3.1 Challenges during the early period
3.1.1 Issues pertaining to training
For the sixth training course, 85 trainees had arrived
from 14 states46. The collaborative relationship with the LWSTC was strengthened.
There were 1300 patients in its various urban sub-centres and the records
and registers were standardised. Officers and staff were active in running
all facets of the programme including training. In a years time,
it was hoped that this centre would provide NTI with its first information
on the methodology of rendering technical assistance to other district
centres and their evaluation. To this end, there had been active support
from the state government, DHS and the Superintendent of the LWSTC. The
NTI faculty made regular visits. Trainees were taken there on scheduled
trips. Often, collaborative studies were taken up. All these helped to
maintain the encouraging work atmosphere.
Amidst these activities, the NTI initiated action in
improving the content and methodology of training. The duration of training
was reduced from four months to thirteen weeks and was conducted thrice
a year. The faculty began to take keen interest in learning by observing
successive batches of trainees. Refinement of methodology became a continuous
process in which training itself provided the vital feed back. A major
deterrent noticed was the language barrier especially among the para medical
staff. They had genuine difficulties in accessing information. Firstly,
the language of training was English. Since trainees came from different
states, English alone or even Hindi, if introduced, would not suffice.
The NTI faculty could not be conversant in 19 major languages and hundreds
of dialects. Secondly, despite didactic lectures and field demonstrations,
there were missing links. The NTP was a system oriented programme in which
different constituent activities were interlinked to the envisaged objectives.
The basic training philosophy, therefore laid emphasis on the team
concept, rather than the individual. There were always some trainees
who would not or could not absorb this concept or develop the knowledge
and attitudes required in certain areas. To partially solve this problem
and enhance the learning process, a Dummy Programme was started in 1965.
Dr Nagpaul himself took an active part, in leading the faculty. His very
presence energised everyone. The atmosphere was informal. Lengthy debates
were encouraged. So enthused was Dr D Savic, he wrote: 1966 could indeed
be described as the year of training47.
Lady Willingdon State Tuberculosis Centre, Bangalore
Dr. Susai Mary, Med. Superintendent (Inset)
All these innovations had been steadily gaining international
attention. Trainees from other Asian countries arrived. Dr Nagpaul was
invited to Singapore to give a series of lectures related to NTP at the
International Regional Course on Epidemiology organised by WHO/SEARO.
Cooperation was established with the International TB Control Centre,
Prague. The Indian Chapter of the International Course in Epidemiology
and Control of TB (Prague Course) was inaugurated at the NTI on 16.8.1967
by Sri K Puttaswamy, Honourable Minister for Health, Mysore State. The
Indian Chapter was a continuation course after Prague. The four week premier
course was attended by 15 fellows and four observers who came from 14
different countries of the world48.