Empowering Rural People for Primary Health Care
Contributed by Shanavaskhan A.E., Binu S, Rajasekharan S, Jacob Thomas and P.Pushpangagan, Tropical Botanic Garden and Research Institute, Thiruvananthapuram
The role of botanical gardens in p[popularisation of science is well recognised. Botanical gardens’ new roles in educating people on environmental, conservation, sustainable management and utilisation of local biodiversity elements are nowadays getting more important. In a developing country like India, rural people are concerned more on health problems and livelihood. During the past few years TBGRI has developed a programme called ‘health for all and herb for all’ as a part of its outreach programmes. This programme was designed to develop the productive potential of the rural people using the under utilised floristic wealth for income generation and primary health care.
India has perhaps one of the richest ethno botanical traditions in the world. A study conducted by the Al India Co-ordinated Research Project on Ethnobiology reveals that different communities use more than 7000 species of plants across the country for an unbroken 5000 year old living legacy. This system is working in India through two main streams; well codified indigenous systems like Ayurveda, Sidha, Unani, Amchi and immensely rich and diverse fold practices. A good portion of modern plant based drugs were developed as a result of scientific study of plants used in traditional systems. Unfortunately, these traditions have largely been eroded due to lack of support and recognition as well as due to the rapid destruction of forest wealth which has resulted in the shortage of medicinal plants. In this context, a combined approach of conserving both the traditional knowledge as well as the medicinal plants ahs turned out to be the only option for protecting the country’s age-old medical heritage. A healthy population is the real wealth of a nation and it is the collective responsibility of individuals, families and governments to ensure the community’s health security, for which food security is the basic requirement. The TBGRI outreach programme addresses this core theme and has launched various activities aimed at the conservation and sustainable utilization of biodiversity.
Over the past few years TBGRI scientists have been carrying out certain community participatory activities especially with medicinal plants in certain rural villages. Some of these villages were selected for the present programme. To start with, background information on the socio economic and resource profile of the villages was obtained as a base document for properly planning the programme. The data collected included information on the bio-resources of the region and their utilization pattern. Social organizations of the villages, socio-economic and techno-economic capabilities of the villages, health profile of the villagers and the status of health management in the villages were also recorded.
After the assessment of the above data, four rural villages in Thiruvananthapurum District were selected for implementation of the programme; Njaraneeli, Bharathanoor, Pampuchathamannu and Panangode. The villages are situated within a distance of 20km from TBGRI and the majority (80%) of the people belong to farming communities owning small pieces of land (0.1 – 0.5 ha) cultivating rubber, paddy, pepper and tapioca. The villagers are mostly Christians, Muslims and Hindis and the majority are literate.
A team of TBGRI scientists visited the villages and interacted with several influential people and discussed the proposed action plan. Encourages by their positive responses, a series of seminars and exhibitions were organized in the villages. During seminars an action plan was introduced before the village people and their co-operation was sought for the programme. Ten people form each village were selected based on their ability to write, read, and speak before a group of people. These ‘core group member’ were brought o TBGRI for a three day residential training.
On the first day of the programme, scientists gave lectures on
- wild bio-resources,
- sustainable and productive use of bio-resources and value addition,
- ecologically sound and economically sustainable utilization strategies,
- importance of traditional diets,
- qualitative superiority of local fruits and vegetables,
- issues involved with the disappearance of home gardens,
- harmful effects and problems associated with monoculture.
On the second and third days, the importance of primary health care and the need for sustainable utilization of bio-resources were discussed. The uses of thirty single plants which can be used for common ailments and the preparation of 10 combination drugs were clearly demonstrated, so that they can prepare them without the help of the experts in their villages.
After this residential training the core group members were asked to go back to their respective villages and to organise village level family meetings of 20 people each at an interval of 15 days. All these meetings were organized conveniently during evening hours under the supervision of TBGRI scientists. In the meetings the core group members took the lead role and taught uses of some common plants for treating common ailments. They then recorded some of the traditional knowledge of the villagers who were willing to share it for further evaluation and use. In every meeting they used to prepare one compound herbal drug in sufficient quantities for their own use and shared equally between them under the guidance of core group members and TBGRI scientists. The training programme emphasised the need for self-reliance and aimed to empower the villagers in primary health care. The participating families collectively mobilised funds and herbs for preparing the drugs. This programme continued for a period of 5 months and during this period a full package utilizing locally available bio-resources for primary health care was prepared.
During the course of the programme the participants could not gather some of the ingredients of the combination drugs form their areas. Scientists realized that this was not due to the non-availability of the plants but their inability to identify the plants. The TBGRI scientists took the participants to neighbouring forest wild areas and showed them the diversity of plants including the required herbs. Later these groups came to TBGRI and were taken around the medicinal plants demonstration areas. This exercise enabled them to develop skill to identify locally available medical plants especially for preparing the remedies.
Seedlings of medicinal plants, lesser known wild fruits and local vegetables were supplied to them for developing homestead gardens according to their demands, form TBGRI. The cultivation techniques of the plants were also made available to them.
The success of this programme depends on the effective dissemination of information and materials throughout the community and the committed involvement of the people. Active participation of the rural women was the other major factor. This programme was evaluated in two ways, on economical aspects and on conservation aspects. On the economic side the villagers could prepare al the combination drugs at much cheaper rates compared to their market price. As drugs prepared by them had ingredients readily available, they could avoid travelling to distant hospitals for ht treatment of common ailments.
As the programme progressed, the participants were found observing plants of medicinal use and protecting those in their surroundings. They even started their cultivation along with other plants as they could find some use for them. This change in attitude was very encouraging.
The Story of Success
Encouraged by the success of the trial programmes (1994 – 1996) TBGRI received several requests from adjourning villages for extension for the programmes to their areas. After preliminary analysis of the socio-economic data of the villages, four more rural villages were adopted during 1996-98 by which 800 new villages received the benefit.
During the course of this programme TBGRI produced several brochures, fliers and books in local language for the benefit of the trainers and trainees. The topics selected include primary health care, commonly cultivated medicinal and aromatic plants, wild edible fruits and vegetables etc. The programme was highly regarded by several international bodies, like the World bank, which appointed a team to record the entire programme to be used in other developing countries as a model.
The authors are grateful to Dr G Sreekandan Nair, Director, Tropical Botanic Garden and Research Institute for his constant encouragement and guidance.