DISTRICT PROFILE – CHAMOLI (2008)

Introduction

Chamoli district is located in the lap of Himalayas was created out of the erstwhile Pauri Garhwal district in 1960. The district is dotted with many prilgrim centres of Hindus. The district is flooded with the natural beauty, which is accentuated during monsoon when there is burst of flowers, everywhere. Agriculture is the main occupation of the people of this district. The district headquarters are located in the Gopeshwar town.

Chamoli is surrounded by Tibet region in the north, districts of Pithoragarh and Bageshwar in the east, Almora district in the south, Pauri Garhwal district in the southwest, Rudraprayag district in the west, and Uttarkashi district in the northwest.

Further details of the district can be seen as under:

Area (Sq. km.) 7,520 Total Population (projected - 2008) 417,157 Urban (%) 13.8 Rural (%) 86.2 Male (%) Data Not Available Female (%) Data Not Available Scheduled Caste (%) 18.4 Scheduled Tribe (%) 2.8 Sex Ratio (M:F) 1000:1017 No. of Nyay Panchayats 39 No. of Gram Sabha 552 No. of Villages 1,233 Total No. of School Primary 989 Junior High School 223 High School 126 Intermediate Graduate 6 Post Graduate 1 Literacy Rate (%) 76.23 Male Literacy Rate (%) 90 Female Literacy Rate (%) 67 No. of Urban Slums Data Not Available JJ Cluster Data Not Available Persons Affected with Leprosy Homes Nil No. of PAL living in these homes Not Applicable

Health Facilities in District The rural health care system is a three tier structure. It has “Sub-center” at the most peripheral level, “Primary Health Centre” at the intermediate level and “Community Health Centre” at the secondary level. The population covered by a “Sub Centre”, “Primary Health Centre” and “Community Health Centre” are “3,000-5,000”, “20,000-30,000” and “100,000”, respectively. In addition, there are Private Voluntary Healthy Facilities, also. As per Uttarakhand government organizational set up, the District is headed by a District Magistrate, who is also the chair person

District Profile Chamoli - Uttarakhand 2008 Page 1 of 5 of the Integrated District Health Society of Chamoli district. The District health set up of Uttarakhand government is headed by the Chief Medical Officer followed by a Deputy CMO as second-in-command. Chief Medical Superintendent looks after the Uttarakhand government hospitals in the district.

There are 207 government health care facilities in the district, as can be seen from the table given below.

Category Number District Hospitals 01 No. of CHC 05 No. of PHC 04 No. of APHC 07 No. of FW/MCH Centres 104 Urban Health Posts/ Maternity centres 01 State Allopathic Dispensaries 29 Ayurvedic Hospital 51 Homeopathic Hospitals 05

Staff Position in the District Following is the list of Health Personnel employed under Uttarakhand Government. Figures related to other health agencies are not available.

Category Approved In Position Leprosy Training Number received (No. trained) Medical Officers 99 42 42 Pharmacist 55 36 36 Health Supervisor(F) 21 21 21 Health Supervisor(M) 62 32 32 Health Worker (F) 134 120 120 Health Worker (M) Data Not Data Not Data Not Available Available Available NMS 4 1 1 NMA 16 0 Data Not Available ASHA 386 386 386

Epidemiological picture of the District Both Pr and ANCDR have shown any specific pattern over the past 5 years. However, the comment about other indicators can not be made because the number of cases registered in the year 2003-04, 2004-05, 2005-06, 2006-07 and 2007-08 were small i.e. 27, 15, 13, 09 and 18, respectively.

District Profile Chamoli - Uttarakhand 2008 Page 2 of 5 PR & ANCDR MB, Gr 2, Female & Child Proportion

0.8 80

0.6 60 40 0.4 20 0.2 0 0 2003-04 2004-05 2005-06 2006-07 2007-08 2003-04 2004-05 2005-06 2006-07 2007-08 Financial Year Financial Year MB Proportion Child Proportion ANCDR PR Female Proportion Gr 2 Proportion

Treatment Completion Rate (TCR) in the District Multibacillary cases registered in the year 2005-06 – 45.45 Paucibacillary cases registered in the year 2006-07 – 75.00

The TCR of both “Paucibacillary” and “Multibacillary” cases is slightly below the state average.

SUPPORT

Programme Support

NLR has placed a one Leprosy Programme Advisor (LPA), who is a medical doctor with training in leprosy and having experience of working in public health activities. He is covering 6 districts with his head quarter at Haldwani (Nainital) The LPA is visiting this district and transferring his skills, and providing guidance to District Nucleus (DN) so that DN improves their supervisory activities and in turn quality of leprosy services are improved, which will be provided through GHC staff. Through support from this LPA, following support activities have been completed in Chamoli District in the year 2008.

 On the basis of information available in the district, LPA has prepared the district profile of Chamoli District.

 During first quarter of 2008, situational analysis of functioning of District Nucleus (DN) was conducted. On the basis of this analysis, weaknesses, of the functioning of DN, were identified and following activities were planned to overcome these weaknesses.

 Support in Supervision: NLR LPA initiated & motivated DN for the preparation of Advance Tour programme, Activity Under Taken Report and Checklist for supervision, Gantt Chart and Supervisory Report. LPA supports the District Nucleus and visits peripheral health care facilities along with District Nucleus Team and provides them on the job technical support in carrying out supervision of the peripheral GHC staff and in performing Cohort study.

 LPA also assists and transfers his skills required in preparation of “Annual Plan of Action” and monitoring of activities in the district.

 DN team of Chamoli district was supported by LPA, in preparation of monthly reports including “Quarterly Performance Reports” and “Monthly Reporting Formats”.

District Profile Chamoli - Uttarakhand 2008 Page 3 of 5  Training of Pharmacists and Storekeepers: In the third quarter of 2008 LPA facilitated the training of Pharmacists and storekeepers in the district; so as to streamline the MDT management with special emphasis on indenting of MDT. 13 out of 13 Pharmacists participated in this workshop.

 Management of “Lepra Reactions” and “Complicated Cases”: LPA supported the DN in management of lepra reactions and complicated cases and maintenance of records & generation of reports related to it.

 LPA also supported the D.N. in Case Validation, Health Education and IEC Activities.

Outcome

 Preparation of ATP will be done in future also.  Preparation of Gantt Chart and Supervisory Report in future also.  Cohort study for the reporting year 2007-2008 (MB-100% & PB-100%)  Improvement in record keeping.  Improvement in MDT management  Improvement in technical skill of D.N.  Improvement in Retrieval of Absentees.  Improvement in Healthy Contact.  Preparation of need based result oriented POA for the year 2009-2010

REHABILITATION

Promotion of self care Because Chamoli District has no Leprosy Colony so no promotion activity could be done.

District Profile Chamoli - Uttarakhand 2008 Page 4 of 5 Contact addresses of District Officials

Dr. D. S. Rawat Mr. Y. P. Thapaliyal Chief Medical Officer Non Medical Supervisor C.M.O. Office C.M.O. Office Gopeshwar Gopeshwar Chamoli Chamoli Tel: 01372-252187 Tel: 01372-252930 Fax not available Fax not available E-mail not available E-mail not available

Dr. O. P. Agarwal Dr. V. S. Pal District Leprosy Officer NLR Leprosy Programme Advisor C.M.O. Office Netherlands Leprosy Relief – India Branch Gopeshwar Villa Garima, Plot No. 15, T.H.D.C. Colony Chamoli Tea Estate, Banjarawala Tel: 01372-252930 Chamoli – 248001 (UK) Fax not available Mob 09412006248 E-mail not available E-mail [email protected]

District Profile Chamoli - Uttarakhand 2008 Page 5 of 5