Karimadom Colony – interesting survey by Community Medicine Department of GHMC Trivandrum

KarimadomKarimadom Colony –  interesting survey by Community Medicine Department of GHMC Trivandrum

Dr Nived Vasudevan Nair

A real inspiration to all medical students – evoked great impact and wide discussion among the political organisations and medias.

The results of the survey while throwing light on a few areas of concern also bring out a few potential avenues for intervention, especially as Karimadom is at the threshold of a major change.

Karimadom Colony, thereby, is one such place near to Govt. Homoeopathic Medical College. Trivandrum. Kerala ,where, economically, socially, culturally, educationally and nutritionally backward population reside and that was the main reason for The Department of Community Medicine, to conduct a baseline survey collecting the demographical, epidemiological, nutritional, occupational, social and environmental status including the health and family conditions of the people in Karimadom Colony.

The Survey was a cross sectional descriptive type. The work commenced on 18th October 2011 and the project report was submitted on 18th October 2012.

A proforma/questionnaire was prepared on the basis of various discussions which were headed by The Head of the Department, Department of Community Medicine,who was the Principal Investigator of the Survey. It was made,taking into consideration of the questionnaires prepared in various colleges and departments in and out of Kerala.

A sum total of 449 families of Karimadom Colony were questioned and data was collected by a team of 20 small groups, each groups headed either by a House Surgeon or by a Post Graduate Scholar. Each team collected datas regarding the total demography, socio-economic status, educational status, health status highlighting maternal and child health including vaccination, hygiene practices and nutritional status. The team collected suggestions of the inhabitants of the Colony.

The array of pipes supplying water for domestic purposes passes adjacent to the sewers, increasing the risk of contamination of drinking water. The poor system of drainage in the Colony causes overflooding of the sewage creating health hazards especially during rainfall. Immediate measures need to be taken for the preservation and uninterrupted supply of water; and proper irrigation of the drainage.

Addiction is another major problem in the Colony. 36.6% of the males were having some form of addiction.

A small step taken towards the reformation of a community is a giant initiative taken for improving life and health in a larger society for which, every citizen must actively participate and contribute as and when required.

OBJECTIVES

The specific objectives of the survey included the following targets:

  • to collect data on total demography of Karimadom Colony,
  • to analyze the environment, sanitation and housing facilities in Karimadom Colony,
  • to assess the socio economic and cultural variables like educational qualification, economic status and occupational status of the people living in Karimadom Colony,
  • to assess the population nutritional status in Karimadom Colony,
  • to assess infant and young child feeding and care practices, including exclusivebreastfeeding and weaning practices/complementary feeding rate in Karimadom Colony,
  • to collect data on food intake and food security in Karimadom Colony ,
  • to assess the disease prevalence and to study the health status in relation to morbidity and mortality rates among the people living in Karimadom Colony,
  • to assess the maternal health, antenatal natal and postnatal care among the women of Karimadom Colony,
  • to assess the rate of addictions in males of Karimadom Colony.

Summary and conclusion

The Survey report can be concluded as follows:

  • the Survey covered 449 families and 1910 population;
  • sex ratio is 1127, in favor of women;
  • dependency ratio is 599:1311 (dependent age group:economically productive age group), which is in favor of dependent age group;
  • annual growth rate is 3.1;
  • general fertility rate is 56and general marital fertility rate is 73.3;
  • population density is 197 per acre;
  • 100 houses have no separate rooms and 219 houses have only one room showing the overcrowding of the Colony;
  • 81 houses have no electricity;
  • inadequate ventilation is seen in 323 houses and inadequate lighting in 306 houses;
  • 387 families used to dump the refusal, which might be the major cause of epidemic fevers;
  • 2 families are still preferring open air latrines, another major cause for spread of several diseases;
  • literacy rate is 88.5 percent, whichis below the state average;
  • 231 persons in the economically productive age group have no job;
  • 395 housewives are there, having no economically productive jobs;
  • 286 families are below poverty line;
  • life style disorders, carcinomas, TB and epidemic fevers are the major health problems facing;
  • 110 persons have the three life style disorders, viz. diabetes, hypertension and dyslipidemia;
  • 12 Carcinoma,31 TB, 3 Leprosy, 8 Filariasis and 6 Polio cases were reported;
  • 8 persons with any type of psychiatric illness were reported, for whom medical and social support is in need;
  • out of 138 deliveries 4 were conducted by nursing staff only and another 2 were conducted in house itself;
  • out of 189 eligible couples, 174 have knowledge about contraceptives and 110 were using orfollowing any type of contraception;
  • out of 89 infants (below 2 years of age) 6 didn’t get breast feeding and 26 discontinued completely before 6 months;
  • 45 infants had not taken vitamin A supplementation;
  • 31.5 percent infants were partially immunized;
  • out of 194 under 5 age group children, 78 children were affected by acute respiratory infections and 68 were affected with diarrhoeal diseases in last 2 weeks preceding the Survey; 47 were affected with measles any time in the past and 3 children have polio;
  • 5 children have primary TB and one child is affected with spastic quadriparesis who is crying all the time;
  • 32 elder persons were living alone, out of which 2 have no source of income;
  • 44 people out of 122 elders are still engaged in hard labour for their daily bread;
  • only 3.13 percent of the total population were getting recommended daily energy intake;
  • Out of 898 males 329 have any type of addictions.

Recommendations

The results of the survey while throwing light on a few areas of concern also bring out a few potential avenues for intervention, especially as Karimadom is at the threshold of a major change.

  • Waste disposal is a major problem facing the Colony. Proper management in the disposal of waste is necessary. Usage of waste material for agricultural purposes by Bangalore Method or Hot Fermentation Method may be considered.
  • Reconstruction of the drainage system should be considered immediately. It may reduce the floods during the rainy season and there by the epidemics may be controlled. The sewage pond should be cleaned urgently. And the cleaning should be done atleast once in a year.
  • The public water taps near the drainage should be removed. More taps should be made available, and whose surrounding should be maintained clean.
  • A hospital is necessary within or near the Colony. Adequate staffs should be maintained. Health education programmes may be conducted through this hospital facility. These health education programmes should highlight maternal health, child care and other general health, hygiene and sanitation topics which are necessary for preventing diseases. De-addiction facilities should be present in the hospital. Proper counseling arrangements should be present. Counseling can be given for teenagers, girls, pregnant ladies, addicts, elders and those who are in need. A Special OP or ward should work for Pain and Palliative Care. For this co-operation from other Non Governmental Organizations can be made.
  • Proper housing facilities should be made available and overcrowding may be reduced.
  • Roads should be built within the Colony.
  • Proper rehabilitation of elders, especially those who were living alone, should be made.
  • Special care should be given for the mentally challenged persons. Rehabilitation programmes may be made possible on need.
  • Small scale industries may be started, through which jobs may be given for those jobless in the economically productive age group.
  • Those economically non-productive housewives may be utilized by starting small economically productive household jobs by creating co-operative groups or societies within themselves. These societies may be under their own control and government should be financially aided.
  • The women in the Colony can be trained in tailoring, honeybee rearing etc. like jobs and can be developed into self employable workers.
  • The existing small businesses in the Colony may be developed by proper financial aid.
  • Interestless financial aid should be given for starting all new business enterprises.
  • A well planned economic survey should be done through which proper APL-BPL classification may be done. Proper rationing can be done after this survey.
  • Through talent search programmes talented children may be found out early and can be given proper training and support. Scholarships can also be given for such children. With the support of Non Governmental Organisations, note books and other study materials can be distributed to all school going children.
  • A police-aid post may be created within the Colony itself, through which substance abuse and violence can be reduced.

However, slum communities provide the core of a thriving service economy and act as informal recycling centers, working towards long term perhaps sustainable urban growth. Available statistics, tell a somber story of poverty and underdevelopment in the slum. To date, not only has urban planning mostly been focused on metropolitan areas, but the plans that have been developed have not been fully implemented due to under investment in infra structure and utilities and underlying deficiencies in land tenure and rule of law. While the main land of the city has recently seen considerable investment, its size, high growth rate and historical lack of planning still constitute major challenges. Lack of financial resources and lack of political commitment are other two of the main causes for problems commonly encountered in this area.

These neighbourhoods are made even more vulnerable by overcrowded living conditions, the lack of adequate infrastructure and services including water, sanitation, drainage, solid waste collection and unsafe housing, inadequate nutrition and poor health. When a disaster hits impact can include the loss of these basic services, damage or destruction to one’s home, reduction or loss of livelihoods and the rapid spread of malnutrition and water and vector borne-diseases like malaria.Hence before taking any kind of action from the planning point of view,it is necessary to improve the environmental conditions of this settlement.

In complex confluence of environmental values and essential human rights,the ubiquitous urban space of slums becomes the most visible point of the hostile encounter.Though essential to the daily functioning of cities,socially constructed barriers of land use and political manipulation deprive slum dwellers of essential access to safe shelter,protected water supply and sanitation and ultimately make them invisible to the affluent.

“The city still needs the poor; it needs their labour, enterprise and ingenuity. The vegetable vendor, the rickshaw driver, the cook can’t be banished forever. If the urban centre is deprived of their presence, the centre itself will have to shift”

Read the full report

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