That's great news about finding someone to send to the training course Joseph!!
I will re-send Dr Roys email to you via your Nabuur email account.
Regards
Carolyn

Hai Carolyn,
Thankyou for sending the email of Dr. Roy. I will contact him soon. We happened to read in todays news paper that there will be a training programme by the ARDSI Cochi. We wish to attend the same. It is for one month. We are preparing the structure of the project it it will be send to you soon.
Thanking you
Regards
Joseph

That's great Jospeh! I hope someone will be able to attend the training.
And i think it is a very positive step forward to put down your ideas and requirements for the home service down on paper as a plan. It will help you a lot!
Best wishes Carolyn

Hallo Madam,
I have contancted Project Manager Sri Babu Vargheese of the training course which will be contected by the ARDSI Cochin. This is One moths' training. But sorry to say that the admission has been closed. The news about the training course was published in our newspaper very late. So I wish to visit the Paliative Care Centre of M M Basheer at Nilampoor.
Thanking You
Joseph

Hallo Carolyn,
Sorry for the delay in sending you the organization structure and other details of our project ‘Medical Home Care Service’. Now we are sending the same for your kind consideration and further action.

OUR ORGANISATION AND OBJECTIVES:
We have established an organization named ‘Human Resource Education and Socio Economic Development Centre.’ It was registered with Register No: 427/2008 in Kottayam sub registrar office, having a managing trusty and eight other Board Members. is established for the all round development of the society, like the eradication of poverty and improving the life style of the society, providing help and education to the poor students, establishing social justice, equality, womence empowerment etc. It is a humanitarian organization to make a change in the society as a whole, by creating equal opportunity and rights to lead a good life. Priority is given to the development of education among the children and ladies. So also we wish to educate the society about the existing superstition and social evils. Secondly, the organization intends to achieve good health and living conditions to the poor villagers. Third preference is given to the development of agriculture and farming. Another objective is to provide employment opportunities among the village people. So also the labour conditions of the women labourers will be looked after.
Taking into consideration about the health conditions of the society at present, we have decided to give priority for the Medical Home Care Service for the sick old patients in the poor families and there improving life style of poor families by providing free medicines, medical care, medical materials, nutritious food to the sick old patients freely.

MEDICAL HOME CARE SERVICE: FOR WHAT?
Now we undertake the case of poor old and chronic diseased patients in our locality, as it has become the most importuned problem to save the lives of the old as well as that of their families. So the medical home care service has given the top priority. We wish to do this Medical Home Care Service as a humanitarian one. We consider this as part of our duty in this world of humanity without any barriers, and with the co-operation of others, as the human race cannot exist without co-operation and mutual help. It is meant for the well being of the poor sick old chronic diseased people in our society. The long term treatment of the old aged people will lead the families to severe poverty and huge Bank debts that will result in family suicide and the loss of residential plots. 'Medical Home Care Service' for the poor and the needy old patients especially the Alzhimers patients in my locality. Through this service we wish to help the poor sick and elderly people who suffer most. We also wish to help other needy patients on a humanitarian consideration. We may also invite your attention to the fact that in our country there is no practice of Medical Home Care Service for the old and bed ridden patients by Doctors and nurses. So the poor and old including the Alzhimers patients do not get proper attention and nursing care in their homes. The poor families are unable to provide them with nutritious food sufficient medicines and medical care, medical materials like water bed, tena bed, urine bag, necel tube, gloves etc. Even though there are Multi Speciality Hospitals, they are out of reach for the poor as they are expensive and profit motivated. In Government Hospital also there are no facilities for better treatment to the poor due to the corruption among the Doctors and other staff. Considering these financial problems the poor families do not care to take sick old patients to hospital. This is very miserable and sympathetic. The poor people are unable to provide their dear ones with the expensive treatment and conveyance. So we wish to provide them with a free Ambulance service to the disabled and bed ridden the poor patients especially the Alzhimers patients.
The Alzhimers patients usually do not get full attention of the poor families because the family members are unaware of this disease. They think that it is a mental disease or otherwise caused by evil spirits. So they neglect the treatment of The Alzhimers patients and do not care to take them to the hospital. They are left to lead a very miserable life till the end of their life. So the family members of the Alzhimers patients should be given awareness or education about this serious disease. In our country the family members are looking after the old and sick patients as it is very expensive to hire a Home nurse at home. Due to the long term treatment of the patients will lead the family to debt and disappointment. This will impoverish the poor families.

MEDICAL HOME CARE SERVICE: HOW TO OPERATE?
We wish to help the patients as well as their families why providing free medicines, medical care, medical materials, nutritious food and other necessary things to the patients and also helping the children to continue their studies. The family members also will be given education about the caring of their old diseased parents and councelling to all. Medical campaign also will be conducted regularly.
The home care service, according to us, requires a full time doctors, nurses and Attenders in the office to attend the sick old people as an when necessary. The service should be for 24 hours. The people are given awareness about this project of Medical Home Care Service. Those who want the service of the doctors and nurses will contact us through phone call and they will visit the patients and will do the necessary help. For the purpose a mobile medical care service in an ambulance is necessary. In the case of very serious patients, they will be admitted in hospitals which are linked with special service to this. Arrangements will be made to give the patients special care and attention in those hospitals with the help of the medical home care service. So also the free service of trained home nurses will be made available to those who are in urgent need of it.
My ultimate goal to provide medical help to the poor sick old patients and there by make them not a burden to the families as well as to the society as a whole. To provide the families of the patients are to be given sufficient help to lessen the poverty and mental tress. The bed ridden old patients should be made available the services of Doctors nurses lab technicians, at home. To extent the life span of the patients in the poor community by providing them with better medicines and medical care and to enable them to live long in the society. It is a longterm project and incourse of time the rich patients who are willing to be helped will also be attended for a nominal charge and this amount utilized for the poor.

RESULT:
The patients will not be curse to the family as well as to the society as a whole. Their lives will be made peaceful and pleasant. Through the counselling and education to the families will make a society that is careful about their family members and treat them with love and care. The society can be improved in their life style. By eradicating poverty and huge bank debt caused by the longterm treatment of the old sick patients, the families will become pleasant and peace full. The children will be able to continue their studies and also their health can be improved. In general family sucides and loss of residential plots can be controlled to a great extend.

REQUIERMENTS:

A permanent office building is the most important requirement for this programme. A van is an essential necessity for transporting the medical staff to the homes of the bed ridden old patients for consultation and other treatment as well as for the medical campaigns.
A doctor and a nurse as well as a nursing assistant is required for attending the patients. So also two attenders/ drivers, one office assistant a co-ordinator etc are also required. Some basic medicines medical materials like glous, urinary tube, nasal tube, pampers, cotton, dressing medicines, detol etc are also required. A fridge for keeping the medicines and almirah for keeping the files and other office furnitures are necessary.

THE FOLLOWING IS OUR ANTICIPATED BUDGET ESTIMATE:
1. Building (rented)
a. Security Rs. 10000 thousand for an year
b. Rent Rs. 42000 for an year
2. office table 3 nos. Rs. 12000
3. office chairs 10 nos. Rs. 8000
4. executive table 1 nos Rs. 5000
5. executive chair 1 nos Rs. 3500
6. computer 1 Rs. 30000
7. Van Rs. 400000
8. Medicine Rs. 10000
9 . Medical Materials Rs. 10000
10. Medical Equipments Rs. 10000
11. Co-ordinator (honorarium) Rs. 72000
12. Accountant (1 no.) Rs. 45000
13. Doctor (1 no.) Rs. 240000
14. Nurse (1no.) Rs. 42000
15. Attender (1 no.) Rs. 36000
16. Driver (1 nos.) Rs. 36000
17. counsellor Rs. 48000
18. nutritious food Rs. 25000
19. petrol Alowance Rs. 100000
20. working capital Rs. 100000
21. Miscellaneous Rs. 50000
22. Land phone Rs. 12000
23. Mobaile Phone (2 nos.) Rs. 4000
24. Fridge Rs. 12000
25. Project Manager Rs. 42000
Total Rs. 1404500

At least the above mentioned amount is required for the efficient running of our project Medical Home Care Service. We hope that favaroble reply and assistance will be received without further delay.
Tahnking you
Joseph

Hi Joseph, congratulations to you and your colleagues for making such a great start on this planning document. You’ve done a lot of work to put down the key issues on paper. I have had a good look at it, and have also re-formatted the document so that it begins to look like a strategic plan.
I hope you can open it- it’s in Microsoft Word.

I have some questions and comments which you could take back to your organisation for further discussion.
• Is HRESEDC only working in the area of Kottayam or the whole state of Kerela? You will need to specify which geographical area you are interested in working with in the first phase of this service.
• I have taken out the bits about corruption. Whilst I absolutely accept that corruption is a very serious problem for access to healthcare for the poor, I don’t think it’s helpful to highlight that in a formal document such as this. Especially if this document will be sent off as part of applications to try and get funding or assistance. So I have changed the way you wrote about lack of access due to corruption.
• My biggest concern about your Plan is the list of requirements. You state that a permanent building is the most important requirement. Joseph, I personally do not agree with you about that. I think your priority it to have trained staff first, a vehicle, solid partnerships with other organisation that can help you (eg Alzheimer’s association etc). Having an “office’ would be something that you could strive for over 2-3 years but right now having an office is not really going to help you get this service up and running. In today’s world all you need is a computer, access to the internet, and maybe a place for regular meetings. I know you need a fridge for medication but you will need to establish yourselves very well before the health authorities give you permission to store medication. You don’t need an office to hold medical equipment like gloves, nasal tubes etc- but you will need to find a temporary space. This may cost you a small amount of rent- but not as much as an office. I would suggest that you start small and if you can actually start the mobile service then in say 12-18 months time you can re-visit the strategic plan with the view of expanding it.
• The bit that is missing in your plan is NEXT STEPS. You and your colleagues will need to brain-storm the first things that need to be done to start developing this mobile service. I’d like to caution you against the idea that there will be one philanthropist or aid organisation who will give you all the funding you need to start your service. I would suggest that you break down the steps with the view that you will find assistance from several different organisations to help you either get some small amounts of funding or assistance or advice etc. For example finding a donation for the van/ambulance would be one step. Training local staff would be another. How are you going to do this? Who will you partner with to achieve this? Etc etc
• Finally, you and your colleagues really need to start finding people in India to work with- so one of the tasks that you can start on is finding out who these organisations could be. (this could also be an area where Nabuur neighbours can help too) Now that you have established yourselves as a group, and now that we are working on this document, you will have something more solid to approach other government and non-government organisations with. You need to start talking about your plans to as many people as possible. This will hopefully open up opportunities.
Regards Carolyn

OUR ORGANISATION AND OBJECTIVES.doc

hi Joseph
my compliments having written your businessplan.
But i think, and agree on that with Carolyn, it IS too ambitious and needs a planning scheme as building up is concerned and in time.
I say too ambitious because even in a wealthy country as the Netherlands your plan would not be financed.
I think it would already a big achievement if some service was there every day in working hours, estimating that about 95 of all problems could be handled then (talking about Alzeimer patients and terminally ill people needing palliative care). Most intercurrent problems can be handled by instructions to the family etc. A 24 hours service would be inefficient and very costly, fe you would need 3 doctors instead of 1.
As is said before hospital treatment will seldom be necessary, most problems can be handled at home, and for Alzheimer patients, in general, hospitalisation is not a good idea. So why stressing as you do the facilities to make possible use of some hospital.
Some quantitative elements need to be inserted:
.what is the area you want to cover? Is it about your own village (to start with) or the provimce of Kerala. Btw IF is abouyt your own village only why should doctors etc need a car? I used a bike to visit my patients at home.
.how many patients is it about? Alzheimer disease occurs in 10 % of people over 65, in 50% of people over 85. Knowing the number of people living in the area you are targeting you can calculate what is needed. I have no idea how many patients there are in the region you are targeting needing palliative care, but again: estimating their number is important for your planning.
Last remarks: i think it would be very profitable to make a concrete connection to the organisations in your region busy with Alzheimer and palliative care. Might be an idea to ask (one of) them to participate in thinking about of your project, and the organisation of it?
All the best.Bram de Waard

Hai Carolyn,
Thank you very much for your encouraging message and good comments. Your great efforts in making our project a realistic one, will always be appreciated and respected. Thank you once again for your modifications in the structure, making it a perfect one.
It is noted that you have some questions and comments related to the structure and strategic plan.
• Our organization HREASEDC intends to work in our district, Kottayam, at first. So also our members are ready to extend the work to our state Kerala as a whole, in course of time depending on the availability of funds.
• It is said that you have reformatted the original document. It is a very good thing that you have done for us. Thank you for making such a modification to help us in presenting the document.
• As you have suggested we have given up the idea of hiring a building for office purpose for the time being in order to minimize expenses. I have planed to use a portion of my own house for this purpose temporarily. We have planed to find out a trained nurse. But main problem is how to provide her salaries. Our team is trying to get a four wheeler as a donation from any organization or philanthropist. It is a must for this project. The sick old patients cannot be taken to the hospital in emergencies situations without a four wheeler. So also there should be computer for office work and communications. So also we will try to get permission from the health authorities to store the medicines. We have searched out the address of the some philanthropist who will be able to help us in funding. We request you to help us in contact with them. We will also do our best in this matter.

The below are websites of the organizations and philanthropist we have serched out.
The George Foundation : www.tgfworld.org/home.html
www.giveindia.org
www.idrf.org
www.oneworld.net
www.aifounation.org
www.indiasocial.org
www.phmovement.org
www.haiap.org

We are thinking about a new way to find out funding for our Medical Home Care Service by receiving charitable donations through website and inturn providing those donors with free Home Based Accommodations during the visiting programmes to Kottayam, according to the priority. We wish to arrange both receiving donation and accommodation booking through website. Perhaps it may be something strange and unrealistic. If it will we carried out we think that we will be able to run the Medical Home Care Service smoothly. We wish your advice and comments in this regard.
Thanking you
Yours Joseph, For HREASEDC

Dear Bram,
Thank you for your advice and commence. Our ambition may be great. But there is a financial problem still to achieve it. But we are trying to collect funds to start it.
In connection with the Medical Home Care Service we wish to invite your attention to the fact that in our country there is no practice of doctors attending the patients at home or giving home care service even to the old bed ridden patients. So we wish to have a four wheeler to transport the sick old patients to the hospital at times of emergency situations. Her in our country doctors do not prefer two wheelers. So we are trying to get the services of atleast a part time doctor. So also for conducting health campaigns the services of the doctor is essential to impressed the people. So for meeting all these expenses we are also contacting other funding agencies. Future also we wish your guidance and advice as well as your support to carryout our project.
Thanking you
Joseph

hi Joseph
tahks fopr your reaction. I stay available for any advice. " Change the doctors" might be a target of another project. Regards: Bram

Hai Carolyn,
We whish you to know that we have planned to start a co-program for raising the fund for our Medical Home Care project. Please give us advice as well as comments relating to this program. We have planned to start a program of Home stay accommodation for the tourists at free rent, to those who are willing to donate to our charitable Medical Home Care Service. Amount donated to charities will be exempted from tax also.
The accommodation will be made available according to the seniority in donating. The details will be shown in the web site created. Accommodation will be on priority basis. A part of the income will be utilized for the running of the medical home care service. We have also to find out a partner for financial assistance to start this programme. For this purpose we could not find out a partner till now. So we welcome even a foreign partners to help us financially through nabuur. A part of the income from this service will also be distributed to the partners.
Your opinion and advice about this program will be welcomed. Awaiting your reply,
We wish to attach the photograph of our group.

Thanking you,
Joseph A M

Hi Joseph,

Sorry I haven’t replied sooner. I’ve been doing some more research and have found that there are in fact some similar home-based medical care programmes in other regions of India. At the moment your plans are basic and you will need to further develop them. Any organisation (Indian or foreign) who might consider helping you will need as much info as possible. The sooner you put this together- the better chance you have of attracting willing partners.

In particular the Kerala chapter of the National Rural Health Mission (NRHM) has initiated a project for the development of the community based healthcare services for bedridden, elderly, and chronically and incurably ill. I strongly suggest that your group try to meet with a key person in this organisation so that they can share information with you.
Here is what I found from that article that Bram posted:
"The Rs 4-crore project is the largest palliative care project in India and the only palliative project under NRHM," said Mohammed Saif, the manager of the palliative care component of Kerala's NRHM.
"Kerala has integrated the services of 26,000-odd government-accredited health activists with the community-based palliative care units," Mehta said. Neighbourhood Network in Palliative Care’s (NNPC) success has inspired local self-government institutions. The Malappuram district panchayat has formulated a joint home care programme with NNPC groups-Pariraksha.
Joseph, can you find someone to talk with regarding this local program? I’m sure they will be able to give you lots of good advice which will help you further develop your plans.

The contact for the NNPC is National Information Officer in Palliative Care (India) Institute of Palliative Medicine Ph: +91.4953290956. Contact them specifically in regards to information about the home-care service they offer.

In regards to your Next Steps, have you found out when the next training course is for the community health volunteers? I know you have missed out on this month’s course- but when is the next? Someone from your community should, ideally, complete this training. In the absence of a trained nurse this person could be a good addition to your program.

I’ve had a look at some of the websites you posted last week and I will report back what I found in another post.
Regards Carolyn

Hai Carolyn,
Thank you for your reply and for your great efforts. As you have mentioned we have searched out certain projects. But all these projects are accessible to the rich only because the poor people are not at all aware of such a program. They are ignorant about it. So also the authorities do not tray to make these schemes beneficial to the poor. Some health program like NRHM is new to us because there is no propaganda or announcement about it in the society. We have tried to contact with NNPC project with the help of phone number but it was in vain. We have also sent an email to palliative care unit at Calicut medical collage and awaiting for the reply. As per your advice we have planned to send a person for next training program at Cochi. Our main aim is to help the” poor” sick old people by medical as well as palliative care.
We are awaiting for your opinion about starting the home stay for the tourist to utilize the amount for the medical home care service. We think that if someone will be ready to become a partner in this program through nabuur it will be more better. We wish your help in this matter .
Best regards
Joseph A M
For HREASEDC

Hi Joseph, my advice to you is that you have to keep trying!! Making one phone call or sending one email is not enough. You need to be persistance to get the right people to listen to you. Even in countries like Australia and the US we have to knock on doors many times before people listen and help! I can see and understand what you mean that only those who are economically advantaged might hear of available programs that would help them. The poor always miss out or hear of these when it's too late. And you want to change that. Isn't the role of HREASEC to advocate for the poor people in Kottayam? I would urge you to keep trying to make contact and meet with the key organisations that we have all discussed over the past few months. You cannot roll out this program from scratch- and you shouldn't have to re-invent the wheel. Again, that is why you need to have a very good plan which you can present to other organisations. The tighter and stronger your plans- the better chance you have of getting people to take your group seriously. In my opinion Jospeh money is not your main and first obstacle. Your main problem right now is that you don't actually have a concrete plan that will attract interested groups or volunteers to help you. This is what you need to keep working on. Your strategic plan is a good first step but needs more work. It's great that you have someone down to attend the next training course!

In regards to your idea of home stay- I do not wish to be negative or disuade you- but personally I'm not sure this is a good idea. Setting up a home-stay program is not a quick fix to fund raising. It requires a lot of marketing, a lot of thought about the type of homes people can offer, training those people in how to be good hosts to tourists, and an understanding of the tourism market. Not to mention that you would need to build a website and market that as well (although there is some expertise in doing this here on Nabuur). Then you have to wait to see if tourists will be willing to pay for the homestay you offer.
I know that the state of Kerela is a highly desirable place for tourist to vist. There are also many many different types of accommodation available. What does your group have to offer that is different? You need to think about how you would attract tourists. This is not my area of epxertise at all so I would suggest that you try to find other Neighbours on Nabuur who can help you decide if this is a viable venture that will help you raise adequate funds. I'll do a little search and see if there are some people who can advise you asap.

Best regards
Carolyn

Hi Joseph in your earlier post this week you listed a few more organisations that might be of help.
I have searched I think most of them.
I have only found that one might be of use to us- www.idrf.org - IDRF’s mission is clear: to support volunteer-based, honest and highly experienced non-governmental organizations (NGOs) in India in serving their populations’ critical needs around education, healthcare, and welfare, without regard to religion, caste or creed.
I have actually written to this group previously but I will try again and also to see if there are other contact details.
For you info and record here is what I have found out about the others:

www.indiasocial.org Does not seem to be current. Last updated info was a few years back.
Indiasocial.org is the only specialised portal totally dedicated to development work in India. We want to create more awareness about, and mobilise greater support for India’s struggle for sustainable and equitable development.

Through www.phmovement.org I came across http://phm-india.org/
The Jan Swasthya Abhiyan is the India regional circle of the People’s Health Movement, a growing coalition of people’s organisations, civil society organisations, NGOs, social activists, health professionals, academics and researchers that endorse the Indian People's health Charter and the People's Charter for Health. Again It was not clear to me if they could be of assistance at this stage of the project- but possibly later.
I did find an excellent resource for you to take a look at:
http://phm-india.org/index.php?option=com_docman&Itemid=15

The George Foundation : www.tgfworld.org/home.html
No current activities from what I can see. Last main postings were in 2007. No indication that there is opportunity for new projects.

www.giveindia.org - basically like KIVA- people can donate to certain charities in India. Again maybe something we can tap into later on but you are not ready for this as you don't have a program set up yet.

Regards
Carolyn