The Mangrol Dispensary was established in 1982 and continues to serve about 11 -12,000 patients every year. We have established a kind of reputation for chronic disease management which could be described as secondary care centre for the extremely poor, ill-served tribal people of the vast hinterland.

The most important chronic killer disease remains T.B. But asthma-bronchitis; diabetes mallitus (DM); hypertension; heart failure; coronary heart disease; chronic mental illnesses; chronic skin disorders like psoriasis, atrophic dermatitis, fungus infections; auto immune disorders of all kinds including thyroid disorders are increasingly brought to us for diagnosis and management.

The satisfactory part of the story is that most of the above problems plus many more are now competently (within limits) handled by our senior health workers’ team of seven. We have taken fifteen years to develop elaborate informal evidence-based protocols for about 25-30 chronic diseases. The health workers are quite adept to these protocols and the quality of the care has improved considerably. The social and cultural acceptance of the care provided mainly by the health workers is quite gratifying.