The Afzalpur project: Micro-volunteering by doctors

The Afzalpur Taluk hospital has no appointed Gynaecologist or Paediatrician. Travelling to the nearest town of Gulbarga is possible for some pregnant women despite the bad roads and 60 km distance to be covered in a crowded bus during pregnancy. Other women, who cannot afford the travel, resign themselves to fate. The locals do not find it odd since it has been this way since the last 15 years. Maybe longer…

When the DFS team first decided to pick Afzalpur Taluk of Gulbarga to try the concept of micro volunteering through doctors, we did not fully realise what we were attempting to change.

“Why Afzalpur of all places? When the government, despite offering Rs.70,000 a month has failed to bring in specialists, how can you even imagine that you will get the same doctors to volunteer in a place like Afzalpur?”

Need assessment in Gulbarga by DFS volunteers (Nov 2011)

These questions have been asked many times since we first decided to start work in Afzalpur Taluk of Gulbarga district. Our rather simple answer of “Afzalpur has zero specialist doctors and hence is one of the neediest places which can benefit by doctors volunteering regularly” didn’t seem to impress many who saw it as an idea that would never succeed. Terrible connecting roads, lack of motivation among doctors to volunteer, several failed attempts by the government and the fact that this is a never-before-tried idea, were challenges assumed by many.

The concept of micro-volunteering by a team of local doctors reduces the burden on any one doctor, and yet ensures that people have regular access to a doctor. By roping in 15 specialists (gynaecologists and paediatricians) to take turns, with each doctor volunteering only once a month, we found a solution to an age old problem of finding specialists to work in remote locations. We realised that attending to simple issues like having a local coordinator as the link between the patients and changing doctors, providing transportation & basic hospitality for the volunteering doctors and by facilitating communication between private practitioners and the government hospital staff, most problems get resolved. Using the existing 100 bedded Taluk hospital premises was another reason why we were able to initiate the process so quickly and with relative ease as compared to having our own set up. The main idea that the volunteering doctors will be from the nearest town of Gulbarga (and not Bangalore just because we have a team here) has been the key to ensuring continuity of the process and ownership by locals.

It is interesting to note that there are so many genuine doctors in Gulbarga who wish to do their bit (and we are certain it’s the same in most other small towns as well). Providing them a platform was all it took to get them to volunteer. When Dr. Vipul Shah & Dr. Ravi More, both Paediatricians, offered to get their own vehicles to Afzalpur to reduce our costs; when Dr. Greeshma, a Gynecologist, despite having a young child makes it a point to visit Afzalpur during her turn each month; when Dr. Rasalkar and Dr. Desai, who are over 65 years of age do not complain about the terrible roads to Afzalpur; when Dr. Milind, a Pediatircian, humbly says his job is done even if it is just one child who he helped during his visit to Afzalpur; we know that we’ve got a team of sincere and dedicated people who are more than just certified medical practitioners.

Dr. Rasalkar with Dr. Dayaprasad and coordinator Latha (Apr 2012)

Without any publicity, the number of patients visiting the Taluk Hospital in Afzalpur has steadily increased in 3 months from just around 5 to 74 patients in July on a single day. With the consistency of volunteering doctors, the government too has been very supportive in offering to take care of the transportation, hospitality of volunteering doctors and providing any additional medicines or equipment as requested by the DFS members.

Yes, there have been challenges, be it in getting the two medical colleges to volunteer; in finding local coordinators; in finding private practitioners willing to close their clinic one day in a month; in ensuring enough patients turn up to keep the motivation going; and in starting from scratch in a completely new place. However, with strong belief in the concept of volunteering and the spirit of never giving up, we have so far managed to address challenges that have come our way.

8 months since our first visit to Gulbarga in November 2011 and 3 months since April 2012 when we started bringing 20 specialists to volunteer in Afzalpur, benefitting 297 patients, we are glad we took up this initiative despite all odds.