Mahatma Gandhi Institute of Medical Sciences.
Keywords: Academies and Institutes, history,organization &administration,Curriculum, Education, Medical, history,organization &administration,History of Medicine, 20th Cent., Human, India, Internship and Residency, history,Rural Health Services,
Mahatma Gandhi Institute of Medical Sciences (MGIMS) was started as Gandhi Centenary Project in the year 1969. In mid sixties it was realised that 80% of rural India was bereft of health care despite increase in number of medical colleges and Primary Health Centres and Sub-centres. Most of the medical graduates remained in urban area or went abroad for seeking greener pastures. “Why not to have a medical college in rural area? This will enable the medical students to understand the problems of rural people in a better way and some of them will definitely get motivated to work in the villages”. This noble ideal was conceived by the then Prime Minister Shri Lal Bahadur Shastri, who put this idea to Dr. Sushila Nayar, Union Health Minister. She selected Sevagram for such an experiment.
After leaving Sabarmati Ashram, revered Shri Mahatma Gandhi, set up Ashram in Sevagram in 1936. Dr. Sushila Nayar joined Bapuji in 1938, especially to look after him on the suggestions of Dr. B. C. Roy. Since other patients also started coming to her in Ashram, which disturbed the serenity of the Ashram, Bapuji asked her, “You go and start your clinic in the Birla Guest House”, (It was built by Shri G. D. Birla for Bapuji’s guests, about 1 km. away from Ashram). Thus, a small hospital for women and children of surrounding villages was started. Kasturba Hospital, thus, was founded by Father of Nation, Mahatma Gandhi in 1945. Because of this background of Sevagram, it was chosen for the medical college.
Kasturba Health Society registered in September 1964, as a Trust; is the Apex body which runs the Institute. Kasturba Hospital has now 640 beds and all the disciplines. For providing nursing services, Auxillary Nurse Midwifery (ANM) course was started in 1945 and it was replaced by Kasturba Nursing School in 1973 as a Nursing Diploma Course and has trained so far about 1000 nurses. Recently, Kasturba Nursing College for Post Basic B.Sc. Nursing course has also been started.
MGIMS admits 64 students per year and has turned out about 1800 graduates and about 600 post-graduates in different disciplines so far. Admission to MBBS course is made through All India Premedical Entrance Test. Initial finances were met from USAID as grant-in-aid for building and equipments. The recurring expenses are shared by Central Government, Maharashtra Government and Kasturba Health Society.
1. To demonstrate that medical education at undergraduate and postgraduate levels can be made for the delivery of health care to the community at their door steps
2. Training of young doctors can be carried out in the community to a large extent
3. To show that the cost of medical education can be reduced without sacrificing academic standards
4. To evolve a pattern of medical education and delivery of total health care to the community suitable for developing countries
5. To determine the role of the community leaders and para medical staff in the delivery of primary health care and the extent to which other system of medicines such as Ayurveda, Yoga and Nature Cure can be utilized for this purpose
6. To develop research programmes for understanding and control of community health problems and communicable diseases such as Filariasis, Leprosy, Tuberculosis, etc.
7. To demonstrate that adequate resources for the promotion of physical and emotional health care can lead to all round development of rural communities.
The Institute has evolved a number of unique innovations in medical education, health care delivery system and research to give a rural bias to the work and also to promote greater involvement of the community in improving their own health.
Development of competence requires knowledge, psychomotor skill and attitude. The last component is paid least attention these days. This institute on the other hand endeavours to build up the attitude necessary for doctors, immediately after admission by holding an Orientation Camp in Gandhi Ashram for 15 days. Eminent Gandhians deliver lectures on Gandhian Ideology. They are also told about the problem of rural people, their health, nutrition, sanitation, etc. The students have to follow certain code of conduct throughout their career like wearing khadi clothes, participate in community prayer and shramdan (a symbol of dignity of labour), taking only vegetarian food, and eschewing of alcohol, smoking, and drugs.
To further orient the students and provide them with a personal experience of rural life, Social Service Camp is held in a village adopted each year for the purpose for a period of 15 days. Students have to stay in the village. Under the guidance of faculty of Community Medicine, they carry out health, sanitation and nutrition surveys.
A health exhibition is put up and students are trained to explain the importance of good nutrition, cleanliness, prevention of malaria, cholera, worm infections etc. Villagers are encouraged to participate in cleanliness programme, to have soakage pits for disposal of waste water and to have flush latrine, tree plantation etc.
First Postgraduate course was started in 1977 in Community Medicine. The emphasis during teaching programmes is to provide insight of comprehensive health care so that the postgraduates may work as clinician, administrator, teacher and researcher in the later part of their career. Since 1980 postgraduate courses have been started in all the specialities.
The Institute, since 1992 has made it mandatory that after completion of internship the new graduates serve for two years in villages. They work with NGOs approved by the Institute or in a peripheral health centre or rural health centres of Government of India or Government of Maharashtra or any other state.
This scheme is in vogue for over 40 years to provide health care to workers of the unorganised sector. It helped to create health consciousness in the community which has been motivated to participate in the activities to plan preventive and curative measures from available facilities.
Other Village Activities: The village development activities are also organized
1. Village sanitation-(one latrine-one soak pit for each house)
2. Self financing groups of women
3. Self financing through milk co-operative scheme
4. Lift irrigation
5. Drinking Water scheme
6. Low cost housing
8. Watershed development
9. Artisan Training.
To help desperate and destitute unwed/ divorced mothers, this project is working in collaboration with the Adoption Center, Denmark. The new born is taken care and adoption is encouraged through legal process. The women are provided vocational training so that they can live with dignity.
Melghat is a tribal area in Dharni and Chikhaldhara of Amravati District. Located 250 Kms north west from Sevagram. This area attracted wide media coverage because of malnutrition associated deaths last year. Men, women and children were further hit by inequality of health services. Most of the sickness and deaths were due to malnutrition, pneumonia, malaria and diarrhoea.
The Institute has planned a three year project in this area and has posted a lecturer in Medicine, who has voluntarily opted to reach the unreached. A base hospital at Dharni – Trimurty Hospital – and six villages of Melghat have been chosen for clinical and research work. These villages are difficult to access, lack proper transport facilities and are located in the midst of dense forest, and hills about 50 kms from Dharni. Living and interacting informally with tribal community has yielded highly satisfying spin offs: People began to understand hazards of malnutrition, alcohol, unsafe sex, reproductive ill health and unscientific medicine. A beginning was made to get people off alcohol by organising a de-addiction camp. Health education on malnutrition, breast feeding, diarrhoea, sexually transmitted diseases, etc. has been started.
Kasturba Hospital is one of the largest rural hospital serving the rural poor with 640 beds and an average annual admission of 25,000 patients. Over 80% of its patients come from lower socio-economic strata especially from rural area. It is one of the very few hospitals which also offers facilities of indigenous medicine (Ayurveda), Yoga and Naturopathy. The main objective of the Hospital is to offer to both the sick and the well, a comprehensive medical care of highest standard with an effort to use advanced knowledge and skills of medical management of the patients.
* The Institute has a Tropical Disease Research Centre. A FILA-KIT for detection of Filarial antigen / antibodies has been developed and is being used in various part of country. D.B.T. has recognised TDRC as Filaria Repository.
* Similarly an ELISA KIT for detection of Tuberculosis antigen / antibodies is under test.
* Under ICMR scheme whole Wardha district has been surveyed for Tuberculosis and positive cases have been treated with short term intermittent chemotherapy under direct supervision during 1985 – 1990 and had very good result.
* Similarly many other funded and un-funded research projects are going-on.
1. The Institute is serving the rural cause
a) 80% of the patients coming from rural community
b) Community participation is increased in management of their own health
c) Rural people paying more attention to sanitation, cleanliness and nutrition at the same time trying to do away with alcohol/tobacco
d) Doctors are posted with NGO working in health field in various part of country, or in PHCs.
e) Doctor posted at Melghat serving to help poor tribal people in health by preventive/promotive and curative management with encouraging results.
2. Cost effective management, Health Insurance Scheme has helped rural people to get medical help at the highly subsidized cost without discrimination.
3. Training in Community– Students are trained in medical care beyond the four walls of hospital also
4. Research in Tropical Disease like Filaria, Malaria and Tuberculosis, Leprosy, etc. are going on.
5. Institute is also attempting to develop super speciality courses to expose students to the modern technology and also to help rural people to get cheaper and best treatment
6. The results at undergraduate and postgraduate examinations are very good
Dr. Sushila Nayar received Dr. B. C. Roy Award, Deshikouttama Award from Vishwa Bharti University, Shantiniketan(1995). Amal Prabha Das Award (1996) by Assam Government, President of India Award for ‘Karavas Ki Kahani’ and was honoured by WHO/SEARO and Manipal Education Society. Dr. B. C. Roy Award has been received by Dr. J. S. Mathur, Dr. B. C. Harinath and Dr. B. S. Garg.