Introducing eArth Swasthya

Our vision:
At Project Potential, we envision thriving communities in rural Bihar creating their own sustainable and inclusive solutions. We do this by developing and attracting people, organizations and resources. Our eArth ecosystem extends to programs for transformative change in education, community welfare and empowerment with local capacity building as a fundamental part of what we do. For two years now, our local team has used street and radio theatre as a medium to spread awareness amongst communities on crucial public health topics related to malnutrition, maternal welfare, infant mortality and more. Through these efforts, we have reached a total of 5,41,619 people across 361 villages of Kishanganj District, Bihar.

Why health?
Health is the be all and end all of human existence and without it on our side our lives become stalled, or at worse, cease to exist. Without sound health we cannot wake up to go to school to learn or work to earn our wages. Without sound health we cannot plan for household savings to mitigate dire circumstances and without sound health, we are unable to enjoy time with our families or stay engrossed in our hobbies. The outbreak of the coronavirus pandemic in 2019–2020 has been a reminder of how important our health is along with bringing to the forefront the importance of public health systems in our country.

In the last six months or so, we have seen the grave inequalities in our country, as well as how so many people face multiple socio-economic vulnerabilities. Millions of daily wage laborer's have lost jobs and are still out of jobs, migrant workers have travelled thousands of kilometers returning to their home villages in hope of seeking respite and providing support to their kin at home. In schools, students have abandoned their studies especially those in public schools where human and technical infrastructure for remote learning is not possible. With the temporary setback of the mid-day meal scheme provided in schools, more children are going hungry and malnourishment levels are plummeting.

Amidst these challenges, our preparedness to handle crises has been starkly aggravating. Despite the various health and population schemes operational in the country targeting infectious diseases including the Ayushman Bharat National Health Protection Mission as the world’s largest healthcare scheme- the investment in public health for decades has been in shortage of the actual demand. With 1.3% of the national GDP going towards healthcare, it is only natural that a weak system won’t have the wherewithal to deal with a pandemic. This preparedness or lack of it thereof is on two levels:

1. The relative lack of success in reducing poverty and economic vulnerability.
2. Severe under investment on public health, including but not limited to awareness, behavior change, facilities, technology, personnel etc.

Welcome to eArth Swasthya:
Considered a “Bimaru” (meaning sickness) state in the mid 1980s, the high incidence of various diseases and low socioeconomic status remains a reality even till date in Bihar. Thirty years later good nutrition and food security remain a dream for many households across villages while they simultaneously battle issues of safe drinking water and lack of sanitation facilities. Grappling with infectious diseases such as malaria, tuberculosis, leprosy and HIV/AIDs along with other challenges of maternal mortality, under 5 mortality ratio and lack of immunization programs in Bihar is a matter of concern and requires attention.

Following our mass awareness through entertainment on pertinent health concerns and challenges amongst rural communities, we at Project Potential have created a novel health vertical in line with our eArth ecosystem strategy. Here we work in tandem with the community for its mobilization, tap into knowledge partners, government stakeholders and technology resources required to improve the healthcare systems and outcomes in rural Bihar. Our new health program, “eArth Swasthya,” is directed at improving the public health of local communities by targeting various health pitfalls and issues.

Working to Eradicate Tuberculosis:
Before the outbreak of the coronavirus pandemic, humanity has been dealing with another respiratory disease for several thousand years — Tuberculosis (TB). Various stakeholders ranging from the World Health Organization, the Central Government of India and panchayats across the country were committed to eliminate TB once and for all. Despite TB treatment being available to Indians before India being an independent nation, scores of people who get infected with TB die of the disease every year. In 2019, India recorded a total of 24 lakh TB cases, killing approximately 20,000 TB patients every quarter i.e. almost 1 lakh patients a year, not including the uncounted cases.

The goal of making India TB free is in jeopardy due to the focus on COVID 19, but is still crucial. Considering that TB is a disease primarily affecting economically vulnerable people, it is frequently ignored despite India having the highest incidence of TB cases in the world contributing to roughly 25% of global cases. It is estimated that roughly 40% of the population is infected with TB, though in most cases, the TB is latent- meaning that the TB bacteria is present but kept in check and asymptomatic by the body’s immune system. In a poverty ridden state like Bihar, TB is extremely dangerous for the poorest and most vulnerable citizens who may be malnourished, anemic or facing other health issues.

To contribute towards the eradication of TB in Kishanganj, we have partnered up with Innovators in Health-a nonprofit ensuring healthcare for the rural poor. They are successfully implementing a model to eradicate TB in the Samastipur district of Bihar which has benefitted 15,00,000 rural poor in the district. With their technical expertise and knowledge we will replicate a similar model across 350 plus villages of Kishanganj district.

• Active Case Finding: Engaging with ASHA’s (Accredited Social Health Activists), we build their capacity to actively identify suspected TB patients at the community level. By providing required training and refresher training, these ASHA’s then monitor and report community members they suspect might have TB. As an incentive, an honorarium of Rs. 200 is paid to ASHAs for each community member they identify who ultimately tests positive for TB.
• Diagnosis: Suspected TB patients will be provided a container to collect their sputum sample which will be tested for TB. The sputum is transported to the testing centre and at all stages, the collectors and supervisors take necessary precautionary measures before and after touching the sample.
• Treatment: We support ASHA’s to ensure they have the capabilities to deliver and monitor patient drug consumption. We also work with the public health system to ensure ASHAs receive timely payments for TB work so that they remain motivated and support ASHAs in counselling patients.

We believe that we will walk further if we walk together. In tandem with our local community, ASHA workers, Primary Health Centres and Panchayati Raj we come together to work towards TB eradication, one case and one village at a time. While this project is in alignment with our eArth ecosystem strategy, we target improving health as a means of improving other aspects of people’s lives (such as education and income security) which are just as important.