SEVAK Project in India and Guyana Modeled After the Independent Duty Corpsman of the U.S. Navy.

Abstract

INTRODUCTION SEVAK Project (www.sevakproject.org) was initiated in July 2010 in India and empowers and pays a local person to look after the health of the people in their own village. The acronym SEVAK stands for “Sanitation and Health, Education in Village communities through improved Awareness and Knowledge of Prevention/Management of Diseases and Health Promotion.” The inspiration for this project came from the long-standing and successful—Independent Duty Corpsman (IDC) program in the U.S. Navy. One of the authors, Dr Thakor G. Patel, retired U.S. Navy Captain worked extensively with the U.S. Navy IDC program during his distinguished career and used this experience to design the SEVAK program. IDC are high-school graduates interested in health care who were given 12 months of intensive training and then assigned to Marine Corps units or Navy Ships, where they are fondly referred to as the “doc.” IDCs provide primary and preventive care, evaluate trauma, and initiate disaster management protocols. In addition, they monitor occupational health through environmental checks such as humidity, temperature and sanitation. In global health terms, they are community health workers trained in a consistent fashion to provide health services and monitoring for a specific population. The SEVAK Project aimed to produce similar capability for underserved civilian villages with an intense two and a half month curriculum. SEVAK training emphasizes lifestyle intervention and health screening for diabetes, hypertension, obesity, immunization, and chronic diseases. SEVAKs also received basic training in sanitation, environment, water purification, infectious diseases, and how to build toilets and smokeless cooking stoves. The project started in July 2010 in the Indian state of Gujarat and was approved by the Prime Minister N. Modi, when he was the Governor of Gujarat (http://sevakproject.org/index.html). It is the basis of Modi’s current national program to improve sanitation in the entire country of India (http://www.narendramodi.in/pm-modissanitation-campaign-gets-lauded-by-united-nations/) and the SEVAK Project compliments and supports the existing public health system and plans. The SEVAK Project was extended to Guyana, South America, in 2013. So in addition to the one village per district (n = 27) in Gujarat, India, the project added 14 villages in Guyana, South America, with an intent to screen the residents for diabetes, hypertension, obesity and monitor those with chronic diseases. The major difference between the Indian model and the Guyanese model is that the SEVAKS in Guyana are still in high school and they work in their villages only during the weekends, whereas SEVAKs in India are full-time workers and are paid a salary. The Guyana Project involves coordinating with the villages and identifying bright, interested individuals with, medical and or nonmedical, backgrounds (one per a village of 1,000–1,500 population) to be SEVAKs. Training includes techniques for good sanitation practices, safe drinking water, smoking cessation and malaria prevention. SEVAKs are also trained for monitoring/recording of blood pressure, blood sugar, observing for peripheral edema, lifestyle modification education and noting dietary practices, so that they could keep better surveillance on the health of their respective villages. Biology teachers from the local school accomplish day-to-day supervision of the Guyana SEVAKs. The SEVAK Project in Guyana recently received approval from the Government of Guyana. Preand postevaluation of the training is done by the authors via Internet and visits to India and Guyana. During these visits, we accompany the SEVAKS in the field and monitor their progress. Particular attention is paid to visit the patients who have been diagnosed with hypertension and diabetes to confirm the findings of the SEVAKS. Our preliminary *Division of Global Health, Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814. †Department of Medicine, University of Pittsburgh Medical Center, 3550 Terrace Street, Pittsburgh, PA 15261. ‡Government Medical College, Khatodra Wadi, Surat, Gujarat 395001, India. §Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814. The views expressed are those of the authors and do not reflect the official policy or position of the Uniformed Services University of the Health Sciences, the U.S. Navy, the Department of Defense, or the U.S. Government. doi: 10.7205/MILMED-D-15-00340