POPE Project area in Tiruvannamalai District covers 3 blocks. We have studied the health problems of rural community. In the rural community, the people are under privileged and their health problems are heavy. The details of health problems are given below:

• Infant mortality rate is 87/1000. Where as the National average 68/1000.

• MMR of the project area 300 for every 100000 population but the National average is 407 for 100000 population.

• Fully immunized children in India are 67% where as in POPE project area it is round 87 per 1000.

• Births by skilled attendant is only 43%. In POPE’s project area, it is around 30% over.

• Under weight women is around 35%, where as the National figure is 46%.

• Anaemia among the pregnant women in POPE’s project is 45% where as the National average is only 60%.

• The Institutional delivery is only 57% rest of the deliveries are conducted by the untrained dais.

• Under weight children are about 66% and the National average is about 46%. Mover number of malnourished children are in our project area.

• Sanitation was very poor. Water related diseases caused by a lack of adequate sanitation are the second biggest killer of children.

• Diarrhoeal disease like dysentery kill many children every day, that is five times of dying from HIV/AIDS.

• Children below age 14 have been facing severe nutritional problems. 68% children from age 1 to 14, are facing the problem of malnutrition.

Protein malnutrition is wide spread, the major problem among Dalits in our project area can be broadly categorized as protein energy malnutrition among pre-school children, vitamin-A deficiency among pre school and school children and iron deficiency anemia among school children, young girls, pregnant and nursing women. Protein energy malnutrition prevailing among pre school children is another problem for the Dalits. Kwashiorkor and marasmus are the two main clinical forms of severe protein and energy deficiency respectively. About 80% of the children suffer from various levels of growth retardation.

Protein – energy malnutrition is a result of various factors like inadequate and imbalanced food intake, poor living conditions, unsatisfactory environment and hygiene, lack of protected drinking water, lack of primary health care. The purchasing power of Dalit families had not increased in spite of the changes taken places in the occupational pattern.

Dietary intake of vitamin A is low among pregnant women belonging to the Dalit communities and low income groups. This implies that the infants born to such mothers will have poor stores of vitamin A. Iyengar and Apte have shown that the concentration of Vitamin A in livers of infants born to under nourished mothers is very low a compared to infants of well nourished mothers.

Despite the achievements made technologically the family welfare programmes in our project area need attention. They are as follows:

• Dalits – Non Dalits disparities in various indicators of the programmes such as crude birth rate, contraceptive prevalence rate and indicators of safe motherhood and child survival.

• Slower decline in crude birth rate, total fertility rate, death rate and infant mortality rate.

The health status of adolescent girls among Dalit is very poor. Due to early marriage, they become adolescent mothers and anemic.

Pregnancy and child birth are unsafe in the project area because of poverty, uncontrolled fertility, malnutrition anemia, infections and poor health care. Seven out of 10 deaths were under reported and out of the total number of maternal deaths 31% were not simply registered at all and 14% were classified wrongly. Non-registration of deaths was most likely of the women who died at home or in her way to hospital. Misclassification was commonest of the death did not occur during or immediately after delivery. Most women who died were unable to reach a level of care that could provide treatment for their complications. Day in seeking care and appropriate referral through various levels of the health system were factors that increased a women’s livelihood of dying. Delay in seeking care was a factor, while misreferal played a role in more than half the case. Outlying settlements is not likely to be available, decreased the chances of survival, as did the absence of an ANM – in the village – uneducated husband – lack of ambulance services and giving birth in her own dark, unsanitary own home. Poor family planning acceptance results in repeated pregnancies exposing them to increasing health hazards.

Treatment for Tuberculosis, treatment for AIDS, treatment for children, more specifically girl children, mothers, adolescent girls, treatment for the aged people treatment for malnutrition, intake of Vitamins (A, B, C, Iron, E, calcium etc.) are ignored among the rural communities.

Critical care for snake bites, first aid and treatment for food poison, accidents, suicidal attempts, treatment for alcoholism and mental health care are not completely available at the village. They have to travel for about 20 kms to get any impatient care.

The traditional systems of medicine like use of health medicines, food supplements, Indian system of medicine Ayur veda, Siddha, Unani, Homeopathy, Yoga, Naturopathy etc., not available now at the rural villages. Herbal treatment was very popular during British India but after independence, such treatment was completed out from the villages of our project area.