SEB/RC7/2 Page 128

5. I N D I A

5.1 Tubercul p s i s and BCG V a c c f n u ~

5.1.1 FB i)emon ation and Training Centre. P a k g WW No. India- 11)

(TAB No. IND.54) (UNICEF NO. FE"9-32)

The international .personnel provided by Wff3

consisted of 1 Senior Medical, Officer, 1 Epidmiologist,

1 Bacteriologist, 1 Laboratory Technician, 1 X-ray Technician

(only for a sbr t i n i t i a l period) and 1 Public Health Nurse.

h r i n g the period of the operation from September l952 to

December 1953, the t o t a l number of first attenders was

47,509 of whom 9,880 were classed a s suspects. O f the

l a t t e r 4,676 were def in i te ly diagnosed a s tuberculosis. In

the laboratory section, 11,513 d i r ec t snears and 8,835

cultures'were made. In the domiciliary section there were

787 i n i t i a l v i s i t s and 3,555 r e v i s i t s by nurses. Besides,

more than 20,000 persons were tuberculin tested and x-rayed

outside the centre by the mobile unit . An appreciable number

of persons received ambulatory treatment.

Weekly radiological pulmonary demonstrations and

monthly surgical conferences were held. A po st- graduate

course fo r private practitioners and a training course for

graciuate nurses were conducted. 3 laboratory technicians

f2om other centres were also trained.

The international team was withdraw a t the end of

December lQ53. h s i n g i t s a years of existence t h i s TB

Centre has became an in tegra l p a r t of the medical services of .- Bihar Stete and doubtless it w i l l continue to fhnction a s the

s s / ~ m / z Page 129

main centre for tuberculosis control i n t h a t State . The

Centre i s wrking e f f i c i e n t l y i n a l l i t s various sect ions

and it i s hoped tha t the rout ine establ ished, including the

standerdised technique o f diagnosis, w i l l be adhked to.

. . 5.1.2 T b r a a c Sur

(Wi No.

T h i s p ro jec t was inaugurated by , the Health'Minister , . , . . , . > , m

of b d i a 30 April 1954. The tMO personnel . . . . .coq@ist of a . Thoracic Surgeon, an Anaesthetist, a Physiotherapist and a

Theatre Sister . Equipment and a p p l i e s "u, the value of

a b u t $15,000 have been provided.

Wlth an output of more than a mil l ion t e s t s per

month t h i s programme continued t o work sa t i s fac to r i ly .

A supplement to the p l a n o f operat ions for the

development of mass BCG campaigns in India was signed by the

Government of India on behalf of the Sta te Governments. The

supplement extends the basic plan of operation up to the end

o f 1954 with the main object ive o f mmpleting development of

110 bass campaign u n i t s by June 1954.

Mass campaigns are proceeding i n 7 States. l'm

more S t a t e s are ac t ively planning to commence similar

campaigns shortly. The cumulative s t a t i s t i c s of the mass

campaign in India from its commencement in 19119 Up to March

31, l954 are - lJumber tes ted 29,086,244 Number of pos i t ive r eac to r s 12,930,991 Number of vaccinated 9 272 776 Return percentage - about 80j6

Tm Sta tes are not yet i n favour of a mass campaign.

5.2 'Venereal. Mseaseg

5 . 2 1 F&&VD Te TWHO No. In$:- 15) (UNICEF No. FEP-34)

The various WHO/UNICEF assis ted VD centres i n India

have evolved into funct ional r o l e s which are widely divergent

and vary from mass survey and treatment a s seen in Himachal

Pradesh, East Punj ab, 3mi and Kasfrmir, e tc . , to outpat ient

departments of hospi ta ls a s i n Bombay, New Delhi, etc.

Despite the f a c t t ha t a l l the centres are no t h i n g f i e l d mrk ,

they have however been responsible for disseminating up-to-date

mettodology in VD control m r k throughout t h e country. The

f a c t t h a t over 100,000 new cases of syph i l i s came under treat-

ment i n t h i s programme in I953 i s a major achievement.

Following the recommendations of WHO, UNICEF have now agreed

to continue supplies o f PJX f o r this programme for 12 months

beginning from 1 July I954 on the same scale as for the previous

12 months. Substant ial stocl:s of Meinicke and MRL antigens

have bem imported by the Government of India to meet among

other needs, those of the VD f i e l d t-ems in India to which

UNICEF has been supplying this material so fa r .

During the period under review, a team from the

Madurai Municipality completed t ra in ing a t the VD Department,

General Hospital , Madras. A se t of serologic equipment has

been supplied by UNICEF to t h i s centre. Another s e t has

recent ly been loaned to the VD department of the Safdarjang

Hospital (New D e l h i ) where the ex-team leader of the W O VD

demonstration teem, Simla, has taken over charge a s

. ' Pag.0:; ,,

venereologist. An evaluation of the working of the various . . ~ , .

"M centres i n 1 n d i a ' i s being conducted by the Government o f

India. . . . . . .

The Government of Jammu and Kasfvrrir have

requested WHO/UNICEF ass i s tqnce i n t h e i r programme t o

t r e a t the e n t i r e population a t r i s k of ce r ta in v i l l ages in

tha t State, where an incidence of 40% or more i s expected.

The assis tance f o r t h i s programme, vhich the S t a t e has already . .

commenced, i s under consider ation.

5.2.2

(UNICEF NO. FW-34)

Though UNICEF has released the e n t i r e equipment

required for the establiskrment of the cardiol ip in production

p l a n t a t Calcutta, t h i s programme has been behind schedule.

Lack of proper accommodation which has been a major obstacle

has a t l a s t been overcome. The necessary nat ional s t a f f have

been recruited. It i s expected t h a t the u n i t w i l l go in to

p r o h c t i o n as soon a s the laboratory f i t t i n g s and in s t a l l a -

t ion of gas, water, etc. , a re complete.

b e n t . M w General No. India-25)

The upgrading of the VD departanent of the Madras

General Hospital provides VD t r a in ing for all categories of . I

heal th personnel, atld specia l ly advance t ra in ing fo r post-

graduates, i n an atmosphere which w i l l fos te r a t rue scient i-

f i c outlook. The object ives emphasised the establishment of

sEmc7/2 Page 132

a model t ra in ing u n i t , which could demonstrate the close

in te r - re la t ion between the c l i n i c a l , serological and pre-

ventive hea l th aspects, paying pa r t i cu l a r a t tent ion to the

development of the soc ia l and preventive aspects, and the

undertaking of research without which' control of these

diseases could no t be achieved.

The pro jec t commenced in June B52. Staf f provided

was 1 serologis t and 1 public hea l t h nurse from WHO and 1

socia l worker from UnTTAA. During the period of WHO-assistance,

the laboratory par t ic ipated in the special a c t i v i t i e s such a s

preparation of Fre i antigen, blood surveys, the A l l India

S e ~ o l o g i c Survey sponsored by the Indian Council of Iiedical

Research, the i n t e r - s t a t e VD f i e l d laboratory a r k etc. %use

surgeons assfgned to the department were given laboratory

t ra in ing; l e c tu re demonstrations were arranged fo r medical

students. The nursing and hea l th education a c t i v i t i e s were

developed sa t i s fac to r i ly . Case finding and case holding were

ins t i tu ted .

Wlth the equipment provided by WHO and t l i th the

introduction of newer techniques and up todate methohlogy

and knowledge gained by the key personnel who have also been

awarded WO fellowships, the VD qepartment i s now well f i t t e d

to serve a s a t r a in ing institu.bion for the whole o f India.

. 5.2.4 w s Contr

i & No. Ind3-24) TAB NO. IND-57) . (UNICEF No. FEP'233)

Since September 1953, when the WlQ coordinator l e f t '

the projec t , the a c t i v i t i e s of the campaign in Madhya Pradesh'

and Hyderabad have been continued by the nat ional teams. With

SEIc/RC7/2 Page 133

the formation of the new State of Andhra, the yaws t r a c t s

or iginal ly i n Madras State have now come urder t h i s new

State. Though UNICEF has already released the necessary

penic i l l in , t ransport etc. for m r k i n tinis Sta te , the ex-

tension of the scheme has been behind schedule for want of

necessary government sanction.

In Hyderabad, only 3 teams are a t present doing

f i e ld work. The necessity for the consti tut ion of a fourth

team and increasing the number of working days from 12 to 20

a month has been stressed in order to reach the target. 80

f a r as Madhya Pradesh i s concerned, Bastar d i s t r i c t has the

highest incidence of yaws which var ies from 11 to 35%.

In Madhya Pradesh over 100,000 people have been

examined of whom nearly .10,000 cases of yaws have been

diagnosed and treated upto June 1954. DI Hyderabad State

approximately 63,000 people have been examined of whom

nearly 5,500 cases of yaws have been treated between July

1953 and May 1954.

Plans are under consideration t o t r e a t the en t i re

population a t r i s k in a yam focus in'Coimbatore d i s t r i c t in

the Madras State as par t of the anti-yaws campaign

with possible WfJD/UNICEF aid, where f i e l d trials on

methodology and newer therapy are contemplated,

5.3 e Control Project. D e o r a No. India-31) ,

This project had to be suspended in May 1953

consequent on the resignation of the WI1) ecologist due to

i l l -hea l th and subsequent d i f f i c u l t i e s i n recrui t ing Wtf)

personnel, In May l954, under an agreement with the Pasteur.

=B/Rc7/2 Page 134

Ins t i t u t e , Iran, a consultant was made available for one

month to carry out a f resh assessment of the si tuation in

an attempt to reorganise the programme and to decide with the

government about i t s continuation. He vis i ted the endemic

areas of Uttar Pradesh i n May 1954. He has recommended t h a t

(1) the project be continued for a tw-year period from

October 1954 with the a id of the national team and with four

consultants to be provided by WHO, each mrking f o r s i x

months, (2) the research project be located i n the north-

western pa r t o f the Uttar Pradesh (e i ther Dehra Dm o r

Saharanpur) instead of the north-eastern pa r t and (3 ) an

autonomous and mobile laboratory be provided with supplies

from WHO.

Arrangements are being made i n agreement with the

government la r e s t a r t t h i s project on the l i n e s of the above

recommendations.

5.4.1 g u r s i n . ~ PrQject. M (m No. I n i i

This project was successfully concluded a t the end

o f 1953. Considerable in t e re s t and awareness of the need

for good pediat r ic nursing have been aroused not only in the

Madras General Hospital but i n the Madras Sta te as a whole.

The teaching programme, although primarily developed

for student nurses, was expanded to include graduate

nurses, health v i s i to r s and medical students. Both

theoretical and c l in ica l teaching was undertaken. The

ready cooperation of both the medical and nursing s t a f f

made ward rounds and c l in i c s an every day teaching and

learning experience.

A three months refresher course i n ped i a t r i c

nursing sponsored j o in t l y by the Government of Madras and

WHO i n coilnection with t h i s p ro jec t proved very successful.

Nineteen nurses, seven of w b m were from the Madras State ,

attended the course which not only stimulated i n t e r e s t i n

ped ia t r i c nursing in all i t s aspects but a lso aroused

s t a t e wide i n t e r e s t in the wider aspect of chi ld health.

V i s u a l a ids were developed and used a s teaching a ids and a

mall ped ia t r i c nursing procedure manual was prepared f o r

use of the teaching and student nursing s t a f f of the Madras

General lbsp i ta l . One of the two nat ional opposite numbers

proceeded over seas on fellowship fo r advanced t r a in ing in

ped ia t r i c nursing and had not returned a t the t im, of the

withdrawal of WHO s taff .

5.4.2 pursing Pro.iect. C a l c u t t ~ (WMO No. India-I91

TNs pro jec t has been in operation f o r two years with

the assis tance of four in te rna t iona l t u t o r s and teaching

equipment and supplies provided by WHO. Matching nurses

have been provided by government and generally speaking good

progress has been made.

A t en ta t ive p r o g r m e of study based on the Indian

Nursing Council syllabus has been drawn up, and although

i t may not be possible t o implement i t in i t s en t i re ty , it

i s bwever being followed a s f a r a s practicable. Admissions

o f students have been increased according t o plan.

SEjEA/RC7/2 Page 3.36

An inservice education programme has been

functioning f o r the pas t year and regular s t a f f meetings

are held f o r purpas e s o f discussion and planning. In order

to provide be t t e r in tegra t ion o f cl'ass-room and practice-

teaching, a patient-assignment plan has been formulated in

selected wards and i s working sa t i s fac to r i ly . Ward teaching

programmes have been developed, but i n cer ta in wards which are

normally over- crowded they are limited.

The Midwifery Section remains overcrowded, but

several improvements have been made i n the labour rooms and

wards. With the acute overcrowding in the Nursery, good

teaching i s extremely d i f f i cu l t . Insp i te of the shortage of

student midwives, regular c lasses have been organised, end

recent ly a well equipped c lass room was made avai lable t o the

Midwife Tutors. ,

The nat ional opposite numbers to the Midwife Tutor

and the Nursing Arts Tutor proceeded overseas on WHO

fellowships during the year. The ped i a t r i c nurse w i l l also

undertake advanced s tudies a t a l a t e r date, and all w i l l

re turn in time to kork with the h t e r n a t i o n a l nurses p r io r

to assuming f u l l responsibi l i ty for the expanded t ra in ing

programmes.

175 students are undertaking the course i n general

nursing and 40 the course in midwifery.

5.4.3 Nursing Pro.lect. Bamba (WHO No. India-40)

The pro jec t was i n i t i a t e d in September I953 with

the appointment of a general nurse educator, a midwife tu to r

and a ped ia t r i c nurse. The fourth in ternat ional nurse

8E4/RC7/2 Page 137

( c l i n i c a l ins t ruc tor ) has since been added to t h e team.

Local cooperation has been good, and the nat ional and

in ternat ional s t a f f have together planned and iwlemented an

expanded t ra in ing programme,

Some d i f f i c u l t y has been experienced i n adopting

f u l l y the nursing syllabus recommended by the Indian Nursing

Council. This syllabus i s however being used a s a guide and i s

followed to the f u l l e s t possible extent.

Teaching in ' the ped i a t r i c wards presented obstac les

mainly due to overcrowding and so a sect ion of the ward with

a more p rac t i ca l nurse-patient r a t i o has now been i so la ted

a s a teaching uni t . fn an e f f o r t to give sound teaching to

the nurses i n regard to the normal chi ld, a mother and chi ld

welfare c l i n i c f o r servants and the i r famil ies (5000 people)

l i v i n g within the hospi ta l compound has been s tar ted with

the help o f the medical s t a f f and a medical soc ia l worker.

A home nursing service for the same group has jus t

been commenced and when t h e domiciliary midwifery service

planned to commence in October gets underway a complete

r e f e r r a l system should be possible. By u t i l i s i n g this new

teaching f i e l d it i s hoped t h a t the student experience w i l l be

broadened and provide f o r be t t e r understanding of nursing needs

a s a whole.

The student s trength of the School i s 262 including

24 student midwives. New subjects are being gra&ally

introduced and plans a re underway for an organised ward teach-

i n g programme. A p a r t time course for midwife tutors

r e s t r i c t ed in the f irst instance to midwives working in

hosp i ta l s in Bombay i s under discussion and may be implemented

l a t e r i n t h e year.

$E1C/RC7/2 Page 138

5.4.4

(TAB No. IND.62)

The projec t commenced in June 1954 with one

Public Health Nurse Educator and the first month was spent

in studying the various aspects of the p ro jec t and in

drawing up of a l i s t of supplies and eapipment.

5.4.5 gursiniz e c t of MCH Project . D a e ( W H D ~ N O . India-8)

This p ro jec t commenced ea r ly in 1950 and was t s k a

over by the D e l N S t a t e Government in December 1953. The

in ternat ional team of f i v e exper ts were gradually withdram

and the public heal th nurse attached to the Najafgarh Health

Unit was the l a s t in the f i e l d and she completed her

assignment in December 1953.

The t ra in ing a c t i v i t i e s of this pro jec t were as

follows 1

The Health Unit area a t Najafgarh covers 27 v i l l ages

and a t o t a l population of some 27,000. m a t i v e and

preventive medicine were combined and concentrated e f f o r t s

were made to enlarge the scope and to improve the standard

of work in order to make t h i s area a good student t r a in ing

f i e l d in generalised public hea l t h m r k , including domiciliary

midwifery. The necessary supplies to the four MCH centres

and to the newly constructed Health Unit a t Naj af garh were

provided by UNICEF. Midwifery bags were made avai lable f o r

the p rac t i s ing midwives and students under training.

In-service t ra in ing, a s well as the t raining of nursing

students and post-gracluate groups formed a regular p a r t of

w m / 2 Page \ . 13%. ,, , ...,. , .

, . .i. / - . , .

the programme and t h e f i e l d was u t i l i s e d f o r this purpose f o r

approximately e igh t months each year. Mral t ra in ing i n an

ove ra l l heal th prograuke 3s m important aspect o f nursing

t ra in ing and it i s disappointing to note t h a t during the

l a s t year of the projec t , arrangement Was not made by the

government t o assign a nat ional to work with the interne-

t iona l nurse and take over f r o m her.

A pedia t r i c nurse was assigned to the Irwin

Hospital fo r a period of tuo- y e e s oomencing ih 1950. FW1

r ea l i s a t i on of the need fo r improved teaching i n ch i ld care

has only recently become an accepted Fact. The ped i a t r i c

nurse working together with the nat ional s t a f f of the

Chi18ren1 s Unit and with the in te rna t iona l pedia t r ic ian ,

developed a teaching programme, both c l i n i c a l and

theore t ica l , f o r nursing students a t the I r w i l i Hospital and

College of Nursing. Classes were also given t o nursing

students attached to other hospitals. Two ref resher courses

in ped ia t r i c nursing were developed f o r graduate nurses

from the various s t a t e s in India. They were planned by the

in ternat ional nurse with the cooperation o f the Delhi Sta te

au thor i t i e s and the s t a f f o f the Childrenls Department a t the

Irwin Hospital. T h i s section o f the p ro jec t was completed

in March 1952.

A t the College of Nursing, New Delhi, a post-

graduate murse i n Public Health Nursing, the first of i t s

kind in India, was developed under the diz'ection of an

in ternat ional public hea l th nurse a s p a r t bf the overa l l

teaching programme of the College of Nursing. 15 students

completed the course. A s a r e su l t of the decision of the

W R C 7 / 2 Page 140

Government of India to of fe r only one public heal th

nursing course in India for the present and to develop it a t

Calcutta, the international public heal th nurse was

transferred t o the Calcutta project ill mid- 3.953.

The nursing aspects of t h i s project have demons-

trated the importance of improved child care and the broader

concept of nursing, which includes not only the care of the

sick but also prevention o f disease and the promotion of

health.

5.4.6 plursinqag)ect of MCH/Nursin (WHO No. M i a -

This project was i n i t i a t e d i n March I954 with

UNICEF assistance, A large and comprehensive nursing

education prograplmg i s envisaged as par t of t h i s project.

Three international nurses are now in the f i e l d and the

o thers w i l l take up their assignment s b r t l y .

5.4.7 $hort-tB,rm Refreshen CouUiLfQr Nurseg (kHO No. India- 58

Three short-term refresher courses, each of three

months duration, were developed i n conjunction with WHO

ass is ted projects a t N~.dras, D e l h i and Patna. The subjects

chosen were Pedia t r ic Nursing, Tuberculosis Nursing and a "

course f o r Health Visitors. Par t ic ipants attending the

courses came from a l l over India end tota l led 48.

The pediat r ic nursing course held in Madras was

planned primarily for nurses wrking in children's wards.

The need for good integration of curative and preventive

nursing was stressed throughout. Opportunities fo r

experience and observation of chi ld care programmes in the

f i e ld , which Included home v i s i t s , and theore t i ca l and c l i n i c a l

teaching in the out-pat ient departanent and hosp i ta l wards,

were provided. This murse proved very successful and

s t i m l a t e d fu r the r i n t e r e s t in improved chi ld care.

A t Patna, the course in tuberculosis nursing

provided opportunity f o r nurses working in the tuberculosis

f i e l d (both i n s t i t u t i o n a l and publ ic heal th) to r e f r e sh and

t o expand t h e i r knowledge and experience. Some time was spent

in the hospi ta l ward i n c l i n i c s and i n home v i s i t ing . B

complete fo'llow up of pa t i en t s and t h e i ~ contacts was arranged

fo r each individual student. This included BCG vaccination

where required.

The course for heal th v i s i t o r s held in Delhi was

conducted p a r t l y i n an urban area and pa r t l y in a r u r a l

setting. Students resided a t the Najafgarh Rural Health

Unit during the l a s t half of t he i r course. Many new aspects

of hea l t h m r k were introduced to this group of students and

a t the completion of the course it was obvious t h a t they

were more fully aware of the overa l l needs of the people and

the p a r t tha t nursing can play i n supplying these needs.

In a l l the three courses a s e r i e s of well planned

l ec tu re s were given, followed by c l i n i c s , demonstrations and

t u t o r i a l s in r a a t i o n to the s p e c i d nursing treatment required.

The students o f dl three courses varied considerably

in age, experience and background. One thing common was

t h e i r des i re t o learn and to be more adequately prepared

fo r the posi t ions they held. Good cooperation between the

WHO s t a f f and the nat ional medic& arid nursing s t a f f s made

6Eq/RC7/2 Page 142

i t possible ta o f f e r these courses of a high academic . .

l e v e l and to e n w e a ~ : y e l l - & ~ e r v i i ~ d ~ ~ c l i n i c d and . . .

prac t ice experience..

5.4.8 ,pa- N W g Educafr;LPn ( WIP) No. India-64F)

F a c i l i t i e s fo r t r a in ihg a s nurse educators @a

a t the moment not available in India. merefore , it was

proposed to award 20 in te rna t iona l fellowships to selected

candidates for under g0in.g advanced studies. Seven nurses have

proceeded overseas and a re undertaking advanced s tudies a s , .

follows r

1 in Pedia t r ics , 2 in Midwifery, 2 i n Nursing

Administration, 1 in Teaching and 1 i n Tuberculosis Nursing. _ 1

S i x s e a t s have been reserved f o r the next school year, and

placements are being arranged for the remaining seven.

5.5 W n A and Q&l H e a l u

CH Project, D e w WW No. In&-8

During the l a t t e r half of 3953, a c t i v i t i e s under t h e

p ro jec t were confined to rural f i e l d t ra in ing of various

categories of nursing personnel a t the r u r a l d-nstration

and t r a in ing centre a t Naj afgarh. Petails o f these t ra in ing

programmes are gLven unaer lUursingn. WN3 assis tance to t h i s

p ro jec t was withdrawn a t the end o f 49.53.

The Najafgarh Centre has continued a s an important

t r a in ing area f o r all categories of public heal th wrkers .

Now it I s also being u t i l i s e d a s a p r ac t i ca l base f o r t h e

t ra in ing of hea l th workers in the nat ional community

development pro gr anme.

This UNICEF-assisted p ro jec t has a s i t s main

object ive t h e establisianent of an up-to-date depetslent in

Maternal and Child Health for the t ra in ing of na t iona l s of

India and other neighbouring countries.

Ac t iv i t i e s under the p ro jec t were commenced wlth 1

the a r r i va l in mid 1953 of the in te rna t iona l Public Heath

Nurse Ins t ructor and the Ped ia t r i c Nurse Instructor . Late i n

1953, a Health Mucator from Headquarters was tmpora r i l y

assigned. The (Lh in i s t r a t i ve Officer f o r the p ro jec t arrived

in January, while t h e Public Health Nurse Midwife arrived in ,-.

'I June B64. 1 Pedia t r ic ian has been recrui ted and e f f o r t s are i

being made to secure the remaining in ternat ional s taf f . A

number of nat ional s t a f f have been appointed and o the r s are

under recruitment.

The buildings knd other f a c i l i t i e s required for

p m g r m e expansion i n rural and urban t r a i n i n g f i e l d s are

not a l l completed but considerable progress has been made.

The outlook f o r progress during the next year seems bet ter .

maining a c t i v i t i e s carr ied out under the pro jec t thus

f a r consist of one course $n Public Health Nursing s t a t e d in

mid 1953 in which 9 out of 10 students were successful. A

second course has s tar ted in June 1954. It i s anticipated

t ha t MCH t r a i n a g caurses w i l l be conducted i n the coming year. , . . , . . . .

. I : . '

~ : . . WRC7/2 Page 144

5.5.3 rc Project. RrcI . India-49) erabad

(UNICEF NO. F'EP-234)

The UNICEF- assis ted MCWur sing Pro jec t i n Wder abad

commenced operation i n March 1954 with the a r r i v a l o f the

WHO Senior Officer of the p ro jec t i n the f i e ld . The

Paed ia t r i c Nurse joined i n May and a Midwifery Tutor in

June. The four remaining WHD members and tw o the r s f r o m

the Colombo Plan have been selected and should soon be in

ppsition.

An o f f i c e f o r the projec t has been s e t u~ i n the

Nilaufer Hospital t o wark in cloge co-operation w i t h t h e MCH

and Nursing Sect ions in t h e Directorate of Medical and Health

Services. Well qualified nat ional personnel are working with

each of the in te rna t i0n .d s t a f f now i n t h e f i e ld .

5.5.4 e

1. West Bengal Pro jec t - bJtPD. Ne.India-55, UNICEF No.F@-235 2, Bihar Pro jec t - WO No, Jndia-56, UNICEF No.FEP.236 3. Uttar Pradesh Project- WHD No,lndia-97, UNICEF No.=-237 4. Travancore- Co chin Pro3 ect- WHO No. India-62, UNICEF

No.F'EiP.239

Plans f o r these p ro jec t s are being developed i n . collaboration with t h e Government of India, with supplies and

equipment f r o m UNICEF. &1 these p ro jec t s w i l l develop into

a large-scale prograorme f o r the expansion o f maternal and chi ld

heal th services th rougbut the country. Important nursing

education programmes a re included i n the plans. The planning

stage i s now being completed and all the above programmes

should get into operation before the end o f 1954. Supplies

and equipment from UNICEF are enroute and personnel are under

w c 7 / 2 Page 146 .

recrui tment , The Colomb Plan i s also par t i c ipa t ing with

the provision of somk nurses b9 Canada.

The plan for the development of MQI services and

nursing t ra in ing iri Mysore has been developed. UNICEF i s

considering this pro jec t fo r the p o s s i b i l i t y of providing

upp plies and equipment. P State-wide progreanme f o r t h e

in tens i f i ca t ion and expansion of MCH services, nursing and

midvilfery t ra in ing i d f i 6 i t h edkcatian i s beir&deiwlo*ed i n

Bombay State. Plsnning ' h a~ ' ' ~been conipleted m d U N I C E F " ~ ~ ~ ~

be considering provision of supplies and equipment for t h i s

p ro jec t also. It is , therefore? ant icipated t ha t during 3955,

seven State-wide MCH p ro j ec t s w i l l be developing i n India - KCH and Nursing const i tu t ing one'of the major p~ogranrmes o f

t h e countrycs 'Five Y e a Plan.

, , . . . . . . .,:: : . . . .

The. Ministry of ~e a l th .bf the; Gov6rment of. Inq'a . . , . L ' , . ,

launched i t s family planning prbgrame in 1951, following a

decision t o have p i l o t s tudies in the rhythm method conducted

in selected areas of the country. One consultant for the . initial survey and tw f i e l d w r k e r s fo r the a c t u e l

., . s tudies were provided by WKO. Two studie= were i n i t i a t e d

i n 1952, one amongst educated, lower-incume c i v i l servants

in New Delhi and thd o ther amongst i l l i t e r a t e res iden ts o f

14 v i l l ages i n Mysore State. The aims of these s tudies

were to ascer ta in in corlnection with the rhythm method

i t s acceptabi l i ty the population, i t s ef fec t iveness in

reducfng pregnancies and i t s effect iveness i n reducing the

b i r t h r a t e of the community.

Although a f u l l assessment o f the s tud ies must await

t h e i r completion, the Interim repor t s have called a t t en t ion

( a ) On Attitude Survey among 1088 couples i n 14

v i l l ages near Ramanagaram (Mysore s t a t e ) and 1214 wmen

in Lodi Colony (New Delhi) revealed a high degree of exis t ing

readiness fo r f amiZy planning i n tm very d i f f e r en t p a r t s of

the country and amongst r ad i ca l l y d i f fe ren t groups o f

population, Approxinately 75% of each population expressed a

des i re to l ea rn a family planning method,

(b) Curing the e n t i r e period of the s tudies there

was ample evidence from all p a r t s of the country and mong

various economic groups, o f the increasing i n t e r e s t i n family

planning and family l imi ta t ion among the people of India. Mot

only was there a demand f o r family planning information f o r

personal use, but there was an equally great demand f o r a

governmental policy on and governmental particip.ation in t h e

development of family planning services.

The in ternat ional s t a f f o f 2 f i e l d w0rker.s a n t h u e d

the i r services up t o the end o f March 1954. Their repor t has

been submitted t o Government.

5.7 U d i a I n s t i t u t e o f Ment eal th. Ban- ( W H O No. Indi

Covernment's request for 3 in te rna t iona l experts fo r

tw years, with equipment and supplies mrth $7,000, tw sshrb

term consultants f o r th ree months each and f i v e fellowships has

8Eq/RC7/2 Page 147

been received, but due to f inanc ia l stringency and lack of

sui table experts recruitment i s i n progress only for one

spec i a l i s t in electrophysiology and one psychia t r ic nurse

fo r a period of two years each.

5.8 &rvev of - Fro- (WHO -67) '

The services of a short-term consultant in audio-

v isual a ids production were made avai lable fo r a b u t four

weeks during November-December 2953 to India and Ceylon ta

co l l ec t information concerning t h e v i sua l a ids employed fo r

heal th education work by the government or p r iva te agencies and

to explore t1:e p o s s i b i l i t i e s of production of v isual media in

the country for heal th education work.

H i s repor t and recommendations are under study by the

government. Plans are developing f o r f'urther a c t i v i t i e s i n

t h i s f i e l d including possible assis tance from the Colombo

Plan,

T h i s p ro jec t terminated in June 19E4, af te r a period

of two years. The S t a t e Goverment did not appoint the

nat ional opposite number to the WIB expert (Pr incipal ) and also

d id not ava i l o f the fellowship provided. Although many

important improvements were effected which w i l l endure, the

chief object of t r a in ing a successor was not achieved.

sw=7/2 Page 1443

. .

5.9.2

TAB No. DID-26

This pro jec t has been proceeding very sa t i s fa*

t o r i l y , especia l ly in regard to the r e s e a c h carried out by

the WHD expert in collaboration with h i s colleagues. The

teaching programme i s also proceeding well. Considerable

research i s being done on indigenous drugs.

5.9.3

(TAB No. INP36)

The projec t has gone very well and with considerable

development in the ins t ruct ion programme. In addition, a

considerable amount of research work has been done In

collaboration with the nat ional opposite number and other

colleagues. The pro jec t w i l l terminate in September, 1954 and

the work w i l l be continued by the nat ional opposite number

who has recently returned from a fellowship abroad,

The WHO expert has been able to e s t ab l i sh teaching of

pharmacnlogy on sound l i n e s , so much so, the postgraZtuates can

now be accepted f o r t r a in ing i n pharmacology. Research has

been developed In co-operation with h i s colleagues. The

Pharmacology Department also received considerable assis tance

from t h e Rockefeller Foundation i n the form o f equipment. The

counterpart to the WID expert i s now on fellowship abroad and

on his re tu rn w i l l become the head of the Departauent.

: , . , ., , <.,

BEll/RC7/2 - Page 149

Since the School commenced in 1952, the number of

pa t i en t s and treattnents given has been steadily increasing.

The School has become very popular and many pa t ien ts f r o m

outs ta t ions attend the treatment centre, No counterpart was

appointed u n t i l the project had been underway fo r 19 months.

The pro~ipectus of the school has . .been . printed and .$stpi,buted b . . . . - .

. . . . . .. . . the govemta:nt s in t ~ s , 'pegion with the iii.timation t h a t WI~)

. .:-. would be prepared to award some f e l l o w s ~ p s for t ra ining a t

the School.

10 students, a l l from India, appeared for the f i r s t

year examination snd a l l of them have been promoted to the

second year. A new batch of 15 students (11 from b d i a ,

admitted' to the second year course which commenced 'in June

l9 54.

5.9.6 pro erinn . . . . , .: . ., .

The University of Madras will open a post-graduate

degree course in public health engineering in the near

future. In t h i s connection, the Government of India have

approached WHO for a professor of public heal th engineering

f o r a period of two years to a s s i s t i n the organization of

the department of public health engineering and in the

development of a t ra ining and education programmes

( theoret ical and prac t ica l ) i n collaboration with the

SEO/RC7/2 Page L50

hea l th agencies. The professor Is under recruitment and

i s expected ta be in posi t ion ea r ly in 1955.

TNrty-two fellowships C a l l in te rna t iona l ) were

awarded a s follows:

20 - Nursing 2 - Public Health Engineering 2 - Maternal & Child Health 2 - Health Education 1 - Indus t r i a l Health 2 - Tuberculosis 3 - Medical Services and Education