Health & sight
The child who was not slow
The cheapest thing we do, and the one that surprised us most
- Reach
- 2,790 children screened last year
- Where
- All eleven centres, one full day each, between June and September
- Who
- Every enrolled child, and any sibling under twelve who turns up with them
In 2024 we added an eye test to the annual health check almost as an afterthought. It cost a few thousand rupees to add and we expected it to find very little.
It found forty-one children in the first year who could not see a blackboard, in a group of about six hundred. Every one of them had been sitting in a class of sixty for years. Several had been moved to the back row for being inattentive.
What a pair of glasses costs
Seven hundred rupees, all in — the test, the frame, the lenses and the fitting. Set against a year at a learning centre, or a year of meals, it is nothing.
It is also the only thing we do where the effect is visible in a week. A child who can suddenly read the board does not need to be persuaded to come back.
Why we do not run a clinic
Because we would be bad at it, and because there is a municipal health post four hundred metres from the Ramtekdi centre that is better equipped than anything we could build.
What that health post does not have is a way to get two thousand children through its door. We do that part, once a year, and refer everything we find that is beyond a screening.
How it runs
What actually happens
- 01
The doctor comes to the centre
A visiting doctor and two technicians spend a full day at each centre. Sending a family to a clinic instead costs a parent a day of wages plus the fare, which is why the referral slips we used to hand out came back unused.
- 02
Eyes are tested first, not last
Every child reads a chart. It takes ninety seconds and it is the single highest-return minute of the whole day. Roughly one child in fourteen needs glasses and almost none of them knew.
- 03
The spectacles are handed over at the centre
A prescription is not a pair of glasses. We buy the frames in bulk, the child chooses the colour, and they are fitted at the centre within three weeks. A child sent to buy their own comes back without them.
- 04
Haemoglobin, because the girls are anaemic
A finger-prick test for every child over eight. The results are worst among girls in Classes 8 to 10 and improve on the iron and folic acid the government already supplies free, when somebody actually hands it over weekly.
- 05
Everything goes on one card the family keeps
A single card, updated each year, that the family holds. Not a file in our office. Families move, and a record they carry is the only kind that survives it.
How we are judged
The measures,
including the flat ones
Children found to need spectacles
Never screened before 20241 in 14 at first screeningPLACEHOLDER ratio. The client's own screening register will have the real figure, and it is worth quoting exactly.
Teachers reclassifying a child as struggling to see
0 before screening41 children in the first yearPLACEHOLDER. These are children a teacher had already written down as slow, inattentive or difficult.
Girls in the low-haemoglobin band, Classes 8 to 10
57% at first test39% after a year of weekly supervised ironPLACEHOLDER. The tablets are supplied free by the state; the missing part was somebody handing them over every week.
What has not worked
We screen once a year and that is not enough. A child who breaks their glasses in October waits until the following June unless a teacher notices and tells us, and teachers are busy. We have not solved this and we are not going to pretend that an annual camp is a health programme.
In this programme
What a rupee buys here
- ₹350
An annual health check
Height, weight, haemoglobin, teeth, ears, eyes. Run at the centre by a visiting doctor so no parent has to lose a day's wage taking a child to a clinic.
PlaceholderPLACEHOLDER. Confirm against what the visiting doctor and the lab actually charge.
- ₹700
An eye test and a pair of spectacles
We screen every child once a year. Roughly one in fourteen needs glasses, and almost none of them knew it — they had been told they were slow.
PlaceholderPLACEHOLDER for both the cost and the one-in-fourteen figure. Replace the ratio with the client's own screening data, which they will have.
- ₹720
A year of sanitary pads
Handed out at the centre with no ceremony and no assembly about it. Attendance in Classes 8 to 10 is the measure we watch.
PlaceholderPLACEHOLDER. Confirm against the client's bulk purchase price.