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 Pregnant Mothers in Kariyalur Hail Ford’s Pioneering SUMURR Project

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Erikarai village locals Parvathy, left, and Jayakodi, right, pose with the Ford Endeavour that has brought healthcare to their doors.
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CHENNAI, India — In the small village of Erikarai in a southern state of India, three women proudly hold their babies, aged between four and ten months, as a local health nurse visits them for a regular check-up.

For these young mothers — Sanamma, Unnamalai and Jayakodi —their new-found happiness was made possible thanks to a just-concluded nine-month pilot program by Ford helping pregnant women overcome geographical and technological barriers that prevented them from receiving adequate healthcare.

“If not for the Ford Endeavor, I don’t know if I could have reached the hospital in time,” said Unnamalai, 20. “Being carried on a two-wheeler in the middle of a night is what I would have been forced to risk.”
Sustainable Urban Mobility with Uncompromised Rural Reach (SUMURR), an initiative launched by Ford in partnership with multiple stakeholders, has made a difference in providing maternal and child health care in the remote, almost inaccessible mountainous terrain of Kalrayan Hills in the state of Tamil Nadu. Until recently, the only way to access Erikarai was by foot or bike. The SUMURR project employed the advanced technology available in Ford vehicles to bring maternal and neo-natal health care to approximately 3,000 people, in 54 impoverished rural villages.
Ford partnered with Hand in Hand (HIH), a non-government organization working to improve maternal and child health in Kalrayan Hills, Tamil Nadu Health Department, U.S. Department of State, Indian Institute of Technology Madras and its Rural Technology and Business Incubator, Reliance IITM Telecom Center of Excellence, and George Washington University to roll out the pilot project. A private-public partnership, SUMMUR aimed to improve the delivery of maternal and child healthcare services by addressing accessibility gaps.
Ford is leveraging its expertise in automobiles and technology by providing mobility and working towards better connectivity so that data can be easily transferred to a central database. A 4x4 SUV Endeavour which was designed to handle the most difficult of terrains, was provided by Ford to Hand in Hand and proved a major boon for health workers and patients in the remote village. As many as 41 women, who were provided easier access to emergency care because of the SUV, gave birth during the life of the program.
Bhavani, 21, a mother from neighbouring Thuburanpattu village, smiled happily at her first child, a boy, whom she named Gokulnathan. But when asked about the birth she remembered the night in July 2012 when she had a complicated delivery. So critical was the case that she could not be treated at the nearest health centre, nor at the one at Kariyalur and had to be transported to Salem, a town nearly 50 kms away for a safe delivery – made possible with the Ford Endeavour.
“Earlier they gave birth at home mostly, under unsafe and unhygienic conditions. If there were complications during childbirth, the villagers walked miles down the hilly terrain in the dark to the nearest PHC carrying the mother on a makeshift stretcher made of a bedsheet and a couple of bamboo sticks, or tried to carry them on a two-wheeler. Many died on the way,” said Illara Jothi, a village health nurse (VHN) working at the Kariyalur PHC.
Under these circumstances, maternal and infant mortality is common, with half of all pregnant women and their newborns at high risk of death, disease or disability resulting from inadequate care. Many pregnant women go for months – if not for their entire pregnancies – without any medical care.
The most common way health care touches these women is via the village health nurses who must go on their daily rounds walking from village to village - as far as 10 km, carrying a heavy bag of medical supplies in one hand and patients’ medical records in the other.
“It is very difficult to cover more than 2 – 3 villages in a single round. Often we have to ask for a pillion ride if some biker is going that way,” said Laxmi, another health worker. “By covering the ground on the Endeavour, the health nurses can cover 5-7 villages now, increasing the reach and efficacy of health care,” Jothi added.
At Kariyalur Primary Health Centre (PHC), a basic health centre maintained by the Government of Tamil Nadu, a doctor is stationed to treat patients from the nearby seven villages. But although most of the villages are within a 10 – 15 km radius, the hilly terrain and non-existent roads make them extremely inaccessible. Dr. Paneer Selvam, the resident doctor, said he handles 15 – 20 newborn deliveries a month, out of which 3–4 could be critical.
“The SUV has definitely improved accessibility  for the pregnant women to the PHC. It has helped in expediting safe deliveries, and will help many more.”
Efforts are now on to use the mobility and capabilities of the Ford vehicle to fashion out an effective data collection and transfer plan to PICME, and all the SUMURR stakeholders have spent countless hours tweaking the technologies to ensure it works.
“The visiting nurses can place calls directly from the Ford vehicle to register patients into a medical data base. Mothers can then use a cell phone to connect with the database during the course of a pregnancy. (Cell phones are readily available in India, even in the poorest villages where basic necessities are lacking.) A voice recognition system prompts mothers with questions, verifying the registration number and matching it with the family name and medical history. At specific intervals during the course of the pregnancy, the application calls the mother to monitor her health and to determine if medical tests are necessary,” said K. Venkatesh Prasad, senior technical leader for open innovation at Ford Motor Company, who framed the initial vision for SUMURR and worked on its technology development.        
“After the baby is born, a new record is entered, the health of the baby is monitored and the mother is reminded of when immunizations are due. This mobile technology makes it possible to dispel myths and give practical information to uneducated mothers,” he said.
In some of the remote hilly villages where the Ford Endeavor was used, cellular phone signals were weak or non-existent.
As a result, researchers are developing a way to use the recently launched open source platform OpenXC to create a local cloud housed in the Ford Endeavor. This would enable nurses in the village to record and store crucial information about patients and transmit it when connectivity is available at a later time. Another new App could help in the timely communication of vital health parameters of the mother and enable hospital readiness while she is en route.
Prasad said that what Ford is learning about the technologies it developed for SUMURR, especially their performance under extremely demanding environmental conditions, is invaluable, and can potentially be applied to any Ford global technology development.
“SUMURR exemplifies how Ford is using its global reach to address regional issues and causes around the world and at the same time identify local social and technology entrepreneurs that we can partner with to further develop the kind of solutions that will shape our future,” said Prasad. “The fundamental aspects of what we did in rural India could very much wind up in the driveways of Detroit.”
Unnamalai, a young mother who benefitted from SUMURR, with her daughter Akilla.
Two young mothers from Erikarai village--(from left) Unnamalai, with her daughter Akilla and Jayakodi with her four month old boy child (unnamed)—have had safe deliveries thanks to SUMURR.
The Ford Endeavour 4x4 negotiates the difficult hilly terrain on a sortie to a remote village.
Dr Karthik, a physician from Serapet primary health centre, along with a group of Ford and Hand in Hand officials, counsels the villagers to use the ambulance service. 
Priya Sundaram, general manager, IT Global Quality Assurance and Quality Control Shared Services, and Ford intern Jansi Rani (clockwise from left) — both volunteers for the SUMURR project - reach out to a woman in Melmuruvam village in the Kalrayan Hills.



3/7/2013 2:00 AM