A camp is broadly defined as a stationary or mobile short-term intervention for targeted communities typically lasting a few hours a day up to a week. In the 1800s, army camps saw many soldiers dying due to disease rather than from war. Numerous soldiers required medical attention. The term ‘health camp’ was first used in New Zealand in 1920, where the camp approach was taken to improve children’s health.
In India, government and private organizations have conducted camps for various reasons. Health camps bring healthcare closer to those who cannot access it, like women, elderly people, children, people living in remote locations, and other vulnerable groups like indigenous peoples. Camps have been used to conduct surgical procedures like cataract surgery, Tubectomy, Vasectomy, and even Hysterectomy on large groups of people in India! The history of some of these camps has turned out to be unpleasant when quality and protocols were not maintained and when people, mostly women were coerced to undergo some of these procedures. Camps have also been used to increase the ‘client base’ and improve rapport with the community served. Non-governmental organizations, non-profits, foundations, and funding agencies conduct camps sporadically (once in a while) as acts of solidarity/ charity. Employers hold camps to check the health status of their employees and schools, and colleges organize health camps for their students as well. A consortium of NGOs also labels camps as tools in research and a deeper understanding of problems to plan and execute public health action.
An ideal health camp needs to be aligned with the community’s needs. The Indian Medical Association has drafted a Standard Operating Procedure (SOP) document for organizing medical and surgical camps. The SOP mentions the ‘ABCDEF’ of conducting a camp. ‘A’ stands for awareness among the people that a camp would be organized on a particular date, time, and venue. ‘B’ stands for the basic training of the team who will provide the services. ‘C’ stands for a checklist of items to be carried and things to be organized for the smooth conduct of the camp. ‘D’ stands for delivery of services in a standardized manner. ‘E’ stands for emergency and exit for the team and the community. ‘F’ stands for follow-up, feedback, and future strategy.
As a new organization, we at MPSAK are attempting to follow SOPs and guidelines to maintain focus on quality and impact. A to E has seemed doable. ‘F’ seems to be the most challenging so far. We intend to conduct these camps periodically in the nearby villages and after assessing the need, in the coming months/years change our modus operandi to regular mobile-clinic outreach, if required. Hence Follow-up is a key feature of our strategy to ensure continuity of care. Continuity of care is a huge challenge in the current health system, where ‘doctor-shopping’ is common and documentation of visits to healthcare personnel is either incomplete or missing. We use software to document health data and maintain confidentiality with continuity of care. It has been 1.5 months since we started working, and in this period, we have conducted 3 camps and have been invited to one. Of the 4 camps, the first and last were in the same village, one month apart. Before the second camp in the same village, we followed up with the women to check if they had completed the investigations and tasks suggested to them. Unfortunately, not even one of them had followed our advice. Women’s health is not prioritized due to umpteen social and economic reasons. We, at MPSAK hope to change that in the coming years.
In the 4 camps, we have seen 80 women and 17 children. Among the women, the commonest complaint has been pain and the commonest condition has been hypertension. Menstrual disorders are common as well. Women have been vocal about various social issues like substance abuse at home, increased workload, lack of rest, and days packed with caregiving. Tears have been shed, anger has been expressed and helplessness has been felt. Stories rooted in prolonged pain, irrational treatment practices, and unnecessary hysterectomies have been verbalized. Fear of the unknown, financial, and social dependency, a fractured healthcare system, and a lack of agency prevent women from seeking the care that provides them with holistic health. Women caring for intellectually challenged children sought help from us after years of futile healthcare. We attempted to connect them with occupational therapists and educators in a special school in the city. However, we have been unsuccessful so far due to the unwillingness of the fathers of these two female children, who have already spent time, money, and effort earlier and seem to presume that this will be a waste too.
An article in the Indian Journal of Community Medicine portrays health camps as an opportunity to hone the health teams’ public health skills in event management, resource mobilization, communication, clinical care provision, teamwork, and information management. I agree with the article, that organizing these camps also allows me to take on and practice my roles as a care provider, decision-maker, communicator, community leader, and manager. It is an opportunity to engage with the community.
We will continue these camps, collect feedback, and invite professionals from allied health disciplines like physiotherapy, nutrition, and social work to improve patient experience and satisfaction. We intend to hold school camps and organize specialist camps in Ophthalmology, pain management, and Dermatology (the current felt need). These camps have helped us understand the women’s lives in these villages and provide them access to a continuity of care. Health camps conducted in this manner have been proven beneficial in terms of referrals and patient satisfaction in rural areas of other states in India. We hope to create a positive difference too.
1 Comment