The Dangoria charitable Trust is grateful to the following for their varied contributions.
Several donors, who have contributed in cash or kind, particularly Concern India, and C C Modi Trust, Hyderabad, for financial assistance.
Department of Biotechnology, (DBT), Government of India, and National Institute of Public Cooperation and Chid Development (NIPCCID), Regional Centre, Bangaluru, for supporting research and development projects mentioned in the report.
The Aurobindo Institute of Rural Development, Gaddepalli, Nalgonda District, for advice and help in organic farming and helping with training programmes.
Horticulture department, Medak district, for selling seeds at subsidised rate to the farmers.
To the Freedom Foundation, Hyderabad for running the AIDS detection and counselling clinics, for pregnant women and treatment of HIV affected women. .
Dr. Janardhan Rao, for doing scanning of pregnant women. Dr. Shankar Dev (anaesthetist) for professional help during clinic days at Narsapur.
The Hon. Consultants mentioned on page 6 for advice and help.
Dangoria Hospital, Hyderabad for medical and material support. Geet Medical shop for facilitating supply of drugs.
The doctors at the Tapadia diagnostic clinic and Eashwar Lakshmi Hospital, Hyderabad, and Dr. M. Ravi for treatment of the residents of the Home for the aged at minimal or no charge.
Philippe Henneau (Servernet.com) for giving free website hosting space and Rajendra Tapadia (Genesis Insoft Limited) for managing the web site at no cost.
R.K. Bang and Co. Chartered accountant for auditing the accounts of the trust and for advice and Mr. M. Patti, Chartered account for auditing the project accounts.
Director F&VP, Ministry of Food processing industry, Chennai, and District food licensing authority, Sangareddy for issuing licenses for food products.
Raj Flavours, Hyderabad, and Deepa S.Kumar for interest and help in the food processing centre.
Residents of Home for the Aged- Bhaskar Rao for helping with the maintenance of home accounts, and Renuka Mudaliar and K Ansuya for helping with kitchen supervision.
Devyani Dangoria, MBBS, DGO, DRCOG (Lond.) Managing Trustee and
Rukmini, Pratiba, Chandrakala Cooks- Home for the aged
Rani, Yadamma, Narsamma, Sujata , Susheela Helpers-Home for the aged
Shiviah, Narasimlu Gardeners
Lata . Raju, Shobha Dhobi
Agriculture and Horticulture
Prof. G. Satyanarayana, Professor (Retd.) APAU, Hyderabad, Sri Aurobindo Institute of Rural Development, Gaddepalli, Nalgonda, AP.
Prof. V.L.K Prasad, Professor and head, Retd. Department of livestock production and management, College of veterinary science, ANGRAU, Hyderabad
Dr.S.T. Viroji Rao, Principal Scientist & Head, AICRP on Poultry Breeding, Rajendranagar, Hyderabad-30
Sri Narsimha Reddy, Training associate, Krishi Vignan Kendra, Sri Aurobindo Institute, Gaddepalli, Nalgonda, A.P.
Food Processing/ equipping the food processing centre, quality control and food analysis:
Dr. V. Prakash, Director, CFTRI, Mysore.
Dr. NG Malleshi, Dr. P. Vijayanand, Dr. K. Venkatesh Murthy, Dr. Sheila Bhattacharya and other staff of the Fruit and vegetables division, Grain science technology, Analytical quality control laboratory, and Food engineering division, CFTRI, Mysore.
Sri Surendra Sood, Consultant, Food technologist, Hyderabad
Director and staff, National Institute of Nutrition (NIN), Hyderabad,
Dr. Sandro Pampallona (biostatistician), Dr. Paola Bollini ( Physician,Social medicine) Consultants, Switzerland
Adolescent Girls’ Health and nutrition- NIPCCID supported project on KAP Adolescence girls: scope for educational and vocational interventions.
Dr. Sundari Krishna, Retd. Professor of Obstetrics and gynaecology, AP; Dr. MS Tara (Regional Director), Drs. Jyothi , and Aparna, NIPCCID, Bangaluru
Since 32 years Dangoria Charitable Trust has been serving the rural community in and around the village Narsapur, Medak district in pursuit of its goal of reaching out to the unreached. In the area of health care delivery, caring for the elderly and empowering the community through Science and Technology.
The major achievements are: 1. A 20 bedded hospital for women and children, mostly catering to obstetrics and gynaecology, 2. A home for elderly and destitute, and 3. Out- reach programme in the surrounding villages to evolve models for improving health, nutrition, environment and livelihood security. The last includes a Food processing and training centre, run by a society ` Mahila Udyog’, which operates under the guidance of DCT. 4. Tailoring and embroidery classes.
While activities like the Home for the aged and hospital run on donations (mentioned under acknowledgements), and patient fees (heavily subsidised), the science and technology –based extension activities in the villages are supported by Government grant giving agencies. The voluntary service given by the honorary staff and consultants mentioned in the report contributes substantially to sustain the activities.
HOSPITAL BASED ACTIVITIES
Reproductive Health and Child Health
On every Tuesday and Friday a medical team consisting of doctors, from the Dangoria Hospital for women, Hyderabad, and a technician visit the Narsapur hospital to conduct the out- patient antenatal clinic and obstetric/gynaec surgeries. On Tuesdays, a paediatrician also accompanies the medical team. From April 2010, to March 2011, 1203 deliveries, (including 309 caesarean sections), 103 Tubectomies, 11 PNS, 6 vaginal hysterectomies, 1 MTP, 1 Abdominal hysterectomy, were done. Total of 2183 new cases were recorded. Immunisations are done on every first Tuesday of the month during the paediatric clinic.
DCT runs an ambulance service to take patients to the city hospital(s).
hiv Screening of pregnant women
A team of technicians from the Freedom Foundation, Hyderabad, a voluntary agency, screens all pregnant women attending the antenatal clinics run by the Dangoria Charitable Trust for HIV/AIDS infection. The infected women are treated free of cost to prevent mother to child transmission of infections. During the reporting period April 2010 to March 2011, 2183 antenatal cases were tested for HIV infection and 9 cases (0.41%) were found to be positive.
ANALYSIS OF HOSPITAL DATA OF THE PAST 30 YEARS
DCT hospital in Narsapur was set-up with an objective of bringing professional obstetric gynaecological care to a rural community at an affordable price, to reduce perinatal and maternal mortality, which is otherwise very high in rural India. Analysis of hospital data of over 30 years, shows a steep increase in deliveries since 1998, and significant reduction in the incidence of perinatal mortality ( discharged alive). There was no reduction in the incidence of low birth-weight over time ( about 23%). It was significantly higher in the primepara ( about 30%) than in parity above 1 (about 15 %). The percentage of deliveries done by caesarean section under medical indication, increased from < 10% in the initial years to about 20%.
TARALAKSHMI HOME FOR THE AGED
DCT is running a home for the aged since 1994, to cater to the needs of elderly women and men. Currently 36 elderly reside in the home. In the absence of a dedicated manager, the home is managed by the residents by sharing responsibility of kitchen supervision and maintenance of accounts, with supervision from the managing trustee- Dr. Devyani Dangoria and help from the staff.
Women, Health and Nutrition Entrepreneurs and Mobilisers (HNEM), and Dai training.
This project began in 1998 and is operating in five villages. The Health and Nutrition Entrepreneurs and Mobilisers ( HNEMs) function as human resource in the village. They advise the community on preventive health care and nutrition, ensure antenatal check up, immunisation, identify at –risk cases of pregnancy and motivate for institutional delivery and family planning. They also treat minor ailments for which the community pays them. Records maintained till the year 2008-2009, showed remarkable increase in institutional deliveries, reduction in peri-natal, neonatal and infant mortality, and incidence of low birth weight.
INTEGRATED CROP LIVESTOCK FARMING SYSTEM FOR FOOD, NUTRITION, ENVIRONMENT AND LIVELIHOOD SECURITY
The above project running in 15 villages of 4 `mandals’ addresses the dual problem of micronutrient (vitamins and minerals) deficiency in Indian diets and environmentally harmful, water and chemicals- intensive agriculture practices. The components include: 1) crop diversification from paddy and sugar cane to nutritionally promotive horticulture; 2) promotion of organic fertilisers like ermin compost and botanical pesticides ( neem kernel decoction, chilli-garlic decoction, etc); 3) soil testing; 4) fodder cultivation; 5) cultivation of ragi ( finger millet), 6) Micro-irrigation, mostly micro-drip to conserve water and 7). Promotion of backyard poultry.
There was a remarkable improvement in knowledge and use of organic methods of farming. (Annual report 2009-10). Consumption of Green leafy vegetables increased significantly. Families who had participated in the programme were shielded against price rise in vegetables over a three year period. Thus, while vegetable consumption went down significantly in the non-participating families (control group), the stake holders (Experimental group) did not show similar decline. (Table 1). (Sight and Life in press).
Table 1 Food consumption: Weekly frequency and quantity consumed per capita per day.
Number of respondents
52.3 ± 21.7a
37.1 ± 10.34b
36.0 ± 20.08c
51.6 ± 24.3a
57.1 ± 24.4ab
20.4 ± 13.03
19.0 ± 8.62
17.9 ± 5.52
95.8 ± 138.68c
71.3 ± 46.75a
47.7 ± 18.78b
number / capita/day
0.41 ± 1.16b
0.3 ± 0.079b
18.49 ± 8.745a
poultry, went up almost three times.
Acceptance of back-yard poultry using high egg yielding birds was good and preliminary data suggest that egg consumption in households that accepted
Nine farmers purchased Murrah buffalo calves to introduce high milk yielding stock. One animal died. Three have calved, and 3 are pregnant.
mahila udyog-food processing CUM TRAINING centre
This is an ongoing activity run by Mahila Udyog Society formed for the purpose of training, production and marketing of processed foods. Objectives are: to prevent wastage of farm produce, generate employment, and improve nutrition security. A variety of 30 products – many nutritious, are being produced and marketed through institutions, shops, exhibitions and outpatient clinic of DCT hospital Narsapur (Table 2). During this year a new product, ragi biscuits was added. Acceptance is very good.
While government institutions like the Centre for Cellular and Molecular Biology (CCMB) and Indian Institute of Chemical Technology (IICT) buy `sambhar’ / `rasam’ powders for their canteens; NGOs like LV Prasad Eye institute, Reddy Foundation and Institute of Rural Health Studies, purchase nutritious foods like the cereal –pulse mix, Poshana and ragi malt for feeding poor children.
KNOWLEDGE, ATTITUDE AND PRACTICE (KAP) OF ADOLESCENT GIRLS ON HEALTH, NUTRITION, ENVIRONMENT AND SOCIAL ISSUES IN SELECTED VILLAGES OF MEDAK DISTRICT –Scope for educational and vocational interventions
This Project, supported by the National Institute of Public co-operation and Child Development (NIPCCD), Regional Centre, Bangaluru: was started in May, 2010. It is running in five villages-PC Kunta, Reddipally, Narayanpur, Avanch and Ramchandrapur of Narsapur Mandal of Medak District covering 7000 population. The objectives are:.
To develop educational and vocational intervention strategies to improve the situation.
Project activities and findings
KAP survey on adolescent girls
An initial knowledge, attitude and practice (KAP) survey was done on 240 adolescent girls ( aged 10-18).
Findings are given below
Only 4 girls aged 13, and 10 from village Avancha and 16 and 15 form the village Narayanpur were illiterate. The mean years of schooling being 7.82 ± 1.99.
More than 80% girls were in school and 94% were not married
Illiteracy among parents was high- 63% mothers, 43% fathers. Thus the generation shift in education is very encouraging.
It is a basically farming community with 87% girls from farming households. Only 17 families were landless (7.1%). The rest had own or leased land, mostly small and marginal.
Though most families had own brick and mud houses, only 33% had a latrine which was in use. Low use of latrines is an area of concern.
Access to safe drinking water was good, with 70% households getting piped water through deep bore wells and some even getting mineral water from village- level reverse osmosis plants –Sujala
Facilities for waste disposal were poor. Though most girls felt that their own home surrounding was clean, 21% felt that the village was not clean. About half said it was average.
Understanding of adolescence/ gender issues
There was good understanding of age at menarche, physical changes (not the details) during adolescence, need for more food during adolescence etc.
There was almost total rejection of the idea that boys should be given preference over girls, and the dowry system. They felt that both the parents participate in decision making
Though most girls felt that the parents did not discriminate between male and female siblings, gender roles giving greater freedom and leisure time to boys were acknowledged during focus group discussions.
Most girls (87%) said that breast feeding should be started within first hour or the same day. More than 80% said weaning food should be introduced between 6-9 months. Almost 63% knew what pre-lacteal foods were and said they should not be given. Thus overall understanding of breast feeding, and complementary feeding was good.
Though most girls knew that more food is needed during adolescence and pregnancy, knowledge of nutrition like balanced diet, functions of food and nutrients, nutrition deficiency diseases etc was vague.
Data on consumption of protective foods showed the following
Roti ( wheat, maize or jowar) was consumed by most families 1-3 times a week, Rice was consumed daily.
Foods like dal, vegetables, including GLV, were consumed 2-3 times a week, but the quantity consumed was very low Fruit consumption was mostly once or twice a week.
Milk was consumed daily, mostly in tea in small quantity
The frequency of egg consumption was once or twice and meat consumption only once a week in small quantity
Personal hygiene and knowledge of infectious diseases
All girls said they bathe daily even during menstruation, and use tooth paste etc.
Knowledge of causes of infectious diseases except cause of malaria was not good.
About 15% respondents had not matured
Almost 50% had regular periods and regular blood flow during periods. But a third complained of pain during periods.
Almost 50% girls said they used sanitary napkins- commercial or home made. The rest used washed cloth.
General understanding of the physiology of reproduction as revealed in focus group discussion and classes, was very poor even in higher classes.
Focus group discussions with elders and slide and sound shows
Eight meetings were held with the elders in the villages and social issues such as gender equity, age at marriage, dowry, etc were discussed. Issues related to . Village problems such as waste disposal, water, housing, electricity, hospital, school and road facilities were also discussed. Emphasis was on cleanliness of roads and waste disposal. Late evening slide shows were held in the villages.
Education and training: in the village
Periodic meetings are being held with groups of girls in the school or village. Topics like health including reproductive health, nutrition, environment, and social issues like gender equity, dowry marriage etc are discussed in an interactive manner. On 25/26 November 2010 resource persons, (Drs Jyothi –nutritionist and Aparna –psychologist) came from NIPCCID, Bangalore and participated in training in 2 villages.
Nursery raising and homestead gardens.
Training in raising home garden and nursery was given to girls. Two hundred and twenty eight girls were given saplings and seeds of nutritionally- rich varieties of vegetables for raising homestead gardens. Only 126 girls raised vegetables worth Rs 802± 460.86., out of which Rs 501.6±287.43 worth were consumed at home and the rest sold.
Forty girls from five villages were given seeds and sachets for raising the seedlings of plants like drumstick, papaya and creeper spinach (bachali) .
One hundred girls interested in raising backyard poultry (BYP) with high egg-yielding variety (Rajasree) were identified. Two farmers from two villages, willing to nurture day old chicks to the age of 3-4 months were identified and sheds established. These birds will be sold to the identified girls families. Day old chicks were brought from veterinary University, ,ANGRAU campus, Hyderabad. The families will purchase 4 female birds and one male bird will be given free as incentive. In addition 16 girls have started nurturing day old chicks in night shelters constructed by them.
Home gardens and BYP along with nutrition education helps to promote nutrition security
Centralised training programmes:
Tailoring and embroidery: 12 girls were trained in tailoring and embroidery for a period of 3 months (Nov 2010- Jan, 2011). Two girls have bought machines and started self-employment in their villages.
Food processing: 13 girls were given a 3-days training in food processing. Recipes such as; tomato- puree, sauce, pickle, ragi –malt, instant dosa, papad, burfi and biscuits, cereal pulse complementary food- Poshana, solar- dried GLV chutney powders, lime squash etc., were demonstrated. Nutrition education, GMP, HACCP, packaging etc formed part of the training. Some girls came for repeat training and clearing doubts. Lot of interest was evinced. Samples of processed foods were given.
Green methods of farming:: 55 girls were given one day training (on a school holiday) in preparation of vermin compost and botanical pesticides like chilli-garlic decoction, neem seed kernel decoction. . Resource person was Mr. Narsimha Reddy from KVK, Gaddepally of Nalgonda District. Hands on training is being continued at village level. So far 23 village- level training/demonstrations on preparation of botanical pesticides ( neem seed and chilli-garlic extracts) have been given. 27 girls have started making vermi compost either by the pit method or the surface method.
Back- yard poultry: 87 girls from five villages attended one day training programme on Back- yard poultry and its management. Prevention and control of various types of diseases and immunisation were explained.
Dr. S.T. Viroji Rao Principal Scientist, All India Coordinated Project on Poultry Breeding, Rajendranagar, Hyderabad was the Resource person.
Fuel efficient, smokeless rocket stove
Under the guidance and help from Dr. Sandro Pampallona and Paola Bollini, visiting scientist from Switzerland, DCT has started testing a fuel-efficient, smokeless stove for institutional cooking in ICDS centres. Few experiments, with one, locally fabricated prototype are very encouraging. Fuel wood use is about 1/3 of conventional cooking with three bricks stove, and there is no smoke at all. The stove costs only Rs1200/- and seems to be much cheaper than stoves advertised by other agencies in India. Systematic studies on this stove will be carried out. Being smokeless, cooking can be done indoors
.PIlutla Stree Mandal- Wicks making
This is an ongoing activity. Women of village Pilutla continue to make and market wicks under Pilutla Stree Mandal. The wicks are being sold in Hyderabad and have good market.
Tailoring and Embroidery Classes
Since few years, tailoring and embroidery classes for girls are being run in the premises of the home for the aged. Batches of 20-30 girls participate in these classes.
Women of one self-help group are making detergent powders and selling them in institutions.
Observational Study of rural schools: SUMMER PROJECT OF STUDENTS FROM USA
Deepak & Sneha Lingam USA, students from Freemont California USA, along with their mother Sudha did a short summer project in three schools of Narsapur mandal, in the month of July , 2010 to observe the environment and offer suggestions for improvement based on personal experience in U.S. schools. Their observations and conclusions are summarised in table 2 Table 3 Salient Observations of Working of Rural Schools
No kitchen or storeroom, insufficient funds for vegetables and very small garden, eggshells littered all over
Water leakage/overflow, low funds, but overall nice with sheds, storerooms, and garden and gate to prevent stealing
Low funds, but overall nice with sheds for cooking and a thriving garden and gate to prevent stealing
Main concerns-observed and/or expressed by students & teachers
Understaffing, primary teachers’ attitudes, notebooks (cost), uniforms (not every student can afford), attendance, insufficient number of classrooms
Overcrowding results in high student-teacher ratio (high school only), but overall understaffing is less of a problem & teachers, headmasters have good attitudes
Understaffing, parents’ attitudes (attendance), insufficient number of classrooms (but new block is being built)
.AWARDS AND RECOGNITION:
Dr. Mahtab S. Bamji received the 1st Dr. Rajammal Devdas oration award of the Nutrition Society of India (NSI) on November 19, 2010, during the NSI meeting in Mumabai. The title of her talk was: Striving for village level nutrition security: Challenges and opportunities
Dr. Mahtab.S.Bamji, was honoured by Society for Energy ,Environment & Development (SEED), Hyderabad on the occasion of The National Workshop on Solar Food Processing Technologies 11-12 February, 2011 at Hyderabad in recognition of her “yeoman efforts to empower the rural women to achieve rural prosperity and food and nutrition security by effectively harnessing and preserving local food and nutrition resources by employing cost- effective technologies based on solar and renewable sources of energy”
Dr. Devyani Dangoria was felicitated by Walker’s group, Hyderabad on International Mothers’ day on May 9 for her selfless motherly care and service to the society.
June 18, Department of Biotechnology, Task force meeting. Presented the final report on Crop livestock integrated farming.
February 11, 12. SEED work shop on solar food processing technologies. Resource person. Spoke on Importance of solar drying in food processing
Following visitors came to DCT Hospital for Women and Children,and Mahila Udyog food processing centre, at Narsapur, in connection with official activities of the Trust .
Drs Paula Bollini (a public health physician) and Sandro Pampallona (a biostatistician) from Switzerland. December, 10, 2010 to January 18, 2011.
Sudha, Sneha and Deepak Lingam, Freemont, California. July, 2010
April 17, 2010.Dr. P.V.V.Satyanarayana Reddy, Director of Extensiion, Sri Venkateswara Veterinary University, Tirupathi, A.P. and Dr. D. Krishna, Asst. Professor, Veterinary University, ANGRAU campus, Hyderabad.
May 9, 2010. Walker’s club, Hyderabad to felicitate Dr. Devyani Dangoria, Managing Trustee in connection with Mother’s day celebration.
August 13, 2010. M. Rajendra Prasad, Branch Manager, State Bank of Hyderabd, Narsapur.
August16, 2010. Dr. Padmaja Prasad, Nutrition Consultant, Hyderabad, and Sri Ravi Kumar, software engineer, Bangalore .
September 3, 2010. M.Sc .students from National Institute of Nutrition, Hyderabad.
September 15, 2010. Sri. G. Satyanrayana,& Sri. K. Govindaraju , NEDCAP AP. Hyderabad, Smt. Rama, Scientist
October18, 2010. Dr. Rama Nayak, Dean & Professor, College of Home Science, Dharward, Karnatak.
November 20, 2010. Sri. Balaji DM, I AS., .Asst. Collector, Medak A.P.& Dr. A. Narsimha Reddy, Tahsildar, Narsapur Mandal, Narsapur, Medak Dist. A.P.
November 26, 2010. Dr. Sundari Krishna, Retd Superintendent, Govt. Maternity Hospital, Kothi,
November 25-26, 2010. Dr. Jyothi, Nutritionist, and Ms. Aparna, Psychologist, National Institute of Public Co-operation and Child Development (NIPCCD), Regional Centre, Bangalore.
December12, 2010. Dr. N. Praneeth Raj, Veterinary Asst. Surgeon, Veterinary Dispensary, Kowdipally, Medak Dist. A.P.
February 28, 2011.Dr. Subhadra Seshadri, Professor (Retd) MS University, Vadodara.
March 3, 2011. T. Ramesh, Dy. Manager,& other staff, State Bank of Hyderabad, Narsapur