Download - Annual Report Karuna-Shechen 2013
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ANNUAL REPORT
2013
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CONTENTS
PAGE NUMBER
Main Achievements 4
Main Events and Activities 6
Introduction 7
Health
An Overview of Medical Activities 13
Access to Primary Healthcare in Urban Area: Shechen Medical
Centre in Bodhgaya, Bihar
18
Mobile Clinics 22
Medical Camps for the Poor and Needy
24
Health Education Program (HEP)
27
Malnutrition 29
Education
Strengthening Basic Education 34
Early Childcare and Development 35
Non-Formal Education (NFE) 36
Environment
Solar Electricity
37
Rainwater Harvesting 38
Bodhgaya Clean Environment, Hygiene and Sanitation Programme 39
Social
Small money, BIG CHANGE 41
Kitchen Garden
43
Vocational Training for Underprivileged Youth & Women 44
Networking with other Local NGOs
46
Other Important Informations
Finances 47
International Audit 48
External Visitors 48
Orientation on Programme Activities 48
Upcoming Activities 49
Our Partners 49
Annex-Success Story 50
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Message from Director
Greeting from Karuna-Shechen, India!
It is my privilege to present the Annual Report of Karuna-Shechen, India for the financial year 2013.
This year, Karuna-Shechen, India made some important contributions in holistic community
development efforts through the launching of new programmes like Kitchen Gardening,
Rainwater Harvesting, small money, BIG CHANGE, Vocational Training, Strengthening Basic
Education and Menstrual Health and Hygiene, and scaling-up of some existing ones- Non-
Formal Education and Solar Electricity. With the aim to increase and reach out to more
underprivileged people we expanded our geographical area of operation to 6 new villages in Gaya
district.
In 2013 our approach to development activities was entrenched in Community Participation, as
we believe it to be the key to Community Development and Empowerment. Therefore, we made
sure that we tap into the local needs, conditions and dynamics of a village through active
community involvement at each stage of all our outreach programmes, right from planning to
implementation to management. The focus of our work has been increasingly looking at the
importance of participatory approach for sustainable development.
Our main objective to use participatory approach has been our endeavour to restore the
community bonding and confidence that have weakened over the years due to several factors like,
outward migration and urbanisation. Besides, active participation of villagers in development
programmes will promote transparency in transactions as the community will have knowledge
about the exact amount of money invested by our organisation for the project and the amount
contributed by them in terms of labour and locally available raw materials.
With our new community-planned, community-managed programme, popularly known as ‘small
money, BIG CHANGE’ has been shown positive impact. It is important to mention that in Kadal
38% contribution came from the community. Total expenses INR 1,57,358 = USD 2623, where
community contributed INR 59,310 = USD 989.
For the past 13 years, Karuna-Shechen, India has been working with the underserved and
marginalised population of Gaya district adopting a holistic approach in responding to the specific
needs and aspirations of the communities. Now as we move ahead on the path of humanitarian
development, I would like to extend my sincere thanks and gratitude to Matthieu Ricard, the Board
President, the Board members, Management and the staff for transforming our vision and dreams
into reality. I would also like to express my gratitude to our donors (Shining Hope Foundation,
Foundation Chanel and many small donors for being a pillar of support in all our endeavours. We
look forward to accomplishing our goals with your continued support. I must appreciate all your
effort towards making a better life and society.
I do believe this year will bring more visible change and fulfil our dreams which will contribute
towards making our society better than yesterday. Let’s pray together we can make a BIG CHANGE
through our small effort. And will remain Humble.............
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MAIN ACHIEVEMENTS
Health
48,232 patients availed healthcare services provided by our Outreach Patients Department
(OPD), Mobile Clinic and Medical Camps.
Our outreach healthcare service was extended from 12 villages to 18 with the introduction
of a second Mobile Clinic.
4,714 medical tests were conducted at our Pathology laboratory.
Refresher training was given to our Doctors by Dr. Jaya Maitra from the Red Cross Society in
Jamshedpur, Jharkhand.
A DOT training was conducted for all staff members, especially our DOT providers at OPD
and the villages. Training on malnutrition was conducted in February for the entire staff as
a preparatory stage for our upcoming Malnutrition programme.
Our Menstrual Hygiene program commenced in June with the starting of distribution of cheap sanitary napkins to poor girls and women in our 18 adopted villages and Bodhgaya town. A total of 6679 sanitary pads were sold in 7 months (June-December). Appointment of Female Medical Officer to better serve the women and child patients.
Education Non-formal Education (NFE) was scaled-up from 6 villages to 16.
Currently 447 women are enrolled in the programme.
Support faculties have been recruited for primary schools in Dema and Gopalkhera in an effort to ameliorate the otherwise low teacher-student ratio. Parent-Teacher Associations (PTAs) have been formed in 5 schools and parent-teacher meetings are organised on a regular basis. We have started Yoga classes for school children in the villages.
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MAIN ACHIEVEMENTS
Environment
3 women have successfully completed their 6 month training in Solar Engineering from
Barefoot College in Rajasthan.
In 27 schools drawing and speech competitions were conducted in order to raise awareness
on environmental cleanliness, hygiene and sanitation.
32 households have installed rainwater harvesting system in their houses under the
Rainwater harvesting programme.
4 Rainwater Harvesting systems have been installed in 4 Schools (Chando, Barsuddi, Dema
and Gopalkhera)
Social
1000 households and 4 schools (Chando, Barsuddi, Dema and Gopalkhera) have been benefitted by
our Kitchen Gardening programme across 18 villages.
108 NFE students participated in vocational training workshops on candle and incense stick
making, snacks, phenyl and chalk. 7 women from amongst those learning candle-making
were sent to Jamshedpur, Jharkhand for a seven day advanced course.
36 students are taking free computer courses under our vocational training programme
targeted at the underprivileged youth.
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MAIN EVENTS AND ACTIVITIES
Health
Generic medicines were introduced in January 2013.
Identity Cards are issued to all Patientsat the OPD and Mobile Clinics in an effort to keep a track
of the medical history of the patients. 16,373 identity cards were issued this year.
On the basis of the training imparted during our training on Malnutrition our able staff members
conducted a baseline survey on children below 5 years of age in the 6 newly added villages in
order to know the nutritional status of these children.
Education
Bright and enthusiastic women from within the community have been recruited as faculty for the new NFE centres.
A temporary candle-making unit was opened within our office premises in Bodhgaya in October
with our NFE students who had gone to Jamshedpur for an advanced training in the vocation.
Now those working at the candle-making unit are now visiting all the NFE centres, providing
advanced training and guidance to the students.
A member of Iner’Lude, France has come down to Bodhgaya in December to give a 4-month
training, workers on child development through games and play the ground work for which has
started the same month Anganwadi.
Environment
Several meetings were held with stakeholders regarding our Bodhgaya Clean Environment,
Hygiene and Sanitation programme.
Household Survey was conducted in the villages where solar lights were installed in 2011 and in
the villages where it will be installed in 2014. The intensive survey formed a
feedback/evaluation of the progamme that has been running in the 3 villages and was also a
feasibility test for the new villages.
The Green Schools Programme (GSP) audit was conducted in all our operational villages.
Other Events and Activities
New staff members were recruited for various positions starting from medical officers and nurses to village motivators. A one-day Orientation was conducted for all the staff members. An international Audit for the financial year 2012-2013 successfully took place during the last
quarter of the year.
We had the honour of welcoming several external visitors including Matthieu Ricard, President
of Karuna-Shechen; Tarek Toubale, Chief Operating Officer of Karuna-Shechen; Anne Oliver,
Chief Financial Officer of Karuna-Shechen Sanjeev Pradhan, Director of Shechen Clinic, Nepal;
and Serge, Astrid and Marie Saint-Arnoult from Shining Hope Foundation.
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The year 2013 can be considered as a watershed for Karuna-Shechen, India as we launched several
new programmes, such as Kitchen Gardening, Rainwater Harvesting, small money, BIG
CHANGE, Strengthening Basic Education, Vocational Training and Menstrual Health and
Hygiene as well as added a fourth area of intervention, ‘Social’ to the existing three areas- Health,
Education, Environment. Besides, we scaled-up some existing project, like Non-Formal
Education and Solar Electricity. Continuing with our sincere effort towards holistic community
development we began the year with the expansion of our outreach services from 12 villages to 18.
These villages were selected primarily on the basis of their need for intervention in the areas of
health, education, environment and social factors.
This report, apart from providing the details of various events, programme activities and
achievements of Karuna-Shechen, India in the year 2013, will also give a comparative analysis of
the achievements in 2012 and 2013.
INTRODUCTION
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Table 1:Update on Programme Activities of 2013 and their Comparison with 2012
AREAS OF
INTERVENTION
INDICATORS
2012 2013 RESULTS/ACHIEVEMENT
S OF 2013
HEALTH
Healthcare Services
OPD/Medical Centre Number of
Consultants
17,953 20,535 There has been a 14.38%
increase in the number of
patientsvisiting our OPD,
showing a growing
satisfaction among the
patientsand a consequent
spread of word through
them.
DOT Total Number of
Sputum tests
conducted
303 465 53.47% increase in the
total number of Sputum
tests conducted compared
to 2012. It is testimony to
the rising confidence in the
Shechen Clinic and
increasing awareness about
Tuberculosis.
Number of People
diagnosed with TB
38
27
Pathology Laboratory Number of Patients
who came for
medical tests
722 1665 A 130.61% increase in the
number of people
approaching our pathology
laboratory for conducting
medical tests as compared
to 2012 clearly
demonstrates the immense
satisfaction and success of
our services.
Total Number of
Medical Tests
conducted
2179 4714 116.34% increase in the
total number of medical
examinations done
compared to 2012
Mobile Clinic Total Number of
Patients
16587 24550 48.01% increase in the
number of patientsat
mobile clinics primarily
due to extension of our
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outreach healthcare
services from 12 villages to
18.
Medical Camp Total Number of
Patients
2167 3147 45.22% increase in the
number of patientsat
medical camps for the poor
and needy including monks
Health Education
Programme (HEP)
Number of Health
Groups
87 87
Total Home visits by
Village Coordinators
(vc) and Motivators
(m)
4262(vc)
+ 9165
(m)
2502 (vc)
+ 8010
(m/0
There has been a slight
decline in the number of
home visits under HEP
programme.
Total Number of
Sanitary Napkins
distributed
----
6679
We have started a new
programme on menstrual
health and hygiene under
HEP where we are
providing sanitary napkins
to underserved women and
girls.
Percentage of
Pregnant Women
Followed-up by
Village Coordinators
and Motivators
27.06
57.78
An 30.72% rise in the
number of pregnant
women followed-up by
Village Coordinators and
Motivators in 2013.
Percentage of
Pregnant Women
having Institutional
Delivery
58.50
61.34
2.84% rise in institutional
delivery cases,
demonstrating a clearly
positive impact of our
health education
programme on the target
populations.
Percentage of Neo-
natal deaths
5.43
2.10
A 3.33% decline in the
number of neo-natal
deaths, a result of increased
awareness through HEP
among the rural
communities.
Percentage of new-
born children
immunized with BCG
73.77
59.23
A slight decline (14.54%)
compared to the 2012
figures.
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and 1st DPT
Total number of
children surveyed in
phases I and II of the
Baseline survey for
Malnutrition
programme
---
460
children
in Phase I
and 193
children
in Phase
II
A baseline study was
conducted for our
upcoming programme on
Malnutrition
EDUCATION
Non-Formal Education
(NFE)
Total number of
women enrolled in
NFE
180
447
NFE programme was
scaled-up from 6 villages to
16 villages (18 centres) in
2013
Total number of
villages where NFE
programme is
running
6
16
Strengthening Basic
Education
Total number of
schools where
Parent-Teacher
Association (PTA)
has been formed
---
5
Under our new programme,
Strengthening Basic
Education, we have formed
PTAs in 5 schools
Total number of
villages where Yoga
classes are held
----
9
Yoga classes have been
introduced in all schools
across our 18 villages to
better the physical and
mental health of the school
children.
ENVIRONMENT
Solar Electricity Total number of
villages where solar
lights have been
installed
0 0 This year we did not
provide solar lights to any
village although through
the year we prepared the
ground for such
installations early next year
like conducting feasibility
studies and sending women
to Barefoot college for
training in Solar
Engineering.
Total number of This year 4 rural, illiterate
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women who have
been successfully
trained as Solar
Engineers at the
Barefoot college,
Rajasthan
----
3
women were sent to
Barefoot college to learn
Solar Engineering. Apart
from one woman who had
to return to her family in
the middle of the course for
personal reasons, the rest
have successfully
completed the training.
Rainwater Harvesting Total number of
households where it
has been installed
----
32
We have started a new
programme, Rainwater
Harvesting, as an outreach
Environmental activity.
Total number of
households where it
is in the process of
being installed
----
277
Households that have
started constructing
platform for installing the
tank.
Total number of
schools where it has
been installed
----
4
Chando, Barsuddi, Dema
and Gopalkhera
Clean Environment,
Hygiene and Sanitation
in BodhGaya
Number of food
covers distributed
ordered by vendors
-----
30
Street vendors and snacks
shop-owners have placed
orders with us for covers
to protect food on display
from dust and germs.
Number of schools
where various intra-
school competitions
were organized as a
part of our
environmental
awareness campaign
------
27
We had organised drawing
and speech competitions in
27 schools in Bodhgaya and
our operational villages;
the purpose being
awareness generation
among the children
regarding environmental
cleanliness, hygiene and
sanitation.
Number of schools
where audit for the
Green Schools
Programme was
conducted
------
17
SOCIAL
Vocational Training Vocations taught to
NFE students
--- 6 Candles, incense-sticks, 2
types of snacks, phenyl and
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chalk
Total Number
participating in the
workshops
----
108
Total Number of
Students in Computer
training classes
---
36
As a vocational training for
the young underserved
populations we started free
computer training courses
in 2013.
Kitchen Garden Total number of
households to whom
fruit and vegetable
seeds/plantations
were distributed
---
1000
Total number of
schools where fruit
and vegetable
seeds/plantations
were distributed
----
4
Dema, Gopalkhera, Kadal
and Chando
small money, BIG
CHANGE
Number of villages
covered under the
programme
----
5
Kadal, Barsuddi, Chando,
Banai and Gopalkhera
Community
development projects
undertaken
--- Pond
digging,
reconstru
ction of a
well and
a check-
dam,
levelling
of
undulatin
g
agricultu
ral land
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AN OVERVIEW OF MEDICAL ACTIVITIES
OPD & MOBILE CLINICS
In the year 2013, the total number of Patientswho availed the healthcare services of our OPD
(Outreach Patients Department) Mobile Clinic and Medical Camps was 48,232. New patients(for
OPD and Mobile Clinics) constituted 19,073 people.
We can see from the graph that during the summer the number of patientshas been less
compared to the monsoons and winter due to the scorching heat.
From June to December the total number of patientsshow an upward trend. However,
during the festive season in November there is a a slight drop.
The number of patients referred to PHC & Government Hospitals was 204 (0.45% of total
patientsat OPD and Mobile Clinics).
The total patients who were treated “Free of Cost” (Pregnant women, children and aged people
above 60 years) in the OPD Clinic and by our Doctors were 26,098 ( 57.89% of total patientsat
OPD and Mobile Clinics).
HEALTH
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DOT
Out of 4,718 medical examinations conducted in our pathology laboratory 465 were Sputum tests
(for Tuberculosis). Out of these the number of people who were diagnosed with TB was 27.
Currently, the total number of TB patients undergoing treatment at the DOT centre within our OPD
and DOT services provided in the villages is 40.
Table 2: Details of DOT Program
Indicators Total
Total number of medical tests conducted In laboratory 4718
Total number of patients coming for medical tests 1665
Sputum Test(AFB) 465
Sputum Positive 27
Total number of TB patients who started medicine 57
Refer TB Patients 9
Completed TB Medicine 4
Total No. Of TB Patients are undergoing treatment 40
DOT Training
DOT Providers’ Training
A one-day DOT Providers’ Training was conducted in July for the motivators of the 6 newly added
villages as they are responsible for administering DOT services to TB patients within their
communities. The training also served as a refresher for our laboratory technicians and motivators
of the rest of the villages who act as DOT providers at our medical centre in Bodhgaya and in our 12
villages respectively.
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Meeting with TB Patients
Lab Technician and Director with the TB Patients who attended the Meeting
As tuberculosis leaves a person weakened and fragile, leading to loss of several days of work which,
in turn, hampers their socio-economic lives we realised that medical treatment and cure form just a
part of restoring them to normalcy. Therefore, we plan to invest the money collected as registration
fees from our OPD and Mobile health services, for the improvement of the livelihood opportunities
of our TB patients. To discuss this, a meeting was organised with those people who have recovered
completely from TB under our DOT treatment and those on their road to recovery. At the meeting
we discussed our plans with the TB patients, seeking their opinion and feedback.
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TYPES OF DISEASES OBSERVED AMONG PATIENTS IN OPD AND MOBILE CLINICS
The following table gives us information about the various types of diseases observed among the
patients in our OPD and Mobile clinics.
Table 3: Types of Diseases
Diseases Total
Diarrohoea/children 91
Diarrhoea / dysentery adults 1167
Amoebiasis 583
Typhoid 508
TB 705
Gynecological patients 2100
Bone & joints patients 7868
Burn patient 375
Worm manifestation 73
Skin diseases of all kinds 3482
Ophthalmologic infections 160
Malnourished children 2
Cardiac Inf. 74
HTN 2150
Diabetes 278
Asthma & COPD 1982
Cough & Cold 9017
Epilepsy 295
ENT patient 4125
Lymphadenopathy 67
I&D Dressing 416
Other Patients 8739
The table and graph show that the most common health problems observed among our OPD and
Mobile clinic patients were Cough and Cold, Bone and Joint pain, Skin diseases and ENT problem.
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Refresher Training for our Medical Officers
In February a Refresher Training was given to our Medical Officers by Dr. Jaya Maitra from the Red
Cross Society in Jamshedpur, Jharkhand.
Identity Cards for Medical Consultants
In order to maintain the patient history we started issuing Identity Cards to all medical
patientsvisiting our OPD in Bodhgaya and mobile clinics in the villages. A total of 16,373 identity
cards (8721 for OPD and 7652 for Mobile Clinics) were issued.
Appointment of New Staff
With the expansion of our outreach activities from 12 villages to 18 and the launch of several new
programmes Karuna-Shechen (India) expanded its team to incorporate new staff members,
including 2 female and 1 male doctor, 1 laboratory technician, 2 nurses, 1 pharmacist, 1 driver and
1 research and documentation officer; and village motivators for our 6 new villages, instructors for
our new NFE centres and 2 Computer teachers for our computer training courses. Besides, we have
hired 4 interns from the Department of Rural Development and Management of the Magadh
University to assist us in various programme activities.
Till 2012 only male doctors served the patients at OPD and mobile clinics but in February 2 female
medical officers were appointed to better serve the women and children who form majority of our
medical consultants. Unfortunately, both of them had to discontinue after a few months of service
due to personal reasons. However, in July we hired a sincere and dedicated female doctor.
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ACCESS TO PRIMARY HEALTHCARE IN URBAN AREA: SHECHEN MEDICAL
CENTRE IN BODHGAYA, BIHAR
The total number of people who came to the Medical centre in Bodhgaya for Consultations in 2013
was 20,535. Out of this total 9621 were new consultants, representing 46.85% of total
consultations in OPD.
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Table 5: Details of Patientsin OPD
From the table and graphs we see that the number of patientsat OPD show a decline in
the months of March through May compared to the January-February. This may be
primarily attributed to the scorching summers as majority of our consultants, both at
OPD and Mobile clinics, travel considerable distances (often on foot) from the
neighbouring villages to come for medical check-ups.
June onwards until December the number of patientsshow considerable increase,
except for November when there is a slight drop in the number of patientsas it is the
month of festivals.
Months Total
Consultants
New
Consultants
January 1360 872
February 1321 864
March 1153 674
April 1092 520
May 1085 674
June 1585 760
July 1851 858
August 1904 881
September 2218 907
October 2398 913
November 2002 788
December 2566 910
Total 20535 9621
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The above graphs demonstrate clearly that women and children constitute majority of patientsat
OPD (71% of the total patientsat OPD).
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Pathology Laboratory
Total number of patients who came in 2013 for different medical tests was 1665 and total analysis
done was 4718. The number of patients and tests are different because one patient may go for
several tests. Patients tested Free of Registration Charges was 195.
Table 6: Types of Medical Tests conducted in our Laboratory
From the above table and graph we see that the highest number of medical tests conducted are
TC/DC, ESR, Blood Sugar, HB% and Sputum Test.
Types of Medical Tests
Conducted
Total
Number of
Tests
TC/DC 862
ESR 732
HB% 537
Malaria 162
Uric Acid 126
Blood Sugar 530
Serum Blirubin 82
AFB (Sputum test) 465
ECG 51
Urine routine
examination
274
Urine culture sensitivity
test
126
Other Tests 771
Total 4718
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MOBILE CLINICS
Till January 2013 our outreach health services were provided to the rural population of our 12
operational villages through a mobile clinic that functioned 6 days a week. With the objective of
providing comprehensive healthcare to a larger number of the underserved communities we
expanded our services to 6 new villages from February 2013 by launching a second Mobile clinic.
In 2013 the number of patients who came for the consultations in mobile clinic from 18 village was
24,550, out of which 9452 (38.50% of total patientsat Mobile Clinics) were new patients
The total patients who were treated Free of Registration Charge (Pregnant women, children and
aged people above 60 years) in the Mobile Clinic was 17,375 (70.77% of the total patientsat
mobile clinics).
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Table 7: Patientsat Mobile Clinics
Months Total
Consultants
New
Consultants
January 632 237
February 1511 915
March 1381 659
April 1425 618
May 1360 659
June 1605 648
July 2572 1040
August 2311 853
September 3012 1068
October 2909 1018
November 2652 865
December 3180 872
Total 24550 9452
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Women and children constitute 74% of the total patientsat Mobile clinics, which is similar to the
trend in OPD where they form more than 70% of consultants.
MEDICAL CAMPS
With the objective of extending our healthcare services to the maximum number of underserved
people, every year we organise free medical camps for the poor and needy. In 2013 the medical
camps were organised in the months of January, February, November and December not only for
the underprivileged populations in and around Bodhgaya but also for the Buddhist monks at
Nyingima Monastery.
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Table 8: Number of Patients at Medical Camps
Of the 3147 patientsat the medical camps, 748 were registered at the camp
exclusively for Buddhist monks at Nyingima Monastery. The camp at Nyingima Monastery
had run for a greater number of days in the month of February compared to that in January,
hence the larger number of patientsregistered in that month.
Medical camps for the poor and needy registered the highest number of patientsin
December as 2 camps were organised that month, instead of the usual 1 camp per month
schedule that had been followed for January, February and November.
Months Total Number of
Patientsat Medical
Camps for Poor
and Needy
Total Number of
Patientsat Medical
Camp in Nyingima
Monastery
January 500 148
February 359 600
March 0
April 0
May 0
June 0
July 0
August 0
September 0
October 0
November 523
December 1017
Total 2399 748
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The following table and graph show the number of male, female and child patientsat the medical
camp for the poor and needy.
Table 9 : Men, Women and Children at Medical Camp for the Poor and Needy
Month Male Female Children Total
January 78 325 97 500
February 116 203 40 359
March 0 0 0 0
April 0 0 0 0
May 0 0 0 0
June 0 0 0 0
July 0 0 0 0
August 0 0 0 0
September 0 0 0 0
October 0 0 0 0
November 158 198 167 523
December 264 419 334 1017
Total 616 1145 638 2399
From the above table and graphs we see that, just like in OPD and Mobile Clinics, at medical camps
too women and children for majority of the patients( 74% of total consultants).
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HEALTH EDUCATION PROGRAMME (HEP)
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Our Health Education Programme continues to run successfully as can be seen from the following
tables:
Table 10: Some Details of HEP
Indicators
Total Population reached 9449
Total Households reached 1285
Total Families reached 1936
Total Number of Health Groups 87
Total Number of Members in Health Groups 340
Total Number of Home Visits by Village Coordinators (vc) and
Motivators (m)
2502 (vc) and
8010 (m)
Table 11: RCH Programme Details
Indicators
Total Number of Sanitary Napkins distributed 6679
Total Number of Pregnant women benefitted from the awareness generation
and information dissemination under our sage pregnancy programme.
500
Total Number of Pregnant women received minerals and vitamins and were
followed-up by our village coordinators and motivators.
193
Percentage of Pregnant Women Followed-up by Village Coordinators and
Motivators
57.78
Percentage of Pregnant Women sent for Immunisation by Village Coordinators 41.32
Percentage of Pregnant women immunized with TT1& TT2 53.89
Percentage of Pregnant Women having Institutional Delivery 61.34
Percentage of new-born children immunized with BCG and 1st DPT 59.23
Percentage of Neo-natal deaths 2.1
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MALNUTRITION
Considering health programs as a critical component of our endeavour to reach out to the
underserved populations we recognise malnutrition as a major impediment to welfare of the poor
and needy. According to the Global Hunger Index 2011, Bihar’s child malnutrition rate is higher
than any country in the world1. Gaya district, like other parts of Bihar, has a high incidence of
malnutrition. Therefore, keeping in tandem with our vision and mission we intend to start a child
malnutrition program in the 6 villages that have been brought under the aegis of Karuna-Shechen’s
support early this year.
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In February, one-day training on Malnutrition was conducted by Dr. Nadine Donnet, the
organisation’s malnutrition consultant, for the entire staff of Karuna-Shechen India, where apart
from imparting knowledge on the various aspects, problems and policies of malnutrition the use of
a tools for measuring it, MUAC (Mid-Upper Arm Circumference) and Weight for Height were
demonstrated.
A baseline survey was conducted to guage the intensity of the prevalence of acute and chronic
malnourishment among children under 5 years of age in the target areas so as to evaluate the
relevance of a nutrition programme in the chosen villages. As acute malnutrition is seasonal in
nature the survey was conducted in two phases to get a clear picture of the prevalence and
intensity of the problem; the first phase was conducted in February, the time of the year when food
shortage does not usually take place and so chances of finding severe acute malnutrition is much
less. The second phase was conducted in the third quarter, during the monsoons when people,
especially children are susceptible to water-borne and other diseases. It is also the season of food
scarcity.
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Results of the Survey2
Phase I of Baseline Survey
Table 12: Phase I Results
Village Total
Number of
under-five
Children in
the Village
Number of
Children
Absent
Number of
Children
Measured
MUAC>11.5
cm
Severe Acute
Malnourished
(SAM)
MUAC>12.5cm
Moderate
Acute
Malnourished
(MAM)
Dema 283 85 198 1 17
Chando 110 27 83 0 0
Barsuddi 30 6 25 0 1
Kadal 45 8 37 1 2
Nawatari-
Meghubigha
44 17 26 0 3
Meghubigha 43 13 30 1 1
Bandha 95 34 61 0 7
Total 650 190 460 3 31
The above table shows that Severe and Moderate Acute Malnourishment was found to be 7.39% in
Phase I of the baseline survey where Severe Acute Malnutrition (MUAC >11.5cm) was 0.65% and
Moderate Acute Malnutrition (MUAC >12.5cm) was 6.74%.
Phase II of Baseline Survey
A second phase of survey was conducted during the monsoons for the following reasons:
People, especially children are susceptible to water-borne diseases during the rainy season
which highly increases the risk of falling into malnutrition.
The monsoons are usually plagued by food shortage
We wanted to measure the children who were absent during Phase I and also those who
were found to be SAM or MAM.
In June our Malnutrition team visited the villages to conduct the second round of survey but out of
224 children to be measured (190 absent during Phase I and 3 SAM and 31 MAM children) only 60
were present. Therefore, we had to conduct the survey again in the months of August-September
when 193 children were measured, 31 being absent.
2 Malnutrition Baseline Survey Report, 2013, Karuna-Shechen (India)
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The following table gives the results of Phase II of the survey:
Table 13: Phase II Results
Village Number of
Children
Measured
Number of
Children
Absent
MUAC>11.5 cm
Severe Acute
Malnourished (SAM)
MUAC> 12.5cm
Moderate Acute
Malnourished (MAM)
Dema 74 18 2 7
Chando 24 5 1 0
Barsuddi 15 2 0 1
Kadal 18 0 0 3
Nawatari 19 1 0 3
Meghubigha 15 2 0 1
Bandha 28 3 1 2
Total 193 31 4 17
The above table shows that Severe and Moderate Acute Malnourishment together was found to be
10.88% in Phase II of the baseline survey. Severe Acute Malnutrition (MUAC >11.5cm) was 2.07%
and Moderate Acute Malnutrition (MUAC >12.5cm) was 8.81%.
Table 14: Phases I and II Comparison
Baseline Survey
Percentage of
Children with
Severe Acute
Malnourishment
(SAM)
Percentage of
Children with
Moderate Acute
Malnourishment
(MAM)
Percentage of
Children with
Acute Malnutrition
(SAM + MAM)
Phase I (February) 0.65 6.74 7.39
Phase II (August-
September)
2.07 8.81 10.88
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In both the phases of the baseline survey we find more children afflicted by MAM compared to
SAM. Phase II has recorded 218.46% higher SAM and 30.71% higher MAM. Phase I of the Baseline
Survey shows a lower prevalence of acute malnutrition among children below 5 years of age
because of the following reasons:
All children in the target villages were measured. So, compared to the total number of
children measured the number suffering from acute malnutrition was very low However,
the Phase II of the survey measured exclusively those who were found to be acute
malnourished in Phase I. Thus, the percentage of Acute Malnutrition (both SAM and MAM)
among those measured in the second phase was higher than the first.
Secondly, Phase I was conducted when the villages are not plagued by food scarcity
whereas Phase II was carried out in the rainy season when there is food shortage and high
susceptibility of the villagers, especially children to various infections and diseases.
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STRENGTHENING BASIC EDUCATION
Yoga classes
Support Faculty at Dema School PTA Meeting
With the aim to establish a strong foundation for a child’s proper all-round development through
the strengthening of primary education we launched our ‘Strengthening Basic Education’
Programme in early 2013.
The first step was to visit schools in all our operational villages, engage in discussions with the
school principal, faculty members, students and their parents in order to identify the problems
facing basic education system in those schools.
As the teacher-student ratio was found out to be a major problem in all the schools our next step
was to recruit bright and enthusiastic teachers from within the community who would make
learning an interesting and joyful experience. We thus provided support faculty to the schools in
Dema and Gopalkhera. However, we were unable to get well-educated and bright support faculty
EDUCATION
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for schools in the rest of the villages due to dearth of such people in the communities. This has
made our progress on the Education front tardy due to lack of expected development in this area.
Parent-Teacher Associations (PTA) have been formed in Dema, Gopalkhera, Lohjhara, Kadal and
Chando. Regular PTA meetings are held in these schools. Our aim of forming PTA in schools is to
sensitise the target communities about the various governmental schemes and programs related to
education. This knowledge will make the children and parents aware of their right to good
education, enabling them to better judge the existing education standard and facilities at school.
Looking at the importance of physical and mental fitness we introduced Yoga classes at schools in
all our operational villages in June this year.
We have started supplying Teaching-Learning Materials (TLM) to schools in an effort to fulfil the
basic requirements of teachers and students and help ameliorate the basic education standards
there. The TLMs also include indoor and out-door game materials like carom board, badminton
racket and shuttle cork, cricket bat and ball, etc which would encourage extra-curricular activities
thereby helping the overall growth of the children.
EARLY CHILDCARE AND DEVELOPMENT
Our volunteer from Inter’Lude with children at Anganwadi Centre in Dema
A child’s development in his early years forms the foundation for his future learning, well-being
and success. Integrated Child Development Scheme (ICDS), India’s programme on early childcare
and development responds to the inter-related needs of children below 6 years, through various
services like provision of supplementary nutrition, immunization, health check-up, referral
services, health education and non-formal education. These services are delivered to pregnant and
nursing mothers and preschool children (up to 6 years) through Anganwadi Centres (AWCs) set up
at the community level. Thus, recognising the vital role that Early Childhood Care and Development
(ECCD) plays in ensuring proper physical, emotional, cognitive and social growth of a child, we
have introduced an ECCD programme. In 2013 the base of the programme was formed through
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meetings and discussions with the District Programme Officer for Integrated Child Development
Services (ICDS-India’s programme on early childcare and development) and the District Magistrate
of Gaya district regarding our new intervention in Anganwadi centres.
We expect to start our ECCD programme on children’s games and play from early 2014. The
project will be conducted on a pilot basis in four villages (Gopalkhera, Dema, Chando and Banahi).
We have had the honour of welcoming a volunteer from Inter’Lude, France for imparting 4- month
training to the Anganwadi workers on the importance and organisation of various types of games
for children. Besides, we will be designing different in-door and out-door games from locally
available resources and providing the same to the children at Anganwadi centres.
NON-FORMAL EDUCATION (NFE)
Our NFE programme that had been running in 6 villages (Banahi, J.P Nagar, Karhara, Trilokapur,
Kharati and Gopalkhera) since 2011 was scaled-up to cover 10 more villages in response to the
demand of their rural illiterate female populace. 487 women are currently enrolled in our NFE
classes running in 18 centres across 16 villages. Apart from teaching the students basic alphabets,
simple sentence construction and numericals, different important national and global geographical
locations are shown on the map. Besides, daily newspapers are used as a learning tool not only to
improve the students’ reading abilities but also to expose them to current affairs.
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SOLAR ELECTRICITY
This year saw a new step taken towards the scale-up of our solar electricity programme that has
been running in 3 of our villages, J.P. Nagar, Banahi and Kharati. 4 women (three from Chando and
1 from Kadal) were selected for the 6-month training at Tilonia, Rajasthan’s Barefoot College in
Solar Engineering. Unfortunately, one woman had to return to her village mid-way due to family
reasons but the rest 3 successfully completed it and went back home in December 2013, equipped
with the designation of Solar Engineers. While these women were away in Tilonia we conducted ty
2 surveys, one in April and another in October-November in the villages of Chando, Kadal and
Barsuddi as a feasibility study; in order toknow the total number of households willing to pay a
one-time installment, specifying the amount they are willing to pay; how much, if any, do they want
to pay on a monthly basis for light maintenance and battery replacement; the number of lights
required per household, etc.
ENVIRONMENT
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RAIN WATER HARVESTING
All our operational villages, located in the drought-prone agro-climatic zone of southern Bihar face
water shortage problem for large parts of the year, especially during summers when there is severe
dearth of water for irrigation, washing etc. In order to combat this problem we have started our
new water harvesting programme in the villages where rain water is collected from roof-tops and
stored in water tanks. The stored water can be used for various productive purposes like washing,
cooking, sanitation requirements and watering of kitchen gardens in the household backyards.
We started the project by conducting several meetings and discussions with the village
communities, explaining to them the concept, uses and advantages of rain water harvesting. Those
interested were instructed to build platforms for the installation of water tanks and to fit pipes that
would carry water from roof-tops to the tank. While some households have already completed the
process of installing the whole system and are ready to use the system, several are yet to
accomplish the task. This project, which began in the last leg of the year, has already managed to
have 32 households and 4 schools (Dema, Gopalkhera, Chando and Barsuddi) install the whole
rainwater harvesting system while several others are in the process of installing it. By the end of
this project we expect our villages to boast of household level water harvesting.
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BODHGAYA CLEAN ENVIRONMENT, HYGIENE AND SANITATION
Drawing Competition Participants with Jute bags
Meeting with Stakeholders of the Programme
With the mandate to create a clean and hygienic town we launched the Bodhgaya Clean
Environment, Hygiene and Sanitation Program early this year.
In order to create awareness about the importance of cleanliness and hygiene and, in the process,
make it an integral part of the lives of the local people we have taken the following steps through
2013:
We have held several meetings and discussions with various stakeholders ; food-shop
owners, street vendors, local communities and school prinicipal and faculty members, to
make them understand the important nexus between health and clean environment and to
achieve awareness genration through constant interaction with them.
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Prior to community-level meetings we conducted an extensive household survey in 142
households in Bodhgaya town to get an idea about the level of awareness, problems and
practices related to sanitation and hygiene at household and locality levels.
We have organised intra-school drawing and speech competitions, in 27 schools (15
schools in Bodhgaya and 12 in our operational villages) in order to create awareness on
Environmental Cleanliness and Hygiene among young students ; and have received
appreciation for our initiative.
Three of our staff members (the Director, a Village Coordinator and the Research and
Documentation Officer) attended a 2-day intensive training program (Green Schools
Program) at the Centre for Science and Environment (CSE), New Delhi. On the basis of the
training we successfully conducted Green Schools audit in all schools within our
operational villages.
In a bid to discouraging the usage of plastic bags and motivate people to use substitutes we
have ordered jute bags of different sizes to serve various pruposes. These bags have our
organizational logo and a message pertaining to our programme. In order to promote the
use of bio-degradable alternatives to plastic bags we are distributing these jute bags for free
among participants of school competitions, our medical consultants, staff members, and
others.
We will be providing food covers to the vendors and sweet-shop owners in Bodhgaya and
at Gaya station. Till now we 30 vendors have placed orders with us for the covers that will
protect the food on display from roadside dust and germs.
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SMALL MONEY, BIG CHANGE
Village Scan in Dema and Bandha
Levelling of Agricultural Land in Chando After the Land was Levelled
The repaired well at Kadal The newly dug pond at Kadal The Bathroom at Kadal
Recognising the imperative role that active participation of underprivileged target communities in
development projects play in empowering them, we launched our new programme- ‘small money,
SOCIAL
Page 42 of 50
BIG CHANGE’ early this year. Community participation ensures effectiveness as communities bring
understanding, knowledge and experience integral to the development process. Besides, the
community is best informed about the needs, attitude and socio-economic conditions of its
members.
We conducted a Village Scan in our 6 new villages, Chando, Bandha, Kadal, Barsuddi, Dema and
Gopalkhera. This step, by helping us identify the specific needs and aspirations of the local
communities, formed the base for determining what projects will be introduced in the villages. The
community development work under ‘small money, BIG CHANGE’ started in Chando and Kadal
from June this year. Eventually the programme was extended to two more villages, Gopalkhera and
Banahi.
In Kadal, the community’s primary source of water for drinking, washing and bathing
purposes; a well was reconstructed. Perviously it was in such a deplorable condition that
the water used for various purposes would flow back into it, polluting the water inside the
well and making it unfit for drinking. Through small money, BIG CHANGE not only was the
well renovated for proper use by the villagers but also made provision for water outlet for
domestic animals and livestock. Apart from a private bathing space or bathroom was built
exclusively for the women. The waste water from the bathrooms are channeled to a nearby
land which we have turned into a Kitchen Garden. Also a pond has been dug nearby where
pisciculture is being cultivated in order to add to the livelihood opportunities of the
community.
In Chando the undulating agricultural lands that adversely affected both crop yield and
quality, were levelled. This is expected to enable better weeding and increased crop
production and productivity. Besides, the ground within Chando school premises was also
levelled and turned into a playground for children.
In Gopalkhera, an existing check dam which had been broken and had remained
dysfunctional for long, was successfully repaired. This has enabled rainwater to flow
straight into the village pond which will not only allow the villagers to perform their daily
activities but also provide water for the agricultural fields, increasing crop productivity and
consequently improving the villagers’ livelihoods.
A small pond was dug in Banahi village, thereby giving the community access to an
additional source of water which was a basic requirement and demand of the community as
it faces serious water shortage during summers.
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KITCHEN GARDEN
Looking at the abysmally high incidence of malnourishment in Bihar (around 80% of children
below five years of age and 68.2% of women in reproductive age group (15-49 years) in Bihar are
malnourished) and the extreme poverty of small and marginal farmers we have started a
programme on Kitchen Gardening. Contrary to commercial farming which encourages mono-
cropping, we practice multiple-cropping in the kitchen gardens in order to ensure a sustained
supply of fresh vegetables and fruits throughout the year.
The success of our new programme can be gauged from the fact that, in contrast to our initial
estimation of covering 100 households across 18 villages, 1000 households showed interest in the
project and are now practicing kitchen gardening with the fruit seeds and vegetable plants
provided by us. Our Kitchen Garden programme is also going on in 4 schools (Dema, Gopalkhera,
Chando and Kadal)
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VOCATIONAL TRAINING FOR UNDERPRIVILEGED YOUTH AND WOMEN
With the objective equipping the underprivileged youth with adequate digital skills so as to provide
them with better employment opportunities and socio-economic empowerment we have started
free computer training programme from July this year. Two types of computer courses are being
taught at our Bodhgaya office namely, Office Management (which will teach MS Office) and DTP
(Page maker, Coral Draw and Photoshop). The duration of each course is 6 months. While the
trainings are imparted free of charge it is mandatory for the students to devote 5 hours per week
towards voluntary services in their respective villages. This provision will fulfil the twin objective
of promoting computer literacy amongst the marginalised communities and serving the rural poor.
36 enthusiastic youths are pursuing the courses with great dedication.
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With the aim to empower the NFE students with both educational and skill enhancement services
we introduced vocational training for them. Under this programme NFE we organised 3 vocational
training workshops in July. Conducted by an eminent vocational trainer from Jamshedpur,
Jharkhand the workshops, attended by our NFE students from all 18 centres and by village
motivators, taught the making of incense sticks, candles, 2 types of popular snacks, Phenyl and
chalk. The vocations were selected on the basis of their market demand, income-earning
capabilities and interests of the NFE students.
All the workshops saw much greater turn-out than the expected 40 (90 participants at candle and
incense stick-making workshop, 41 participants for snacks and 54 for the workshop on phenyl and
chalk). 7 participants from the candle-making workshop were chosen on the basis of their ability to
produce what they had leant. They were sent to Jamshedpur in August for a week-long intensive
advanced training. The next step was the economic empowerment of these women through the
opening of a temporary candle-production unit within the premises of our medical centre at
Bodhgaya. These women were assisted by 4 others who had attended the candle-making workshop
that we had organised.
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NETWORKING WITH OTHER NGOS
We have collected detailed information on all the non-governmental organizations working in Gaya
district. This is the first step towards our goal of creating a network of like-minded NGOs so that
instead of working in isolation, organisations with similar views and mission would be able to work
collectively towards the realisation of their common aspirations.
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FINANCES
The budget and expenses for the year 2013 are as follows:
Table 16: Budget and Expenses
Budget in USD ($1=INR 58)
Expenses in USD ($1=INR
58)
Administration, transportation and functioning cost 51719 43448
OPD , Mobile Clinics and Medical Camps 1,57,858 80,137
Education direct benefit to population in 18 villages 39714 23536
Environmental Program 42355 11393
Social Program 59441 39202
Program Support and Investment 54,590 28,430
Total 405678 264314
OTHER IMPORTANT
INFORMATION
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INTERNATIONAL AUDIT
An international Audit for the financial year 2012-2013 successfully took place during the fourth
quarter of this year.
EXTERNAL VISITORS
We were honoured to welcome our guests who took out time from their busy schedules to pay us a
visit. Our list of esteemed visitors included Matthieu Ricard, President of Karuna-Shechen; Tarek
Toubale, Chief Operating Officer; Anne Oliver, Chief Financial Officer of Karuna-Shechen, Sanjeev
Pradhan, Director of Shechen Clinic, Nepal, Vanessa Challinor, Serge, Astrid and Marie Saint-
Arnoult from Shining Hope Foundation. Besides, our ex-Field Operations Director, Dr. Nadine
Donnet, Dr. Jaya Maitra from Red Cross Society in Jamshedpur and Sebastien, our volunteer from
Inter’Lude, France also graced us with their presence.
ORIENTATION ON PROGRAMME ACTIVITIES
In March, a one-day Orientation on our programme activities was organised. It was attended by the
entire staff of Karuna-Shecehn, India with our Director acting as the Facilitator.
The objectives of the Orientation were:
To give a clearer understanding about the organization
To give a clearer understanding of the program activities
To make all new colleagues feel as part of the team and enable them to do their best to help
the organization achieve its goals.
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ACTIVITIES -2014
A 4-month training imparted to Anganwadi workers in our villages by a volunteer from
Inter’Lude, France. The primary focus of the training will be child development through
games and activities.
A pathology laboratory expert will join us from France for a 6-month training and
supervision session at the laboratory in our medical centre, Bodhgaya.
Solar lights to be installed in the villages of Chando, Barsuddi, Kadal and Banahi by our
newly trained Solar Engineers.
Rainwater harvesting to be completed in the households and/or schools where the process
of installation has begun. Also, as there is a gradual increase in interest regarding the
project amongst the communities in our operational villages more households are likely to
install rainwater harvesting system in the coming months.
We may conduct the Green Schools Programme in schools in and around the town of
Bodhgaya.
This year we envisage extending our services to Aurangabad, Jehanabad, Nalanda and
Nawada, i.e., the districts neighbouring our present area of intervention; Gaya district.
Besides, we intend to expand our geographical area of operation to the neighbouring State
of Jharkhand.
OUR PARTNERS
Current Partner: Barefoot College in Tilonia, Rajasthan
Prospective Partner: Centre for Science and Environment, New Delhi.
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THE BENEFITS OF PRACTISING KITCHEN GARDENING WITH HELP FROM KARUNA-
SHECHEN, INDIA: EXPERIENCE OF SAKER MANJHI FROM BHUPNAGAR
Saket Manjhi, a rural youth from the village of Bhupnagar is extremely happy to have started a
Kitchen Garden in his backyard with fruits and vegetables provided by our organisation. 4 months
since he began growing brinjals, tomatoes, green chillies, bitter gourd, pumpkin, potatoes, etc in
August 2013, his family has not had to worry about market availability and prices of food as he now
cultivates them in their own backyard. The biggest satisfaction is that Kitchen Garden contributes
to his household food security by providing direct access to food that can be grown, prepared and
fed to family members, on a regular basis. Saket Manjhi believes that the primary benefits of
practicing kitchen gardening is increased direct access to nutritious foods by the otherwise, often
food insecure rural communities like theirs. Talking about the economic benefits that his family
enjoys due to this programme Saket Manjhi says that he has been growing vegetables worth INR
700 per month.
He sincerely thanks Karuna-Shechen, India for coming up with such a dynamic programme which
will provide his family and other community members with steady source of nutritious food and
income. He is especially satisfied with our regular follow-ups with the participants of this
programme where we guide them regarding protection of the plants from animals, proper watering
and maintenance of the plants, the use of composting, proper use of pesticides, etc. Saket Manjhi
expects to expand his Kitchen Garden by planting greater varieties of crops next year.
ANNEX-SUCCESS STORY