Tag Archives: Fakir Bagan

Gov’t-assisted immunization training

In September, Calcutta Kids organized an immunization training program, which served as a refresher training for some of our team and a new experience for others.  The training was carried out by a colleague in the government sector, Dr. Swagata Mukherjee, the Assistant Medical Officer for the Howrah Municipal Corporation (HMC).  Despite his busy schedule, he volunteered his services to Calcutta Kids during his personal time.  During the training, participants learned about vaccine-preventable diseases and related vaccines, the proper vaccination schedule, and how to technically administer each type of vaccine.  The training comprised of two days of observation at the Municipal Health Center during immunization camps, and three days of theory, observation, and practice in the Calcutta Kids clinic.

Training with Dr. Swagata Mukherjee

The training is one of many steps in the process towards implementing a community-based health care model at Calcutta Kids.  Until recently, our curative health, nutrition care, and immunization components have been held in our health center, Swastha Kendra, situated outside of Fakir Bagan.  During immunizations, vaccines were primarily administered by our nurse under the supervision of our doctor.  But this month we are merging the health center into our community center Ma o Shishu Shiksha Kendra, so immunizations are also transitioning to the new space in the heart of Fakir Bagan.  This is part of our effort to bring cost-effective healthcare solutions closer to the community.

The immunization camp will now be carried out in the community by the area in charges (senior community health workers) and the health assistant-counselors who are now qualified in immunizations as a result of the excellent training they received in September.  Where we once relied on one person to conduct immunizations every week (with the doctor as a back-up), we now have four trained staff members who are proficient in administering immunizations.  This will help ensure that immunizations are even more accessible for the families in Fakir Bagan, and provides Calcutta Kids the capacity to extend our immunization program to neighboring areas, thereby targeting more children in need of immunization.

Laxmi administering vaccinations after the training

Around the world, routine immunizations have reduced and even eliminated many childhood illnesses that once killed and debilitated many children.  Although many vaccine preventable diseases (VPDs) have been controlled, children are still dying from diseases that could be prevented by providing the critical vaccinations during the first few years of life.  The World Health Organization estimated that, every year, 1.5 million children die from diseases that could have been prevented by routine vaccination.  That staggering total represents almost one-fifth of all the children who died worldwide before reaching their fifth birthday. (1)

The Indian National Immunization Schedule includes the following six VPDs: Tuberculosis, Diphtheria, Pertussis, Tetanus, Measles, and Polio. For a child to be considered fully immunized, he or she must have received one dose each of BCG and Measles and three doses of DPT and Polio in the first year of life. There is still much more work to be done in terms of immunization coverage in India: Nationally, less than half (43.5%) of children 12-23 months are fully immunized. West Bengal is faring better than the national average, with 64.3% of children 12-23 months fully immunized. (2)

Waiting for immunizations at the Calcutta Kids clinic. Photography by Brett Cole, November 2012

Immunization in India must be sustained, not only to prevent VPDs, but also to reduce the incidence of measles and tetanus, and eradicate poliomyelitis. India, known as one of the greatest challenges for the global polio eradication campaign, has now been polio free for 18 months. (3) The last reported polio case was in Shahapur village in Howrah district, the same district where Calcutta Kids operates. Sustained immunization and coverage will ensure that polio does not make a comeback to this country.

Calcutta Kids is committed to help sustain immunization coverage in Fakir Bagan by ensuring that every young child in Fakir Bagan is fully immunized and therefore protected against vaccine-preventable childhood illnesses.–Danya Sarkar

1.http://www.who.int/immunization_monitoring/diseases/en/
2.NFHS-3, India and West Bengal Factsheets
3.http://www.un.org/millenniumgoals/pdf/UNGA%20Polio%20Event_Press%20Release%20and%20Quote%20Sheet_Final.pdf

AIF Fellow impressions 2012-13 (1 of 2)

I am so impressed and inspired by the motivation you see at Calcutta Kids. Every health worker I have been able to spend time with during my first month here is doing a wholehearted job to be a good resource to the organization and more importantly to the community they are serving. Thanks to our mentor Danya Sarkar, who helped us feel settled down, Pranav and I have been able to explore the community and learn all the various functions of the organization. As we make our visits into the field with the health workers, the community has noticed and recognizes us as new members of Calcutta Kids. We realized this as we looked a little lost while trying to find our way to the community center and two women immediately gave us directions before we even asked them!

The mission of Calcutta Kids can be understood through the manner in which the health workers communicate with the women of the community. Every child is important and can be given adequate care by simply monitoring them. If a child’s weight has not increased during the monthly Growth, Monitoring and Promotion Program, the health worker visits the mother in the following week and counsels her. The health workers express how they are really sad when they see no positive growth in the child. They encourage each mother to take more care of the baby, give her simple tips on how to create a healthy diet and also praise her when she has done a good job. Thus, the health workers have built a great relationship with the mothers of the community. The mothers are always happy to see the didis and welcome them into their houses. They also offer tea or lunch and ask us to spend time with them. When the health worker completes filling up her form and questionnaire, the women thank her for coming and tell her that they felt happy they got to chat with them. The women also trust the health workers as much as they trust a doctor. Even when the health workers are merely on their walk from one house visit to another, many women stop them with their babies and talk about how their child still has a cold or might have developed a skin infection.

Meeting for pregnant women lead by Laxmi Gupta

Meeting for pregnant women led by Laxmi Gupta

The success stories from Calcutta Kids are commendable and its establishment in Fakir Bagan is very apparent in the number of people who visit the clinic everyday or the manner in which we are received in each house. However, there is still work to be done. Although the women recognize the messages delivered by the health workers, many women still do not seem to be adopting a change in their habits. They usually quote too much housework and stress in their lives as reasons for not being able to follow the health workers advice. Even when they come to the community meetings, they listen to the messages or watch the videos but whether they are following the key points is something yet to be assessed. This is a project I plan to work on during my time at Calcutta Kids. I will be working out behavior change communication strategies using different methods of delivering messages to the community. I will be working with the health workers and the beneficiaries to find out why they are not able to follow simple, yet key health practices. Through the health counseling sessions, community meetings and discussions groups I hope to understand the needs of the women, analyze existing techniques of delivering health messages and find ways to improve them. Eventually, I hope to create a sustainable structure to monitor and evaluate changes in health behavior as put forth by the health workers.- Sriya Srikrishnan (AIF William J. Clinton Fellow 2012-2013)

CK Starts Routine Deworming

We introduced an exciting new component to our young child health initiative that we hope will help improve the health status of children in Fakir Bagan.  During our Growth Monitoring and Promotion (GMP) camp this week, Calcutta Kids carried out routine deworming of preschool age children. We have been discussing this idea for several months now after our data analysis showed a high prevalence of worm infestation in a group of malnourished children enrolled in our nutrition pilot program (YChiNG). At the time, we dewormed the children in the YChiNG program, but realized that there were many more children in our catchment area who could benefit from deworming.

Nasreen helping a father give deworming medicine

We were motivated in part by a Government of India mass deworming campaign in New Delhi earlier this year, which included deworming not only school-age children in government schools, but also pre-school age children in ICDS/Anganwadi (government health) centers. During last month’s GMP in Fakir Bagan, we conducted a survey with mothers of children 1-3 years old, asking them to report if their child had an incidence of intestinal worms in the past 6 months. A resounding 43% of mothers answered yes, which reflected a clear need for an intervention.

Intestinal worms, which are pervasive in India, can have devastating effects on a child’s physical and mental growth. In low-income urban areas like Fakir Bagan, where sanitation and hygiene are poor and many children walk around without shoes for protection, the most common type of intestinal worms are soil transmitted helminthes. Once in the body, these parasitic worms feed on host tissues, including blood, leading to a loss of iron and protein. They also hinder the absorption of nutrients. The result is diarrhea, anemia, and malnutrition, all which have a detrimental impact on child health, growth, and development. To counter the negative effects of worms, the WHO recommends periodic drug treatment (deworming) of all children living in endemic areas. (1) Studies have shown that routine deworming of children can have significant positive outcomes on nutrition, growth, and cognitive performance.

A child excited about the new deworming medicine

School-age children are thought to have a high burden of worm infestation. Fortunately, they are easy to reach for deworming because schools serve as pre-established distribution networks. The evidence shows that routine deworming makes a difference. One landmark study showed that deworming can reduce school absenteeism by 25%. Furthermore, children who are regularly dewormed earn over 20% more as adults and work 12% more hours, while those infected are 13% less likely to be literate. (2) Global campaigns now target pre-school age children, who are tougher to reach but also a vulnerable group in terms of exposure to worms. Studies conducted in Indian slums show that there is substantial weight gain in young children (pre-school age) who are dewormed regularly. (3)

Apart from the mass campaign in Delhi this year, which followed mass campaigns in Bihar and Andhra Pradesh a few years back, deworming campaigns have not been widely organized in India. Given that deworming is extremely cost-effective at only a few cents per pill, and provides both short-term and long-term physical and cognitive benefits to a child, India could see great benefits by ramping up state deworming campaigns, which can be effectively carried out through government schools and ICDS/Anganwadi health centers. The WHO includes intestinal worms among “the 17 neglected tropical diseases” which WHO Director General Margaret Chan described as “diseases that are largely silent, as the people affected or at risk have no political voice.”. The WHO launched its “neglected tropical diseases” campaign to raise awareness among policy makers and donors, in hopes of stimulating more action, like deworming campaigns. For Calcutta Kids, this new deworming initiative marks a proactive step to address the “neglected disease” that is most prevalent in our community.

The first round of deworming this week marked the beginning of our commitment to ensure routine deworming every 6 months to each preschool aged child in Fakir Bagan. We reached each of the 311 children between 1-3 years old, but missed some children who had traveled to the village with their families, but they should be covered in future rounds. Between rounds, we will immediately treat any children who present with worms. Parents at the camp were positive about the deworming intervention. The results were telling. In the words of one father, “My child was feeling sick and her stomach was swollen from worms. I am happy that she is now getting medicine to make her better.” – Danya Sarkar

1. http://www.who.int/elena/titles/deworming/en/
2. http://www.dewormtheworld.org/why-deworm/the-evidence-for-school-based-deworming
3. Effects of Deworming on Malnourished Preschool Children in India: An Open-Labelled, Cluster-Randomized Trial. Shally Awasthi, Richard Peto, Vinod K. Pande, Robert H. Fletcher, Simon Read, Donald A. P. Bundy. PLOS Neglected Tropical Diseases, April 2008, Volume 2, Issue 4

New Child Development Corner

Despite the sweltering heat in the last couple months, and the impending torrential rains of monsoon, there is a lot going on at Calcutta Kids this summer. In the midst of all the new activities, in mid-May, Calcutta Kids received the wonderful news that we will be receiving a small grant to set up a child development corner in our new community center, from the J. Kirby Simon Foreign Service Trust. We are very excited about this prospect, because a child development corner will allow us to provide a more holistic approach to child growth and development within the larger young child health initiative. In the past six years, we have made remarkable improvements in the nutrition and growth of young children in Fakir Bagan. The average birth weight has increased from a dismal 1.8 kg in 2005 to 2.8 kg in 2011. Indicators of children’s nutritional status have improved greatly– in the past three years, the severe malnutrition rate has fallen by more than half, from 12.3% to 5.5%. However, there is still a lot to do to ensure that children in this urban poor community are able to achieve optimum development.

Calcutta Kids became conscious that in Fakir Bagan slum as in most urban poor settings, young children have little or no access to play and stimulation. There are no playgrounds for children, and although there is a maidan (field) nearby, it is frequented by older children and teens, and usually only boys. Young children (under 3 years old) are often seen sitting passively on a cot or in the doorway, while their mothers are doing domestic work such as cleaning, cooking, fetching water, or part-time factory work such as sewing garments or making zippers. In homes, families rarely have any toys available for the young children, a luxury that many cannot afford.

Play is essential to development because it contributes to the physical, cognitive, social, and emotional well-being of children. In fact, play is so important to optimal child development that it has been recognized by the United Nations High Commission for Human Rights as a right of every child. In this light, Calcutta Kids appreciates the need to create a child development component to ensure this basic right, with the goal of improved cognitive growth and overall development for all our young children in Fakir Bagan.

The child development corner in the community center will be a safe, clean, and stimulating environment for young children to simply play – to create and explore the world with toys, with other children, and with their caregivers. The project will also facilitate parents’ and caregivers’ understanding of the importance of play and stimulation in child development. It is anticipated that this type of play will provide the needed stimulation that will help very young children with both gross and fine motor skills that will allow them to reach appropriate developmental milestones, develop new competencies, and improve cognitive development. It is hoped that this unique early childhood stimulation project will serve as a model for other NGOs in Kolkata who are working in child health in the urban slums.

Stay tuned for more updates on the child development corner which should be fully established by early 2013. –Danya Sarkar

Swarathma Brings in the Monsoon

I pegged Swarathma as a small time band from a mile away. It was presumptive, sure, naïve even, but it didn’t occur to me that anyone else would play for an NGO in the dusty heat of a slum for free. Little did I know how wrong I was.

When Noah divulged the details to me, I found out that the band is actually something of an Indian phenomenon. Their first album won them Best Band, Best Album, and Song of the Year at India’s most prestigious annual rock awards show. They were on the iconic TV series The Dewarists. They have toured Australia, Britian, and Morocco. And now they were playing for Calcutta Kids.

Back in the old days, for every paid gig they played one for free. They’ve since run out of enough time to keep up the one to one ratio, but when they can they still try to play for those who would not see them otherwise. Thanks to their bassist and spokesman Jishnu’s old friendship with Evangeline, the final concert on the tour to mark the launch of their second album would be in Fakir Bagan.

Weaving around piles of sand and through patches of the road lost in mud, Evangeline and I eventually led their van to Howrah and the impromptu stage that had been miraculously constructed for them. I think the band was almost so impressed as we were, and the juxtaposition of big-band electronics and crumbling-wall school grounds was immensely pleasing.

I picked out a spot in the sea of rickety plastic chairs that bulged at the edges of the colorful canopy above it, and the band sound checked as the crowd filtered in. Chandan and Kalyan lugged some wooden benches out from the school to augment the periphery as it became clear that spectators would outnumber chairs. When all was said and done, a floor of women and children—often balanced on laps or sitting together two to a chair—gazed up at the first bandstand of their lives.

Just before the band went backstage to change into performance attire, their lead singer arrived. No one was going to disappoint the crowd by admitting that he had been missing—the doctors had to knock him out cold at the hospital the night before to put a dislocated shoulder back in—and the band assured us that they could play without him. But after we left him at the hotel and told him to lie low, he just couldn’t. So with a piece of cloth to support his arm (to everyone’s amazement, he even replaced that with a guitar strap when the concert began, strumming away as though nothing had happened), he made it just in time. Security—a graying old man with a stoop and a hard stick—almost wouldn’t let him in. He didn’t have a ticket, after all.

When the band took the stage and plunged into their first song, it seemed to me that an almost tangible incredulousness emanated from the audience. The end of the first number and no more than a sparse acknowledgement of applause underlined the pristine newness of the occasion: the crowd did not know how to react simply because they had never reacted to such a thing before.

Slowly but surely, though, the audience grew less self-conscious and more absorbed by the music. Jishnu has a way of connecting with the floor before him, and in between songs he lightheartedly instructed the crowd in performance manners—when to clap, when to cheer—and introduced the songs that followed, explaining their significance and meaning. On the second song there was little cooperation when he tried to stimulate a clap, but when he motioned for the mothers to lift up their babies in front of them with the chorus of the fourth, there wasn’t a moment’s hesitation. He even seamlessly promoted Calcutta Kids’ new and critical mantra: “A child gaining weight cannot be very sick. A child not gaining weight cannot be very well.”

As the concert went on, the clouds around us darkened, rumbling closer. Just as the mood was reaching unabashed exuberance, the thunder clapped above us and the rain began to fall. At first, no one seemed to know what to do. As soon as it became clear that an inundation was in store, however, the crowd lurched into motion, fleeing either home or into the schoolhouse next door. The band and their helpers scurried to protect the equipment from the blowing rain.

Perhaps unexpectedly to the westerners among us, the deluge did not bring with it a downhearted regret that the concert had been called off before its due course. Instead, the cooling blessing of storm and rain stimulated the same energetic exuberance that had radiated up moments before at Swarathma. As we huddled inside to wait out the downpour, we figured that nature could have given us fifteen more minutes of music. But we agreed that no one could have planned so powerful a coda to the slum’s first concert.—Evan Mullen

Celebrating Women

Around the world, International Women’s Day is marked every year on March 8 to celebrate the participation, contribution, and achievements of women in society. In Fakir Bagan, women live day-to-day taking care of their children and husbands, and have little time to think about themselves. They live in a male dominated environment where alcohol abuse, verbal abuse, and domestic violence is considered a norm that they must accept. Women who earn an income to support the family not only face the same issues, but also face the problem of having their hard earned money taken away by their husbands to spend on alcohol or cigarettes. It is still a struggle for women in this community to make their own voices heard and to be aware of their rights and needs as women.

On the afternoon of March 7, Calcutta Kids held an early celebration of International Women’s Day in our Maa o Shishu Shiksha Kendra (Mother and Child Learning Center) in Fakir Bagan. Members of our women’s support group and their friends from the community joined in the celebration. We celebrated the immense strength women exhibit in their day to day lives throughout the year, recognizing the unlimited sacrifices made by women in this community.

During the event, our program coordinator Sumana helped the community reflect on the status of women in society, how to create awareness about women’s rights, and to think about approaches to empower women in Fakir Bagan. One beneficiary Hira Poddar, said, “These forums allow us the opportunity to get together and share our problems and gain strength from each other.” Another beneficiary, Mira Shaw, a single mother and sole income earner whose husband left her with two young children said, “I am very happy with my life because I can take responsibility for my own life and take good care of my children.”

After the staff members and women spoke, we stood in a circle and sang We Shall Overcome. The then danced to Bollywood music and played with Holi colors! It was a wonderful celebration and a reminder to all of us at Calcutta Kids to continue striving to create a space where women’s voices can be heard. –Danya Sarkar

Children’s Day in Fakir Bagan

November 14 was Children’s Day. To celebrate, the entire Calcutta Kids team came together with the community to have a parade through Fakir Bagan. It started with a nine-person band, which gathered mothers and children from around the community. Health workers had prepared balloons, noise makers, and health-promotion signs for the children. Starting from the edge of the community, a large group of women and children followed the band and shared in the message of a healthier community. The parade was followed by one of our health workers on a bicycle rickshaw, providing health information to the community through a loud speaker. The name “Calcutta Kids” was heard throughout the community, and many women and children joined in the parade as it looped through the narrow lanes of Fakir Bagan. After over an hour of energizing the community, health workers provided snacks and the great Children’s Day event was brought to a close. Bringing the community together to celebrate and inform on healthy choices made this year’s Children’s Day great for Fakir Bagan.