The service is innovatively done by basing the Mobile Hospital in the village school (the school remains closed on the date every month and instead works on second Saturday, which is otherwise a holiday) and creating literally a hospital, and at the end of the day winding it up and moving to the next nodal point.
The Mobile Hospital is sketched into five sections namely; reception, waiting, doctors work section, diagnostics and pharmacy. The doctors working area is based in the school rooms and five departments are created viz.
Department of Medicine Specialist Physicians and General Physicians
Department of Surgery General Surgeon, Ortho and ENT Surgeon
Department of Obstetrics & Gynecology Obstetricians, Gynecologists and Lady General Physicians
Department of Pediatrics Pediatrician and General Physician
Department of Dentistry / Ophthalmology Dental Surgeons / Ophthalmologists
For Dentistry there is a fully equipped mobile unit (bus) with two dental chairs. Each of these departments has the full complement of all equipments required for effective function and get uninterrupted power supply drawn from the diagnostic bus which has a 15 KW inbuilt generator.
Effective curative care emerges owing to the presence of specialists belonging to 9 specialties, taking care of 400 - 500 patients at each of the nodal points. The approach in each of the department is absolutely proactive. The Department of Medicine and Surgery treat, all the 5 types of community ailments viz common, chronic, intricate, asymptomatic and preventive ailments. The Department of Dentistry does procedures like fillings, extractions, root canal treatment (RCT), scaling, removable partial dentures (RPD), full set dentures in the dental bus. The Department of Obstetrics & Gynecology does procedures like pap smears, cervical biopsies, cancer cervix screening followed by cryo surgery or loop electrical excision procedures (LEEP). Antenatal checkup of pregnant women is done and their deliveries are arranged in Sri Sathya Sai General Hospital.
The Department of Pathology does procedures like Fine Needle Aspiration Cytology (FNAC) and Core Needle Biopsy. An excellent follow-up mechanism contributes to the quality care that is rendered in each of the departments.
Patients requiring diagnostic tests like USG, X-ray, hematological and biochemical investigations are sent to the diagnostic bus, which is parked a little away from the Doctors working area. An innovation is done for tests, which cannot be done in the bus by collecting the blood samples, processing it, delivering it in vacutainers to the labs in Sri Sathya Sai Super Specialty Hospital for testing and reporting, thus ensuring that the objective of providing a loving door-step service is achieved.
The curative work is further strengthened by a strong pharmacy which ensures that patients with chronic ailments like epilepsy, diabetes, hypertension, heart disease, asthma etc. are all provided with continuous and uninterrupted supply of medicines (1 month till the next month's visit). This has very useful implication since effective treatment prevents serious complications like diabetic retinopathy, nephropathy etc. which would have meant greater suffering for the patient and huge expenditure for the Government.
About 10% of patients coming to the Mobile Hospital require further care in the form of sophisticated diagnostic procedures, medical in patient management, surgical interventions etc. The surgical profile for patients requiring surgery is done on the field and these patients are operated by the Mobile Hospital surgeons in Sri Sathya Sai General Hospital which gives the operation theatre and nursing support form 1st to 5th of every month. For surgeries, which cannot be done in the General Hospital, the patients are sent to designated referral centers after the diagnostic procedures are completed. The patients come back to Mobile Hospital for post-surgical care. For C.T scan and MRI scan, the patients are sent to Sri Sathya Sai Super Specialty Hospital with a referral letter. For ailments covered under "Arogyasri" scheme, patients are sent to the recognized Government centers with relevant reports.
As regards Tuberculosis, Leprosy and HIV there is excellent cooperative work with Governmental agencies. The clinically suspected patients undergo blood tests, X-rays or procedures like FNAC, Biopsy etc. and are sent with reports to the Govt. agencies like DOTS centers for Tuberculosis & Leprosy and State Government designated hospitals for anti-retrovirus drugs. Follow-up work like drug compliance, review investigations are again done by Mobile Hospital.
The preventive work consists of health education, which is done both intensively and extensively. Six major subjects viz; cleanliness (environmental, home & individual), nutrition, healthy air and water, harmful effects of habits like smoking and alcoholism, proper physical exercise and mind relaxation, lifestyle changes, have been selected. Education on these subjects is done at the individual, family and community levels using a variety of tools like audiovisual presentations, demonstrative sessions, interactive meets, photo exhibition etc.
The education is done at three different times. Firstly, before the start of curative services at every nodal point. The presence of villagers from 30 to 40 villages helps in conveying the message, in effect to a large population. Secondly, during the curative service, the different specialists go to the waiting areas of the patients now and then and educate them on issues relating to their specialty. The third time is during evenings when villagers are back from their work. A community level program is arranged at the center-point of the village. Audio-visual programs along with formal & informal talks by doctors, is arranged. Health Education is done not only by doctors but also by volunteers who have been trained and designated as Health educators.
As regards, Nutrition in addition to education, the subset of patients like malnourished children, pregnant women are provided with nutritional supplements like Sai protein which is an easily digestible, protein rich recipe. It can be made with ingredients available at home.
Another related preventive work is, conducting of screening services aimed at detecting asymptomatic ailments or premalignant conditions. Cancer cervix (uterus) screening by the World Health Organization approved latest technique namely VIA method, is done daily by the Department of Obstetrics & Gynecology. The method involves both diagnosis and treatment. Collaboration with an international NGO called PINCC (Prevention International No Cancer Cervix) based in USA has resulted in this useful exercise.
The School Health Service is another useful and interesting component of work of the Mobile Hospital. In this service, school children undergo a check-up every year and this involves outlining what is called the three H's - Health, Habits, and Home environment of every child. Necessary corrections and interventions are attempted for children deficient in each of the fronts and they are also monitored periodically till they come up to expected levels.
The Mobile Hospital also has an academic wing. Medical students from medical colleges come for clinical training.
With this holistic approach 90% of health problems in the community are solved because the approach is professional, proactive and integrated and takes care of all types of ailments.
Community ailments have been identified and classified into five categories and the operative strategy for each of the category has been outlined as follows.
Type of Ailments Operative Strategy
Common Ailments Simple treatment, education and arrangement of first aid kits in every village.
Chronic Ailments (25% population suffers from either diabetes, or hypertension, or heart diseases or others) Monthly specialist doctor examination and dispensing of medicines.
Intricate Ailments Field identification and evaluation. Base hospital support for higher medical management, diagnostic procedures, surgical interventions
Asymptomatic Ailments Screening Programs
Preventable Ailments Relentless Health Education
Sri Sathya Sai Mobile Hospital is indeed not only a state of the art rural outreach service but a state of the heart caring and loving service.
Service Schedule
Date Nodal Village Mandal
1st of every month Vengalammacheruvu Puttaparthi
2nd of every month Chandrayunipalli Bukkapatnam
3rd of every month Marala Bukkapatnam
4th of every month Yerravankapalli Nallamada
5th of every month Patha Bathalapalli Nallamada
6th of every month Kondakamarla Obuladevaracheruvu
7th of every month Vanavolu Gorantla
8th of every month Nidimamidi Puttaparthi
9th of every month Byrapuram Kothacheruvu
10th of every month Venkatampalli Chennekothapalli (C.K.Palli)
11th of every month Veldurthi Chennekothapalli (C.K.Palli)
12th of every month Talamarla Kothacheruvu
Service Area Map
Structure and Flow at the Programme Site