Jawadhi Hills Campaign – Background Information
By Dr. James Taylor – India Grants Chair and Board Member
© Scudder Association Foundation, All rights reserved
About the Jawadhi Hills
Outreach by CMC’s CHAD
The Model Villages Program
The Current Healthcare Center
Scudder Cousins visit the Jawadhi Hills in 2019
Maternity Hospital Proposal
Our Partners
About the Jawadhi Hills
The Jawadhi Hills (also Javadhu, Jawadhu, Javadi Hills) are an extension of the Eastern Ghats mountains about 40 miles south and west of Vellore. This range of granite peaks is 50 miles wide by twenty miles long, reaching an altitude of 4000 feet. Their height is sufficient to produce rainfall, which leaves them clothed in green, in vivid contrast to the dry plains surrounding Vellore. The drive from Vellore takes 2 to 3 hours over difficult roads. Some villages are accessible only by foot path. The landscape features dramatic peaks and valleys with breath taking vistas. Rugged terrain and sparse population mark the Jawadhi Hills as a world apart from the hustle of Vellore.
The Jawadhi Hills are the home of about 80,000 indigenous Malayali (meaning “people of the hills.”) tribal people. They are one of the earliest indigenous groups native to the Indian Sub-continent, and predate the Aryan migration to South India. The ethnically distinct and remotely located Malayali people live outside of the mainstream of Indian society. Most of these tribal people work as small-scale subsistence farmers or land laborers. The Malayali people’s lack running water and basic hygiene presents a clear health hazard that results in unnecessary critical illnesses and deaths. The remote location combined with a lack of healthcare and transportation infrastructure has led to high rates of morbidity and low life expectancy. A recent CMC survey discovered that 98 percent of Jawadhi Hills children are born at home and only 20 percent complete immunization before the age of five.
Outreach by CMC’s CHAD
CMC’s Community Health and Development (CHAD) department has long championed cost-effective care for the people in and around Vellore. CHAD goes beyond healthcare to address the social and economic problems which often underly and complicate medical issues. Rigorous medical and public health measurements are used to direct their interventions and then evaluate their effectiveness. Since the 1980s CHAD has brought this proven approach to address the health and social needs of the tribal people of the Jawadhi Hills. Their project has focused on improving maternal and child health with direct medical interventions while simultaneously supporting economic and social development with education and advocacy training.
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The Model Villages Program
A Comprehensive Approach to Sustainable Livelihoods in the Hills
Through discussions with the communities and village leadership, the Jawadhi HIlls Model Villages Project was launched with four primary goals in mind:
- To provide access to health care, clean water, means for personal hygiene and sanitation
- To prevent distress migration from rural to urban areas that tends to undermine the potential for development in the home villages
- To contribute towards social empowerment by engaging all sectors of the community in the task of village development
- To make the model village(s) a “hub” that can inspire positive development in other Jawadhi villages and attract resources for this type of sustainable development
This comprehensive Model Villages Project is currently being implemented in four separate villages to demonstrate the benefits of improved hygiene, social & educational programs, and employment training for villagers.
The first of four Model Villages is Koiloor. In addition to the installation of running water and toilets, there is a major social and educational component. For disease to decrease and economic progress to increase, CHAD has committed to a full time facility and staffing for the project. The goal of CHAD is long term and includes:
Reduction in infant/maternal morbidity and mortality
Reduction in enteric diseases that cause malnutrition, stunting, etc.
Adoption of clean water for cooking and cleaning
Cessation of open and public defecation
Full immunization of children
Awareness of the risk of alcohol abuse
Community leadership advocacy
The Current Healthcare Center
The Dr. C.K. Job Tribal Health and Development Center, was established by CMC’s CHAD in July, 2014 on land leased from the Don Bosco Institute in the Village of Veerapanur.
The original purpose of the Center was to eradicate Hanson’s Disease (Leprosy). With leprosy now largely eradicated, the center focuses on patients with acute illnesses, non-communicable diseases, pregnancy care and pediatrics. The Center is currently manned by a doctor, a nurse, a health aide and house-keeping staff. The healthcare team travels from Vellore each day, Monday through Saturday with hours from 9 am – 4 pm. Additional special clinics are run from the Center on specific days of the month. When the needs of the patients are beyond the Center’s capabilities, they are referred to CMC.
The center is led by Dr. Anu Rose. Anu and her staff seek to serve 40,000 of the 80,000 tribal people of the Jawadhi Hills through mobile clinics, community organizing, capacity-building of traditional leaders, self-help groups, life skills coaching, vocational training and support of formal education.
Scudder Cousins visit the Jawadhi Hills in 2019
In January of 2019, about a dozen members of the Scudder family spent a week visiting Christian Medical College in Vellore and nearby Scudder Memorial Hospital in Ranipet. Our trip was a commemoration and celebration of the 200th Anniversary of missionary John Scudder’s original trip to India. The Scudders spent a day meeting the people and touring the facility in the Jawadhi Hills. Terry Sherman has kindly provided an account.
Jawadhi Hills visit January 2019; by Terry Sherman
In the morning, part of the Scudder contingent set out for the CHAD (Community Health and Development) hospital in the Jawadhi Hills, winding up the many breath-taking switchbacks and finally arriving at the Dr. C.K. Job Tribal Health and Development Center, in Veerapanur.
The Health and Development Center was established in July, 2014 and is situated on land leased from the Don Bosco Institute. The Center is manned by a doctor, a nurse, a health aide and house-keeping staff. Currently the Center functions Monday through Saturday from 9 am – 4 pm with the team traveling from Vellore each day, some 2 hours away.
Dr C K Job Tribal Health
Laura Fisher Kaiser, Tema Kaiser Silk, Sarah Kaiser Hyams with Dr. Anu Rose – Director of the Jawahdi Hills clinic
While the original purpose of the Center was to eradicate Hanson’s Disease (Leprosy), that debilitating disease being largely cured, the patients are usually those with acute illnesses, non-communicable diseases, antenatal concerns and children. Additionally, special clinics are run from the Center on specific days of the month. When the needs of the patients are beyond the Center’s capabilities, they are referred to CMC.
We were impressed by the dedication of Dr. Anu Rose and her staff as they seek to serve the 40,000 of the 80,000 tribal people of the Jawadhi Hills through mobile clinics, community organizing, capacity-building of traditional leaders, self-help groups, life skills and vocational training for youth and support of formal education.
Another major focus of this project is the development of Model Villages. After a picnic lunch, we climbed into the van and drove to one of these model villages of 98 households named, Vallithathankottai. Stopping along the side of the road, villagers came out to meet us, cut open coconuts for us to drink and then trekked with us through the dry fields to show us the new water wells that have been dug for irrigation. We were also taken to see a model working toilet that has been successfully introduced to each household and to hear from the social director, Mr. John Paul, about the strategic plan for governing each of these villages.
We were intrigued to learn that for community organizing, a program was started to generate income for the town. Each household received an animal, whether a cow, goat, chicken, pig, fish or bees. Eight families with agricultural wells had their wells desilted and deepened. All families with farmland received 100 fruit tree saplings. The money is combined and controlled by appointed leaders who manage the funds for the town and seek the wellbeing of the whole community. In an interesting turn, the villagers are expected to pay something for each of these opportunities and then the payments are used for the benefit of the town and its people, sometimes for supporting a student in school, or for town festivals, or improvements, thus building value, responsibility and ownership.
Our visit with the villagers from Vallithathankottai finished with cups of tea, selfies and a gift of a flower for each of us. Our hearts were warmed as we said goodbye, stopped by the Center in Veerapanoor one last time and headed down the windy road for the two-hour treck back to Vellore. The Scudder Association Foundation provides financial support for CHAD and the Jawadhi Hills project.
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Maternity Hospital Proposal
After four decades of experience and study CMC’s CHAD has determined that a maternity hospital will address the most critical healthcare needs of the people living in the Jawadhi Hills. Here is a synopsis of their proposal:
Background on the need and an intro to the proposed project:
In the Jawadhi Hills region of South India, (which is a part of the Eastern Ghats, a range of steeped-hills and valleys located about 50 kilometers from Vellore), there lives a population of more than 60,000 tribal members in a collection of 294 villages and hamlets. The hilly terrain in which they live makes access to health care and other facilities difficult. Consequently, medical teams and patients often are required to trek several hours to meet each other.
Health status indicators like Infant Mortality Rate (IMR), Maternal Mortality Ratio (MMR), etc. in this population are comparatively high (IMR -73/1000, MMR-170/100,000). This is primarily due to poor health care infrastructure, limited health services, low literacy and inadequate quality education, no opportunity for employment locally, dependence on subsistence farming, migratory labor, and poor relationship with administrative structure. More than 50% of children are born at home and completed immunization in children under the age of five is about 30% according to surveys recently completed by CMC.
CMC has been involved in health outreach program in the Jawadhi Hills since the 1980s, providing general health services through the introduction of mobile clinics. Initial outreach programs were primarily to address Hansen’s disease in the hills. However, with a notable decrease in the incidence of new cases of Hansen’s disease, CMC expanded its program to include general care. Its work consisted of running mobile clinics in fixed spots (in the hills) and providing referral to those patients who needed secondary or tertiary care.
Today, there is a small CMC-funded and staffed day clinic in Veerapanoor village (a facility that is located on the arterial roads which lead to the town of Jammunamarathur, the economic hub of the tribal area). It is this property where the day clinic is located that will serve as the site of our proposed 24-hour maternity and emergency care hospital. Currently, the existing clinic sees an average of 60 outpatients per day, and on special days, there are much larger numbers of patients. Our expectation is that these numbers will double if we can extend our outpatient hours to include the evenings.
Large numbers of infant deliveries (in the Jawadhi Hills) take place in unsafe environments and immunization coverage is very low. Prevalence of syphilis, non-communicable diseases (NCDs) and people with disabilities are much higher in this region than elsewhere in the country. For these primary reasons, CMC is committed to the opening of 24-hour hospital in the Jawadhi Hills, to include a maternity ward, an Emergency Obstetric & Neonatal Care unit, a patient, and healthcare workers training facility, a chapel, a 6-room dormitory for the onsite medical staff, and a common eating area.
Within the larger context of the country, the overall health, literacy and development indicators of the people living in this area – across age groups – are poor as compared to those living in most other parts of India. As mentioned previously, health status indicators like IMR and MMR in this population are comparatively high primarily due to poor health care infrastructure, limited health services, low literacy and inadequate quality education, no opportunity for employment locally, dependence on subsistence farming, migratory labor, and poor relationship with administrative structure. Access to quality healthcare and proper healthcare education will result in improved medical outcomes which will further result in better community development.
What we hope to accomplish through the completion of this project:
The three main objectives we hope to accomplish are:
- Reduce infant mortality rates (IMR) from 70/1000 live births to 40/1000 live births
- Reduce maternal mortality rates (MMR) from 3/1000 live births to <1/1000 live births
- To improve immunization coverage from 30% to 95%.
Our key indicators to measure whether we accomplish our goal are:
- Infant and Maternal Mortality Rates, and # of Children Immunized in the region.
In collaboration with the Christian Medical College Foundation, we are working with the faith based community including the Reform Church of America, the American Baptist Church, and others.
The matching gift campaign has a deadline of October 31st.
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