The Mangrol Dispensary was established in 1982 and continues to serve about 11 -12,000 patients every year. We have established a kind of reputation for chronic disease management which could be described as a secondary care centre for the extremely poor, ill-served tribal people of the vast hinterland.
The most important chronic killer remains tuberculosis (T.B.), but respiratory, skin, heart, and other disorders are common. We see plenty of asthma-bronchitis, diabetes mallitus (DM), hypertension, heart failure, and coronary heart disease. Mental illnesses are also increasingly brought to us for diagnosis and management. Chronic skin disorders like psoriasis, atrophic dermatitis, fungus infections are rampant, as are auto immune disorders of all kinds including thyroid disorders.
The satisfactory part of the story is that most of the above problems plus many more are now almost entirely handled by our team of seven competent senior health workers. We have taken fifteen years to develop elaborate informal evidence-based protocols for about 25-30 chronic diseases. The health workers are quite adept to these protocols and the quality of the care has improved considerably. The social and cultural acceptance of the care provided mainly by the health workers is quite gratifying.