Healthcare goes mobile - and rural !

'Smile on Wheels' has been envisaged as a national level project aimed at providing basic healthcare services to underprivileged communities living in rural areas, urban slums or in the proximity of cities and towns. Special attention is given to children and women.

The project incorporates mobile vans fitted with quality medical equipment - and manned by qualified doctors and paramedics - that are on the road 24 days

a month, touring rural areas around the urban centres where they are based. The vehicles are modified Tempo Travellers, customized for delivery of varied preventive and palliative healthcare.

Typically, a 'Smile on Wheels' van has the following systems and hardware on board:

• Portable X-ray unit
• Portable ECG unit
• Basic lab/analysis equipment for pathological examination
• Nebulizer * First aid kit
• Mini chiller/refrigerator
• Oxygen cylinder
• IV fluid transfusion kit
• Examination table
• Fire extinguisher
• Wash basin
• Intercom linking driver and medical team.

Thus equipped, the vans make these services possible:

• X-ray and ECG examination
• Blood/urine tests
• Curative medication for common ailments
• Ante- and post-natal support
• Identification of challenging pregnancies for referral to medical institutions
• Health education & family planning orientation: including distribution of
  condoms & oral contraceptives, insertion of IUDs, etc.
• Immunization of mothers & children
• Treatment of malnutrition and growth disorders
• Minor surgery and dressing of cuts/wounds
• Distribution of Iron Folic tablets, Vitamin A prophylaxis, etc.

Smile Foundation intends to have a fleet of 30 such exclusive vans fully operational in the near future.
Once mobile, these are expected to cover a population of nearly 40 lakh people.


An inspiring first phase : SoW-ing the seeds of success

The 'Smile on Wheels' programme has been successfully launched in five states in the initial phase : Orissa, Chhatisgarh, Uttarakhand, Uttar Pradesh and Maharashtra.

In each state, the Smile Foundation has partnered with a reputed local NGO or development institution to access villages where no governmental health services exist. These include the Sevadham Trust (based in Pune, Maharashtra); Berojgar Mahila Sewa Samiti (Bhilai, Chhatisgarh); Orissa Institute of Medical Research & Health Services (Cuttack, Orissa); Ambuja Cement Foundation (Roorkee, Uttarakhand); Suraj Hospital (Kanpur, UP).

The SoW vans have been given a designated coverage area of up to 50 km radius around its base city/town. This usually places 12 to 15 villages under its jurisdiction. Every day, the vehicle is expected to touch 2-3 villages - and provide committed medical support to all the concerned villages throughout the month.

The project has received enthusiastic response from the beneficiaries in each state. People have found the vans to be a true blessing: that fill a crying need for a service of this kind. They no longer have to trudge miles, spend hours or invest their limited funds to be treated at the nearest healthcare centre. They have found a professional and safe alternative to the local quacks. And their attitude towards healthcare has changed as well.

Besides the outreach success, the 'Smile on Wheels' project has also seen the organization of regular health check-up camps in the villages, including those for schoolchildren.

     (Quotes from SOW beneficiaries and participants)

"Prior to the Smile on Wheels van, we were dependent on bullock carts to take our patients 3 to 5 hours before treatment could start. Now treatment starts within the first half an hour and we don't have to go anywhere, thanks to Smile on Wheels."
                                                                      -- Rambhau Bhagwat, Nigade

"We have identified some villages as 'Smile on Wheels villages' and given them a special ambulance facility in emergencies, on local charge rates. This has proved very useful for them."z
                                         -- Dr SV Gore, Managing Trustee, Sevadham Trust

"The poor economic condition of the people doesn't permit them to avail the services provided by the Medical College in Cuttack. But the Smile on Wheels van has diminished the health problem of our area… the equipment is operated by experienced and efficient doctors… the patients are under proper supervision of the health workers till recovery."
                                                                                       -- Keshab Chandra Lal, Orissa

"The vans serve the outreach communities at their doorstep and provide services irrespective of sex, caste and creed."
                                                                           -- Shreedhar Barik, Orissa

"The SoW programme is definitely reducing the childhood morbidity, and the resuscitation cum incubation kit is very useful to save the life of the baby."
                                                              -- Dr Pradeep Mishra, paediatrician

"Even the village women and girls are expressing their health problems without any hesitation. Special attention is given to women, especially pregnant women, as well as children who were deprived of quality services due to transportation problem.
                                                                 -- Janaki Devi, paramedical staff

"SoW is very helpful in providing timely health services in our village. Earlier we used to ignore our diseases, but now we get timely treatment."
                                                                                      -- Javed, Sikanderpur, UP

"The awareness sessions conducted for adolescent girls have promoted better hygienic and health practices among them. The change in their behaviour and attitude is visible."                                       -- Parmita, Anganwadi worker, UP