CHAPTER XVI
MEDICAL AND
PUBLIC HEALTH SERVICES
|
(a) |
|
|
(b) |
|
|
(c) |
|
|
(d) |
|
|
(e) |
(a) Public
Health and Medical Facilities in Early Times
Public health is the science and art of preventing disease, prolonging life and promoting physical health and efficiency through organized community efforts for the sanitation of the individuals in the principal of personal hygiene, organization of medical and nursing service for early diagnosis and preventive treatment of diseases and the development of social machinery which ensure to every for the maintenance of health.
With the advent of Muslim rule, the Unani system of medicine was also introduced into the country – essentially in urban areas. Both the system, i.e. Ayurveda and Unani and were simultaneously practiced by Vaids and Hakims in the Urban and rural areas. The Vaids laid more stress on Ayurveda and Hakims Unani systems of medicines, respectively.
The allopathic system of medicine came with the Britishers. Due to the state patronage, it gained popularity and wider adoption. Homoeopethy, however, did not enjoy State patronage under them.
In 1904, there was a civil Hospital at Hoshiarpur. It had 45 beds (33 males and 12 females). Besides, there were dispensaries at Dasuya, Tanda, Garhshankar, Hariana, Garhdiwala, Miani, Mukerian, Hajipur, Balachaur and Mahalpur in the district.
There were two Hakims in Municipal employ: One at Hoshiarpur and the other at Khanpur. They were working under the civil Surgeons, Hoshiarpur.
The American Presbyterian Mission opened a Janana Hospital at Hoshiarpur in 1902. It had indoor facility with 6 beds. On an average, 80 outdoor patients attended it daily.
In addition to this, local wrestlers or sianas (wise men) attended to the broken limbs. The practice of treating such patients still exists.
After independence, Government have endeavoured to popularise the indigenous system of medicine, viz. Ayurdeva and Unani. The number of Ayurvedic dispensaries in 1976 was 40 and those of Unani 2. Ayurvedic dispensaries are under the charge of Vaids and Unani ones are under the charge of Hakims. Vaids and Hakims are inder the administrative control of the Director of Ayurveda, Punjab.
The birth rate, death rate and infantile morality rate in the Hoshiarpur District, from 1966 to 1975, are given hereunder :
The birth rate, death rate and infantile mortality rate in the Hoshiarpur District, from 1966 to 1975, are given hereunder:
|
Year (Calendar year) |
Birth
rate per thousand population |
Death
rate per thousand population |
Infantile
mortality rate under one year of age against per thousand live births |
|
1966 |
29.87 |
11.18 |
90.55 |
|
1967 |
32.38 |
10.14 |
65.78 |
|
1968 |
32.43 |
10.22 |
84.15 |
|
1969 |
31.00 |
10.74 |
99.10 |
|
1970 |
30.64 |
10.03 |
76.27 |
|
1971 |
30.95 |
9.27 |
75.83 |
|
1972 |
29.27 |
9.14 |
72.58 |
|
1973 |
28.79 |
7.85 |
68.71 |
|
1974 |
24.76 |
8.45 |
74.07 |
|
1975 |
28.20 |
9.56 |
78.56 |
(Statistical Abstracts
of Punjab, 1972 to 1976)
The registration of vital statistics is compulsory. In the rural areas, the Chowkidars maintain ‘Birth and Death Registers’. Such records are maintained by the municipalities in the urban areas. the Principal Medical Officer, Talwara Township also maintains such records. These records are based on records of populations. From these records, the growth rate of population is examined and percentage of death, due to certain diseases, is worked out. Measures are taken to check the morality rate, etc., caused by different diseases. The Civil Surgeon, Hoshiarpur, complies the data.
Important causes of Morality.- The important cause of morality, as elsewhere in the State, are fever, dysentery respiratory disease, etc. The table at Appendix I page 377, gives the statistics regarding some of important causes of deaths.
(c) Diseases Common to the District
(i) Fevers.- The largest number of morality is caused by fevers which include ordinary fevers and seasonal fevers, influenza, typhoid malaria, etc. these fevers are caused either due to unhygienic conditions or infection or malnutrition or unbalanced diet. The constant attacks of fever make a man weak which lowers his resistance. Subsequently, he becomes more prone to continual attacks.
In the past, unhygienic conditions were responsible for the spread of malaria and typhoid. Early in the fifties, the eradication of malaria was taken on national level. The houses were sprayed with D.D.T. The refuse in now got deposited in the technically designed manure pits. It has been fairly possible to overcome unhygienic conditions. The other cause of fever is infection. Mostly the infection used to travel from melas (festivals), etc. Utmost care is taken in melas to vaccinate and inoculate the persons, if necessary. Clean water-supply is ensured. Steps are taken the spread to ban the sale of stale, or exposed sweets and fruits so as to check the spread of infection. The problem of malnutrition is being tackled through the implementation of applied Nutrition Programmes.
Steps are taken by the Medical authorities to control the spread of fevers through timely check-up, blood testins, intculations and distribution of tablets, medicines and drugs.
The incidence of deaths due to fevers among young persons is negligible. It is however, high among infant and old persons. Both these categories are affected due to their low resistance.
The insanitary environments, which include dingy and dark rooms, slum-dwellings, narrow and dark lanes and surface drainage and others allied ubhygienic conditions are also responsible for the high incidence of fever.
In order to improve environmental sanitation, the Government have taken up the schemes like the pavement streets, construction of drains, smokeless chullahs and latrines, etc. in the rural areas.
(ii) Respiratory Diseases.- Next to fevers are respiratory diseases. Smoky and dingy rooms without smoke outlets, windows and ventilators cause breathing troubles or respiratory diseases. Allergic diseases viz., bronchitis and asthma, etc. are also caused by environmental pollution. Since the district is not adequately industrialised, the incidence of respiratory diseases is low. Persons suffering from such diseases are provided treatment in different hospitals, health centres and dispensaries.
(iii) Malaria.- Malaria is caused by a blood parasite called ‘plasmodium’ which is present in a malaria patient blood. It was a dreadful diseases for years together and took heavy toll of lives in the district. Quinine was distributed in the rural areas through many years agencies. It, no doubt lowered the incidence but could not eradicate the disease. It was only after the independence that steps were taken to control and ultimately eradicate malaria. The steps taken to eradicate this disease are detailed below :
Malaria control programme can be divided into three phases. The first phase was that of National Malaria Control Programme, the second that of National Malaria Eradication Programme and third of Maintenance Phase. The work done under each phase is discussed hereunder :
1. National Malaria Control Programme.- Prior to the switching over from National Malaria Control Programme to National Malaria Eradication Programme in 1958, the hyperendemic areas of Dasuya and Garhshankar tahsil were under the control of Malaria Unit, Jullundur and Una Tahsil (now a portion of it in Himachal Pradesh) was served by Malaria Unit, Ambala.
2. National Malaria Eradication Programme.- On introduction of National Malaria Eradication Programme, a separate hyperendemic unit was established with headquarters at Hoshiarpur and the entire district was covered by it with a view eradication malaria. In the affected areas, D.D.T. was intensively sprayed. The spraying operations were repeated from time to time. In the less affected areas, D.D.T. was sprayed once in a year. As a result of these operations malaria was completely eradicated.
3. The Maintenance Phase.- The unit entered the Maintenance phase in 1962 under which the surveillance operations were started. Subsequently, the surveillance reports revealed the recurrence of sufficient number of malaria cases. Since 1975, the entire district is being sprayed with D.D.T. In 1975, 4,36,930 houses were sprayed. Under surveillance operations, 1,29,157 blood slides were collected. The medical authorities have been able to check the menace of malaria in the district to a great extent.
(iv) Communicable Diseases.- The communicable diseases are plague, cholera, smallpox, etc. A brief reference to each of these with particular reference to the district is given below:
Plague
The history of plague in Punjab dates from the infection in Khatkar Kalan, a village near Banga-Nawashar Road in the Jullundhur District. The disease was supposed to have been introduced by a Brahman, named Ram Saran, who returned from Haridwar in a high fever on April 28, 1897 and died shortly after wards, but plague did not assume on epidemic from in the village until the following September.
In December 1897, plague was found in Hoshiarpur in the village of Birampur. In March, 1898 the town of Garhshankar was attacked, and by the following July some 70 villages in the Jullundhar District and measures were undertaken to combat the disease.
In June 1901 when plague had spread widely over the Punjab the last remnants of compulsion with regard to plague operations were withdrawn. In the autumn of 1902, a scheme of inoculation on a grand scale as sanctioned for the Province was introduced and 6 European and 1 Native Doctors were attached to the district for the purpose. A consideration measures of success was obtained 1,58,550 persons being inoculated between October 1902 and April 1903.
The chart given hereunder shows the incidence of plague in the district during 1898-1903:
|
Year ending 30th September |
Hoshiarpur |
Punjab |
||
|
|
Cases |
Deaths |
Cases |
Deaths |
|
1898 |
704 |
408 |
3,406 |
2,105 |
|
1899 |
50 |
16 |
423 |
293 |
|
1900 |
107 |
54 |
859 |
545 |
|
1901 |
694 |
356 |
9,777 |
5,923 |
|
1902 |
22,434 |
12,299 |
3,17,938 |
2,18,932 |
|
1903 |
35,522 |
19,355 |
3,25,747 |
1,95,141 |
Thereafter, plague never disappeared from Punjab. It is only after the independence (1947) that plague has been eradicated. The D.D.T. and B.C.G. sprays disinfect the houses and kill the germs. In the past years, several derating schemes have been started on wide scale and pesticides like, zinc phosphide and aluminum phosphide were distributed to kill rats. Besides, Sanitary Inspectors and Swasth Sahaiks are deputed to destroy rats by cynogassing the holes, baiting with zinc phosphide and by laying rat traps. Utmost care is taken to detect plague amongst rats or in human population and preventive measures are taken.
Cholera
Cholera is caused by pathogenic germs. The faces of such patients contain these germs. The food or water gets infected by the infected stools, through files, clothes, hands, rats, etc., when a healthy person eats or drinks the infected food or drinks, the germs grow inside the persons and then attack the intestines and produce cholera. In choleras, there are watery stools with great frequency and the condition of the patient becomes very serious in hours and may die. With the introduction of piped water supply in the urban areas and periodical cholrnation of wells, measures taken for maintaining cleanliness, and timely vaccinations, it has been possible to overcome this deadly disease. Whenever, necessity arises, sale of rotten fruits and sweets placed in open is banned in the urban areas. this disease is imported from melas such as held on eclipseat Kurukshetra, kumbh at Haridwar or melas held at Chintpurni or Jalwa Mukhi (Kangra District, Himachal Pradesh). Since the health authorities of the concerned States are alive to the situation and take utmost care for the provision of the clean water supply, etc., the channel of import of cholera are eliminated.
With the increase of medical facilities in the district, cases of gastro-enteritis are attended to promptly. The health staff freely distributes sulphaguanadine tablets in the villages, Cholera disease, as such, stands practically controlled in the district.
Smallbox
Smallpox is a very serious disease. It spreads through ‘Virola Verus’. It travels through extra disposal of the patients or through the smallpox spots. Even a healthy attendant can have the infection from the patient. This fatal disease took heavy toll of lives, blinded lacs of people and made several persons ugly. It left far-reaching effects on the affected ones and they carried these impressions throughout life.
In the past, people were opposed to every treatment which was ministered to them, as they considered this disease as the visitation of goddess Sitla.
In the beginning of the twentieth century, vaccination of the population was started. There was a tough opposition from the people. they would run away to avoid vaccination. But now vaccination is routine affair for all. During the last decade or so, mass vaccination of the population has been done. It is gratifying to note that the disease has been eradicated from the State since August 1974. The Government have fixed a prize of Rs. 1,000 for anyone who could report even a single case of smallpox to the authorities.
The incidence of smallpox and details of the preventive measures taken in the district, during 1965 to 1975 are given in Appendix II at page 378.
Goitre
A peculiar disease which needs mention is goiter. The disease is caused due to the shortage of iodine. In the hilly tracts, iodised is being supplied and the sale of refined or non-iodinsed salt has been banned.
The Hoshiarpur District Gazetteer, 1904, gives the following account of goiter then existing in the district :
“A low intellectual condition amounting is rare cases to imbecility is sometimes found co-existent with the affection of goiter, or Derbyshire neck, which is extremely common in some of the hill villages in the district, particularly in the thanas of Harijans, Amb, Una and Anandpur. The district is commonly attributed to the water of mountain streams. The affliction is much more common across the Beas in the Kangra District than it is here, so common indeed, that when a betrothal is arranged there, there is always an enquiry made as to whether or not the bride is afflicted with goiter. The Chahng tribe located in the hills of Tappa, Tharra and in Bab – villages of Kamahi is closely allied to the Ghirth tribe of Kangra District. They are, however, very different in physique, the Chahngs being far superior. The difference is ascribed by the people to the fact that the Chahungs drink good water, and not the water of the hill-streams such as the Kangra Ghirths drink. The Ghirths are feeble race, and suffer greatly from the goiter.
Tuberculosis
Tuberculosis is a widespread disease in our country. It is frequently precipitated in poor women following childbirth. In persons above 40 years of age the disease may by precipitated because of unknown or uncontrolled diabetes. Whereas previously it was considered an expensive, relapsing and hopeless disease it is now most gratifying to treat it with almost 100 percent success. B.C.G. is a safe and effective vaccination against tuberculosis. It is now0a-days being given directly to the age group from 0-20years. New born infants can be vaccinated quite safely.
Rai Bahadur Jodha Mal Government T.B. Clinic at Hoshiarpur provides treatment to both outdoor and indoor patients. In 1974-75, total number of outdoor and indoor patients treated in the clinic was 2,170 and 58 respectively.
(d)
Medical ands Public Health Services
Previously, medical services were divided into two wings. The Civil Surgeons was responsible for the functioning of hospital and dispensaries, medical and surgical work in the district, besides being Government medico-legal-expert. The District Medical and Health Officer was in charge of the health wing and was responsible for sanitation prevention of diseases and health promotion services in the district. He was also to advise the municipalities on public health matters. Both the wings worked under the administrative control of the Director of Health Services, Punjab, Chandigarh.
In April 1964, the two wings of the health and medical services were merged and the Chief Medical Officer was made incharge of both these wings. The post of Chief Medical Officer was redesignated as Civil Suegeons in June 1974. The Medical Officers and the staff employed by the Zila Parishad, Hoshiarpur, also work under his control. The Medical Officer and the staff, however, continue to draw their salaries form the exchequer of Zila Parishad. The prevailing system has ensured efficiently and prompt services, eliminating the chances of unnecessary delay.
In the Hoshiarpur District, the Civil Surgeons is assisted by 3 Senior Medical Officer, 1 District Family Planning Officer, 74 Medical Officer, 1 Assistant Medical Officer, 6 Dental Surgeons, 40 Dispensaries, 11 Nurse Dais, 7 X-rays Assistants, 42 Vaids, 1 Hakim and 43 Up-Vaids.
On the health side, Malaria Officer, Vaccinators and Medical Officer (incharge of dispensaries ) also assist the Civil Surgeon. Similar functions are performed by the Zila Parishad dispensaries. The municipalities also assist the Civil Surgeons in the Public health field. In order to check the adulteration of foodstuffs, the civil Surgeons has delegated powers to the Medical Officers of hospitals/dispensaries empowering them for taking sample of foodstuffs.
Hospitals,
Primary Health Centres, Dispensaries, etc.
The expenditure incurred by the State Government on Hospitals, health centres, dispensaries, and other health / services in the district during 1974-75 was Rs. 22,18,520. these medical institutions include both allopathic as well as Ayurvedic and Unani. All these are under the control of Civil Surgeons, Hoshiarpur.
Allopathic Medical Institutions.- As on January 1, 1976, there were 64 medical institutions in the district. Their tahsil- wise and area-wise break-up is given below:
|
Tahsil |
Rural |
Urban |
Total |
|
Hoshiarpur |
21 |
10 |
31 |
|
Dasuya |
15 |
3 |
18 |
|
Garhshankar |
13 |
1 |
14 |
|
Balachaur |
1 |
- |
1 |
|
District Hoshiarpur |
50 |
14 |
64 |
The management-wise break up of the above medical institutions (allopathic) is; 49 State Public, 4 State Special, 1 Municipal, 5 Zila Parishad, 3 Private Aided and 2 Subsized. The list of hospitals, primary health centres and dispensaries in the district is given in Appendix III at page 379.
The particulars regarding the family planning units/clinics and maternity and child health centres are given in Appendix IV and V at pages 383 and 384, respectively.
Ayurvedic and Unani Medical Institution .- As on January 1, 1976, there were 40 Ayurvedic and 2 Unani medical institutions in the district. All these are functioning in the rural areas. Their tahsil-wise break-up is given below:
|
Tahsil |
|
Total |
|
Hoshiarpur |
.. |
9 |
|
Dasuya |
.. |
14 |
|
Garhshankar |
.. |
12 |
|
Balachaur |
.. |
7 |
|
District Hoshiarpur |
.. |
42 |
All these institutions are managed by the Government. Their detailed list is given in Appendix VI at page 385.
Government Hospitals and Nursing Homes
Civil Hospitals, Hoshiarpur.- Civil Hospital, Hoshiarpur, said to be opened in the fifties of the 19th century, is the oldest medical institution in the district. Victoria Jublee Ward was attached to it in 1887. The old building fell short to the expanding requirements of the towns. The hospitals shifted to the new building in 1959. the hospital has 100 beds – 54 for males and 46 for females.
The hospital is manned by 1 Senior Medical Officer, 11 Medical Officers, 3 House Surgeons, 1 Matron, 22 Staff Nurses, and 1 Auxiliary Nurse Midwife, besides other allied and miscellaneous Class IV staff.
It provides medical, surgical gynecological and obstetric, eye and E.N.T., dental, X-Ray, laboratory and blood transfusion facilities. There is also a blood bank in the hospital.
The number of outdoor and indoor patients treated in the hospital from 1970 to 1975, is as under:
|
Year |
|
Number
of Outdoor patients treated |
Number
of Indoor patients treated |
|
1970 |
.. |
65,063 |
3,863 |
|
1971 |
.. |
72,369 |
3,401 |
|
1972 |
.. |
66,585 |
3,884 |
|
1973 |
.. |
53,541 |
4,236 |
|
1974 |
.. |
57,916 |
3,984 |
|
1975 |
.. |
91,471 |
7,840 |
Civil Hospitals, Dasuya.- Civil Hospital, Dasuya, is housed in a
newly constructed beautiful building.
It has also 50 beds.
Accommodation for doctors and staff has also been provided. The hospital is manned by 3 Doctors, 5
Nurses and other allied and miscellaneous Class Iv staff.
Facilities
for general surgery, i.e. hernia, piles, abdominal tumours, intestine
obstruction, prostrate enlargement, fractured bones, and obstetric surgery, and
family planning operations are available in the hospitals.
Approximately over one thousand indoor and thirty thousand outdoor patients are treated every year in the hospitals
Civil Hospitals, Garhshanker.- Primary Health Centres, Garhshanker, was raised to Civil Hospital in 1970-71. he is manned by 4 Doctors and 4 Nurses, besides other allied and miscellaneous Class IV staff. It has 50 beds. Over 500 indoor and 20,000 outdoors patients are treated or an average every year. Medical and surgical treatment, where blood transfusion is not required, is available here.
Civil Hospital, Mukerian.- Opened in 1884, this hospital has 33 beds. It is manned by a Doctor and a Nurse, besides other allied and miscellaneous class IV staff.
Over 14,000 outdoor and indoor patients are treated here every year Medical and Surgical facilities are available in the hospital.
Rai Bahadur Jodha Mal Government T.B. Clinic, Hoshiarpur.- Opened in 1968, Rai Bahadur Jodha Mal Government T.B. Clinic, Hoshiarpur, provides treatment to outdoor patients. The clinic is manned by 2 Medical Officers, 4 Pharmacist, 3 T.B. Health Visitors, 3 Staff Nurses, 2 Laboratory Technicians, 2 Laboratory Attendants, 1 Radiographer, 2 Dark Room Assistants, 4 Clerks and 16 Class IV officials.
The clinic has 18 beds – 8 for males and 8 for females and 2 special.
The number of outdoor and indoor patients treated by the clinic is given as under:
|
Year |
|
Number of Outdoor patients treated |
Number of Indoor patients treated |
|
1968 |
.. |
1,160 |
30 |
|
1969 |
.. |
1,570 |
36 |
|
1970 |
.. |
1,263 |
39 |
|
1971 |
.. |
1,257 |
72 |
|
1972 |
.. |
1,273 |
14 |
|
1973 |
.. |
1,552 |
8 |
|
1974 |
.. |
1,962 |
23 |
|
1975 |
.. |
2,170 |
58 |
Private Hospitals and Nursing
Homes
There are only three important hospitals in the district, viz. Red Cross Maternity, hospital, St. Joseph Hospital both at Hoshiarpur, and Lala Chuni Lal Free Hospital, Bajwara. A free reference of these hospitals is given hereunder :
Maternity Hospital, Hoshiarpur.- The hospital was opened in 1951. It is financed by the Indian Red Cross Society, Hoshiarpur District Board. It has 23 beds and is manned by 1 Doctor, 1 Staff Nurse, 1 Auxiliary Nurse and Midwife, 3 Dais and 1 Pharmacist. Gynecologist and obstetric treatment is also provided to the needy available.
The hospital is housed in a modern building. Its yearly expenditure in 1975-76 was Rs. 62,064
The number of indoor and outdoor patients treated from 1972 to 1976, is as hereunder:
|
Year |
|
Number of Indoor patients treated |
Number of Outdoor patients treated |
|
1972 |
.. |
338 |
19.898 |
|
1973 |
.. |
416 |
23,713 |
|
1974 |
.. |
233 |
30,025 |
|
1975 |
.. |
341 |
28,519 |
|
1976 |
.. |
334 |
24,240 |
St. Joseph Hospital, Hoshiarpur.- Opened in 1973, this hospital is situated in Ram Colony Camp, a suburb of Hoshiarpur on the Hoshiarpur-Mahalpur Road. It has 15 beds. A Convent School is also attached to it.
The hospital serves the nearby villages, of the nearby villages, of the Ram Colony Camp. It is manned by one Doctor and three Nurses. Medical facilities are provided to the indoor and outdoor patients.
The hospital is housed in a modern building. The expenditure incurred on the hospital is met by Carmelite sisters, Jullundhur. In 1976 the number of indoor and outdoor patients treated in the hospital was 300 and 15,000 respectively.
Lala Chuni Lal Free Hospital, Bajwara.- The Hospital was opened in 1925 in the memory of L. Chuni Bhalla, a resident of Bajwara. It is housed in a spacious building. It has 6 beds – 4 for males and 2 for females.
The hospital provides free medical facilities to the patients. It is manned by 1 Doctor, 1 Pharmacist, and other staff. The annual expenditure of the hospital is said to be Rs. 1,20,000.
Blood Bank, Hoshiarpur
There is a blood bank in Hoshiarpur attached to the local civil hospital. It was started in 1963. It is manned by 1 Medical Officer and 1 Laboratory Technicians alongwith other allied Class III and Class IV staff.
The bank has 2 sterilizers, 2 microscopes, 3 stills and 2 refrigerators for maintaining and storing blood. The blood caters fully to the needs of the patients admitted in the civil hospital.
Prevention of Adulteration of Foodstuffs
The Punjab Government passed the Prevention of the Food Adulteration Act in 1954 for checking the adulteration of foodstuffs. This Act replaced the Punjab Pure Food Act, 1929. The concerns dealing in sale, stock and preparation of edible articles are subject to inspection by the Food Inspectors, Medical Officers and Civil Surgeons. In order to ensure preparation and sale of pure foodstuffs, edibles and drinks, special powers have been entrusted to the inspecting staff to seize samples. These samples are sent to the Food and Health Laboratory at Chandigarh for chemical examination and analysis. Those found guilty of adulteration are prosecuted.
In the district during 1975, 475 samples were seized. The number of prosecuted launched was 47 and the amount realized as fine was Rs. 17,000.
Applied Nutrition Programme
The Applied Nutrition Programme was started in Punjab in November, 1963. The Programme was in operation in 59 out of a total 117 blocks in the State. By March 31, 1977, Hoshiarpur – 1 Mahalpur, Dasuya, Tanda and Talwara in the Hoshiarpur district were district covered under this programme.
The Applied Nutrition Programme aims at changing the food habits of the people through co-ordinated and comprehensive programme of nutrition, education and training in production, in producing, preservation and consumption of nutritionally valuable foods. It is a Centrally-sponsored scheme. It is being assisted by the United Nations International Children Emergency Fund, the Food and Agriculture Organization and the World Health Organizations. The general objectives of the programmes are; to develop a programme of education and training in the Applied Nutrition Programme and related subjects for establishing an effective field service to improve local diets through production, preservation and use of protective foods by pregnant and nursing mothers, pre-school and school children; to promote through demonstration and education among the communities sound and hygiene knowledge of production, preservation and consumption of protective foods; and to extend facilities for training in Applied Nutrition Programme for the selective groups of personal in community development blocks.
In order to give particle shape to the Applied Nutrition Programme, the specific schemes undertaken include domestic poultry units, domestic piggery units, fisheries, kitchen gardens, schools/community gardens, demonstration feeding programmes, model kitchens, demonstrations of preparation and preservation of foods, economic schemes for mahila mandals ad grant-in-aid for bawadis.
(i) Public Health and Sanitation in Urban Areas.- Public health services are rendered in two ways. Firstly, it is incumbent on the District Health Officer to take preventive measures to check the occurrence and re-occurrence of epidemic and seasonal fevers, etc. Secondly, the functions performed by the Public Health Department, municipalities and Zila Parishad are directed to promoted the well-being of the people, there by preventing the outbreak of diseases.
Among the municipalities of the Hoshiarpur District, water-supply schemes have been introduction only in Hoshiarpur , Talwara Township and Mukerian. Talwara Township and Mukerian. Talwara has been developed on modern lines, equipped with underground drainage system. Some of the municipalities, viz. Hariana, Tanda, Garhdiwala and Sham Churasari have installed hand-pumps for the facility of the residents. All the municipalities have engaged a number of scavengers and sweepers for sanitation and disposal of sewage, etc. Vaccinations and inoculations are also administered by these municipalities. The disposal of drainage and sullage water is problems in the district except in Hoshiarpur town. With the exception Hoshiarpur, other towns in the Hoshiarpur town. With the exception of Hoshiarpur, other towns in the district are not tickly populated and the water supply schemes do not exist in some of the towns, and as such drainage of water is not a serious problem. Besides, these towns are situated on higher level and their water could be easily drained out to the fields. Hoshiarpur is the headquarters of the district and its sanitation system is comparable with the other cities of the Punjab. The underground drainage system is being introduced in Hoshiarpur gradually. The outer areas of the town have been covered under the scheme in the first instance. The water supply scheme was introduced in the town in 1959 but it was only in 1965 that the water connections were given to the public. The other towns of the district have surface drains.
(ii) Rural Sanitation and Water-Supply.- In the second decade of the present century, rural sanitation in the district was in deplorable condition. Consequent upon the poor sanitation, epidemics appeared and spread. These epidemics were considered to be either the wrath or the acts of God. As stated earlier in the chapter, occurrence of smallpox was considered as appearance of goddess Sitla. The occurrence of such diseases was kept secret. It was in the beginning of the third decade of the present century that the Health Department started making extensive propaganda and publicity through the audio-visual aids regarding rural sanitation, disposal of refuse and sewage in the manure pits and dumping debris grounds. The people were vigorously persuaded for vaccination against smallpox. These efforts did not achieve desirable ends. The opening of maternity centres in the rural areas helped in reducing infantile mortality. The preventive measures taken by the Health Department considerable decreased the occurrence of infectious diseases like plague, cholera and smallpox.
After independence, considerable progress has been made in the improvement of rural sanitation. The people have become conscious of personal hygiene. In most of the villages of the district, streets and lanes have been paved and sullage water. The houses, which are now constructed, are well ventilated and sunny.
The panchayats look after the sanitation of the villages. The Zila Parishad gives 50 per cent grant-in-aid to those panchayats who engage regular scavenging staff for cleanliness in the villages. The panchayats disinfect the drinking water wells whenever necessary.
Water-Supply
With a view to improving the environmental sanitation, the Government of India launched a National Water Supply and Sanitation Programme in 1954. This programme caters to the needs of rural as well as urban areas. In the case of rural water schemes, entire cost on these is met by the Government and the beneficiaries have to provide free of cost the land required for the requisite schemes. The villages of Hoshiarpur District suffered from acute scarcity of drinking water. Most of these villages are located in the sub-mountainous areas known as kandi areas. In these areas, the water resources are either deep or far off far in the villages and the people have to cover long distances to get drinking water and that too may not be safe for drinking. In order to provide safe drinking water to the scarcity villages, the Public Health Department had undertaken 72 rural water-supply schemes in the district. Out of these, 20 schemes covering 209 villages were completed by March 31, 1975, and the remaining 52 are in progress.
APPENDIX I
Death rates registered per thousand of population by
causes in the Hoshiarpur District, 1966 to 1975
|
Cause of death |
1966 |
1967 |
1968 |
1969 |
1970 |
1971 |
1972 |
1973 |
1974 |
1975 |
|
Fevers |
5.5 |
4.50 |
6.75 |
7.32 |
5.52 |
5.15 |
4.75 |
4.36 |
4.71 |
5.12 |
|
Dysentery and Diarrhoea |
0.50 |
0.45 |
0.38 |
0.26 |
0.19 |
0.13 |
0.14 |
0.23 |
0.25 |
0.21 |
|
Repiratory Diseases |
0.86 |
0.77 |
0.99 |
1.41 |
1.11 |
1.10 |
0.97 |
0.93 |
0.73 |
0.67 |
|
Injuries |
0.01 |
0.05 |
0.05 |
1.15 |
0.08 |
0.12 |
0.12 |
0.09 |
0.09 |
0.10 |
|
Other Cause |
4.30 |
4.37 |
2.06 |
1.60 |
3.13 |
2.77 |
3.16 |
2.25 |
2.67 |
3.46 |
(Source: Directors, Health and Family Planning, Punjab, Chandigarh)
APPENDIX II
Incidence of Smallpox and Preventive Measures taken in
the Hoshiarpur District, 1966 to 1975
|
Year |
|
No of cases |
No of deaths |
Primary vaccination |
Re-vaccination |
|
|
|
|
|
Number |
Number |
|
1966 |
- |
- |
- |
32,774 |
30,137 |
|
1967 |
- |
- |
1 |
24,306 |
2,25,541 |
|
1968 |
- |
- |
- |
39,068 |
2,58,199 |
|
1969 |
- |
- |
- |
37,087 |
2,00,419 |
|
1970 |
- |
4 |
- |
44,330 |
2,86,403 |
|
1971 |
- |
11 |
1 |
44,785 |
3,21,425 |
|
1972 |
- |
- |
- |
48,875 |
3,94,183 |
|
1973 |
- |
- |
- |
43,085 |
3,20,106 |
|
1974 |
- |
2 |
- |
49,455 |
2,75,095 |
|
1975 |
- |
- |
- |
25,981 |
2,59,916 |
(Source: Director, Health and family Planning, Punjab, Chandigarh)