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Agarasindhur Community Hospital

Introduction:

The Agarasindhur Community Hospital, established in the Pakundia thana of the Kishoreganj District in 2000, provides comprehensive, high-tech health care on a sliding-scale basis to the rural population it serves. The hospital’s primary objective is to improve the health status of the thana, with attention to increasing the awareness of preventative care and improving access to health care for women and the poor. ACH plays a vital role in the lives of the largely poor population of 2,577,240 in Kishoreganj, who are unable to afford the fees of the region’s only other hospital. A project of Nari Uddog Kendra’s Integrated Health and Family Development Program, ACH’s base clinic offers a full range of medical services as well as transportation and accommodation. ACH also operates satellite clinics, blood donation camps and home visits, which comprise a stable and well-reputed network to reach the poorest and most remote patients.

Activities of the Base Clinic:

The hospital’s full-time MBBS doctor of general medicine oversees the operations of the base clinic. A highly qualified Ophthalmologist and a Physiotherapy Specialist visit the hospital every Sunday to provide specialized services; complicated ophthalmology patients are referred and transported free of cost to ACH’s sister-concern, the Kishoreganj Eye Hospital, another project of NUK’s Integrated Health and Family Development program. ACH boasts highly trained technical staff members including a pathology lab assistant, one dental technologist, one general and one gynecological nurse, one pharmacy assistant, and two paramedics. The operational facilities include an operating theater, patient wards with a long-term capacity of 25, a pathological laboratory, x-ray services, dentistry, family planning, ophthalmic and physiotherapy units, and a low-cost pharmacy. The house doctor treats walk-in patients as well as referrals from the satellite clinics, and makes referrals and subsidized financial arrangements with other medical institutions when necessary. An average of 5,000 patients are treated annually; during the most recent reporting period of 2004-2005, the base clinic treated 3,719 patients, 1,730 female, 1,622 male, and 361 children.

ACH implemented a Family Health Card insurance program in 2003 that offers community members a one-year card for Tk 200 (approximately USD $3) and a two-year card for Tk 300 (USD $4.50). Insurance card holders are entitled to the following benefits:

ACH implemented a Family Health Card insurance program in 2003 that offers community members a one-year card for Tk 200 (approximately USD $3) and a two-year card for Tk 300 (USD $4.50). Insurance card holders are entitled to the following benefits:

• Half-price doctor’s consultation fee

• 30% off all clinical costs

• Equal coverage extended for all family members.

As of September 2006, hospital fees are as follows:

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    Outreach Activities:

Satellite Clinic Services

Clinical activities include antenatal care, postnatal care, T.T. vaccination for pregnant mothers and adolescent girls, growth monitoring, case referral to the clinic for appropriate medical treatment, and EPI service. Paramedics and nurses provide general check-ups, diagnoses and disease treatment, and medicine as available. During its first year, ACH’s four satellite clinics treated residents of five micro-credit units in Pakundia, Hussainpur, Jangalia, Charpumdi, and Agarasindhur thanas. Since October 2001, the clinics have also organized traveling medical caravans that establish camps to treat patients in far-flung areas who are unable to visit the satellite clinics. The caravan provides transportation to the hospital as necessary for serious cases. During the last reporting period in 2004-2005, the four clinics and 20 camps treated 2,565 patients and referred 200 to the hospital for further treatment.

Community Health Trainings

• TBAs: Traditional Birth Attendants in the region are enlisted for trainings to enhance their knowledge and skills in safe delivery. In turn, they motivate pregnant women to visit the hospital or satellite clinics to receive regular check-ups, advise them in the preparation of their delivery kits, and encourage participation in the health sessions.

• CHVs: The community health volunteers are given trainings in effective mobilization of the community to accept messages from the health sessions, to visit the base and satellite clinics for regular treatment and check-ups, and to receive vaccination services from government EPI centers.

Health Education Sessions

Selected health messages such as:

• Child Health: Weaning food, colostrums, and vaccinations

• Nutrition: Prevention of night blindness, cooking to retain vitamins and minerals

• Communicable Disease Reduction: Hygiene and oral saline solution instructions

are disseminated among the group members during the education sessions. Additional thematic sessions are regularly held, covering tuberculosis, family planning, reproductive health, and STD/AIDS awareness, with remarkable changes in practice and adoption of preventative measures.

EPI Services

ACH community volunteers visit the homes of micro-credit group recipients to identify children under the age of five and register them with government EPI centers, where they and their mothers receive vaccinations and health information.

Blood Donation Camps

ACH staff and volunteers collaborate with school officials and community leaders to hold regular blood donation camps in schools, colleges, madrassas. Students and teachers at these sites are informed of their blood group and educated about blood donation. During the last reporting period in 2004-2005, eleven such camps received blood from 170 participants.

Home Visits

CHVs make regular visits to villages to disseminate health information and mobilize participation in the hospital and satellite clinics services. During the last reporting period in 2004-2005, 699 homes received visits from ACH staff.

6.  Subsidy for Poor Patients:

Donations, collected from interested individuals by NUK and ACH staff, are awarded as subsidies to the poorest patients who are unable to bear the cost of treatment. Please visit our donation web page to learn how.