Employees State Insurance Corporation health camps at Bengaluru, India: Bridging gaps.

Employees State Insurance Corporation (ESIC) hospital at Rajajinagar, Bengaluru conducts regular health camps at industries. The health camps promote and re-install the confidence among the workers and management of the industries in social security systems. Camps are considered as a stepping stone at reforming and improving the health of the workers for better productivity at industries.

INTRODUCTION

The Employees State Insurance (ESI) Scheme in India is a multidimensional and most preferred social security system customized to provide the socio-economic protection to worker population and their dependents covered under the scheme. On the eve of completion of 60th year of services of Employees State Insurance Corporation (ESIC) in 2012 a year long special initiatives named “Diamond Jubilee Celebrations” were taken up with a theme of “reaching out to our stakeholders” and it aimed at bringing more workers under the coverage of social security system of ESI Scheme.[1] Holding of health camps was one of the activities of this initiative, which gradually gained momentum during 2012-13.

The ESIC Hospital at Rajajinagar, Bangaluru is a tertiary health care hospital providing services to the ESI insured persons referred from the various ESI dispensaries from the state of Karnataka. Apart, from providing the quality in-patient services to the insured persons the hospital also conducts weekly wellness camps and monthly specialist camps at industries whose workers are insured under ESI. A team of doctors and paramedical staff visits the factories/industries, which is usually the insured person's workplace. The employees are screened for any morbidity by verbal screening of symptoms, physical examination and through basic laboratory investigations such as random blood sugar and hemoglobin estimations. The needy patients are provided with medicines and if required, are referred to the tertiary hospital for further management. The working environment is inspected and suggestions to have healthy working atmosphere with emphasis on usage of appropriate personal protective equipments is given to administrators. The whole gamut of managing camp activities at ESI hospital is now being handed over to the Department of Community Medicine, ESIC Medical College and Post Graduate Institute of Medical Sciences and Research and the department is made responsible for conducting and coordinating the health camps with the industries in collaboration with the ESI hospital staff. This is an effort to describe in brief about our experiences and suggestions to industries for better management of health of industry workers.

HEALTH CAMPS-HOW IS IT PERCEIVED BY INDUSTRIES?

The ESI health camps to Industries had always been the feel good factor for ESIC. The camps are meant to promote and re-install the confidence among the management of the industries in one of the India's best social security schemes for employees. There had been mixed responses to camps from the industries. Firstly, though there is a thrust from ESIC for a visit, the industries may have issues with the dates as they have to meet their production targets, which is a priority for their survival and hence may reject the dates proposed. Secondly, with the dates matching and the screening happening the industries are found to be reluctant to spare 30-45 min for each worker, which would indirectly hamper their production targets and later on end-up in examining only 10-15% of their workforce, however, the activity of screening is apparently completed for that industry. Thirdly, there are noticeable issues of co-ordination among the team members of the industries who are assigned the health camp activity from the management. It mainly involves the arrangement of the floor space and logistics for the medical team, which usually delays the camp.

The camps are deemed necessary to bridge the gap between the health provider and the stakeholders with a concomitant step toward monitoring the well-being of the industrial workers. Employees are benefited by knowing their ailments at an earlier date, which otherwise would have gone unrecognized. Normally, they are made aware of their status on hypertension, diabetes and anemia and are also counseled for adopting healthy life-style. Since, ESI camps are not held frequently for the same industry they have the scope to improvise the monitoring of health workers by adopting few strategies with their existing health staff. Essentially, it includes strategy of maintaining medical records and reports. A health card for an insured person describing the details of his personal information which includes age, sex, height, weight, blood group, history of smoking, alcohol, duration of work, type of work and an additional space to enter the findings of his periodic examinations are to be maintained. A register with records of all health card details of insured persons with a unique number to be initiated and followed-up longitudinally at least up to a year. A quarterly health status report of the industrial workers with aggregate number of persons screened, number suffering from different morbidities, number of persons availing sickness leave etc., should be prepared by the concerned industrial health authorities and reported online to the concerned ESI tertiary hospital in the vicinity. This will not only fix the accountability of employees health and working conditions on industry managers, but also helps ESIC in prioritizing industries for conducting camps.

The health camps have their own limitations; foremost, only limited numbers of employees are screened. The patients are screened for general health symptoms and they are subjected to basic investigations alone. For any specialized investigations, they are referred to the nearest ESI dispensary or tertiary hospital; considering the operational issues at industries the probability of worker accessing referral services may be bleak at the first instance. However, workers with their earnest efforts do get examined subsequently.

CONCLUSION

An ESI health camp quite perfectly bridge the gap between the health provider and the stakeholders; and is considered as a stepping stone at reforming and improving the health of the workers for better productivity at industries.