Friday, May 20, 2011

HelpAge in Leh





                          INTERVENTIONS IN LEH DISASTER








BACKGROUND
Leh, in the Ladakh region of Jammu and Kashmir of India has experienced a Cloud burst in the intervening night of the 5th-6th August, 2010.  The sudden natural phenomena especially due to the unpreparedness of the communities in the villages and towns of the occurrence and therefore the lack of coping strategy became a disaster.
The devastation is to be seen all across the areas affected by the cloud burst.  The gushing waters brought rumbling boulders many upto two tonnes in weight, leaving little choice for the residents except to run for their lives.  The official figures are sever underestimates, with hearsay of some people being washed away as far as 40 Kms away.  There still is no account of many migrant labourers from Bihar and Nepal, the work-force of carpenters, masons and casual labour.
The Aftermath
Many tourists turned volunteers overnight, giving up their trekking gear to shovels and pick-axes.  The international tourists were second only to the Indian Army in their response, and get full credit for rescuing whatever or whoever could be rescued.  It also b rought in drones of relief workers that were hitherto less known in the field of disaster response.
The reality however is that none of us were prepared for Leh.  We ourselves were unprepared, our plans and proposals for response largely dependent on a Supercyclone or a flood or a Tsunami and to some extent to the Kashmir Earthquake.  There were organisations of all hues providing food relief to shelter relief, some were into psycho-social counselling and others into medical relief.  Some organisations were into establishing their faith, while some others their religion, but each of the above trying to do their little bit in the chaos and confusion.
Adding to the confusion was an initial (and to some extent continuing) lack of local leadership.  This essentially again because the local organisations were predominantly into Ecology or the Green Wagon or the traditional charity based “development” work, so each knew a bit of their area, and not the entire picture.
The army with its geo-satellite imageries and units of dedicated men and women, went back to the barracks in a couple of weeks (around the 24th of August, 2010) while the GREF continues to toil and make the roads motorable by picking dump truckloads of debris by the day to be used to fill the new channels that formed or gulleys that never existed apriori.  The civil administration, too has started responding by taking up clearance of debris in and around habitations, but the number of JCBs are far too less
THE PROBLEM STATEMENT
As maintained by HelpAge India earlier, Emergency work at Leh, needs special preparations given both the altitude, the “Cold-Desert”climatic conditions and shortage of staff experienced in high-altitude operations.
While there are now strategies borrowed out of experience including that on Shelter, Health, Watsan and all such other priority sectors, what we do not possess as the development community is the requisite time and person power to convert strategies into activities and programmes.
The temperatures have started to plummet, while our shelters are not yet ready.  Estimates of having a two-three room, built-back better shelters have taken a beating, with the costs of material and workmen doubling in no time.  For instance, Shey village, one of the villages of HelpAge intervention, is a known supplier of mud bricks, the traditional building material in the region.  The village was selling mudbricks at 8000 per thousand bricks (€ 130 / $ 175) but now at site, these cost 12000, Masons cost 500 while they came in for 300, that is if one is able to find them. 
The administration on its part had announced plans of airlifting 50 carpenters and masons for the work.  But even if one tries to be optimistic, one would require two masons with 2 labourers each to complete a house in 20-25 days.  Now, the mute question that stares us straight in the face is how many houses can be completed, in the window we have.  If one uses Cement and beam construction, the cement too would not set.  But unless there is a fix on shelter there is little we can do on the other strategies till the May of 2011, and for the nine months starting October 2010 we would still be fire-fighting (irony is that we would be fighting not heat but cold).
What is encouraging however is that there is still optimism and some real thinking happening.  One organisation from Punjab came with truck loads of construction material, their own workmen and stocks to complete Community Shelters in 6 locations and there was optimism that further more would emulate the same strategy, finances allowing.
Till such follow through is ensured and the government of the day recognises the need to innovate, families continue
Based on our flood assessment Report   HelpAge India has started following activities from 19th August onwards:-
1)   Mobile Medicare unit in Flood affected villages and relief camps
2)   Shay Village Agricultural Land Reclamation of 44 families with 162 Kanal planning and 35 Kanal Filling.
3)   Winter relief ( Dry Ration) for Hundred flood affected Families in Leh ,Ladhakh for seven months through Thiksay Cultural and Welfare Society, Thiksay Monastery .
4)   One Time Emergency Support under Winter relief ( Dry ration) for 30 Residents of Mahabodhi International meditation Centre Old Age Home Leh.
5)   HelpAge India Fitness and Wellness Centre in Association with Thiksay Monastery at Chamba Shopping Complex opposite SNM Hospital Leh.
6)   Established Physiotherapy Centre at  Mahabodhi International meditation Centre (MIMC)Devachan, Leh Ladhakh would be run and Managed By MIMC.
7)   Construction of Fitness and Welness Centre at Shay Village by village committee  (Half Canal land Donated to HelpAge India by Village Panchayat) and running successfully.
8)   30 Kanal land has been donated by Shay village to HelpAge India for Elders Village.
HELPAGE CONTRIBUTION[1]
Intervention Villages of HelpAge India w.e.f. 17 Aug., 2010
One of the first agencies to reach the area, HelpAge India quickly realised the challenges.  Egged by the interim support received from CordAid and domestic donors, HelpAge India provided some immediate relief assistance and recovery options. 
The Relief Assistance
Medical Relief (now assistance)
One of the first and continuing interventions of HelpAge India, were the Mobile Medical Units.  Reaching inaccessible areas were a team of qualified medical professionals, para-medics in a vehicle equipped with free medicines.  The team would register patients, prescribe and provide medication and review progress.  Children, women and men continue to approach the Mobile Medical Unit and the 12 sites, despite the health emergency abating, essential reason being that of access. 
Analysis of over 2500 treatments indicates that allergic reactions and respiratory tract infections are increasing.  Skin infections, attributable to the dust and the non-adherance to recommended personal hygiene are also on the upward swing.  Key to mention here is that even in normal conditions, usage of water for cleansing and washing are severely limited, and the situation has only added to the existing problems.  A trained gynaecologist is also currently stationed to meet the requirement of girl children and women.
In 3 instances, the vehicle also became an ambulance in the middle of the night, to refer patients to the Government Civil Hospital and the Army Hospital. 
Three Agecare and Wellness Centres would replace the Mobile Medical Unit on their de-induction  under the Recovery Options.
Commodity Relief
One of the first reactions, for a “Cloud Burst” and floods were the plans to establish “Community (soup) kitchens” and provide for food relief to families affected. 

Thankfully, it was realised that the Army with its Corp headquarters at Leh  and the Para-military forces, set up the kitchens in no time and together the Indian Army, the  Army Wives Welfare Association (AWWA) and the first of local relief agencies have already satiated the need for materials like blankets, clothes and such other requirements. 
The locals reported that within the first 10 days, some of the affected and even the relatively safe households, within the area affected except cut-off areas like Neemu had enough to donate!!
Based on these interactions with the community and local agencies, including the army and the local government, HelpAge India recognised the changed need for Winter relief.  However, it was also a realisation that for every person/family affected, there were at the least 3 families if not five that stood in the queue. 
Seven of the 11 Numberdars (selected representatives of the village community) met personally have expressed that most agencies and stocks would disappear by mid-October and that is when the actual needs and the real needy would be known.  Till such periods, the Numberdars mention, the list of affected continue to grow and the Numberdars would not want to hurt the feelings of their fellow villages.
To ensure that there are no exclusion errors and to ensure that there is enough for every needy individual or family, HelpAge India has signed Memorandum of Understanding (MoUs) or partnership agreement with monasteries like the Thiksey Monastery, who would in turn identify a search committee, select the real needy and provide monthly rations to such families, till June 2011.  We were successful with only the Thiksey Monastery, wherein an Memorandum of understanding was signed for supporting 100 identified families while Hemis Monastery was also offered similar support, yet to respond, since the Abbot is in China.
Another MoU was signed with the Mahabodhi International Meditation Centre at Choglamsar to support the 30 residents of their Old Age Home, for a period of nine months.  The residents are a mix of the Aged as also the mentally challenged.  The Mahabodhi Centre had taken a severe beating in the aftermath and therefore was seriously constrained in maintaining.  A large portion of the Old Age Home has become irreparable and the priority for the Centre was to reconstruct that portion of the Home, so as to move the residents currently under tents back into their rooms.
RECOVERY OPTIONS
Livelihood Recovery – Land Reclamation:
As earlier stated the livelihoods of a majority of the population is dependent on the tourism industry and the five-six productive months (mid of May to Mid October).  While this be the case with the youngsters who double up as trek Guides, taxis drivers and camp attendants, the rural populace is still dependent on agriculture.  A conservative estimate of 1400 hectares of agricultural land was damaged and about 28000 Quintals of standing food grain crop damaged. 
The recovery options therefore identified with the need for Land Reclamation.  With the severe constraint of approach and resources, HelpAge India has identified Shey Village as the focal area of intervention where in approximately 443 Kanals of agricultural land belonging to 44 families was rendered useless. 
Based on the principle of Equity, a total of 162 Kanals for levelling and 35 kanals for filling were identified (details attached).  The purpose was if the land reclamation was completed on time before the onset of winter using machinery like excavators (JCB in common parlance, after J. C. Bamford, the manufacturer) and dump trucks, the land would become productive for the next season.
Since the villagers of Shey would not be in a position to receive foreign funds, based on the realities of Indian Foreign Exchange Laws, Work orders were issued to the identified supplier of services for reclaiming the land and work started.    
Exceptions to Equity and Logic:
Notable here is the inclusion of about 10 families in the list amounting to about 16 Kanals by the community to ensure that the efforts bear fruit, though some of the families can at some point of time take-up the work.  In the case of one family, since there was only the patriarch there was little possibility of his investing, unless stimulus was provided. The logic professed was that once the work is started, the families would be forced to continue and reclaim the lands.
The exceptions also include the Traditional (notional) king of Shey area, the School land belonging to the Hemis Monastery and the Government School.
Emotional and Physical Recovery:-
The populations have been affected both physically (loss of property, life and limb) and psychologically with Post-Traumatic Stress Disorders.  The identified need was to provide therefore both medical as well as psychological recovery support.  An additional need identified is the problem of the Senior Citizens in the extreme cold conditions, where the geriatric ailments especially that of arthritis, worsen.
Therefore the concept of Senior Citizens Wellness and Fitness Centres was mooted in discussions with the local participants.
It was identified that the Fitness and Wellness Centre will provide the following services.
  • Fitness (Physiotherapy, Yoga/Meditation - through volunteer qualified physiotherapist & Yoga teacher)
  • Health Desk (basic health check-up equipment & medicines - through volunteer doctor and traditional medicine man - Aamchi)
  • Recreation & Active Ageing (TV, indoor games, musical instruments, reading material, etc.)
  • Counselling Desk (psychological and other professional counselling through qualified volunteers including senior citizens).

Three vantage locations were identified for establishing the Fitness and Wellness Centres 1) At Leh opposite the Government Civil Hospital, 2) At Shey Village and 3) Mahabodhi International Meditation Centre, at varying costs and methodology (budgets sheet).

The Leh Centre would function out of space provided by the Thiksey Monastery for a period of one year and a review held at that point of time if Thiksey Monastery would itself maintain the centre and the services.  This is based on the principle of Build – Operate – Review.  A Memorandum of Agreement has duly been signed with the Thiksay Cultural and Welfare Society, Thiksay Monastery for the same.



At the Shey village, the village community was appreciative of the input and therefore have provided for land (15 Kanals) where in the centre has to be constructed and equipped appropriately. This shall continue to be serviced and supported by HelpAge India.  HelpAge India had approached SEEDS,  a prominent NGO with a promising build back better option for the construction, whereas the latter had agreed only for technical support, upon which the construction has been handed over to the village community

 

Fitness and Wellness Centre – Shey
                (Not to Scale)   



At the Mahabodhi Centre, only the minimum equipment required and supporting costs would be provided till May, 2011 after which the Mahabodhi Trust would take over and operate the services on their own.

Communtity Recovery

It is planned that the initial interventions required for Community recovery would be provided by the Fitness and Wellness Centres doubling up as entry point Activities.

It is realised that there is potential for promotion of the concept of CMDRR, as essentially this is a gap area and there is scope for action.

The preliminary ideas are of establishing the Disaster Preparedness and Management Committees at eight locations that have already been serviced by the Mobile Medical Unit as part of the immediate medical relief and where an acceptable level of acceptance generated.  The eight tentative locations planned are Phyang, Thiksey, Shey, Choglamsar, Leh, Sabu, Stakna & Spituk.

Representatives of the DPMCs would be trained in the CMDRR approaches (with appropriate support from ASK) and the CMDRR plans materialised for longer term interventions.





Monday, October 4, 2010

Age Care Himachal Pradesh


HelpAge India – A Social Partner in HP

It is people’s participation harnessed for the cause of the elderly. From being a parrtner in social needs in progressive Himachal Pradesh to partnering and initiating steps for the elder population of the state, HelpAge India – with a mission to ensure` improved qaulity of life for the older people’ – has been able to traverse the whole gamut of Agecare.
HelpAge India has made its presence felt in the region, ofetn, by playing as little but significant a role of a coordinator between the government agencies and social participants. For, the style of HelpAge India incorporates self-relience and self-sustenance amont the masses and its NGO partners.
Himachal Pradesh and its elderly issues
With almost 10 per cent or 548,000 of its popluation above the age of 60, Himachal Pradesh has the garantuan task of ensuring their well being. What complicates matters is that Himachal is a hilly state. Trying terrains make reaching out to the elderly is almost always a challenge. To add to this, joblessness is driving Himachal’s youth to greener pastures in nearby states like Punjab, Haryana and Delhi, incarcerating the hapless elderly back home. This has necessitated community care for them.
The state, like othes in the country, is not insulated from social excesses. Traditional norms and social values are breaking down and joint family norms are disintegarting. This has resulted in the neglect of a large number of aged parents.
Further, although a socially responsible and progressive state, Himachal Pradesh lacks a state policy for the elderly.

The HelpAge India participation 
HelpAge India’s mandate demonstrates devotion in fulfilling the needs of about 10 million elderly in the country. This sizeable chunk of India’s population dosen’t only encounter the rigors of advanced age but also apathy of the society. HelpAge India helps ensure the right to a secure and dignified life for them.
HelpAge India understants that the woes of the elderly are:
1.Failing health, 2. Financial insecurity, 3. Isolation, 4. Neglect, 5. Abuse, 6. Fear, 7. Lack of work or vocation, 8. Deteriorating self-esteem, 9. Loss of control, be it in the family or outside, 10.Lack of preparedeness for old age,11. Discrimination , owing to social norms, age or otherwise.


Himachal Pradesh & HelpAge India
Although the plight of the elderly in Himachal Pradesh is marginally better owing to an overall better economic condition and better administrative focus, much needs to be done, because:
1)    It’s a hard life in the hills
2)    Disintegrated family means lack of domestic support
3)    Manifeatation of terrain-related diseases, lilke those related to the bones and joints.
HelpAge India’s services and activities primarily focus on these issues in Himachal Pradesh.

The HelpAge India Programmes

General: HelpAge India plays a active role in alleviating the condition of the elderly in seven – Shimla, Sirmour, Solan, Kangra, Bilaspur, Mandi and Kullu – of the 12 districts in the state.
Elder’s Helpline 1800-180-1253: The all- Himachal toll-free telephonic helpline run from Shimla functions as a facility to inform and rush helathcare to the elderly. Added to the services are:
Ø  A tie-up with Shimla ambulance service providers in Shimla
Ø  Special concessions like Senior Citizen Discount Cards at chemists and general stores and discounts at private hospitals, for senior citizens
Ø  Elder-to elder consultation in collaboration with HP Pensioners Association and HP Senior Citizens Forum.
Ø  Counselling in cases related to property, inheritance,abuse, neglect etc.
Ø  Bridge between departments like Social Justice and Empowerment and Ministry of Health closer to the elderly.

Physiotherapy Programme: A relatively new concept in Agecare for HelpAge India, the physiotherapy projects demonstrate how direct contact with the elderly goes a long way in easing physical manifestations associated with old age.
Because of the terrain and physical work in the Himachal Pradesh, elderly are prone to bone related diseases like arthritis, gout and weakening knees. Physical disability is associated with the will and confidence of a person. HelpAge India’s physiotherapy activities are the prop in elderly healthcare here, as they not only rehabilitate a senior citizen but also motivate him/her to lead an independent and worthy life.

It is perhaps this reason that the HelpAge India centres in Shimla’s Vikasnagar , Kullu and Solan are so popular that there is a crying demand for more. These centres treat about 60-80 elderly on a daily basis and the traffic is growing.
The Physiotehrapy centres established by HelpAge India are examples of another of its primary belief – care for the elderly is best done by the community. At the three centres, HelpAge India’s doctors are not only treating the elderly but also functioning as community trainers, identifying and training care givers with the community of Agecare.

The Physiotherapy centre at Vikasnagar is being runned and managed by SCAs of the community.Such exercises not only help establish a second-line in the realm of Agecare.

Sponsor-A-Grandparent Programme or SaGP : Operational in all the seven districts of HelpAge India network in the state, the Rs 61 lakh plus SaGP helps provide basic needs like fooding, clothing, medicines and housing for the destitute – those who do not have anyone to take care of them abandoned by their immediate family – amont the elderly.
Ø  To ensure a spreading outreach, 13 NGOs have been roped in as partners.
Ø  Income generation programmes of Rs 600 per month per beneficiary also implemented.
Ø  Under SaGP programme, HelpAge India is also actively promoting the HP Government old age pension scheme by helping the elders in submission of pension claims.

Ambulance services for the elders: HelpAge India has helpled augment mobile emergency facility in Shimla and adjoining areas by providing a specialised ambulance(a fully equipped Maruti van ) for the elderly.

Medical Eldercare Unit : HelpAge India, in partnership with the central Department of Science and Technology, has put on the state roads a mobile diagnostic unit that covers Basantpur, Gumma, Sunni(adjoining Mandi dsitrict), Mashobra and urban Vikasnagar. The mobile unit or medical eldercare unit (MEU) has the facility for blood/urine tests and physiotherapy unit for the elderly, with the purpose of:
Ø  Social mobilization for the cause of the elderly.
Ø  Preventive and curative healthcare.
Ø  Counselling the elderly.
Ø  Impart information amont the target group on state policies, programmes and schemes for them.

Cancer awareness and treatment programme: According to Himachal government estimate, there are over 100 new cancer cases every year in the state because of which the number of patients treated at the regional cancer centre’s has gone up from 708 in 1996 to 1,614 at present. Almost half of such cases belong to the 50+ age category.
It has also been found that as mush as 80 per cent of the cancer cases were at a very advanced stage reducing chance of cure. It has been established that the most prevalent form pf cancer in Himachal is cancer of the cervix among women and commonest malignancy affecting the males is cancer in lungs.
Given the grim data, the state has a need of as many cancer screening centres and awareness campaigns as it can muster. For this purpose, HelpAge India, along with Himachal Pradesh Voluntary Health Association and Shimla-based Indira Gandhi Government Medical College at (IGGMC), holds camps and awareness drives. HelpAge India attempts to reach out to the rural population – panchayat meetings are regularly held to focus on the disease and cancer screening camps sensitise the people.

Income Generation Programme :  For the rural veteran, often, his very ability to survive is challenged, impoverished, penniless and abandoned that he is. HelpAge India, with eight NGO partners, has been able to provide succor to these elderly destitute by providing them capital and equipment aid for cattle rearing, daily operations, day-care centres, etc. The income generation programme is for about Rs 16.8 lakh.

Ophthalmic Programme: The Rs 20 lakh programme cover includes apart from Himachal Pradesh, Punjab, Haryana and Chandigarh. The programme facilitates eyecare for the elderly in partnership with local hospitals.
HelpAge India has come a full circle in Himachal Pradesh, as far as caring for the elderly is concerned. It has pioneered some causes and participated in others to ensure better quality of life. There’s more waiting to be done, more districts to be brought within its fold, more ground to be broken in Agecare. HelpAge India awaits the opportunity.

Contact Us
Dr. Rajesh Kumar,State Manager
Lady Hardinge Cottage (No.3), Nr.H.P.High Court
Bamloe, Shimla, H.P. Tel. No.:-0177-2811254

Head Office
C-14, Qutab Institutional Area, New Delhi 16
Tel.:011-42030400, Fax: 91-11-26852916,