MEHAR BABA CHARITABLE TRUST Bassi Pathana Community Collaborative

MEHAR BABA CHARITABLE TRUST Bassi Pathana Community Collaborative Development Project (BP-CCDP) BP-CCDP REPORT OF JUNE VISIT OF UTAH UNIVERSITY Main task of the team: “COMMUNITY HEALTH NEEDS ASSESSMENT”

The BASSI PATHANA COLLABORATIVE COMMUNITY DEVELOPMENT PROGRAM (BPCCDP) is the initiative of four partners: • University of Utah (U of U), Salt Lake City, U. S. A • PGIMER’s School of Public Health, Chandigarh • Mehar Baba Charitable Trust, Bassi Pathana • The Community of 9 Villages Balara, Damheri, Jallowal, Salar Majra, Lohar Majra Kalan, Majri, Bagh Sikander, Ferozepur and Fatehgarh-Niuwan.

• The University of Utah (U of U), Salt Lake City, Utah, USA through its Division of Public Health has shown a deep interest in the activities of Mehar Baba Charitable Trust (MBCT). The U of U has a mission of research, education and service, which is the binding with the MBCT. Dr. Steve Alder, Chief, Division of Public Health, Dept. of Family & Preventive Medicine, the U of U, visited Chandigarh in October 2009 and held preliminary discussions with MBCT and the School of Public Health PGIMER, Chandigarh. • The School of Public Health PGIMER, ever since its inception has helped in promoting meaningful research, quality education and yeoman service to the community. The State of Punjab has benefitted, the recent study of Rheumatic Fever and Congenital heart defects in children being one of its efforts. This School of Public Health is already involved in Fatehgarh Sahib.

The overall objective of the program is to promote community health development by producing positive, measurable improvements among rural people experiencing health inequalities, engaging in partnerships that focus on collaboration and developing community capacity leading to sustainable outcomes. The BP-CCDP is based on principles of collaborative community development with a focus on long-term solutions that promote community-level self-reliance. This program is founded on the premise that working with community members to understand, prioritize and address health and other developmental issues leads to long-term progress and independence, with the ultimate aim of having these same communities mentoring others through it's progression. Using principles from approaches such as Community-Based Participatory Research and building appropriately scaled coalitions, the Sustainable Village Program provides a systematic approach for

PROGRESS SO FAR • In 2009, Dr. Steve Alder visited Mehar Baba Charitable Trust and discussed the possibility of carrying out the project. • Informal partnership was developed and was implemented when a team of four members(Dr. Steve Alder, Sharon Talboys, Dr. Benjamin Crookston and Rick Haskins) from University of Utah, U. S. A again visited MBCT in October, 2010. The U of U encouraged and succeeded in building up community of 9 villages as the 4 th Partner consisting of population base of approx. 25000 villagers (Key Contact persons in each village were nominated). • A series of community, engagement activities and a survey of one pilot village “DAMHERI” in March, 2010 have resulted in the prioritization of sanitation as the main issue to be tackled by the BP-CCDP. Other areas of interest include water, maternal and child health/nutrition, chronic diseases, and lifestyle issues. Improved sanitation has the potential to positively affect health of the whole village by breaking the fecal-oral transmission of diseases, primarily diarrheal diseases. By reducing diarrhea, it also reduces the consequences of prolonged diarrhea, such as malnutrition, stunting, anemia, and cognitive impairments. These health problems are especially harmful to children and pregnant women. Issues around water and hygiene can be addressed concurrently with the sanitation project. It is also important to improve sanitation for reasons other than health. Community demand is high to improve living conditions and achieve the convenience and dignity of having improved toilet facilities.

Continued: Community Engagement - Sanitation was identified as the top priority of the targeted villages through a series of community engagement activities in 2010. MBCT reached out to nine villages based on existing relationships and convenience to begin BP-CCDP activities, including a needs assessment through community engagement. Activities included: Ø Key Informant/Opinion Leader interviews - Several visits were made by MBCT team to the targeted villages to engage with community leaders, such as the sarpanch, panachyat members, village elders, school teachers, and opinion leaders , young men & Women to gain first-hand knowledge about community needs and characteristics. Ø Community census/survey • Census of village Damheri in May, 2010 • Demographic, health, socio-economic • Type of toilet facility Ø Village meetings - One type of meeting was ceremonial in nature, where BP-CCDP members from the Community, PGIMER’s SPH, MBCT and University of Utah, together, met in a village in October, 2010 where all were welcome. These meetings were well attended and included men, women, and in some cases school children. Meeting sizes ranged from 25 -100 people. BP-CCDP members were welcomed and a BP-CCDP banner was displayed.

Continued: • Community forum - In addition to village meetings, a community forum/workshop or Focus Groups was held that targeted village leaders, managers, government workers, community health and social workers, and other dignitaries. Approximately 60 people were in attendance. The full day meeting was held at MBCT's community development centre in Bassi-Pathana on 14 th October, 2010 and included presentations and facilitated discussions led by University of Utah and PGIMER, SPH. and included guest speakers.

Continued: • A household community survey activity in 9 villages was started in April 2011 by MBCT medical volunteers (a team of 8 to 10 members) and was completed in the end of May. • The 22 members team consisting of Doctors and Phd. Students from University of Utah along with PGIMER’S SPH. with the support of MBCT and Community partners of 9 villages launched the BP-CCDP on 1 st of June, 2011 and carried out the activities till 22 nd June, 2011. • Dr. Jim Vanderslice (U of U) prepared a Database Software for the household surveys carried out by MBCT volunteers which is in progress electronically. The primary data was entered into the database by U of U students with the support of MBCT Volunteers in June 2011.

BP-CCDP University of Utah’s Team Jim Van. Derslice, Anita M. Leopardi, Sharon Talboys, T. P. Singh, Isabella Alder, Meghan Arnold, Lauren Elizabeth Bartsch, Jared Blackley, Adrienne Henderson, Wafa. Kadoura, Harjit Kaur (Indian Origin), Manpreet Kaur (Indian Origin), Melissa Larson, Tiffany Law, Robin Moore, Christopher Orlando, Melissa Sperry and Robin Tillery PGIMER’S School of Public Health Team Rajesh Kumar, Binod Patro, P. V. M. Lakshmi, Davinder, Kshitiz. Mehar Baba Charitable Volunteer’s Team (Headed by Hassan Mejie) Dr. P. S. Jassi, Alfred Mejie, Bawa Singh, Robin Gupta, Ajay Malhotra, P. S. Mann, Sandeep Kumar, Ved Dogra, Manjeet Kaur, Kirandeep Kaur, Harjit Kaur Supported By: Kiran Bala, Hema Panesar, Amandeep Kaur, Sandeep Sharma, Sukhjinder Virk Community of 9 Villages – Our BP-CCDP Key Contact Persons Damheri, Salar Majra, Jallowal, Lohar Majra Kalan, Fatehgarh Niuwan, Majri, Bagh Sikander, Ferozepur and Balara

Arrival of Utah’s Delegates Advisor Hassan Mejie reviewing the BP -CCDP at Village Balara • The University of Utah’s team of 18 members, including senior professor and Phd. Students arrived on May 30 th& 31 st at New Delhi. Than they were escorted to Chandigarh by MBCT Volunteer and arrived on June 1 st in the afternoon at UT Guest House, 3 of the team leaders (Dr. Jim, Anita and Sharon Talboys) along with Dr. T. P. Singh, Dr. P. S. Jassi, Hassan Mejie & Alfred Mejie came to Fatehgarh Sahib to have discussions with the Deputy Commissioner (Mr. Yashvir Mahajan) about the BP-CCDP and seek his permission to proceed with the same.

Community Development Pilot Project Launched The BP-CCDP team at Village Balara • BP-CCDP was launched on 2 nd of June, 2011 at village Balara at 9: 00 am in the morning. The Utah team delegates headed by Dr. Jim Vanderslice were introduced to the villagers by Dr. T. P Singh and Mr. Hassan Mejie and they were warmly welcomed by the villagers (They were Garlanded) The villagers were also briefed about the activities which were to follow by Dr. Jim Vanderslice and his team. After the introduction and welcome ceremony, the collaborated teams went around the village. Afterwards the team visited the Civil Hospital at Fatehgarh Sahib where they checked on the facilities and services being provided. On their way back to Bassi Pathana they visited Community Health Centre, Bassi Pathana and Sub-Health Centre, Dhunda.

Community Development Pilot Project Launched • On the same vary day a Seminar on “GENDER EQUALITY & HEALTH” was organized at MHKCDC, Bassi Pathana. The Seminar commenced after Lunch at 2: 00 pm Dr. Harshinder Kaur a renowned speakers presented her views on the above said topic. Her 40 minutes views were hair raising. Mr. R. K. Taneja also enlightened the Utah team and the guests with his knowledgeable views followed by an interactive session between Dr. Harshinder and Utah team, which was covered by the press. The day’s activity came to an end and the team left for Chd. MBCT Trustees & Advisors along with Dr. Jim honouring Dr. Harshinder Kaur & Dr. Ramnik Kaur

Village Visits / Surveys • Bagh Sikander, Ferozpur and Damheri were visited on 3 rd June, 2011 by the Utah team. The team was welcomed and garlanded by the villagers. The team split into different smaller groups and talked to people of different economic and social status. The questions mentioned in the questionnaires were asked. After collecting the complete data verbally, the team headed back to MBCT for Lunch. After Lunch the Utah team compiled their verbal data of the day and discussed further plans among themselves. After their discussions they went back to chd. Village meeting of Dr. Jim, T. P Singh with Satwinder Kaur Dhaliwal at Village Damheri Visit at Village Bagh Sikander

HISTORIC TOUR – A TRAIL BY TONGAS • On 5 th June, MBCT designed a Trail by Tongas - a Historic Tour of Mughal Era Majestic Buildings around Fatehgarh Sahib for the Utah Team. The team was received at Aam Khas Baag, where they were shown Historical Mughal Architecture (how the rooms were air-conditioned without electricity), from there the team travelled on Tongas which were hired by MBCT to Gurduwara Shri Fatehgarh Sahib thereafter to Todar Mall Di Haveli. Than the Tonga Caravan carrying the Utah team had a stop over at Roza Sharief then on to the Monument behind Talania (Tomb of Ustad & Shagird), where Tea and Snacks were organised. The U of U Dignitaries on Tongas At Aam Khas Bagh Gurudwara Shri Fatehgarh Sahib

Historic Tour – A Trail by Tongas Tomb of Ustad at Talanian Roza Shariff at F. G. S • This is the vision of Prof. H. S. Mejie keeping in mind that many foreign visitors we have at Bassi Pathana. As a spin off, it would create an addition to the economy and serve as an extra source of income to the people living in rural Punjab. The tour came to a halt at 4: 30 pm and the team headed back to there resting grounds at chd. Tomb of Ustad at Talanian

Water Sampling and GPS Mapping Water Sample testing by Sharon Talboys from Village Hand pump Meghan Arnold (from U of U) discussing map with MBCT and village volunteers at Fatehgarh Niuwan • On 6 th June village Damheri, on 7 th June village Jallowal, Salar majra and on 8 th June village Fatehgarh Niuwan were surveyed, along with the collection of water samples and GPS mapping. Different teams were formed. Half of the teams went around collecting samples of water from different water sources (Hand Pumps, Submersible Pumps, Govt. Water Supply, Ponds and community water sources), the remaining half of groups went around the outer-skirts and main inner streets of the villages doing GPS mapping. All this became easy to do because of the hardwork put in by the MBCT volunteers earlier when they did household surveys of all the shortlisted 9 villages. The mapping and numbering of the houses done by them really made it very convenient to organize the going about in the villages. Different teams were provided with a village guide who would take them to different locations and houses.

Seminar on Convergence of Services for the Rural Development • On 8 th of June, after Lunch a Seminar was organized on “CONVERGENCE OF SERVICES FOR THE RURAL DEVELOPMENT” was held at MHKCDC, where professional dignitaries from different govt. departments of the district participated. The Chief Guest Mrs. Satwinder Kaur Dhaliwal, Chairperson, District Planning Board, FGS. Dr. Gurinder Kaur Brar, District Medical Commissioner enlightened the audience and the Utah University team from U. S. A about “Rashtriya Suraksha Bima Yojna” (RSBY), the Central Govt. insurance scheme for the BPL families and many other important insurance schemes in detail, followed by Dr. Maninder Bajwa, District School Health Officer, she spoke about the incentives given under various health programs given under National Rural Health Mission and as well detailed about the functioning of the Asha Workers and Auxiliary Nurse Midwife (A. N. M) and also commended the improvement in Gender Ratio from 766 to 843 per 1000 males in Fatehgarh Sahib district.

Seminar Continued… • Than S. D. O water supply, Mr. Sumit Aggarwal told the audience of their various schemes in which supply of water in villages is being provided and as well about the future plans of his department. Pension schemes by the state govt. to the rural old age and urban old age, handicapped pension, widow pension and orphan pension schemes were elaborated in detail with facts and figures by Mr. Varinder Singh Bains, District Social Security Officer. The last speaker Mr. Naresh Kumar, Assistant Research Officer, Economic and Statistics explained about the working of the District Planning Committee and their forthcoming projects. The total financing done till date by the planning committee is around 332 Crores of Rupees to different departments since their commencement as per A. S. O.

Water Sampling and GPS Mapping • On 9 th June, 2011 Lohar Majra Kalan was visited, surveyed, collection of water samples and GPS mapping by the Utah team. Following the same pattern of asking questions from the people belonging to different economic classes and having different lifestyles. • On 10 th, 11 th and 12 th of June, the team went for a pleasure trip to Dharmshala / Maclout Ganj. The team came back from Dharmshala on 12 th June, 2011. • On 13 th June, two different teams were formed. One team was to function at MBCT doing data entry of the household surveys. These household surveys were done by MBCT volunteers in the shape of Household Survey Forms, which were filled earlier by them, when they had gone to survey the 9 villages. The second team went to village Balara to collect water samples and do GPS mapping. Procedure adopted earlier was followed. After Lunch, the team which went to the villages stayed back and joined the data entry team to enter the primary data. Earlier in the morning Dr. Jim Vanderslice uploaded the database software on the Server of S. G. S. S Learning Centre and also trained the members of his team and MBCT Volunteers. Dr. Jim and Anita left for New-Delhi (their flight to salt lake, U. S. A was in the evening) after attending a meeting with Prof. H. S. Mejie, Mr. A. S. Chatha, Mr. Hassan Mejie, Mr. Alfred Mejie, Dr. T. P. Singh and Sharon Talboys, in which future action plan was discussed. Manpreet Kaur and Tiffany Law (from U of U) collecting information from Village Elder Lady

Water Sampling and GPS Mapping • On 14 th, village Bagh Sikander was visited. Along with collection of water sampling and GPS mapping, Focus Group discussions were also held (talking to youth of both sexes ageing between 18 to 25 years, from different economical status). Five groups were formed out of which two for collecting water sampling, one for GPS mapping and two stayed back to do focus group discussions. Same activities with the same groups were performed on 15 th June at village Ferozepur and on 16 th June at village Majri. On all these days, the teams stayed back at MBCT after lunch to do the primary data entry. Meghan Arnold & Wakafdoura (from U of U) collecting Water Samples in village Bagh Sikander • On 17 th June, no field work was performed by the Utah team instead the complete team did enter the primary data.

Visit of Tracy Evans • On 19 th June, a program was organized at MBCT Hockey Nursery Grounds to honour Tracy Evans, 3 time winter Olympic Gold Medalist in Skiing and President of a NGO by the name of “Kids Play International” from U. S. A. She arrived at MBCT Hockey Nursery Grounds at 7: 00 am along with the Utah University team headed by Sharon Talboys (Utah University, Associate Director and Co-Director India Study Abroad). Tracy Evans met with Dhyan Chand Brigade Tracy Evans with Rani Jhansi Brigade • Tracy Evans personally met all the players of the MBCT Hockey Nursery and encouraged them by giving her own examples that how she struggled and achieved the glory. This was a big boost for the small kids, who were able to personally interact with such a great personality. She was very impressed by the services of MBCT towards the upliftment of the Indian National Game “HOCKEY” and was astonished to see that players ages 5 yrs. onwards could play such skilled “HOCKEY”. She also praised the coaches who had given such skills to the adolescents and especially to the committed coach Hansraj Chhabra who being so busy had his devotion for the players.

Visit of Tracy Evans The U of U students playing games with village Kids Sharon Talboys met with Rani Jhansi Brigade

Visit of Tracy Evans S School Importance of an Education P Physical Fitness Healthy Living O Opportunity Equality for both Girls & Boys R Respect Yourself and those around you T Teamwork Working Together S Self-Esteem Building Confidence

Presentation of Reports • On the basis of the hardwork done from 2 nd June till 17 th. June different reports were compiled and village presentations were delivered by Utah team and MBCT volunteers to all the 9 villages. The complete teams went to different villages and formed two groups, one group headed by Sharon Talboys and Meghan Arnold presented the reports to the villagers numbering 60 to 80 people mostly adults and seniors of the village. In the presentations the villagers were told that the report of their village will be translated in Punjabi Dr. T. P. Singh and Sharon Talboys presenting and will be delivered to the Sarpanch/ Key Reports at Village Ferozepur, Fatehgarh Niuwan Contact person. The second group headed by Tracy Evans and Robin Moore took all the village kids (age between 5 yrs to 12 yrs) to an adjoining playground of the School or the Gurdwara where the presentations were being held. Different activities were performed involving the kids such as Merry Go around, Speaking Rhymes, playing games, singing songs through which certain messages were passed on to kids.

Presentation of Reports Presenting Reports at Village Bagh Sikander Dr. T. P. Singh and Sharon Talboys presenting Reports at Village Bagh Sikander • On 18 th June, village presentations were delivered at Jallowal, Salar Majra before Lunch and Fategarh Niuwan after Lunch. On 20 th June, presentations were held at Ferozepur, Bagh Sikander and on 21 st June presentations were held at Lohar Majra Kalan and Majri. After Lunch on 21 st June, Utah team held a meeting with all the MBCT volunteers along with Mr. Alfred Mejie in which the memories of 20 days were shared and also the plans to follow in future. Whole the Utah team was very emotional and had tears in their eyes before parting.

Contents of the Report • Priorities • Health Indicators • • • Socio-Economic Health conditions Maternal Child Health System Determinants of Health • Environmental indicators • • • Water Quality Drainage/Sewerage Sanitation/Hygiene Toilet facilities Solid waste Indoor air quality • Recommendations • Fact Sheets

Priorities • • Water Ponds Sanitation Child nutrition and prevention of diarrhea Drug use Chronic diseases Health system improvements Educational and extracurricular activities for young people

Economics ECONOMY You will get a detailed report on • Income levels • Wealth index • % Below Poverty Line without a BPL card • Type of home construction

Social Aspects • Young people value their traditions and culture and religion. • Want a better future for the next generation • Want to combat social ills • Want more education • Examples of cooperation: Getting person to hospital, coming together for festivals, helping a poor person with healthcare costs

Health Indicators • Child mortality (under 5) rate in Rural Punjab : 53/1000* • Child nutrition • 80% under age 3 are anemic • 25% under age 3 are underweight • 35% under age 3 are stunted • Diarrhea

Causes of Childhood illness • • Poor sanitation; Open defecation; Poor hygiene; Contaminated drinking water sources; Insufficient iron and nutrition intake; High prevalence of Hookworms among children; Low education level and health awareness of mothers

Water Quality – all villages • Bacteria is often found in the water that can make villagers sick. • About 1 out of 3 wells had these bacteria. • This can be a serious problem. These bacteria can make you sick, and cause diarrhea, especially in children. • Bacteria found in all types of water: electric submersible pumps, hand pumps and from government water that had been stored. • The bacteria can come from latrines, or the sewage seeping into the ground.

Water Quality Results - All • The storage tanks might be dirty and causing some of the problems. Also in some areas the groundwater is bad and has bacteria. • The bacteria are not always present, but for some wells, they can be there one day, and not the next day. • Cleaning the storage tanks might be a good idea. • Some of the hand pumps also had high levels of nitrate. This can be dangerous for babies. If possible water from hand pumps should not be given to babies younger than 6 months.

Drainage and Ponds • • Maps will be provided that include Streets Village landmarks Community buildings Boundaries Some water sources Drainage map • Needs further study

Village Projects • Water • Sanitation/drainage • Ponds • Health Education • Nutrition • Drug use • Activities for young people • Others? . . .

How to proceed Community: • Consider all the information and determine which projects to pursue • Identify local resources (money, labour, materials, etc) • Identify a village champion of the effort • Collaborate with BP-CCDP. Ask questions, request more information

How to proceed University of Utah, MBCT, PGI-SPH: • Take up these issues with the Minister of Parliament Local Area Development (MPLAD) project and planning boards • Provide further report details, maps, and recommendations • MBCT: To help carry out interventions • MBCT/Uo. U: To provide training of trainers and support health education efforts • Fill the gap

TOGETHER WE CAN DO IT! BP-CCDP THANKS