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Nutritional Rehabilitation Centre – Supaul

Name :-Nutritional Rehabilitation Centre (NRC) State:-Bihar Areas covered :- Acute malnourished (SAM) children.

Major Issues:-The NRC has been providing medical and nutritional care to severe acute malnourished (SAM) children.

Prayas Juvenile Aid Centre has been running two Nutritional Rehabilitation Centers at Nalanda & Supaul under National Rural Health Mission (NRHM). The objective of the project is to control severe acute malnutrition (SAM) and provide facility-based care to SAM children among 6-59 months children in respective districts.  NRCs provide medical and nutritional care to severe acute malnourished (SAM) children. They are  kept here for treatment for 3 weeks. In NRC, along with medical care, special focus is given on timely, adequate and appropriate feeding to the children and efforts will be made to improve skill of their mothers in regard to Nutrition, Health and Hygiene issues. The caregiver of the SAM children knows the preparation of low cost, nutritious diets from locally available foodstuffs. Those children who are suffering from SAM would get benefit from the program.

Nutrition Rehabilitation Center (NRC) is a in a health facility where children with Severe Acute Malnutrition (SAM) are admitted and managed. A steady linkage with ICDS identifies and refers severely malnourished children in the community using MUAC tape. Children are admitted in NRC as per the defined admission criteria adopted in line with IAP 2006 and new WHO 2009 recommendations and provided with medical and nutritional therapeutic care. Once discharged from the NRC, the child continues to be in the Nutrition Rehabilitation program till she/he attains the defined discharge criteria from the program. In addition to curative care special focus is given on timely, adequate and appropriate feeding for children; and on improving the skills of mothers and caregivers on complete age appropriate caring and feeding practices. In addition, efforts are made to build the capacity of mothers/caregivers through counselling and support to identify the nutrition and health problems in their child.

Objective:- 1. To control severe acute malnutrition (SAM) and provide facility-based care to SAM children among 6 – 59 months children in the district. 2. To halve the percentage of SAM children in the state by 2015. 3.The NRC has been providing medical and nutritional care to severe acute malnourished (SAM) children 20 in number at one batch.

Prayas Intervention in Supaul Flood in 2007 In Bihar flood can be stated a curse for its people since the time immemorial during raining season as many districts of this state remain immersed with the spilling over water of the swollen rivers which have been flowing through these districts. The deluge that aggravated the natural calamity has broken the backbone of the developmental indicators leaving the people at large to face very difficult and struggling life. The devastating impacts of the disaster of the sullen rivers have either ended or changed the normalcy and routine life of people even many of them are not able to save their lives from the deadly affect of the rivers. This year Saharsa, Araria, Purnia and Supaul districts of Bihar have been badly affected by the flood waters of “the sorrow of North Bihar??? koshi river compelling them to be home less as by the time 29 lacs people have been badly affected and encircled by flood water. Thousands of marooned people have been stranded and trapped by flood water owing to the change of the course of Koshi river. The district administration machineries have been working continuously to provide relief work along with evacuation process for the people who have been badly impacted by flood water but that efforts by the government machineries seem to be a drop in the ocean as only one lac people have been rescued and taken to the safer places and more than 41000 displaced people have taken shelter in relief camps stalled by many agencies. The catastrophe has created very pitiable and heart rending situation there and the flood-hit people are left to continue their lives until the grace of God.

First of all we will select such type of place which has been shown in the photograph given below. There we will provide our relief and rescue operation work for the affected people: -

1. The flood affected people are compelled to drink flood water which may cause epidemic in those areas so we will provide the very first need of the flood victims that is pure and safe drinking water for that we will distribute chlorine and water purifier tablets.

2. We will distribute milk powder for infants and babies as the food packets provided by all the agencies to the victimized people do not contain milk that is the food of the infant and babies as they depend to milk only so if milk powder is not distributed for the infants they may die of starvation as their parents are not in condition to give milk to their babies.

3. We will distribute packets which will contain matchbox, candle, torch, live saving drugs for the diseases like dehydration, malaria, fever etc. Having been continuously for the last 12 days with watery environment the victims are likely to face skin diseases so we will distribute them the medicines for that.

4. We will provide food stuffs to the flood affected people and each packet will contain Chura, Sattu, Gur, Namak, bread etc.

5. Cloths and polythene sheets are essential as most of them are now homeless and they have been taking sun shelter for the past twelve days so by making available these items to the flood-hit people we will try to continue their sustainability in those areas and in their turbulent predicament with the ever worst circumstances.

In the above disasters conditions PRAYAS has taken initiative steps for the relief centre and rehabilitation of flood affected people of above mentioned blocks of Samastipur districts.

Distribution of supplementary food- The organization has distributed supplementary food among the flood affected 350 families of aforesaid blocks in form of Chura, Bread, Salt, Sattu, Biscuits etc. Distribution of cloths- The organization has distributed cloths among the flood affected people through the local community support.

Distribution of roof tent material-The organization has distributed roof tent materials among the house less flood affected people in the form of Bamboo, Ropes. Plastic shed, Tripal from self support. Organization has also distributed 1000 sheds which is prepared by the plastic bags for the shelter purpose.

Distribution of medicines like Chlorine tablets, Alum, Bleeching powder, Vaccine, Antisnake vial, skin preventive medicine, medicated soap etc has been done for the flood affected people. Other required materials- distribution of mosquitoes nets, match box, candle, plastic mug, bathing soap, mosquito coil have been distributed among the flood affected people by the organization PRAYAS.

Liaison with Govt institutions – The organization liaisoning with govt. administration and also the officials of the State Government engaged in relief work.

The other organizations are also providing to the flood affected people by distributing the materials as per the requirements of flood affected people.

The Govt. through the district administrations has been providing the relief shelter and rehabilitation to the flood affected peoples but that is inadequate. Other social workers, local leaders, volunteers and social persons are also providing the relief materials to the flood affected people from their end. The following are the action proposed to be taken immediately for the protection and property and preservation of life the flood affected.

Relief Camp – Relief camp is required to be conducted in each Panchayat in flood affected blocks of Samastipur district. These camps will consist of Doctors team and paramedical staff for health checkup, providing necessary medicines and vaccines, distribution of cloths, roof tents, supplementary food and other necessary consumables of items etc.

Transport facility – To take effective measures to reach relief materials to the relief camps swiftly and with due promptness.

Distributions of mosquito net – Distribution of mosquito net is required among the flood affected people for protection from malaria, Kalajar etc.

PRAYAS is yet to assist the flood affected people for their relief shelter and rehabilitation in a big way. The organization would like to provide financial support for the proper help to the flood affected people which is highly required in the dangerous scenario of flood.

Prayas setup two groups of people and the first group will discharge following activities:-

First group: To find and select a place in district head quarter from where we will operate all the relief and rescue operation for example liaison of the agency with administration, providing safety and communications, packaging of the above materials which will be distributed in particular selected area and providing moral and psychological support to face the adverse circumstances positively and boldly.

Second Group: The volunteers who have expertise over working in flood affected areas will be furnished with small shaded hut like structure which will serve as the point to provide various services to the victimized people and the volunteers will also establish coordination with the local influential people so that the most needy and flood afflicted people could be identified and will be handed over the materials. And day by day with providing the services in a speedy process we will convert that place in to a crisis intervention centre.