Taking medical aid to the elderly

Instead of bringing patients to the doctor, Helpage India's mobile medical units are bringing doctors and medicines to the patient

Demographers predict that while the 21st century is that of the elderly, the next one will witness the 'ageing of the aged'. With the 98 million-strong population of senior citizens in India expected to swell to 143 million by 2021, the problems of old age - isolation, poverty and neglect - need to be addressed urgently. That is why Helpage India's mobile medical units, or MMUs, are such a good idea. "Often, we find that older people are the last to seek medical care in a poor household. If a child is sick, he's usually taken to a doctor, but the problems of the elderly are not treated seriously," says Matthew Cherian, chief executive officer, Helpage India. "This problem is exacerbated in mountainous and remote areas, where a sick elder may find it physically impossible to reach a doctor." Since 1982, Helpage has found a unique solution to this problem - instead of bringing patients to the doctor, its MMUs are bringing doctors and medicines to the patient.

Consider these facts: 92 Helpage MMUs operate in 1,065 sites in 22 states across the country, from the Thar Desert to flood-ravaged villages in Bihar and Uttarakhand. Each MMU works six days a week and covers a cluster of 10-15 community sites/villages, averaging 200 km per week. Daily, each unit treats at least 100 patients in remote locations. On-site services include doctor consultations, basic diagnostics, delivery of medicines and home visits for bedridden patients. Links to local health facilities ensure referrals to medical specialists. The NGO has also sent MMUs to natural disaster zones, such as the flood-ravaged villages along River Kosi in Bihar and in Jammu and Kashmir. "We've noticed that the elderly are often the worst-hit by disasters. While the young are able to escape the rising waters, we've found the aged marooned inside flooded houses, waiting for rescue. In Bihar, we found that the young had left their old parents to look after the livestock, even as they moved to higher ground," says Cherian.

One such MMU is stationed in Phata in Uttarakhand, to address the needs of people in 15 villages affected by the 2013 cloudbursts. A few months ago, I spent a day with the MMU, going to a distant village, Triyuginarayan. "We're lucky today," says Madhuri, the doctor on the team. "Usually, the villages we visit are so remote that we have to trek over 10 kilometers to get to them, with the medicines in heavy backpacks!" The villagers say that before the MMU began coming to them, they had to walk about 12 kilometres to reach the nearest medical centre in Phata, quite impossible when they were ill. A lot of the elderly in the area suffered from arthritis and joint pain-related issues, so Helpage India also set up a physiotherapy unit which, judging from the long lines outside, is extremely popular with the locals.

"We've not only set up physiotherapy clinics, but also dementia day care centres in a couple of locations, for we've seen an upswing in dememtia as our population continues to age," says Cherian. "It is touching when we reach a village at our designated time, only to find that the elders have been waiting patiently for the last few hours - just for us to arrive! We've come to realise that for them, our units are not just a source of medical support, but a sign that people still care about them and their welfare; that they still matter."

Recognised by the Limca Book of Records as Asia's largest mobile healthcare network for the elderly, Helpage's MMU programme has also recently been awarded the Times of India Social Impact Award. However, it is an uphill journey for Cherian and his team. The biggest challenge is recruiting doctors willing to undergo the hard life of a mobile medical unit. Unlike Madhuri, who's fresh out of medical college, most of Helpage India's doctors are retired from active service and senior ctizens themselves. "We can't expect them to walk to distant locations inaccessible by road," says Cherian. "And young doctors have little interest in serving in remote rural areas."

Incredibly, the operating costs of MMUs are not very high. "We spend about Rs 17 lakh per year on each unit, most of which goes to paying doctors' salaries," says Cherian. "It would be nice to see corporates come forward and support us in this, for a single unit can make a difference to countless lives." Next on the anvil is a simple phone-in service. "Our doctors report that a majority of the patients, especially the regular ones, can be helped merely by talking to them on the phone," says Matthew. "We also plan to create an app through which people can find the doctor or hospital nearest to them."

To learn more about Helpage India's MMUs, go to http://helpageindiammu.org/