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 year’s 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.