RESEARCH PROJECTS BY B.K.L.W. HOSPITAL
On context to ‘Beti Bachao, Beti Padhao’ campaign being spread over the country in recent years, the world has taken into account the programme ‘Adolescent girls Health and Empowerment’ which is running for last 22 years in this rural part of Maharashtra. Shri Vithalrao Joshi Charities Trust’s B.K.L. Walawalkar Hospital is successfully running this project to improve the health of malnourished girls. It is praised by doctors and researchers from all over the world and this ‘Dervan pattern’ is going to be implemented in 9 centers across the world.
An international workshop on ‘Collaborative Network for Adolescent Nutrition & Health in sub-Saharan Africa and India’ was organised by Medical Research Council, U.K. at B.K.L. Walawalkar Rural Medical College. The council was attended by Researchers, Doctors, and Nutritionists from England, South Africa, Kenya, Ethopia, Jiniva and many more research centers. Dr. David Ross, Adolescent Health Researcher and Guideline Development, WHO, Geneva, and Dr. Caroline Fall, (Southampton, UK) were special guests on this event.
All these doctors, researchers had a thorough discussion on Health, Nutrition and Psychology of adolescent girls and decided to start such research at 9 centers all over the world and B.K.L. Walawalkar Hospital is one of them.
A programme ‘TALENT’, Transforming Adolescence Life Through Nutrition, have been initiated and will work for 18 months at B.K.L. Walawalkar Hospital and latter on it will be implemented in different countries from all over the world. This project will be started at University of Southampton, Medical Research Council, UK, Jimma Ethiopia, Johannesburg, France, Gambia etc.
Adolescent girls are educated through special workshops so that they can be good mothers of our future citizens. Improving the hemoglobin level of preschool age children could yield substantial benefits in cognitive and psychosocial development and overall health. While evidence-based recommendations for reducing childhood anemia in high anemia prevalence countries are available
Adolescent Girls Residential Camp
Objectives of Adolescent Girls Residential Camp
- Clinical examination of girls
- Anthropometry (height, weight and other parameters by using Tanita machine)
- Blood collection for assessment of micronutrients, hemogram.
- Detection and correction of deficiencies of vitamins
- Physical & Health Education
- Psychological counseling and Self Empowerment
Activities
Physical & Psychological Assessment
The camp was guided by clinical specialties and various experts from different part of world to evaluate adolescent health.
B.K.L. Walawalkar Hospital, Diagnostic & Research Center (BKLWH) has been working towards initiation of innovative projects in medical field for the betterment of rural people. In order to take the hospital to the next level, it is necessary for us to get ourselves involved in integrated, locally relevant research in healthcare, which will not only benefit people of Konkan, but also people from all other Low & Middle income countries . For this, fresh and new ideas from the experts in the field, who genuinely want to contribute to the upliftment of mankind, are needed. We want the brightest stars in the field to guide us, and to show us the right path for our future journey.
With these aims in mind Scientific Advisory Committee of our hospital has been formed. The constitution of the committee is as follows
1. Padmavibhushan Dr. Anil Kakodkar (Chairman)
Member, Atomic Energy Centre & INAE Satish Dhawan Chair of Engineering Eminence
2. Padmabhushan Dr. T. Ramasami,
Scientist, Researcher, Social Activist, Administrator
Former Secretary to Govt. of India; Ministry of Science & Technology
3. Dr. Rita Mulherkar
Scientist, Researcher, Administrator
Ex. Chairman & Professor, Mulherkar Lab, ACTREC, Navi Mumbai
4. Prof. B. Ravi
Engineer, Researcher, Educationist
Institute Chair Professor,
Mechanical Engineering Department, IIT, Powai
5. Shri Chandrashekhar S. Garde
Engineer, Researcher
Professor, LMISTE
Dept. of Engineering & Applied Sciences
Vishwakarma Institute of Information Technology, Pune
6. Dr. Sanjay Oak
Surgeon, Educationist, Administrator
Vice Chancellor, DY Patil University, Mumbai
7. Shri Jayantkumar Banthia
Medical Administrator, Social Activist
Chairman, SICOM & Ex-Chief Secretary, Govt. of Maharashtra
8. Dr. Shripad Banavali
Oncologist, Researcher, Administrator
Professor & Head, Dept. of Medical Oncology,
Tata Memorial Centre, Mumbai
9. Vikas Walawalkar (Permanent Member)
Managing Trustee, Shri Vithalrao Joshi Charities Trust
10. Dr. (Mrs.) Suvarna Patil,
Medical Director,
B.K.L. Walawalkar Hospital, Diagnostic & Research Centre
With the aim of countering this problem in the vicinity of Ratnagiri & Sindhudurg Districts, children below 6 years of age & Antenatal & post natal mothers in the area are approached. Specially created teams from the Hospital/Trust imparted this group, information on Health & Healthy Diet. 70 Anganwadis are adopted for this purpose and these teams visit these anganwadis weekly basis.
Target groups
1. 0-6 age group children
2. Adolescent girls
3. Post natal mothers
For the target group, parameters like Hemoglobin, Height, weight, serum proteins were monitored periodically & Nutritious food (in the form of “Ladoo”, prepared by the Hospital/Trust) was supplied to them on weekly basis. This project has created a positive impact on the beneficiaries.
- Registration of Child & ANC Mothers: Children below 6 years of age, Antenatal & Lactating mothers
- Physical Examination & Investigations: Height, Weight, Mid Arm, Head & Chest Circumference
- Nutritious Ladoos Supply : Daily supply of packets of nutritious ladoos
- Medicine Supply: Hematinics, Vit.D, Vit.A, Calcium, Antihelminthics & Hospital Visit on Monthly Basis
- Patho Investigations: Hb%, Serum Proteins, Urine, MT – Every 3 Monthly
- Corrective Surgeries If Required
- Referral services to B.K.L.Walawalakar Hospital, Free 1st Hospital Delivery & subsequent two deliveries at subsidized rates
- Post Natal Baby Care
- Well equipped N.I.C.U.
CDC – Child Development Center – 3 Weeks programme (21 days)
CTC – Child Treatment Center – 3 Days treatment programme
* To assess and improve nutritional status of children of 0-6 years old children
* To assess and improve health status of children of 0-6 years old children.
B.K.L. Walawalkar Hospital?s have been supporting initiatives like free dental check up camps in rural areas and the efforts set the stage for major improvements in oral health care among school children. All zilla parishad schools from Ratnagiri district are selected for dental check up. Dental caries is a major public health problem among schoolchildren in rural areas. They are the main cause of tooth mortality, presentation of dental emergencies and tooth extraction in this group. The many causes of dental caries include poor dietary habits, poor oral hygiene and lack of dental care. Methods to combat this problem include dissemination of dental health messages, promotion of good personal dental care and regular dental check-ups.
The general prevalence rate of positively detected cases of any level of dental caries was 93%. (Poor 59% + Fair 34%) and only 7% found in good condition. The proper treatment and awareness done by hospital throughout the year resulted into reduced caries incidences upto 90% among screened students.
- one day work shop
- 10 days residential camps
- school visits for work shops
- Village visits
Anemia is still one of India’s major public health problems, especially among adolescent girls. It has become necessary to find out correlates of nutritional status of adolescent girls in rural area. Community based cross-sectional study – Nutritional status of study subjects is assessed on the basis of BMI. The health check up camps is organized to know the deformities among the girls and at the same time counseling is done to make them aware of good health.
The overall goal of the hospital is to improve the quality of life for all rural population by increasing access to affordable high quality health care, facilitating enhanced self-care and supportive care in the rural home setting and promoting healthy lifestyles that prevent disease. The hospital accomplishes this goal through advocacy, networking, partnerships, education, outreach, research and service.
To pull the patients away from the darkness of some wrong age-old beliefs & superstitions in treatment of Cancer (or for that matter of any disease), the hospital got associated with the renowned Tata Cancer Hospital (Mumbai) in offering treatment. A continuous campaign in the districts of Ratnagiri & Sindhudurg, based on a team of doctors visiting the patients in their own homes resulted in a detailed survey of the region for Cancer patients. Now, under one roof, the patient can avail treatments ranging from Biopsy to Radiation and that too free of cost while his lodging & boarding needs are taken care of.
One of the outreach projects of the BKLWH is the Tata Memorial Centre Rural Outreach Program.
TATA MEMORIAL CENTRE RURAL OUTREACH PPROGRAMME (TMCROP)
Under this project, Oral Malignancy, Ca Breast and Ca Cervix cases are treated free of cost at B.K.L.Walawalkar Hospital, Dervan. Consultants & surgeons from Tata Memorial Hospital are visiting our hospital regularly on every 3rd Friday, Saturday and Sunday of every month.
The major goals of the TMCROP are to:
- increase community awareness of the health systems,
- Early detection of cancer disease and
- provide ultra modern treatment assistance to participating communities.
CHEST – CANCER OF ESOPHAGUS HYPOPHARYNX SCREENING TRIAL (IN COLLABORATION WITH TATA MEMORIAL CENTRE)
Detection of Esophagus Hypopharynx Cancer by doing Barium swallow at community level. Under this project, 17393 patients are screened for barium swallow through mobile screening unit and 25 patients found positive for DCBS. Also under this programme 13878 patients are screened for oral cancer. The people from Ratnagiri district are screened for „Double contrast Barium Swallow? installed in a mobile vehicle. It’s a community based cluster randomized clinical trial and double contrast barium swallow is used as a screening tool to reduce cancer related mortality due to esophageal and hypopharyngeal cancers.
RURAL CANCER REGISTRY – (IN COLLABORATION WITH TATA MEMORIAL CENTRE)
- The primary concern is to study Cancer in Community, Incidence, Prevalence, trends, overall survival in community.
- Provide background for overall Clinical Research.
- Research-Epidemiological Descriptive/Analytic studies.
- Provides indicators for Cancer Control activity.
- Helps to assess effectiveness of preventive measures.
Tata Memorial Centre (TMC), Mumbai, in collaboration with and BKL Walawalkar hospital (BKLWH), Dervan, has set up a Population based Cancer registry, located at BKLWH, Dervan. The Registry Programme was started in March, 2009. In India, the only rural cancer registry is located at Barshi, Solapur district, Maharashtra; besides this there are several urban-based population registries in different parts of the country. Since there are no cancer statistics from Konkan region, it was felt necessary to set up a Cancer registry at Dervan in Ratnagiri district. The TMC is currently carrying out a large Out-reach programme in the Ratnagiri and Sindhudurg district since Aug 2003, which is screening high-risk groups. To evaluate the effectiveness of the screening programme, a cancer registry is essential. Cancer registry is the backbone for providing all information on the various patterns of cancer that are diagnosed from a geographical region.
RADIOTHERAPY
High density Radiation, Brachytherapy, CT Simulation for planning (Since 2010)
Department of Atomic energy (DAE) has donated BHABHATRON II unit, High Density Brachytherapy, CT simulator, top of the lene planning system in the year 2009. Over the last 14 years, the B.K.L.Walawalkar Hospital has been providing good quality secondary care services. It is backed up with tertiary level medical care and has expanded its scope very rapidly since its inception. In recent time, the institute has set up the Radiotherapy unit which will result in establishment of comprehensive cancer care facilities in the backward Konkan region of Maharashtra. Padmavibhushan Dr. Anil Kakodkar, Chairman Department of Atomic Energy inaugurated Radiotherapy unit “BHABHATRON-2†on 7th February 2009. This unit is under control of AERB
OBJECTIVES
- To identify patients of Cleft Lip & Cleft Palate in Ratnagiri, Sindhudurg & Raigad District.
- To motivate patients for consultation with plastic surgeon for early correction through surgical correction.
- To rehabilitate the patient with dental & speech problems.
- To increase awareness through the population by use of posters, meetings, Fleep Charts etc. with volunteers.
- To increase awareness in Government officers, Medical personnel, Anganwadi workers, staff nurses etc. through zletters, meetings, and awareness seminars.
INNOVATIONS AND LESSONS LEARNED
- Due to this project, Health awareness in community is increased tremendously. So now a days newborns are coming to Hospital in right time for consultation.
- Due to surgical correction, Dental and Speech rehabilitation faces are transforming to smiling faces.
- To overcome rejection of patients, patients are regularly followed up and treated for Anemia, Upper Respiratory infections.
- Regularly Dietary advice sessions, nursing care sessions, Breast feeding sessions are carried out for the parents.
The incidence of Snake-bites & Scorpion-sting is much higher in Konkan than the cities. Most of the times, such patients lose their life when treated with some local “medicine” or by so called “sorcerer”. Based on the research carried out at the Walawalkar hospital, it has developed special treatment for these incidents.
A snake-bite affects blood-coagulation leading to kidney failure hence a treatment is developed using anti-snake venom along with blood-plasma. This cheap and effective treatment has saved lives of many a patient.
A scorpion-sting affects the functioning of heart causing danger to the life of the patient. The hospital has also developed a cure for it and saved a number of lives.
In Konkan region, the farmers growing rice do the sowing in rainy season while standing in mud in the field. These conditions coupled with rats can cause Leptospirosis even leading to death. The hospital feels privileged to have been the first to identify the bacteria causing Leptospirosis. The identification made preventive care easier, saving the lives of scores of farmers of today & tomorrow. ICMR Andaman and CMC Vellore are helping out in this research work.