The Rural Unit for Health and Social Affairs (RUHSA)
K.V.Kuppam and the surrounding area are unusual in that they are served by RUHSA, the Rural Unit for Health and Social Affairs. RUHSA is a department of Christian Medical College Vellore (CMC). It was initially set up in 1977 as an outreach project by Dr Daleep Mukerji, who is now Head of Christian Aid (www.christianaid.org.uk).
RUHSA began with three objectives. To provide:
- SERVICE to the people of K. V. Kuppam Block.
- TRAINING for students in medicine, nursing, health and development
- RESEARCH in health and development.
Its work is based on the belief that:
“Health is a state of positive well-being and not merely the absence of disease.”
RUHSA now covers well over 120,000 people in the area around K.V.Kuppam and has been involved in all aspects of rural development; agriculture, animal husbandry, adult education, vocational training, women’s training and help for the elderly and people with disabilities.
Developing the use of Biogas as a fuel was one of the projects run by RUHSA. This family are able to produce enough gas from cow dung to cook most of their meals.
Workers are placed in the field in two ways. Each village has a Rural Community Officer (RCO); a well-educated and trained local man. Initially there were female RCO’s but social pressures meant that over time they all resigned. The RCO works with local people organising everything from youth clubs to literacy classes to government loans. He can refer people to RUHSA or CMC if they need medical help and advise RUHSA on the needs of the people in his area.
Each RCO will work with several female Family Care Volunteers in his area. These local women are paid a small amount each month to advise the women in their village on such matters as healthy eating, hygiene, immunization, family planning and pregnancy. Research has shown that over the years since RUHSA was founded there has been a dramatic decrease in infant mortality and a fall in the birth rate. The major method of family planning is for the woman to be sterilized. She is given money as an incentive but there is little aftercare available for women who suffer from hormonal and related problems after surgery.
The hospital at RUHSA provides only a bed to lie on and medical facilities. Families have to provide food for the patients. There is no ambulance service although RUHSA can send a van to an accident, so most people make their own way to hospital walking, cycling or riding on a bullock cart.
Student nurses from CMC spend part of their training at the rural hospital. Many of them come from neighbouring Kerala. There are also usually international students in residence, working on projects as part of their degree. RUHSA also runs a successful vocational training programme on the campus for young boys who want to learn skills such as motor cycle maintenance. If they work hard they can earn a good living within the local community.
RUHSA’s approach through research and its close links with the villages has enabled it to tailor its services to the needs of the community. For instance recent research has highlighted the growing plight of elderly people within low income families due to the gradual move away from traditional living arrangements. More young people choose to set up home independently and some move away to the city to find employment. RUHSA is beginning to look at schemes to help the elderly who have no extended family to support them.
The Indian Central Government has been encouraging the formation of Self Help Groups for men and women since 2006, but RUHSA has been working for many years on schemes to give women more income, together with more respect and status in society. They had, in the past, introduced several economic ideas which had always failed. It wasn’t until 1998, when the community were more able to accept some of the suggestions made towards equality of men and women in the family, that the first Women’s Self Help Groups were started. Although some groups do fail, with training and support from RUHSA there are many that are successful. The women then have access to low interest loans to help them, for e.g. to start a small business; pay for a marriage or a child’s further education.