Field Operational Notes

Field Operational Notes - IMA War Room

Field Status : All developed countries have been overflowing with patients. We have to be prepared for such a situation in our state/country as well.

Along with Corona, we have to cater for existing illnesses as well and thus protect the healthcare system from a meltdown.

To treat corona, we have to create a solution with a parallel network.
This meeting covers
1.Where can we set up this system and prototype the same for a blueprint.

2.What people, systems and processes are required

3.How can this scale up to all panchayats?

Prior Experience in scaling with community participation:

In Kerala, we have done community kitchens early due to floods so we could easily scale that up when the Chief Minister asked to set up Community Kitchens for Corona.

However, our community has no prior experience in setting up large scale medical systems. We don't have the model for healthcare and thus we create the blueprint.


Educating the people:

We have to educate people on parallel Primary -> Secondary -> Tertiary healthcare system being built to combat corona.

Primary Centers are designed to bring patients who have Corona suspects, corona positive with no symptoms or mild symptoms.

With a pulse oximeter, we measure if the oxygen levels are going down.

When such a case occurs, the Ambulance network will move patients into Taluk Hospitals and Private Hospitals.

If the condition of a patient worsens at the Taluk level, then we have created a major ICU and Ventilator setup where we have key hospitals which are fully equipped for this.
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At present, we have mostly equipped Secondary and Tertiary systems but we dont have primary facilities that have to be created.

Creating a blueprint for Primary Treatment Centers.
For setting up primary treatment centers, we have to take open halls and spaces which are present across panchayats.

Only if we ensure this, we can scale the model across the state and country.

Without creating and demonstrating a model, people may not understand how to do this.

We will make templates out of the following physical spaces.

1.Community Halls 
2.Hostel with rooms that have attached bathroom
3.Hostel with rooms that have common bathroom
4.Schools (Private and Government)
We have identified the following locations


Yacobian Hall at St: James Church
Short Stay Homes at Rajagiri College
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The goal is to develop the minimum viable product on the ground which can be easily replicable across all 19,000 wards in Kerala.

There are common inventory items that we need to set up

1.Non Medical : Beds, Mattresses, Pillows, Soap etc
2.Medical : IV Stands, Fluids, Pulse Oximeters etc
Central Common Facilities have to be created for

1.Housekeeping and Facilities Management
2.Waste Management
3.Manpower Identification and Training
4.Inventory Management
We have to mobilise inventory planning for common items at the Village Panchayat at each district to enable rapid mobilisation. 

Path to Execution

Step 1. Create four prototypes in Ernakulam to learn
Step 2: . Second four in Ernakulam to test timing
Step 3. Create four in each of 13 districts = 42 centers

Thus, to prepare Kerala Completely we need to set up Total 50 centers and then educate the community 

We have to also identify clear Roles and Responsibilities of each person to set up the center.

India: We might need 600,000 units across India. This level of inventory needs to be sourced from the local panchayat.
Other Notes: Structure or Local Self Government Institutions

Gram Panchayats: 941
Municipalities: 87
Corporations: 6
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Total: 1200 local self governing structures
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Total wards in Panchayats: 18042
Total wards in Municipalities/Corporations: 3527
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Total wards: 21569
Average population of ward: 1500
Total population (Kerala) = 21,900*1500 = 328.5 lakhs
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