Sevak: Of the Village, By the Village, For the Village

Sevak: Of the Village, By the Village, For the Village

September 24, 2015 | Author: Nairuti Shastry, a rising junior at the College of William & Mary pursuing a B.A. in Sociology, French & Francophone Studies, and Public Health.

Sevak. What does this mean? A volunteer? A faithful servant? A devotee? To Dr. Thakor G. Patel, Chairman of the Sevak Project, sevak means solution. A solution to India’s lack of access to proper health care. A solution to India’s leading cause of death: chronic disease.

The Problem

Among the 1.3 billion people currently living in India, 700 million live in rural villages. Among these 700 million individuals, obesity and cardiovascular disease are first among the top 10 causes of death. India is undergoing an epidemiological transition: no longer are infectious diseases the leading causes of death. Instead, according to the World Health Organization, chronic disease is on the rise, killing over 12 million people in the country each year. Studies conducted by Dr. Patel in the state of Tamil Nadu and Gujarat show marginalized access to health care in rural areas. If individuals in rural, resource-poor areas are not educated about this trend and are unable to access basic health care, the death toll will only rise. “If they [the villagers] get sick from these diseases or get complications such as strokes, heart attacks, kidney disease, or diabetes, they will lose their work and their salary. They’ll go from poverty to hell in no time,” Patel warns.

The Model: “Jack of All Trades, Master of None”

The Sevak Project is modelled after the the US Navy’s Independent Duty Corpsman, or IDC. The IDC position was created in 1944 when the Navy believed there was a need to have medical personnel where a medical officer or facility was not available (i.e. submarines, cruisers, destroyers). Sevaks in India function as IDCs for rural villages where a clinic or a hospital is not readily available. Like IDCs, Sevaks in India are trained (during a two-month training program) to provide basic medical care, from taking a patient’s blood pressure to informing them about good hygiene practices.

A Complementary Solution

Sevak, or the sanitation and health education in village communities through improved awareness and knowledge of prevention/management of diseases and health promotion project, is a non-governmental organization dedicated to improving access to health care in rural India. By functioning within the existing health care system in the state of Gujarat, Sevak reflects Gandhi’s philosophy of self-sustainability.

Here’s how it works: one person from each village is chosen as the “sevak” to be the point of contact for all villagers’ health care. The sevak must live in that village, have at least a high school education, and be able to read English. Local medical school staff collaborate with Dr. Patel to train sevaks in sanitation, water purification, prevention of diarrheal diseases, infectious diseases, chronic medical conditions, and lifestyle modification. During this training, they also learn to measure blood pressure and blood sugar. This two-month training prepares sevaks to conduct house visits, screening individuals in the village for prehypertension, hypertension, prediabetes, and diabetes. Those individuals with one or more of these ailments are provided lifestyle modification education (i.e. yoga, pranayam, and a low salt/high fiber/low carbohydrate/low fat diet) and, in special cases, are referred to a doctor in a city hospital. Each state is divided into zones; each zone has a regional coordinator who oversees the sevaks, visiting the villages once a month to provide logistics support (i.e.  survey forms, stylets, strips, repair needs) and collect data (i.e. education level and medical history of villagers, access to drinking water, energy source for cooking, access to toilets) from survey forms. Dr. Patel then uses this information to to evaluate programs in the village and create new, innovative solutions to health problems in the area, such as toilets, clean drinking water, and energy efficient stoves for cooking.

Looking Forward

Though most of Sevak’s projects are funded by individual or family donors, the development of new, more efficient, and sustainable solutions is driven by larger actors like the American Association of Physicians of Indian Origin (AAPI), Johnson & Johnson, Inc., Pfizer, Inc., the American Heart Association, the IIT Alumni Association, and Prime Minister Narendra Modi. With a recent donation, Dr. Patel had a bed made for a female patient in Dharoi who was unable to walk. The frame on the bed was custom-made so she was able to pull herself up, allowing her to be less dependent on family and friends. The WHEELS Global Foundation and Habitat for Humanity India also partnered with Sevak to build toilets all over the village of Agiya. The women and elderly in the village were ecstatic about finally having a toilet in or near their home! Since Sevak’s founding in 2010, Dr. Patel has collected data on 35,000 people in rural India, doubled the number of toilets in rural villages in the state of Gujarat, and increased awareness about chronic disease in India. Furthermore, the Sevak model has been successfully implemented in six villages in the country of Guyana in South America.  In the end, Dr. Patel hopes to achieve equitable, locally-driven, and sustainable healthcare in developing countries around the world, a health care that is truly of the village, by the village, and for the village.
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