75-year-old Vitthal Jayram Vinchu was distraught when he learnt he was ailing from High Blood pressure and Diabetes. Over the past few months, he had been perpetually thirsty and hungry. Subsequently, his weight had swelled to 110 kgs, making it arduous to do any physical activity. His gait had also assumed a limp and needed the support of a walking stick.  That was when he decided to visit a government hospital and get a health checkup done.

While many would imagine living a retired existence at his age, Vitthal could not afford to do so. Working as an agricultural labourer along with his son and daughter-in-law, Vitthal's earnings, though meagre, were vital to make ends meet for the family of five. Living together in a shanty with a tin roof over their heads, the family was hard pressed for money.

The distressing diagnosis meant that Vitthal had to travel at least 35 kms to the nearest weekly dispensary with his son accompanying him. While both government and private hospital facilities were available in Gadchandur, about 5-10 kms away, the ever-persisting scarcity of medicines in Government hospitals and exorbitant pricing in Private hospitals kept the poorest of the poor such as Vitthal, away. Where even a day's loss of work threatened the family's bare earnings, Vitthal's family had to contend with both loss of livelihood and expenditure on treatment. On an average, each month Rs. 800/- was being spent on just travel and medicines.

Sometime back, a Sakhi (ACF supported frontline health worker) came to his ward in Wadgaon and called for a meeting of the villagers. It was at this meeting that he heard about the Community Clinic. Operating a weekly dispensary, the Community Clinics offer a unique model of health provision, led and driven by the village itself. Enabled by ACF, they offer nominally priced health services with reasonably priced medicines to the community in their own villages.

The objectives are threefold:

1. To address clinical needs of the community;
2. To provide timely and affordable basic health services at the doorstep;
3. To make the Community Clinics self-sustainable by strengthening the Village Development Committees (VDC) or Village Health Sanitation and Nutrition Committees (VHSNC)
   

Operating on a fixed day at a fixed time each week, the Community Clinics offer a host of services including:

• General Treatment
• Awareness sessions on all NCD
• Hemoglobin, BP and Sugar tests
• Nebulizer for children
• Inhalers for COPD and Asthma Patients
• Spirometry tests through a Spirometer
• Counselling of all NCD and COPD patients
  

While these clinics are managed either by the VDC or VHSNC, ACF provides technical support to the clinic management for medicine procurement, indent maintenance, and doctors and paramedics support for clinical activities. Sakhis spearhead the outreach in the community and are also trained to offer basic health services to the villages. At present 60 Sakhis reach out to 8516 households in the Chandrapur region, covering a population of over 36862 people.

Hearing about the Community Clinic, Vitthal decided to give it a try and he was delighted with the experience. The staff were courteous, with the doctor going to extraordinary lengths to explain the illness to him. He was advised to pay strict attention to his diet and to exercise regularly to reduce his weight. Over the course of a few visits, his weight now stands at 88 Kgs and he no longer needs a walking stick. His monthly expenditure on medicines has reduced to Rs. 200/- per month and with no need to travel for treatment, he does not miss even a single day at work.

But perhaps, the biggest advantage that Vitthal perceives is the warmth in the attitude of the Community Clinic staff towards him. 'Aadhi Bimaari toh Isi se theek ho jaati hai,' remarks Vitthal and breaks into a smile.

ACF has enabled the setup of 5 Community Clinics servicing 25 villages in the Chandrapur district, Maharashtra. Over 6000 people have been successfully treated at these Community Clinics. There are plans to set up 12 more clinics by the end of this year. To further bolster the impact of this sustainable initiative, ACF plans to link each clinic with its Non-Communicable Disease program to help promote preventive health among target communities.