Keywords: Sundarbans, iCHA, digital healthcare, healthcare,  iKure

My name is Pranati Karan. I am working as an iKure Community Health Activist (iCHA) in Satjalia, Sundarbans.
Six months back my life was confined to household chores and taking care of my family. But now I have a more prominent role to play. Now, I take care of my community as well. Usually, my day starts at 5 am in the morning. I finish cooking mostly fish and rice to feed my family during the day and leave my house by 8 am. My mother in-law takes care of my two children till my husband and I return in the evening. My day at the iKure facility starts by login into the WHIMS application to check the scheduled tasks of the day. I check my Medic Bag, check the BP machine, put on my apron and start with the day’s first door-step visit. Uma Pradhan, 56years of age, has been suffering with high blood pressure. This is my second visit and I find her slightly better than my previous visit. “Uma Amma how are you doing today.” She seems to have recognised me, as she smiled and said, now, I am fine after seeing you.” I told her, Amma, I will monitor you in the next few days, if your blood pressure remains the same, I will connect you to our doctor via teleconsultation. Persistent High BP is not good for you. It can affect your eyes, heart and Kidney, I learnt about this all and more in my training program that I get from the iKure periodically.

iKure selects women like me with minimum educational background. They provide them with a training program that includes clinical training and technology training. At the end of the training, they provided us with Medic Bags that contain Point-of-Care (POC) devices for measuring vitals such as BP, Pulse, temperature, SPO2, height and weight. These are for capturing basic vitals, with advanced training, I will be able to handle other diagnostic tools as well like ECG, blood glucose and identifying anemia. We, iCHAs are medically trained so that we can provide healthcare services even at the last mile where there are no doctors and access to basic healthcare is beyond reach.

Many of the islands of Sundarbans, are not even connected to proper roads. My maternal uncle who was just 38 years old succumbed to death due to a sudden stroke. It took us more than 5 hours to reach a health care facility in Gosaba. There are no healthcare facilities in these islands to handle emergencies. Moreover due to storms and cyclones like Amphan & Fani, there has been increase in the salinity level of the lands, that is why my husband is working as a daily labourer in Bali. I learnt from my iCHA didi, that saline water levels also can cause high blood pressure with other respiratory and skin diseases.

Like me, there are other iCHAs working closely with the local population to raise awareness about sanitation, hygiene, nutrition, maternal and child health, family planning, and disease prevention. We are not here to replace doctors as my neighbours call me during late hours in the night, I answer to them and seek our doctor’s guidance according to their health conditions, rather we are here to reduce the emergencies by treating and managing health conditions on time. Our primary objective is to promote health and well-being through health education, preventive measures, and early detection of health issues. I am taking care of the burden of Hypertension in Sundarbans.

iKure’s iCHA model is enhancing the existing people-centric to process-centric care to improve the quality of care promoting healthy lives and wellness at the grassroots.
I am happy to take the first step with iKure and serve my communities across the remote islands that have never seen a doctor before.

Voice of our iCHAs:

“Working with iKure has helped me gain identity as a health worker. Previously, I was just a housewife who helplessly depended on my husband for the sole income of the family. iKure has given me means to earn my own living and alongside helped me train as a healthcare worker. I have learned to check the blood pressure, blood sugar and body temperature of my patients. In the process I have learned to help my neighbors and community in need while being financially independent.” – Moumita Chhatui, 24yrs, Bally

Our iCHAs taking the ferry to provide accessible and affordable healthcare at the doorstep of the last-mile community.