In Karanjvihire village in Khed taluka (block), Sharda Borade is used to people knocking on her door at any time. She says, “They even come at midnight. Someone may have got bitten by a scorpion, someone might have acute diarrhoea.” Ms Borade gives them medication to see them through the night, and, if required, recommends or assists them with hospitalisation the next day (at neighbouring semi-urban centres such as Chakan or Talegaon). Ms Borade interacts with about 60 such patients every week, and this is just one of the many tasks performed by the busy health worker.

 

Karanjvihire, a village of about 350 households, is primarily an agricultural village. Although cities such as Pune, with upscale medical facilities, are not too far away, in the village itself, as in most of rural India, adequate and affordable medical facilities for all remain elusive. One of the ways in which Tata Motors addresses this gap is by appointing and training health workers such as Ms Borade. The community development department (CDD) of Tata Motors has 22 health workers in 22 villages of Khed taluka. The health workers are the first point of contact with the healthcare system for many in the villages.

 

Ms Borade attends a health workers’ meeting once a month, where she gets the monthly stock of medicines for common ailments such as headaches, coughs and colds, diarrhoea and malaria, and first aid materials such as bandages and ointments. Like the other health workers, Ms Borade was trained by the CDD to identify common illnesses and dispense basic medication.

 

As in its work on water resources and education, Tata Motors works on filling gaps in the healthcare system in a way that complements the work done by the state government.

 

When it started training the health workers, the CDD conducted meetings in the villages to identify suitable candidates. Many (but not all) of the CDD health workers are also anganwadi (a centre providing basic healthcare) workers or auxiliary nurse midwives, whose skills get further upgraded by the training given by the CDD. Tata Motors pays the health workers a monthly honorarium (between Rs230-400 [$4.9 or £2.9 - $8.6 or £5.2]¹), and, if she is an anganwadi worker, she also gets a small salary from the government. With a husband who is an alcoholic, the small income goes a long way in running Ms Borade’s household.

 

In addition to the curative aspect, Ms Borade’s work includes creating awareness about preventing common illnesses, nutrition and conditions such as anaemia. Once a month, Ms Borade and the other health workers come for a review meeting organised by Tata Motors. They report their progress and problems, and this ensures an ongoing exchange of information and learning.

 

The Medical Mobile Society (a doctors’ trust associated with the CDD) has an arrangement with the Niramaya Hospital in Pune. On recommendation, a patient who requires speciality care gets subsidised surgery and treatment at this hospital.

 

The other part of the two-fold healthcare component of the CDD is a mobile medical van. “We go to the villages, doing curative and preventive work,” Ujwala Khaladkar, the CDD’s van nurse, says. “We are a complementary support system.” In 2008, about 5,000 people got medical attention and treatment through the CDD’s van and health workers.

 

From five days a week, the van’s visits have come down to about twice a week. Shrirang Dhavale of CDD says, this is, in part, because Tata Motors is waiting to get a new van and doctors are now available in near semi-urban centres such as Chakan. However, in part, the CDD believes the very demand for such healthcare inputs as a mobile van has dropped because of improvements in people’s level of awareness about prevention; the incidence of disease has also dropped. From the detailed register that the CDD keeps of patients and health workers it is evident that the incidence of diseases is down.

 

Ms Borade says, “All this is because of better awareness, due to better roads and transportation, and because of better healthcare facilities. We contributed through awareness, early diagnosis and better availability of medicines and supplements.”

 

The work done by the CDD to construct biogas plants in the villages and make available safe drinking water also feeds into better health for the people in the villages. Sanitation, a key element in improving overall health, has also improved due to the CDD’s work in constructing toilet blocks in the villages.