With the advent of COVID-19, access to health care, especially for chronic diseases suffered as government resources were increasingly diverted towards control of COVID-19. Therefore in June 2020 we initiated tent-based monthly health camps to provide primary health care to vulnerable families living in interior rural and tribal areas of southern Rajasthan. The camps were set up specifically to minimize the risk of spread of the virus – they were partially open, allowed for greater air circulation, and could be set up or dismantled within 20 minutes.
In the first phase we organized two half-day camps on each day in different villages, and later in the second phase in one location on pre-scheduled and publicised days. Now that the pandemic has ebbed, we have started using schools and other government buildings along with tents, to ensure better privacy and protection from inclement weather. The camps now form part of a health care system for older persons and those with chronic diseases, as shown in the accompanying graphic.
ARTH’s community health workers identify sick persons, including severely malnourished children and older persons and refer them to the nearest camp. There, a doctor examines them, support staff provides the patient with free medication, mobility aids and explains dosage, diet, exercise, etc. The patient is encouraged to visit again to ensure that treatment is working. Those with chronic conditions in need of specialised investigations or care are referred (expenses paid) to the Government Hospital in Udaipur, where ARTH’s referral navigator meets and accompanies them through tests and outpatient clinics.
ARTH’s telephone call centre supports both family and referral navigator to ensure better coordination. Afterwards, patients are encouraged to follow up at subsequent camps, some are referred to the local primary health centre for continuing access to free drugs. We are also beginning to connect to recently established Health & Wellness Centres. Thus our health camps therefore have become a link for enabling the community to access different levels of he alth care for chronic diseases.
From June 2020 to March 2023, ARTH has conducted 345 monthly camps with a footfall of 4,459 persons, of which 28% were senior citizens. Major chronic conditions being treated through these camps include hypertension, malnutrition, diabetes and COPD. We see periodic camps at the same location as representing a hybrid service delivery mechanism, between ad hoc or one-shot health camps and fixed facilities. They have greater relevance for interior areas and under-served communities that carry a heavier burden of undetected or untreated chronic morbidity.