Holy Mother said :

"My child, you have been extremely fortunate in getting this human birth. Have intense devotion to God. One must work hard. Can one achieve anything without effort? You must devote some time for prayer even in the midst of the busiest hours of the day.

Do the Master's work, and along with that practise spiritual disciplines too. Work helps one to keep off idle thoughts. If one is without work, such thoughts rush into one's mind."

Vivek Sanjivani

An Initiative for Healthcare and Education

Annual Report 2020-21

VIVEK SANJIVANI is An Initiative for Healthcare and Education of Ramakrishna Mission Home of Service, Luxa, Varanasi, India. It provides General Healthcare through five Telemedicine units and three Mobile Medical units along with Mother-Child Primary Health Care, Adolescent Healthcare, Community Mental Healthcare, Care for the Differently-abled persons, Visual Health Check-up, General Movement Assessment in Neonates and infants, and distribution of Nutritional Food Supplements. It is also engaged in Gadadhar Abhyudaya Prakalpa (GAP), Value Education Programs, Health Education and Promotion, Health Education-based film Development, publication of books and research programmes. It conducts Foundation courses in Science and Mathematics, online teachers’ training and teachers’ workshops. It is already in the process to start multimedia-based online classes for the rural children. Some of our activities described below in brief.

1. Telemedicine Services: Our Real-time telemedicine solutions offers a virtual alternative to the in-person doctor’s visit. It expands access to quality patient care, especially to regions and underserved populations that need it the most. It provides a way to cut down on healthcare spending and keep connected patients throughout the year. It is gradually showing the potential to change the healthcare delivery system for the better especially at the rural areas.

Telemedicine Units (TMUs) of Vivek Sanjivani: Five Telemedicine units are established at different locations viz., Majhawan, Kalwari and Naugawan (district Mirzapur), Lohara (district Sonbhadra)and Lalganj (district Azamgarh) of Eastern Uttar Pradesh for providing medical services to the poor, needy and underserved people. These centres provide telemedicine services weekly three days on regular basis. In our Telemedicine services we use internet communications and Cloud-based Realtime software solution to provide clinical services to patients without an in-person visit at the Doctor’s chamber. It is frequently used for primary healthcare, mental healthcare, follow-up visits, management of chronic conditions, medication management, health education and other clinical services. Our telemedicine programs of Vivek Sanjivani are backed with a 195 bedded referral hospital of our Ashrama at Varanasi.

The physician’s consultations are done from the Expert centre of Vivek Sanjivani at Varanasi or from the Doctor’s dwelling place. Several Physicians from Kolkata, Anand (Gujarat), and Noida are extending help in treatment of patients. Specialist Doctors are providing free services. The total number of people treated during 2020-21 was 17,067. All received free medicine from the remote TMUs except in a few cases. Pathological tests like Blood Pressure, haemoglobin% by colour card and Sahali method, Random Blood Sugar (RBS) are done for the patients above 30 years of age.

New Patients Old Patients Male Female Male Child Female Child Total
3525 13542 6896 8483 838 850 17,067

Specialist Services offered through Telemedicine at the door step of village people: Psychiatrist, Gynaecologist, ENT, Rheumatologist, Oncologist, and Medicine.

Four fundamental benefits from Vivek Sanjivani Telemedicine services:

Improved Access – For the last three years, telemedicine has been used to bring healthcare services to patients in distant locations of Eastern Uttar Pradesh. Not only does telemedicine improve access to patients but it also allows physicians including specialists and health facilities to expand their reach, beyond their own working places. Our telemedicine has a unique capacity to increase service to many numbers of new patients.
Cost Efficiencies – Reducing the cost of healthcare is one of the most important reasons for funding and adopting telemedicine technologies. Our Telemedicine has shown reduction in cost of healthcare and increase efficiency through better management of chronic diseases, shared health professional staffing, reduced travel times specially for the specialist doctors who can provide treatment from far of places.
Cost Efficiencies – Reducing the cost of healthcare is one of the most important reasons for funding and adopting telemedicine technologies. Our Telemedicine has shown reduction in cost of healthcare and increase efficiency through better management of chronic diseases, shared health professional staffing, reduced travel times specially for the specialist doctors who can provide treatment from far of places.
Improved Quality – Our experiences have consistently shown that the quality of healthcare services delivered via telemedicine are as good those given in traditional in-person consultations.
Within the reach of Patients –Over the last three years, our study and experiences have shown satisfaction about recovery of the patients through our telemedicine services. The services offer to our patients at the rural areas might not be available to them otherwise at their door steps, and they have to travel long distances.

2. Mobile Medical Units (MMUs): Health on Wheels: In the rural Uttar Pradesh nearly 60 per cent of the total rural population lives below the poverty line. Our Mobile Medical Units offer flexible and viable options for treating these vulnerable groups. Our Mobile Medical Units help to conduct screenings, basic diagnosis and provide primary healthcare services to complex medical treatments closer to people’s homes.

Our Mobile Medical Units use to visit to several parts of Mirzapur, Sonbhadra and Azamgarh districts of Uttar Pradesh. Total number of patients treated in villages through Mobile Medical Units during 2020-21is given in a table:

New Patients Old Patients Male Female Male Child Female Child Total
3146 11604 6462 6583 834 871 14,750

3. Non-Communicable Disease Screening (NCDS): Screening done for Hypertension (HTN), Diabetes (DM), Oral Cancer (OCE), and Breast Cancer (BCE) among the target age group of 30years and above through Telemedicine Units (TMU) and Mobile Medical Units (MMU) on the first day of the registration of the patient. Below are the details of screenings done:

  Hypertension Diabetes Oral Cancer Breast Cancer Total
No. NCD Screening 3988 3974 2744 313 11,019

4. Manasik Soundarya (मानसिक सौंदर्य) (Community Mental Health Program): The community Mental Health Program is devoted to the evaluation and improvement of public mental health of poor people affected by mental disorders, emotional disturbances and/or addictions. The patients from Patewar, Kalwari, Naugawan, Lohara, Majhawan, Lalganj, Manikpur, Ramnagar Sikari, Gaura and Amoi and other villages are receiving 3 tiered comprehensive psychiatric and neurological treatment for (i) Common Mental Disorders like Depression, Anxiety, Obsessive Compulsive Disorder (OCD) (ii) Severe Mental Disorders including Psychosis, Bipolar Disorder and Major Depression and (iii) Epilepsy.

Common Mental Disorders (CMD):

New Patient Old Patient Improved Rehabilitation Disengage Re-Engage
M F M F M F M F M F M F
21 46 9 38 10 40 4 10 9 17 2 2

Improved- No Symptoms for Common Mental Disorder, Social Interactions Start

Severe Mental Disorders (SMD):

New Patient Old Patient Remmision Relapse Residual Rehabilitation Disengage Re-Engage
M F CF M F CM M F M F M F CM CF M F M F M F
21 46 10 38 10 40 9 38 10 38 10 38 10 40 4 10 9 17 2 2

Remission- Reduction or disappearance of symptoms for at least 6 months
Relapse-Reappearance of symptoms after a period of well being
Residuals- Continuing symptoms at a low intensity
Disengage- Without any medicine, psycho education or counselling in last 2 months
Rehabilitation- Activities of daily living (ADL) improved, social interactions start, understanding own responsibilities, Earning money etc.

Epilepsy (EPI):

New Patient Old Patient Improvement Level 1 Improvement Level 2 Improvement Level 3
M F CM CF M F CM CF M F CM CF M F CM CF M F CM CF
16 12 6 4 33 23 10 8 1 0 0 0 3 2 4 0 16 12 4 2
Rehabilitation Disengage Re-Engage  
M F M F M F  
9 1 9 11 0 1  

Improvement Level 1-Seizures without unconsciousness
Improvement Level 2- Reduce Seizures (50%)
Improvement Level 3-Totally Controlled (No seizures in 1 year)
Disengage- Medicine discontinuity for more than 2 months
Rehabilitation- Earning Money, Proper Domestic work

5. Visual health Check-up: The new cutting-edge technology 3nethra (a compact, portable, and easy-to-use non-mydriatic digital imaging device) is used in visual check-up for diabetic and hypertensive patients. It is designed to acquire, display, store, and transmit images of the posterior, and anterior surfaces of the human eye. It assists clinicians in the evaluation, diagnosis, and documentation of visual health. The number of patients investigated with the help of 3nethra 162 diabetic and hypertensive patients in this year.

  Male Female Total Beneficiaries Diabetes Hypertension Diabetes and Hypertension
Patients 55 47 102 42 48 12

Eye refraction checking for diseases:

Patients/Beneficiaries Male Female Total Beneficiaries Cataract Problem Other Problem No Problem/Normal
173 215 388 159 170 51

Eye refraction checking for lens power:

New Patients Old Patients Male Female Male Child Female Child Total
164 485 311 261 28 49 649

6. General movement Assessment in Neonates and infants for Early intervention, family Support and Health awareness (G.A.N.E.S.H.): The unique feature of this project is General Movement Assessment of children especially up to 5 months of age. In this year a total of 369 GMs Screening took place and 34 infants suspected for abnormal development were detected, 8 infants were followed up, all8 infants were recovered to normal development and 9 referred to Paediatrician or Neurologist for special treatments and advice. Having pioneering works in this field in rural India, we submitted a paper in international journal, BMJ open to document this work. This has been published in that journal.

We are collaborating with General Movement Trust of Austria for this work. Prof. Christa Einspieler of this organization is providing us the special training and guidance to our Health workers and assisting in writing of paper in reputed journals.

7. Distribution of Nutritional Food Supplements: Nutritional food supplement items (Bajra, Soyabean, Besan, Ground Nut, Jaggary and Mustard Oil) are regularly being distributed to 2192 poor, pregnant, lactating mothers and 111 malnourished children of villages of Mirzapur and Sonebhadra districts which provide 750 kcal/day and 37 gm of additional proteins every day to each woman and child.

8. Promotion of Health Education: The purpose of our Health education is to positively influence the health behaviour of individuals and communities as well as the living and working conditions that influence their health and empower them to lead healthy lives. Health education activities should enhance the overall goal of the health promotion and disease prevention program. It can trigger far-reaching health improvements in serving vulnerable groups. Films are developed for health education programs which are culturally appropriate and tailored for the rural populations to ensure acceptance of the messages. In developing films, we are addressing cultural and linguistic differences, potential barriers to health promotion and disease prevention in rural areas to increase control over and improve their health through attitudinal, behavioural, social and environmental changes.

Eight films based on Health education developed by our department and screened in different areas which were viewed by approx. 1700 villagers including students during 2020-21.

9. Adolescent health education and Iron supplement provided: We provided health education and iron tablets to 708 adolescents boys and girls.

10. Health Education Aids Development: We have published a translated book in Hindi ‘Schizophrenia- A Manual To work with Schizophrenic people and their families, and a booklet in Hindi ‘Janman Swathya’ - which can be used as a supportive document for Middle Level Health workers engaged in Mental healthcare. One video in Hindi on Schizophrenia has been developed to create awareness about the Severe Mental Disorders among vast majority of rural and urban people.

11. Gadadhar Abhyudaya Prakalpa (GAP): Under this program a total of 196 children of poor families of Rampur, Gaura (district Mirzapur), Lalganj (district Azamgarh) and Lohara (Sonebhadra) districts have been enrolled in our four child-friendly holistic non-formal schooling units. These kids receive holistic education and also nutritional snacks and milk on daily basis along with free learning and literacy materials, hygiene and sanitation items, uniforms and school bags for overall growth and development.

12. Jivansudha (Value Education Program): Inculcation of higher human values is one important objective of the Vivek Sanjivani programmes particularly in the youth. Values imbibed and practised in one’s own life makes life valuable and living joyous. To inculcate the attitude of practising higher ideals in life and to influence young minds right from the school days, Vivek Sanjivani has taken up this Jivansudha- value education programme, which used multimedia presentations to illustrate Ramakrishna-Vivekananda teachings for students and adults of various age groups. We screened two films based on value education to 461 villagers.

13. Total number of patients treated through Community Health Workers (CHW): 2,210

14. Total number of Ante-Natal Care (ANC) given to 586 in 12 villages. We provided minimum five check-ups in respect to Ante-Natal Care, two Tetanus Toxoid injections, minimum 90 iron tablets with folic acid, minimum 90 calcium tablets, training regarding nursing of infants to 222 would-be mother which are required for a complete Ante-Natal Care.

15. Total number of vaccines administered in villages

BCG P0 P1 P2 P3 PB1 PB2 PT1 IPV1 PT2 PT3 IPV2
76 75 74 78 68 53 30 74 46 70 73 31
R1 R2 R3 T1 T2 M TT Total
85 98 108 44 25 88 363 1559

P0 to P3=Polio, PB1 & PB2= Polio booster, PT1 to PT3= Penta, T1&T2= Triple booster one and half year, TT= Tetanus toxoid, R = Rota Virus, IPV = inactivated polio vaccine

16. Our trained Women Health Educators and Assistant Health Educators provided 61 women with gynaecological examination and treatment.

17. Staff Team Training and Development: During the year our team members benefited from some special classes or workshops on Medicine, Auscultation, General movement Assessment in Neonates and infants, Community Work etc. conducted by specialists.

18. Relief Works including COVID-19 Relief: Total of 4850 affected families in different villages of Eastern Uttar Pradesh, 4500 migrant workers and 253 GAP students’ families were benefited from our COVID 19 Relief works.

In the middle of the year 2020, in all 5000 kg rice, 5700 kg dal, 500 kg chana, 250 kg chickpea, 500 kg potato, 1375 kg sattu, 1930 litres mustard oil, 27.50 kg salt, 375 kg onion, 65 kg green chili, 5350 packets of multigrain butter cookies, 196.70 kg sweet of pure khowa, 7850 pcs bread buns of pure wheat, 10877 pcs hand-washing soaps and 14037 pcs masks were distributed.
Whereas in late 2020 and early 2021, a total of 9000 poor patients, 271 pregnant and lactating mother and children; 1051 people received lentils; 283 families were supported with winter relief items.
In all approx. 80 types of medicines, 500 packet multigrain cookies, 500 pcs pure khowa sweet, 500 pcs whole wheat bread bun, 391 pcs masks, 162 pcs hand washing soaps, 550 pcs blankets for 283people, 3182.95 kg millet, 578.05 kg peanut butter, 566.75 kg mustard oil, 740.05 kg jaggery, 2289.2 kg soya bean, 289.6 kg gram flour, 180 kg lentils and 25 kg soya bean bari have been distributed on various occasions.