DMF Mobile Medical Unit (MMU) Panchmahal & Dahod – District Mineral Foundation Gujarat

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Case Study

The mining villages in Gujarat have traditionally suffered because of the lack of adequate healthcare infrastructure. Mining activities give rise to specific health complications.

Problem

The healthcare landscape in the rural settings of Panchmahal & Dahod was very limited in terms of capacity and infrastructure. These regions did not have proper medical teams, doctors and healthcare providers. The unavailability of proper diagnostic tools and services led to incorrect and incomplete diagnoses, causing medical conditions to become exacerbated. People were prone to avoiding the limited healthcare services available to them and relied instead on local healers and quacks. This contributed to medical issues worsening and became a systemic problem plaguing the community.

Even in the cases where people sought the help of licensed professionals, the lack of treatment options and medicines meant very little could actually be done with a diagnosis. People had to travel long distances, usually by foot, in order to seek care from outside the village. This also increased the burden on the tertiary care services in the greater region.

The general attitude towards institutionalised healthcare and the inadequacies of the existing system created many challenges once the Covid-19 pandemic hit. The tribal population was not quick to adapt to the new pandemic protocols and precautions. This posed a very serious community/ public healthcare risk in a time of national emergency and crisis.

Setting up an ambitious project like this requires a certain degree of existing infrastructure and support mechanisms, which are hard to come by in remote and rural regions. Training and retraining personnel and technical training workshops are difficult to achieve against a paucity of time, resources and complimentary infrastructure.

Solution

District Mineral Foundation Gujarat set up Mobile Medical Units to deliver healthcare services to the people. In order to get the project going, key healthcare stakeholders were identified and brought on board for planning. Field assessments were conducted in order to understand where the system was failing and what needed to be done to improve it.

The project hired properly trained medical staff and support services providers. In case of advanced cases and specialty requirements, telemedicine is used to consult doctors in Tier-1 Cities. A dynamic referral network has been established with nearby government and private hospitals for patients that need more advanced care. The labs have been outfitted with USFDA-approved equipment and inhouse diagnostics have improved by leaps and bounds. Better pharmaceutical supplies and services are being prioritised.

Outcomes

As a result, proper screening and diagnosis is now available for communicable and non-communicable illnesses. Over 50 tests can now be conducted in the inhouse labs. The Electronic Medical Record System (EMRS) is improving the quality of screening services. People can now seek appropriate treatments and medicines. The new system incorporates specialty services like Cardiology, Dermatology, Gynecology, Pediatrics, Orthopedics etc. Gold Standard POC (Point of Care) devices are improving the quality of treatment options.

Special emphasis is being paid to maternal and child healthcare needs.

The rate of patient follow-ups has increased to fortnightly check-ups. The MIS and e-Clinic system are used to maintain and monitor records. The Single-ID e-Clinic system allows both online and offline registrations for convenience. An ICT platform is being used to store patient records that date back 5 years. The data currently being recorded will be available for perusal for a decade.

These upgrades have improved community awareness about healthcare concerns, needs and services. Palpable community mobilisation has been observed.  The project serves a population of 31,000 people in the Aspirational District of Dahod and 56,000 people in Panchmahal. Over 1,800 physical and diagnostic tests have been conducted in this time. Covid-19 screening and safety practices have improved as a result of this project. Awareness camps have been organised to educate people about issues like anaemia, liver problems and lipid screening.

A partner agency was appointed to monitor project performance. Similar mobile units can be deployed in other villages across the state and in any state where rural/ remote populations are in need of greater medical interventions.  The doorstep delivery of primary healthcare services has transformed the living standards of community residents. Patient outreach has improved tremendously. The project has helped raise the bar for inclusive healthcare services in tribal and underserved areas.

For more information, please contact:
Mr Roopwant Singh, IAS, Commissioner of Geology and Mining at commissioner-cgm@gujarat.gov.in

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