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Twenty-four Hour Service



Nurse Jacinta teaches good health practices to a large group of people

Leprosy medication is explained during a home visit

A leprosy test at the end of a talk helps with early detection, which massively increases the prospect of a full recovery
Working at the Salvation Army clinic in Mirpur, India, is not a nine-to-five job for Albert and his team of community health workers.

Twice a week, when the daily clinic work is over, the outreach team heads off into the dark streets and alleyways of this squatter settlement, taking with them their slide projector, megaphone, posters and leaflets – basic equipment to deliver health care messages to people who really need to hear them.

The squatter settlement is home to a Pakistani refugee community. More than 80 per cent of families there live below the poverty line in slum conditions with poor sanitation and virtually no access to water or other basic services.

It is not uncommon for the night education programme to draw crowds of up to 250 people. Many of those who watch and listen are men who work in the daytime and therefore cannot benefit from the usual programme of health services offered by the clinic during normal working hours.

The outreach team quickly draws a crowd as it steps out of the clinic minibus. Jacinta, the senior nurse, quickly organises her audience, with children kneeling on the floor and adults standing behind. The megaphone comes in useful for organising the people and making sure everyone near knows what is happening.

There is a bit of jostling and chatter as everyone tries to find a little bit of space and the projector screen is put in place, but the hubbub quickly dies down once the first slide appears on the screen and Jacinta begins her presentation on tuberculosis and leprosy.

After the talk, a small crowd gathers around an adolescent boy. A male member of the audience, having listened attentively, now recognises the early signs of leprosy in his 16-year-old son. Jacinta goes over to look. A four-year-old girl is also identified as having signs of leprosy.
Outreach staff talk to the families and refer them to the clinic services where they will now get early treatment, avoiding potentially crippling consequences.

The night programme is clearly valued by the community and fills an important gap in health care services in out-of-office hours. ‘We are getting 24-hour service from The Salvation Army,’ says one of the community members.

The night education programme is increasing awareness among the population on important health issues and is also stimulating behaviour change. The community itself is now able to detect signs of illness and risks to health and refer people to the Mirpur clinic.

‘The most important thing is the prevention of illness,’ says one person, enthusiastically. ‘This is the main thing and we learn it from The Salvation Army.’

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