Rural Camps Research Articles

Gaping gaps in rural mental health care: understanding causes and prioritizing solutions

IntroductionMental health is crucial and is the backbone of all dimensions of health; physical, social and spiritual. Mental health has multiple interfaces and it is important to bring mental health to the center stage as it is the key regulator of all human activities. Unfortunately, there are alarming gaps in mental health care especially in rural areas which require attention of mental health professionals and policy makers.The study aims to understand the causes of these gaps and suggest possible and practical solutions to bridge them.ObjectivesTo study the spectrum of mental health gaps present in rural areas of Haryana, a state in the northern part of India and find culturally sensitive and relevant solutions keeping in view the socio economic realities and prevalent legal framework.Methods Any factor having bearing on mental health but is operative sub-optimally would be considered as mental health gap for the current investigation. Rural camps were organized in 10 villages to assess the service gap at three different levels: overt (measurable), covert (including attitudinal) and ancillary (including those embedded in the psychiatry evaluation and treatment). The camps were organized by following these three basic steps: 1) Evaluating the geographic and demographic details of the villages selected. This was done by meeting the key stakeholders of the villages and the official health and service statistics available on the government website 2) Camp by multidisciplinary team in the villages with an advance intimation. The team members evaluated the mental health care awareness and the felt needs by interviewing all the villagers attending the camp on that particular day. 3) Post camp review by the team to analyze the service gaps and steps to address and narrow the gaps.ResultsApart from inadequate availability of professional and infrastructural resources, there were many attitudinal and ancillary gaps serving as obstacles to treatment seeking. Trust gaps leading to poor acceptance and legislation not congruent with the socio cultural needs were key impediments. Rural people had more faith in Spiritual leaders and faith healers for their mental health issues and medical help was sought only when they have signs of physical illness. Mental health and illnesses were not on priority. Availability, accessibility and affordability of health services were important factors needing immediate attention.Conclusions Rural services need to be augmented by de professionalization and task shifting is the key to address and cover the yawning gaps in the services. Massive, coordinated, multidisciplinary and sustainable efforts are needed to bridge the multitude of gaps keeping in view poverty and illiteracy as compounding factors.Disclosure of InterestNone Declared

The 30-Year Odyssey of Epilepsy Rural Camps: The Exotic Paradigmatic Journey of Change

The 30-Year Odyssey of Epilepsy Rural Camps: The Exotic Paradigmatic Journey of Change

411P Cost-effective analysis of the various cancer screening methods in the community: Pooled analysis of camps of 5 years from 2017-to 2022

The cancer, which claims a million deaths per annum across India is a major concern due to presentation in later stages, owing to lack of awareness and structured screening programs. The fragmented screening happens through hospitals (HBS), rural camps by screening buses (CSB), awareness programs, and augmented self-examination (ASE) protocols using AI. This research is aimed to empower cancer screening strategies.

Interprofessional collaboration to manage allergic disorders in rural areas of Himachal Pradesh

Background: Allergic disorders are common and affect a large population even in rural areas. Medical care is not easily accessible to rural population especially in hilly terrain. Health camps are effective method to deliver medical care in such areas. Interprofessional collaboration involving various professions who work together as a team for management of various disorders is being studied and practiced recently. Aims and Objectives: To study the impact of interprofessional collaboration at these rural health camps to control allergies prevalent in the rural areas of the region. Methodology: Around 18 interprofessional health camps involving doctors of various disciplines – ENT, pulmonary medicine, skin, eyes, yoga experts, health and sanitation workers, public health, lab technicians, pharmacist and nursing staff were held in rural areas with an attempt to manage allergic disorders prevalent there as a team. The treatment was provided as a collaboration of various professions. Results: 608 patients of allergic disorders were identified at these camps which were more prevalent in younger and middle age group and females. The common allergens were dust mite mix, pine mix, cockroach and grass pollen. Nasal allergies were more common followed by skin and pulmonary allergies. On follow up, allergies were more controlled (48%) in patients who followed interprofessional advise and treatment as compared to (5%) in those who didn’t follow the same. Conclusion: Allergic disorders can be best managed by a holistic approach of treatment involving various professions. Health camps through interprofessional approach are an excellent method to provide medical care to rural population in difficult hilly terrain. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 96-100

Efficacy of rural camps in achieving vision 2020: Our contribution

: To assess the effectiveness of rural camps held under DBCS (District Blindness Control Programme) & compare the results of cataract surgery at base hospital cases. It is a retrospective observational study, medical records of patients operated for cataract in camp & patients operated in base hospital are analyzed.In our hospital outpatient department, we saw 2,08,716 patients from 2010-2019 and 7796 underwent cataract surgery. Under DBCS we conducted 262 camps from 2010-2019 & 4611 underwent cataract surgery.A total of 27,524 patients got screened in 262 rural camps and 4671 underwent small incision cataract surgery at the base hospital after detailed clinical examination and IOL (intraocular lens) power calculation for each patient. Among 2,08,716 outpatients at the base hospital, 7796 underwent cataract surgery. The rate of intraoperative complications in the base hospital was 0.885% whereas in camp cases 1.94%.IOL implantation is done in 100%cases in base hospital surgeries and 0.064%patients left aphakic among rural camps.Screening at outreach camps and surgeries at the base hospital can have excellent results. Mass surgeries in camps following standard protocol can have the least number of complications.

Outcomes of Cataract Surgeries Performed in Makeshift Operating Rooms in Rural Camps, Compared to Hospital-based Surgeries in Nepal

ABSTRACT Purpose This study was undertaken to evaluate the complication rates and visual outcomes of outreach cataract surgeries done in makeshift operating rooms. Method In this retrospective study, surgical outcomes of consecutive Manual Small Incision Cataract Surgeries (MSICS) done in 11 rural camps in Nepal were compared with the results of consecutive hospital surgeries (MSICS and phacoemulsification) done by the same surgeon. Surgeries were done from September 2018 to March 2020. Results Out of 1034 study population in each group, a significantly higher number (p < .001) of camp patients (27%, n = 279) were either blind or had severe visual impairment when compared to hospital patients (18.6%, n = 192). Around 88.9% (n = 919) of cases operated in camps and 85.7% (n = 886) in the hospital achieved uncorrected visual acuity (VA) of 6/18 or better on the first postoperative day. Poor outcome (VA<6/60) was seen in 3.7% (n = 38) of cases in camps and 3.9% (n = 40) in the hospital. The difference in visual outcomes was not significant (p = .162) when the results were controlled for other associated variables. There was no significant difference (p = .126) between complication rates in camps (1.9%, n = 20) and hospital surgeries (3.5%, n = 36) when preoperative conditions were statistically controlled. No cases of endophthalmitis were reported. Conclusions Makeshift operating rooms can be used for cataract surgeries in rural areas where no standard operating rooms are available. If appropriate patient selection criteria and standard surgical protocols are followed, good surgical outcomes can be achieved in camps by an experienced surgical team.

Частота и причины железодефицита у малочисленных народов Севера (ханты и манси), мигрировавших в город и ведущих традиционный образ жизни (стойбища, село), опыт применения препаратов железа

Objective. To study the health status of women from among the small-numbered indigenous peoples of the North (SIPN), including those leading a traditional way of life in camps and rural areas. Patients and methods. Using continuous sampling method, a prospective analysis of complaints, anamnestic, anthropometric, and laboratory data was carried out in female patients from among SIPN (Khanty and Mansi) living in rural areas and camps, as well as in the city of Khanty-Mansiysk. The comparison group consisted of women from the migrant population (Russians) living in the city of Khanty-Mansiysk. Results. The greatest number of health disorders was found among SIPN who migrated to the city in the first and second generations. Overweight was observed in 46.2% of women in this cohort, obesity was diagnosed in 19.2% of women. Heavy and prolonged menstrual bleeding was the main cause of iron deficiency (11.5%) and iron deficiency anemia (IDA) (30.8%) in the group of SIPN living in the city. IDA of mild severity occurred in 19.2% of patients, and of moderate severity – in 11.5%. Conclusion. Iron metabolism disorders were observed in 42.3% of women from among SIPN who migrated to the city. Iron(III)- hydroxide polymaltose complex (Ferrum Lek®), which is used in the complex therapy of gynecological diseases (menstrual disorders) and gastrointestinal diseases, has high efficiency, good tolerability and the least number of adverse effects. This makes it possible to recommend it for the treatment of IDA and for the replenishment of iron stores in women in both SIPN and newcomer populations. Key words: anemia, iron deficiency, female residents of the Khanty-Mansi Autonomous Area-Yugra, small-numbered indigenous peoples of the North (Khanty and Mansi), Ferrum Lek

The nesting ecology and postembryonic development of the Baikal white wagtail &lt;i&gt;Motacilla alba baicalensis&lt;/i&gt;

The goal of the paper is to identify the features of the breeding ecology of the Motacilla alba baicalensis in the Baikal region and Transbaikalia. The nesting ecology study deliverable of the Motacilla alba baicalensis in the Baikal region and Transbaikalia showed that this subspecies, unlike other forms, is more synanthropic, more than 95% of populations live in localities and other anthropogenic habitats, and only 23% of populations inhabit natural biotopes. At the same time, the Motacilla alba baicalensis in the region prefers small rural settlements and livestock camps in open landscapes near reservoirs. When the Motacilla alba baicalensis builds nests, like other subspecies, it is quite plastic and easily finds shelter in various anthropogenic and natural biotopes. The higher nesting efficiency of this subspecies indicates its wide opportunities to develop anthropogenic landscapes. Due to the short favorable nesting period, most pairs manage to hatch chicks once, but only a small number of pairs manage to raise chicks twice a season. A comparison of the nesting ecology of the Motacilla alba baicalensis with other forms of the Northern Eurasian species did not reveal any fundamental differences. The differences relate to the phenology of different stages of the breeding season, as well as the timing of arrival and departure of birds.

Dinâmica socioespacial e produção agrícola nos acampamentos rurais Sapucaia e Caípe, União dos Palmares, Alagoas - Brasil

ABSTRACT: The Zona da Mata of Alagoas is a region of the state strongly marked by the creation of beef cattle and sugarcane monoculture, the latter practice being an influence of the sugar and alcohol establishments that for many decades dictated the state's agricultural production. For some years, this scenario has been modified due to the closure of sugar and alcohol mills and some properties changing their production method. However, many areas previously cultivated by the aforementioned crop have had production pauses. Thus, some, through social movements fighting for land, started to be occupied and claim the right to land through agrarian reform. Thus, the objective of this study was to understand the socio-spatial dynamics of the Sapucaia and Caipe campsites, located on the margins of BR-104 in the municipality of Uniao dos Palmares, Alagoas, Brazil, as well to understand the agricultural production of these rural camps. Thus, a qualitative and quantitative research was carried out through interviews. The research provided an understanding of the constitution of the families that make up the camps, which demonstrated the existence of a still patriarchal mode of organization with the invisibility of women. In addition, there are also subhuman conditions regarding infrastructure. In addition to these aspects, there is a lack of technical assistance, which is fundamental in the process of contemplating and implementing land reform. KEYWORDS: land reform, housing structure, rural camp.

English

English

Clinical profile and burden of primary glaucoma in rural camp patients attending a tertiary care center in India

Purpose: To study clinical profile and burden of primary glaucoma in rural camp patients attending a tertiary care center. Materials and Methods: A cross-sectional study was conducted in a tertiary care hospital of a single academic institute after ethical approval. Primary glaucoma patients aged ≥40 years, referred from the outreach camps, were included for a period of 12 months (2016–2017). A detailed history was recorded. Ocular examination included visual acuity, slit-lamp examination, disc evaluation, gonioscopy, intraocular pressure (IOP), and visual fields. Glaucoma was defined according to the International Society Geographical and Epidemiological Ophthalmology. Results: Out of 4204 referred cases from community program, 115 cases had primary glaucoma. Open-angle group had 63 (54.78%) cases whereas narrow-angle group had 52 (45.22%). The hospital-based prevalence for open-angle glaucoma was 1.11% (95% confidence interval [CI]: 0.8, 1.44) and for narrow-angle glaucoma was 1.07% (95% CI: 0.76, 1.38). The mean IOP was higher in narrow-angle group (P

Efficacy of Rural Camps at a Tertiary Centre in Dehradun in Achieving Vision 2020

Background:- To establish the effectiveness of rural outreach camps in reducing preventable blindness caused by cataract and achieving VISION 2020 by WHO.

Role of rural camps in nurturing field practicum: narrative from a faculty of social work, Delhi, India

Rural camps are an integral part of practice learning for most schools of social work in India. The paper locates the relevance of rural camps in social work education and unveils its pedagogy and broad learning framework. Based on the experiential account of the author in a rural camp as a teacher educator, the paper situates the role of camps in professional development of social work students and how it enables to bridge the gaps between academic knowledge base and the complex realities of practice. The unique standpoint of the paper is the students’ account of their experiences, challenges faced and its impact on their personal and professional growth.

The Process, Ground Work and Expected Investment on the Necessary Infrastructures and Places for Rural Tourism Development by Involved Groups in Tehran Province

The Process, Ground Work and Expected Investment on the Necessary Infrastructures and Places for Rural Tourism Development by Involved Groups in Tehran Province

A heritage ‘trailscape’: tracking the exploits of historical figures – an Australian case study

ABSTRACTOne of the many distinct problems encountered in tracking the exploits of historical figures such as folk heroes – especially in their guise as tourist icons – is engagement, not only with the principal routes and trails taken by them, but also with the minor pathways and the many small-scale rural settlements, meeting grounds, base camps, and replenishment stopovers which serviced their lifestyle. An aggregation of these trails and servicing points would contribute significantly to determining, firstly, the regional operational areas of such folk heroes (including highwaymen, outlaws, social bandits, and bushrangers) and secondly, a potential pattern for history-linked and heritage-based regional tourism. It is likely that in responding to the meanderings of the folk hero, the spatial pattern would conform more to the idea of a ‘themescape’ than to other linear-like configurations, and the outcome could be envisaged and interpreted as a ‘trailscape’. Using as a case study the story of the Australian folk hero Edward (Ned) Kelly, this paper experiments with ‘ways of looking at the evidence’ and of interpreting and engaging with the ‘trailscape’ which is a hallmark of the overlapping spheres and clusters of the hero’s activities.

No Scalpel Vasectomy (NSV) with Ligation and Excision: A Single Centre Experience.

No scalpel vasectomy (NSV) has proved to be a safe and simple procedure for permanent sterilization for men. Ligation and excision of the vas deferens followed by fascial interposition is the procedure of choice. It is believed that vas excision without fascial interposition has a risk of failure. The objective of this study was to evaluate the technique of NSV with ligation and excision only. No scalpel vasectomy performed in an urban centre was taken for this prospective study. Only ligation and excision procedure was applied in its execution. It was demonstrated and performed under the supervision of an expert. Information regarding early and late complications including failure was gathered. A total number of 3,392 NSVs were performed in an urban training centre between Apr' 2009 to Mar' 2013. The procedure applied was only excision and ligation of the vas deferens. The fascial interposition was not included in the procedure. Haematoma (1), bleeding (3), foreign body granuloma (1), scrotal pain (3), epididymitis (1) and sinus formations (1) were encountered. There was only one failure in the whole group of acceptors. NSV with ligation and excision is a simple and easy procedure to learn and perform. Complications and failures are negligible. The additional fascial interposition needs more surgical skill and is time-consuming, hence can be avoided where a large number of acceptors need to undergo NSV in a rural camp.

1455P - Cervical Cancer Screening Using Visual Inspection after Application of 5% Acetic Acid (VIA) in Rural West Bengal

ABSTRACT Background Because of problem of manpower in developing countries, cytology screening for cervical cancer is gradually replaced by a Visual Inspection after application of 5% acetic acid (VIA) with triage of colposcopy. Objectives Hence, government and other funding bodies in India are now eager to see its efficacy in the field to screen and manage cervical pre cancer (CIN) in a “see & treat” approach. Methods This simple technology combined with colposcopy is planned in a biotechnology based programme for women under Department of Biotechnology, Govt. of India where efficacy of VIA was assessed by camp approach in rural area of a remote district (Burdwan) of West Bengal province in India from August 2010 to August 2011. We used video colposcopy as triage and managed positive cases by Loop Electrosurgical Excision Procedure (LEEP). We evaluated our early screening and management results by finding out detection rates of early lesions of cervix and in this uncontrolled observational study. Results A total of 2836 women participated in our rural camp for screening during this period. Amongst them 2354women could be subjected to visual inspection by acetic acid (VIA) using 200 watt bulb and 5% acetic acid by the trainedcommunity nurse. We could not do VIA in 482 subjects because of no consent-22.80%, non-cooperation-23.40%, unmarried-18.60%, menstruating-12.80%, pregnant-10.50%, hysterectomised-9.10% and cervix cancer neglected or infollow up-2.50%. We could detect 415 cases of VIA positive cases showing white lesion in their cervix. Colposcopic prediction of cervical Intra-epithelial neoplasia grade I(CIN I) lesion could be detected in 174 cases. These cases are of no immediate risk and most of them actually showregression of their disease. Hence, they are advised to have follow-up colposcopy after six months. There were 25 cases of condyloma/ polyp. They were managed by electro- cautery. We could detect and treat 33 cases of CIN II andIII which are precursor of cervical cancer. They were treated by LEEP. Conclusion Our results show that VIA with colposcopy triage is viable option in rural cervical cancer screening programme in our outreach program. Disclosure All authors have declared no conflicts of interest.

1454P - Evaluation of Colposcopy and Loop Electrosurgical Excision Procedure (LEEP) in A Rural Mobile Cervical Cancer Screening Unit in West Bengal, India

ABSTRACT Background In recent years there are many attempts to see accuracy of colposcopy in poor resource setting where ‘see and treat’ approach is used. Sensitivity and specificity for colposcopy in India is not determined accurately so far because of poormethodology of experiments. Objectives Hence, in a cervical cancer screening and management project for rural poor women in West Bengal province of India we tried to calculate specificity and sensitivity of colposcopy based on management by LEEP. Methods VIA combined with colposcopy and LEEP using mobile van is planned in a biotechnology based programme for women under Department of Biotechnology, Govt. of India where efficacy of colposcopy was assessed by camp approach in rural area of a remote district. We used video colposcopy as triage and managed positive cases by LEEP. We randomly selected 50 cases that wereColposcopy negative & 50 cases with CIN I and did biopsy cervix on all of them. We thus evaluated our early screeningand management to detect sensitivity & specificity of Colposcopy in this rural setting. Results A total of 2836 women participated in our rural camp for screening during this period. We could detect 415 VIA positive cases. In this gold standard test we saw 12 cases of false positive. Only 14 cases of false negative that then underwent LEEP. Thus colposcopy in our series had 60% sensitivity and 63% positive predictive value while 87.7% specificity and 86% negative predictive value. Complication Rate was 3 percent (14 cases). Conclusion In our series sensitivity of colposcopy was comparatively low. Main confounding variable producing false positive result was inflammation of cervix which seems to be a cause of concern in our country. However, obustness of VIA needs to be calculated in a bigger study to find out efficacy of such screening. Disclosure All authors have declared no conflicts of interest.

Segurança alimentar e nutricional de crianças menores de dois anos de famílias de trabalhadores rurais Sem Terra

To date little is known of health, nutrition and food safety conditions of children living in rural camps and settlements. The present cross-sectional descriptive study seeks to present and discuss such conditions for children under two years of age in families of landless rural workers in the Central Western region of the State of Paraná. The study was conducted with a total of 337 children under two years of age in families living in two rural settlements and two rural camps. The main variables related with protein-energy malnutrition were assessed. Results indicated that the prevalence of protein-energy malnutrition was 4.7% in settlements and 10% in camps. Home location, home type and the possibility of producing food for private consumption were the distal variables that influenced most the nutritional status of the pediatric population analyzed. This study established that the search for nutritional and food safety must consider the right of accessing resources and proper means to produce safe and healthy foods in order to enable adequate feeding compatible with the habits and practices of the region.

Religion and African Migration: A Survey

The purpose of this article is to review the available literature on the intersections of religion and migration with reference to African refugees and migrants. I draw primarily on works that have emerged in the last decade to address both the under-explored role of religion in the lives of African refugees and migrants and the active role they play in shaping the religious landscape in their migratory contexts and in their countries of origin. Published research on religion and African migration varies in scope, ranging from rich descriptions of the religious beliefs and practices of refugees in rural camps in Africa to analyzes of the impact of religion on the realities of settlement faced by African migrants in urban cities in Europe. Other works investigate processes of societal change resulting from the intersection of religion and African migration, while others examine how religious institutions that have come into being to deal with the spiritual and socio-economic and political needs of African refugees and migrants and their efforts to maintain contact with people in their homeland. I argue that future research could benefit from moving beyond individual case studies that reflect particular disciplinary perspectives to more comparative and intra-disciplinary analyzes of migrant identities and experiences. Such studies have the potential to inform about conceptual and experiential differences of being an African migrant and alternately, what it entails to be European or American in the age of globalization.