Today in many of the slums and villages in Ludhiana, the sight of children and their families crowded around a big green and yellow vehicle on a hot summer or a cold winter day is not unfamiliar. This vehicle is Smile Foundation’s Smile on Wheels mobile hospital that provides free healthcare to children and their families at their doorsteps.
Over the last two decades, Ludhiana has emerged as one of the most important industrial towns in not just Punjab, but the whole of North India. Such rapid and enormous growth of the city has resulted in migration of poor population from smaller areas of Punjab and other states like Bihar, UP, Haryana and Rajasthan in search of employment. Due to low income level and inadequate housing facilities, several slum clusters mushroomed in and around the city to accommodate the migrants. As per the provisional records in Census 2011, at least 15% of Ludhiana’s estimated population of 1.6 million live in slums; this does not include a significant number of the homeless and other people from non-notified slums who remain outside the purview of municipal records.
Absence of safe potable water, sanitation and toilets, waste collection and other civic amenities in slums have made living conditions onerous for its residents.
Communicable and vector borne ailments like tuberculosis, diarrhoea, dysentery, worm infestation, malaria, typhoid, dengue, skin infection, scabies and RTI/UTI among women are common in the region. Already burdened with the grim physical environment, these slum dwellers working as daily wage labourers, rickshaw pullers, rag pickers and housemaids can hardly make ends meet let alone spend on healthcare.
Smile Foundation has partnered with Deutsche Bank to serve the underserved population in the city. Jugiana, Shrabha Pind, Pratappura, Jamalpur, Tajpur Road, Fatehpur and Mandi Ahmedgarh are among the 18 slum settlements in Ludhiana where Smile Foundation is rendering preventive, promotive and curative healthcare services.
Every day at 9 AM, the team of Smile Foundation’s health workers, including a doctor, nurses, pharmacist, lab technician, volunteers and a project coordinator, start their journey through the grey streets of Ludhiana. They carry out daily OPD services in two shifts – morning and afternoon. The Smile on Wheels mobile hospital treat more than 100 children and women every day for common illnesses, providing medicine and immunization services, as well as micronutrients and nutritional supplements to treat and prevent malnutrition.
“The most common cases we see are related to cold cough, joint pain, scabies, UTI among women during winters and diarrhoea, vomiting, scabies, dysentery, and worm infection during summers. During monsoon, the number of patients increases and we get many cases of malaria, typhoid, dengue and skin infection,” said Dr. GP Singh, Senior Doctor who leads the medical team.
“The slum dwellers live in poor hygiene conditions – amidst the rubble, combined with a general lack of safe water, causing more children to fall ill,” he added. The number of families relying on the Smile on Wheels mobile hospital is increasing every day, as the nearest Primary Health Centre is at least at a distance of 10 km. Moreover, the unwillingness to lose a day’s wage makes people ignore health conditions of their self and of their families.
“Although we come here every day for six hours, we barely stop work for one minute. We see one child or mother every 10 minutes while dozens of others are lining up outside in the chilling cold,” said Sitaram, Project Co-ordinator of the Smile on Wheels Mobile hospital in Ludhiana.
To spread awareness on health-seeking behaviour, a team of community volunteers also accompanies the mobile health clinic, passing on information to caregivers and answering questions on how to prevent children and the family members from common illnesses. Several IEC activities like street plays and audio visual shows are also conducted to encourage health-seeking behaviour in people and sensitise them about basic hygiene and healthy living.
On a regular basis, exclusive community meetings are conducted to address women-related issues, such as childbirth, ANC/PNC, maternal and infant nutrition, immunization and family planning.
“Newborn children and infants are left to be cared for by their grandmothers, deprived by default of natural breastfeeding and even complementary infant feeding, which they can’t afford to buy,” said Gangandeep, one of the nurses and counsellor from the project. Some caregivers are improvising by preparing sugary water drinks. But even children who are under the care of their parents face challenges as well.
“During one-on-one sessions with mothers, we hear all kinds of dreadful stories. Many of them are single mothers who are facing the world alone. Their psychological wellbeing and lack of a support system makes it hard for mothers to exclusively breastfeed and to provide the most nutritious foods in their children’s early years of life,” Gagandeep adds. “So we are their support system, we’re their friends and their confidants.”
Besides delivering preventive, promotive and curative services at the doorstep of beneficiaries, Smile Foundation develops a bridging network between them and the public healthcare system through referrals.
Started in 1st January 2017, the Smile on Wheels mobile hospital project in Ludhiana has benefitted over 18000 children and their families in one year.