGC AssetONGC AssetONGC Asset Concerned OfficialConcerned OfficialConcerned OfficialConcerned Official


Kakinada Mr. Anjaneyalu

Dr. P.R.K. Raju, DGM-HR

MMU-2 Rajahmundry Mr. J. A. Kumar, GM-HR

MMU-3 Rajahmundry Mr. J. A. Kumar, GM-HR

MMU-4 Tamil Nadu Karaikal Mr. Vasudevan, GM-HR

MMU-4 Chennai (Forward Base, Karaikal)

Mr. Prabakaran, DGM & Head Chennai Forward Base

114

Field observations from ield observations from ield observations from ield observations from AAAAndhra ndhra ndhra ndhra PPPPradesh and radesh and radesh and radesh and TTTTamil amil amil amil NNNNaduaduaduadu

FIELD OBSERVATIONS FROM ANDHRA PRADESHFIELD OBSERVATIONS FROM ANDHRA PRADESHFIELD OBSERVATIONS FROM ANDHRA PRADESHFIELD OBSERVATIONS FROM ANDHRA PRADESH The key observations are as follows:

� All the villages visited have substantial Below Poverty Line (BPL) population, the

minimum being around 75%.

� Elderly people are not satisfied with the services provided by government health

infrastructure (PHC & CHC) as well as mobile medical services provided by 104

which is managed by Health Management and Research Institute (HMRI) and

sponsored by the State Government for all people.

� Since elderly people have to travel distances ranging from 3 kilometers to 20

kilometers to approach either a PHC or CHC to avail health services offered by the

government they prefer not to visit these centres; 104 comes to one location in the

village once in a month and some of the hamlets in big villages are 2-3 kms away

from the location where 104 parks. Hence, it does not provide any solution to

health needs of elderly people closer to their doorsteps which is their prime need

keep in view their limited physical capacity for mobility.

� Disease profile of the elders in the visited areas are: joint pain, ulcer diseases,

elephantitis (endemic in Achanta Mandal in W. Godavari), lower back pain, sugar,

BP, hypertension, gastritis, gastro-enteritis, cataract, pneumonia, strokes, prostrate,

arthritis, diabetes.

� The community expressed that there is a great need of health services for the

elders and showed their keen interest to participate in this programme.

� Non-MBBS doctors (RMP) are available in the villages who are not capable to offer

satisfactory health solutions.

� Hence, in a village 2, 3 or 4 locations are needed (depending on the size of the

village) for the ambulance to park and offer services in order to be inclusive in its

approach and achieve visibility as well as success.

� As per our preliminary estimates one MMU may have to offer services to 7000-

8000 elderly people in the 55+ age group.

� Consistent village level mobilization efforts are needed in order to create optimal

patient load or health seeking demand among the focus populace.

� The Project Officer can work as a social mobilizer and he/she can create good

demand for the mobile medicare services with the help of ANMs and ASHA.

� Health and well-being groups of elderly people could be promoted to keep the

health seeking demand growing in focus villages.

� Although each village does not have a sub-centre of its own ANMs regularly visit

the villages. Their help could be taken to spread the message.

� One unit could offer services to maximum 7-8 villages keeping the dense

population, area coverage and representative location plan in view.

� Since the 104 and 108 (emergency medical service) ambulances are usually

bigger vehicles (like Tempo Traveller) it is felt that a bigger vehicle would be

needed to provide mobile medicare services. ONGC prefers bigger size vehicles.

115

� It would be useful to recruit local candidates for the MMUs to keep effective grip

on management aspects as well as local dynamics. However, availability of

English speaking candidates except MBBS Doctors is a practical problem.

� Availability of MBBS doctors is a challenge.

� Keeping the Panchayats informed will be very useful from operational point of

view.

� Building a good network with PHCs and CHCs will be essential. Providing referral

services will be very crucial to satisfactory service delivery and managing people’s

perceptions of service provision effectiveness.

� In case availability of MBBS doctors becomes an issue a strategic business

partnership with private hospitals will be needed.

� ANMs (almost all are Telugu speaking) are available aplenty but pharmacists are

short in supply.

� Deciding the office locations where all staff will board the MMU is another key

issue.

� Preparing a list of all retired (from govt. service) MBBS doctors living in the

operational area will be very helpful for future needs.

FIELD OBSERVATIONS FROM TAMIL NADUFIELD OBSERVATIONS FROM TAMIL NADUFIELD OBSERVATIONS FROM TAMIL NADUFIELD OBSERVATIONS FROM TAMIL NADU The key observations are as follows:

� All villages have sizeable BPL population (70% and above)

� All the villages are serviced by individual as well as community water supply

points. Water tanks are available in all villages

� All villages are located around ONGC’s important currently operational

installations or potential future operational locations

� Most villages are not adequately serviced by currently available health

infrastructure

� Patient load will be enough for optimum utilization of MMU units

� Availability of MBBS Doctors at these locations is a challenge

� All Panchayats have expressed willingness to provide necessary assistance to the

project

� Government health professionals at PHC/CHC levels have expressed interest to

provide all possible help

� Some of the diseases that elderly people mostly suffer from are: Sugar/Diabetes,

Osteo Arthritis, Blood Pressure/Hypertension, Body Pain (Joints and Lower Back),

Ulcer Diseases, Gastritis, UTI & Prolapsed Uterus (women), Prostrate and

Cataract. Other minor but prevalent diseases as reported are: Skin Allergis, TB,

Malnutrition and Fileria

� All the villages (except those in Katumannarkovil Block of Cuddalore district) are

within a radius of 10-15 kms from the suggested office location.

� Almost all the villages are adjacent/ contiguous to each other.

� All locations identified and listed villages and locations (except the identified

location Vilambakam hamlet in Okkur Panchayat, Kilvelur Block, Nagapattinam

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District, Tamil Nadu; this is because of present bad condition of the approach

road) are accessible to Ambulance

� Since almost all villages consist of hamlets locations have been identified in order

to cater to most of the elderly population of the habitations

� Since there is a genuine need to provide ambulance facility at multiple locations in

a village because of the scattered nature of the hamlets (which the present service

provided by 104 of HMRI is not catering to) each location may be given maximum

1 hour in order to cover all locations and optimize provision of services

� Availability of an MBBS Doctor in Allavaram Mandal and

Bhubanagiri/Katumannarkovil Mandals (Sethiatopu Office Location) may come up

as an issue which needs to be addressed.

� The team approached many serving as well as retired MBBS Doctors who

expressed that the salary amount is a big factor that may influence availability of

doctors.

� Almost all villages have RMPs and utilize their services. Government and

appropriate private health infrastructure being away from most of the villages,

people are heavily dependent on RMPs.

� The villages which do not have sub-centres and services by ANMs or VHNs

� There are a number of PHCs in the areas of intervention but the elderly people are

not happy about the services offered by these health centres.

* * * * *

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