Indian Institute of Management

Ahmedabad IIMA/OB0177

Maharogi Sewa Samiti: Baba Amtes Ashram

Leprosy which is a chronic communicable disease ranks as a major health problem in India.
Because of the social stigma attached to the disease, its victims are often ostracised by
society. This creates severe socio-economic strains on patients in addition to their physical
suffering and disfigurement. According to a recent report (Ministry of Health and Family
Welfare, 1987), there are about 4 million leprosy patients in the country, 20 per cent of whom
suffer from the infectious variety. Effective control of leprosy involves the daunting task of
identification and sustained treatment of patients spread across the country. The need for
social and economic rehabilitation adds further to the enormity of the problem.

To supplement governmental action a number of voluntary organizations have been

involved in efforts aimed at giving succour to leprosy patients, Maharogi Sewa Samiti or
Anandwan as it is popularly known is one of the prominent organizations in this field. As
an institution set up originally for the treatment and vocational rehabilitation of leprosy
patient, the uniqueness of the Maharogi Sewa Samiti lies in the fact that besides leprosy
patients it also cares for handicapped people of all categories and helps them acquire skills
which can make them financially self-reliant. However, it is a measure of the close
identification of its promoter Baba Amte with the institution that the latter is known much
less as Maharogi Sewa Samiti the name under which it was started way back, than simply as
Baba Anita's Ashram or Anandwan. The genesis and growth of Maharogi Sewa Samiti is
inextricably linked with the value system, and personal characteristics like indomitable
courage and zeal of its founder. For a comprehensive understanding of the institution, there-
fore, it is imperative that the study starts with Baba Amte, the moving spirit behind
Anandwan.

Baba Amte:

Baba Amte or Murlidhar Devi das Amte was born in a wealthy high-caste family in Warora
in the central part of India. Always a sensitive and courageous person, even as a child he
used to feel strongly for the underdog. He rebelled many times against the social barriers
that separated the rich from the oppressed. After he graduated in law, Murlidhar Devidas
was asked by his father to practice law at Warora where he could also look after his ancestral
property. Dissatisfied with his life of affluence, he soon joined Gandhiji's crusade against
untouchability. He tore up his licence to practice law, renounced his inheritance and started
working for the Harijans. In 1948, he was elected Vice-President of Warora municipality. He
formed a union of the municipal scavengers. In order to understand the working and living
conditions of scavengers, Amte started sharing the work of scavengers something unheard
for a Vice-President of municipality to be doing! While carrying the nights oil in torrential
rain once, Amte came across a heap near a gutter that an closer examination turned out to be
a human being suffering from leprosy in its advanced stage. The panic which prompted him
to run away momentarily created strong self-loathing in him and Amte returned to the
leprosy-ravaged person to care for him till he died. This chance encounter gave hire and his
family their mission for life. Amte studied leprosy at Calcutta's school of Tropical Medicine
Prepared by Professor Deepti Bhatnagar, Indian Institute of Management, Ahmedabad.

Case material of the Indian Institute of Management, Ahmedabad, is prepared as a basis for class
discussion. Gases are not designed to present illustrations of either correct or incorrect handling of
administrative problems.

1988 by the Indian Institute of Management, Ahmedabad.

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where he even offered himself as a guinea pig to researchers to experiment if the bacterium
M leprae could be cultured in the human body. The result fortunately was negative.

He established Maharogi Sewa Samiti for treatment, training and rehabilitation of people
afflicted with leprosy. In 1951, he started his first project at Anandwan with his wife and two
small sons, six leprosy patients, 25 acres of reserve forest land in a stone quarrying area
leased by the government, a lame cow, and Rs. 14 in cash.

Anandwan which means "Forest of Bliss" developed later into a 190 hectare complex which
includes a general hospital for treatment, training, rehabilitation of leprosy afflicted persons
and research on leprosy, schools for leprosy affected and blind children, centres for higher
education, a community nursery for children, a home for the aged, two model biogas plants,
a bank, a post office, craft training centres and workshops. His devotion to and closeness
with leprosy patients and the physically handicapped soon won Murlidhar the fond title of
Baba or father and he is now known far and wide just as Baba Amte.

Besides Anandwan, Maharogi Sewa Samiti has several other projects at Ashokwan,
Somnath, Nagapally and Hemalkasa, each devoted to bettering the lot of either leprosy
patients, physically and mentally handicapped, or the poor, illiterate tribals. A discussion of
the multifarious accomplishments of Baba Amte would be incomplete without a mention of
the Knit India Campaign inspired by him.

Pained deeply by the communal riots, uprising of religious fundamentalism and other
divisive forees in the country, Baba Amte organized in December 1985 a 5000 km. long cycle
march from Kanyakumari, the southernmost point of the country to Kashmir in the north to
spread a message of peace, love and patriotism. Included among the 130 enthusiastic cycle-
riding youth were men and women front all parts of the country representing different
religious, languages, and professions. The campaign participants, accompanied by Baba
Ante travelling in a specially built van due to his injured back, received an overwhelming
reception from the villagers and city dwellers alike. Particularly courageous and touching
was their journey through terror-stricken Punjab. The south to north Knit India Campaign
succeeded in reminding the people that though belonging to different faiths, they are
Indians first. Also it provided a balming touch to the grief-torn victims of communal frenzy
in the north. In November 1988, an east-to-west Knit India March is being planned to focus
attention on the perils to the country's unity.

Baba Amte is recipient of numerous prestigious national and international awards including
the Damien-Dutton award; Ramon Magsaysay award and Padma Vibhushan. In March
1988, he was presented the first GD Birla international award for outstanding contribution to
humanism.

Anandwan

The creation of Anandwan rests upon the philosophy that 'work builds; charity destroys'.
The enactment of this philosophy by leprosy patients helped convert barren, rock-strewn
scrub into a lush green forest years later that too with the help of leprosy afflicted persons
who suffered from crippling deformities. An opportunity to contribute to the production
process despite their handicaps restored in leprosy patients a sense of dignity and self-
*>orth. These people who had been rejected by their own families and friends found not
only warm acceptance at Anandwan, but also an invitation to rise above their physical
weaknesses and discover a new purpose in life. Their response was overwhelming: not only

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did they accept the challenge but worked harder than their able bodied brethren to
transform harsh, stoney land into fertile field.

The word of the work being done at Anandwan was spreading gradually. By 1954 there
were sixty leprosy-afflicted people at Anandwan. Together they toiled hard and long to clear
the land of jungle, put it under cultivation and dug six wells. Hard work and scientific
approach to cultivation paid. The yield was bounteous. However, when Baba Amte took the
high quality vegetables and foodgrains to the local market for sale, there were few takers.
Buyers feared that by consuming the vegetables grown by leprosy patients, they and their
family members would contract the dreaded disease. So deep rooted was the ignorance and
prejudice against leprosy! The same community which held Anandwan inmates in so much
disdain were later to benefit immensely from their gift of love.

As the number of patients was increasing, there was need for better accommodation and
treatment facilities. Yet no carpenters nor masons were willing to work in Anandwan.
Fortunately, a team of fifty young volunteers from thirty-six countries who had just finished
a housing project at Gandhijis old ashram at Sewagram agreed to come and construct
buildings at Anandwan. Within three months a new clinic and two new wards for the
hospital were ready.

Much greater than this tangible gain was the intangible fallout of this voluntary effort. When
the inhabitants of the surrounding villages saw foreigners willingly spending months at
Anandwan, they probably realised that their earlier notions of the very air of Anandwan
being infectious, were wrong. An unintended result of the noble effort of the foreign
volunteers was that it helped lower prejudice against Anandwan in the local populace;
Anandwan that was cut off from the rest of the humanity could now build bridges with the
surrounding villages and communities. It soon became a self-sufficient community in every
respect except salty sugar and kerosene, and it started selling its produce of excellent quality
at lout prices to the nearby markets. Efficient management of medical care and of natural
and human resources transformed the lives of patients from that of despair and
hopelessness to one of confidence, dignity and hope. As patients started flocking in from far
off places, the physical facilities had to be continuously expanded. Mors land was donated
by the government and a dairy was added. Since it was not possible to treat all leprosy
patients in institutions, a "trace and treat" campaign was started to identify pockets with
heavy concentration of leprosy patients, within a radius of thirty miles from Warora, eleven
weekly clinics were being run by the Maharogi Sewa Samiti by 1957.

As the number of inmates at Anandwan grew to be about 600 by the early sixties, a number
of activities were added to agriculture. A Swiss voluntary agency called Swiss Aid Abroad
helped in setting up a tin-can workshop in 1960. Tailoring, carpentry, metal work, weaving,
printing and leather work were added gradually. As Anandwan started approximating the
character of a normal community, except th3t it was probably better run than most, its
members also started feeling the urge to make a contribution to the outside world.

During the Chinese aggression in 1962, the inmates of Anandwan presented a cultural
programme to the local villagers to raise money for the National Relief Fund. Two years
later, they decided to build a college for the same town of Warora that had once rejected the
excellent quality farm produce of Anandwan out of fear of contamination. The residents of
Anandwan did everything from brick laying to furniture making and electricity installation,
in the college buildings and most of the money for acquiring raw material came from the
sale of agriculture produce. Thanks to these efforts, Warora now has Anand Niketan Degree

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College affiliated to Nagpur University which offers bachelor's degree in science, arts and
commerce. The college also conducts diploma courses for vocational training. Students come
from Warora town and nearby areas. In 1987-88, 1419 students were studying in this college.
Another gift of Anandwan to the community is the Anand Niketan College of Agriculture
which is affiliated to the P.K.V. Agriculture University, Akola. This is a senior college and
offers instruction in courses leading to a bachelor's degree in agriculture. In 1987-88, 257
students attended the agriculture college.

With the passage of time a number of activities have been added to the services being
offered by Anandwan. The major activities and their latest status (as in March 1987) are
presented below:

1. Hospital

The hospital for leprosy patients at Anandwan is run by Dr. Vikas Amte, the eldest son of
Baba Amte who has received special training in the field of leprosy. Assisted by his wife,
who is also a doctor, Dr. Amte supervises the treatment and rehabilitation of leprosy
patients. In 1987, more than 1200 leprosy patients were undergoing treatment and 215 were
rehabilitated. Fifty patients were given treatment for planter ulcers. The hospital also runs
two weekly clinics for outpatients. Sometimes the treatment of leprosy patients also
warrants surgery. And Doctor Vikas Amte's chief assistant in the surgery happens to be a
burnt out case of leprosy who lost toes of both feet in amputation. In the hospital a major
helper in administering injections and dressing the mounds is an elderly illiterate woman
who after having been cured of leprosy has become an asset of the hospital. The assistant
medical officer is an ex-school teacher who came to Anandwan for treatment of leprosy and
stayed back to help affect cure in others.

Such examples abound in Anandwan. Not only is the patients' physical ailment arrested and
cured, but they are also encouraged to acquire a positive outlook and develop their
potential. Anandwan has a tradition of spotting the aptitudes and strengths of its patients
and expatients, and of nurturing the interests and talents suitably so that notwithstanding a
lack of formal training most expatients become very useful members of the community.

Besides providing treatment and care to the leprosy patients, research is also carried out
here. The research wing carries out studies on community medicine, leprology,
rehabilitation, and rural and tribal development. During 1987-88, the research projects
pertaining to the utilization of health services, sickle-cell trait in Media tribals, biomass
production, and familial case of scleroderma were completed.

Community Health Programme and Educational Facilities:

In addition to treating leprosy patients, Anandwan also provides free medical treatment to
non-leprosy cases from the surrounding villages. Handicapped people including the blind
and the deaf are also given treatment.

During 1986-87 more than 5000 patients benefitted from the community health programme.

Anand Andh Vidyalaya was founded in 1966 to provide education to blind children from
rural areas. It provides craft and music oriented education to blind children. The number of
students was 73 in 1987. A musical band has been recently obtained by the school. A school
for the deaf and dumb imparts education to about 80 children. Another school for the,

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handicapped has about 40 students. A hostel for the deaf-mute-handicapped students of

these schools is being constructed from a grant sent for this purpose by NCK, Netherlands.

Anand Buniyadi Primary School which gives education and training in different crafts to
the leprosy affected children has 45 students on its rolls. The Zilla Parishad is funding the
construction of a separate building for this school.
2. Sandhi Niketan or House of Opportunities:

This represents an experiment in vocation training and rehabilitation of people with

multiple handicaps.

Established in 1972 with the help of a British count, Sandhi Niketan imparts education and
development, training and rehabilitation facilities for all types of disabled young adults
including blind, deaf-mute, mentally retarded and the leprosy-afflicted persons from rural
areas. The strength of members was 82 in 1987.

Sandhi Niketan consists of a handloom section (with 26 handlooms in working condition)

and a powerloom section with 18 powerlooms. The two sections together produced textiles
worth about 7.45 lakhs in 1987. These sections cater to the in-house need for bed sheets,
towels, dusters, hospital bandage, etc. The surplus is sold in the market. In 1987, the sale of
goods made at Sandhi Niketan fetched Rs. 6 lakhs.

Sandhi Niketan has a greeting cards section which produces elegant card using simple
material like straw. In 1987, over 81,000 cards were produced.

The IDBI has recently sanctioned a grant of Rs. 24 lakh for the expansion of Sandhi Niketan
activities. The other vocations at Sandhi Niketan include tin-can project which helps recycle
old tins, carpentry to produce high-quality furniture, smithy, and wood workshops, water
management and electricity training, printing press which includes composing, binding and
exercise book making, tailoring, cane work, brick manufacture, automobile workshop, and
leather craft. Pi any of these activities involve recycling of waste material from some other
sections. Almost everyone in Anandwan uses shoes and slippers shaped by leprosy-afflicted
persons from discarded truck tyres; used fertiliser sacks are washed, dyed and stitched to
line the walls of the eye-clinic; and useful kitchenware is made out of discarded tin cans.
Wood chips and wood shavings, pulses, thread, dried leaves and flowers are used to adorn
greeting cards and other decoration objects; maize and banana fibre is treated to be used as
weft on the handloom, and a special fibre collected from the tribal areas is used for caning
chairs. Dunk iron and steel is treated in the workshop and reused as cot, cooler frame,
cradle, cycle and tractor parts, etc.

The tools for carrying out these activities are simple, and often modified so that they can be
operated by leprosy patients and the physically handicapped. Intermediate technology is
employed to design, adapt and modify existing tools keeping the physical handicaps of the
operators in mind.

There is a high task interdependence in Sandhi Niketan. For example a leprosy positive
patient works as a carpenter and designs a chair} a leprosy negative patient polishes it and a
blind boy completes it with caning. Likewise in the dairy, the cattle are taken out for grazing
by a positive patient, are looked after in the shed by a negative patient and are milked by a
healthy person.

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There is a heavy emphasis on conservation of resources, maximum utilization of all

materials, and recycling of goods. Even used water is channeled carefully to kitchen garden
and plant roots. Money is carefully accounted for; every waste is scrupulously taken care of.

The foray of Maharogi Sewa Samiti into different, often seemingly unrelated activities is less
a result of long-term planning, and more an eagerness to respond to the immediate needs of
people. Underlying its different activities, however, is not only a burning idealism and
compassion which prompts it to accept in its fold any sufferer who seeks help, but also there
exists a strong pragmatism which upholds the belief that true help means enabling the other
person to acquire self-reliancephysical, emotional and financial. PI any of its activities
started with a small gesture to help someone in dire need, and grew later into full-fledged
sections. Some of the institutions discussed below are examples of such spontaneous
response.

Novel Institutions

Gokul

It started with a two-day old baby girl who was found abandoned by the way-side and was
brought to Anandwan. A cured patient couple later adopted the baby and is bringing her up
as their own daughter. To provide a home to children like this abandoned baby, a children's
home and community nursery was later developed whose beneficiaries now include child
dependents of leprosy patients and orphans. The number of beneficiaries in 1937 was 50.

Uttarayan

The members of Gokul' find grandparental affection and care in Uttarayan which is a hone
for senior citizens. The inmates of Uttarayan are people who having retired from their
regular jobs in the civil and defence services have come to Anandwan to do some
meaningful work. Collectively referred to as the "Wisdom Bank", they contribute their
expertise and experience and in return derive the satisfaction of being useful to others. They
also look after the young members of Gokul. In 1987 there were 16 senior citizens in
Uttarayan.

Mukti Sadan

Treatment, cure and rehabilitation of the leprosy affected and the handicapped is a very
significant contribution of Anandwan to the lives of these people. Yet it does not rest content
with this; its concern to provide a meaningful and totally normal life to the cured patients
prompts Anandwan to care for their need for affection and desire to belong. Cured inmates
are encouraged to enter wedlock. Marriages are solemnised in the midst of sacred hymns of
marriage ceremony at the annual "friends Fleet" Festival.

Married couples are given independent quarters in a separate block of houses called Mukti
Sadan. Each house has some land in front and at the back of the house and almost all
couples grows their own fruits and vegetables.

Sukh Sadan

In this cooperative based primarily on agriculture and cottage industry, there are about 50
members each of whom is expected to shoulder the responsibility of looking after at least

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one handicapped or old patient out of his own earnings.

Besides these institutions, the social life at Anandwan also hums with recreational and
cultural activity which takes place at Muktangana or open air theatre.

The experiment of community living at Anandwan thus combines suffering and

disfigurement with treatment and hope, work with enjoyment, scientific approach with
aesthetic appeal, austerity with cleanliness and growth with self-discipline. The model,
despite its apparent success has not been emulated elsewhere. Some of the reasons for this
are discussed later.

Caring for Tribals:

Lok Biradari Hemal kasa

Deep in the tribal belt bordering Madhya Pradesh, Maharashtra and Andhra is the Lok
Biradari Prakalp which consists of a general hospital, a 140 student nonformal school for
tribal children and five satellite training centres for the Madia- Gond tribals of the region.
The Hemalkasa project was started in 1975 and the hospital is run by Baba Ante's younger
son Doctor Prakash Amte and his doctor wife. Working against severe odds in the interior
forests of the region which is cut off from the rest of the world for six months during
monsoons and which lacks even the basic facilities like electricity and running water, the
dedicated team of doctors and their associates are doing a singular service by treating the
illiterate poor tribals without any expectation of material rewards. In 1987, the base in
hospital and its eight subcentres in the area had treated 43,000 patients. The hospital at
Hemalkasa enjoys such a favourable reputation that not only Nadia - Gonds but also forest,
police and other government officials and the staff of a private paper mill regularly benefit
from its services.

Besides treatment, the tribals are also given practical training in farming. They are taught
improved methods of farming, and are given training in dairy, poultry, goat and pig
farming. High yielding paddy seeds are distributed to the trial farmers and community
nurseries are run to make available saplings during the planting season. Seeds are not sold;
the same quantity is demanded back. To the surprise of all, the recovery of seeds after the
harvest has been almost hundred per cent. Farmers are being trained to preserve their seeds
for the next crop so as to reduce their dependence on external sources for high quality seeds.

Village level workers are trained at the base camp not only in rudimentary health education,
but also in basics of agriculture and social awareness. In their interactions with the tribals,
the former try to sensitize the tribals to their social rights and duties so that tribals are not
exploited by unscrupulous forces which may try to take advantage of their ignorance.

The school for tribals was supported by an OXFAM grant for 5-6 years. On the expiry of the
OXFAM grant, financial help came from Holland. The state government has recognized the
tribal school and has given sanction for 50 students (as against the current strength of 285
students). The sanction will increase by 20 students per year. The objective of the school is to
offer the tribal children an education which will make them proud of their cultural heritage
instead of feeling ashamed of it. Also, positive values like creative concern for the
environment and the people are sought to be instilled in students while very young. School
children carry home packets of seeds for their kitchen garden. In an effort to bring together
the Madia every month and Gonds tribe which seldom interacts otherwise, every month

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each student takes classmate home for overnight stay. Intertribe mixing and greater
understanding is thus promoted. Formal and informal methods of education are
innovatively combined. A recent tribal parents' meet evoked a very enthusiastic response
from the parents and other tribals.

At Hemal kasa, a fair price shop is run to sell essential commodities like kerosene to the
tribals.

Invigorating the Youth: Somnath

In 1966, the Maharogi Sewa Samiti was given 2000 acres of barren forest land to be
developed into "workers university". The objective was to provide an integrated education
to students in science, technology, agriculture, hygiene and personal life style. Under the
original plan, each student was to be given two acres of land to cultivate and experiment
with and he was to enjoy the yield from his land after paying for hi9 expenses at the
university. This was an innovative approach to education in which students' stakes were
greater than merely acquiring a paper degree.

Yet just when work on the project was about to start, local politicians mobilised the
population against the project and claimed that the land actually belonged to the local
populace. A struggle of sorts ensured and Sarvodaya leader Vinoba Bhave was asked to
arbitrate. At his instance Maharogi Sewa Samiti relinquished 700 acres of land along with all
rights to irrigation from natural streams and springs. Nonavailability of natural irrigation
became a major setback. Amte and his patients decided to redefine their earlier objective,
and proceeded to convert the remaining inhospitable land into a model farm.

Under the guidance of one of the cured leprosy patients, other leprosy patients started
reclaiming land and built numerous bunds and reservoirs which could hold rainwater
during the dry season. A series of tanks have been constructed innovatively at descending
levels including a 100 feet dam, exclusively by internal human resources, without any help
from engineering experts or contractors. 700 acres of land have already been brought under
cultivation giving the most unexpected farming results. The farm yield is five times higher
than that of the local farms. The project is not only self-sufficient but also manages to
produce huge surpluses which are used to finance the non-earning projects and hospitals
run by the Maharogi Sewa Samiti. Youth camps are regularly held in Somnath every year to
help participants develop an appreciation of the dignity of labour and to promote national
integration. Participants in these camps come from different parts of the country and
represent various professions like students, teachers, writers, lawyers, doctors, etc. They
work along with the cured leprosy patients to help the former overcome their mental
leprosy or numbing of their social conscience and sensibilities.

In 1987, there were about 400 leprosy patients at Somnath. Their main activities consist of
agriculture, dairy, poultry farming and construction. The value of agricultural produce
during the year was Rs. 8 lakh.

The annual youth camp at Somnath in Play 1987 attracted 400 participants.

Centre for Social Action at Anandwan:

A Centre for Social Action (CSA) is being developed at Anandwan to evolve a philosophy

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and a perspective for development which is responsive to the aspirations of the 'entire
people of India'. Still at its nascent stage, the CSA intends to provide a meeting ground to
social workers and economists, scientists and technologists, farmers and workers, and all
those concerned with the national problems of poverty and underdevelopment, who can
forge together a common ideology, a clear vision of the society they want, followed by
formation of appropriate strategies and realistic action plans.
Novel Activities:
Biomass Production

Not satisfied with its phenomenal contribution to the treatment, growth and rehabilitation of
people suffering from leprosy or other handicaps, the Maharogi Sewa Samiti has also
addressed itself to the burning issues facing the community at large.

Its project on biomass production is one such endeavour. Concerned with the rapid
denudation of forests and consequent environmental degradation, biomass farming helps
create alternative sources for fuel, fodder and constructional material. The specific objectives
of this project are to utilize the human resources of leprosy patients and the physically
handicapped in a scientific pursuit of a system of plantation suitable for the local agro
climatic conditions, which can satisfy the local villagers need for fodder, firewood and
constructional material. Biomass research can help ease pressure on natural forests for
firewood; it can help utilize marginal land for productive purpose, and by supplying fuel for
cooking, can prevent the wasteful burning of cowdung which can be utilized as rich manure.

In 1935, 23 indigenous tree species were selected for plantation out of which five multiple
use species showed a growth rate which compares very favourably with exotic species. The
progress of plants is being monitored closely.

Research is also afoot on multitier silvipastoral land use system wherein food, fodder,
firewood and constructional wood would be obtained from the same piece of land. The
toptier in this system would consist of trees of multiple uses. The second tier will be legume
or tuber climber far fodder and food. On the grourdtier will be herbaceous posture plants of
perennial variety. Besides providing important products for the rural use, the silvi-pastoral
system also ensures the stability of land and soil amelioration. Different varieties of grasses
and legunes are being subjected to field trials and their progress is being watched and
documented meticulously.

In 1987, PPI, USA had sanctioned Rs. 60,000 for the biomass project.

Renewable Energy:

The project is also actively exploring renewable sources of energy for lifting water. Methods
are being developed to harness the wind energy to operate pumps during the summer when
water would be required for irrigating the transplanted plants and when the wind in the
area is also strong. When not required for lifting water, wind can be stored as compressed
air.

Also efforts are underway to capture the solar energy by photosynthesis in biomass which
can be used as a raw material to obtain energy through bio-chemical processes.

Water Management and Agriculture:

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Due to a very strong concern for the receding water table, water, even the waste water is
carefully consumed, managed, and utilized.

For developing water resource for irrigation in dry hot season, cheap and indigenously
suitable methods are being developed. It is proposed to try the drip irrigation method
developed by the Indian Agricultural Research Institute. Temporary ponds are being created
which can hold water during the rainy season and recharge ground water. Nallahs and
overflow check dams are made at different levels on the land in an effort to maintain a high
level of ground water. Fish are also kept in some of these ponds. Slowly the place is turning
into a bird sanctuary.

Sewage water is recycled and utilised for irrigation purposes. All the farm waste is crushed
and utilised to retain the richness of the top soil.

Anandwan has 50 underground wells. In 1987, a project sponsored by the Catholic Relief
Services worth Rs. 3.5 lakh for two borewells, submersible pumps, pipelines, tractor-trailer
implements, etc. was completed. The standing crops in the fields and fruit orchards are
guarded by leprosy patients who cannot perform any other task. The lush green gardens,
prize winning vegetables and crops, thick forests, and fruit-laden vines and trees in orchards
bear a testimony to the hard work of the inmates of Anandwan and the success of indi-
genously developed scientific methods of irrigation, cultivation and silviculture plantation.

In 1967, the value of agricultural production at Anandwan was to the tune of Rs. 7.8 lakhs.

Experimenting with Silviculture Plantation at Anandwan:

Established in 1957, Ashokwan is situated at a distance of a hundred kilometres from

Anandwan. The Ashokwan farm is run by about 100 cured leprosy patients who are mainly
engaged in agricultural activities. Ashokwan has developed into a model seed farm which
produces high quality agricultural seeds for various government agencies. The value of
agricultural production at Ashokwan exceeded Rs. 1 lakh in 1987. The surplus generated at
Ashokwan is employed to subsidies treatment at Anandwan.

Also underway at Ashokwan is an innovative prototype project on the use of poorly-

endowed land for growing energy plantation of trees which will yield fodder, fuel, timber
and organic fibre. The objective of the project is to generate learning from this techno-
silviculture experience and pass it on to villagers, particularly those owning poorly-
endowed and waste land. It is proposed to develop a prototype project to generate
preliminary learning at Ashokwan. A pilot project is being planned at Somnath, which offers
a truly representative rural site with poorly-endowed, under-irrigated land, where results
from the Ashokwan experiment would be checked and confirmed. The final lessons from
this integrated experiment on silviculture plantation are to be disseminated to villagers
through ongoing discussions, workshops, seminars etc. at Anandwan which not only enjoys
excellent reputation and immense credibility among villagers, but also has an experimental
site, and offers infrastructural facilities.

The thrust of the project is not only on fast-growing trees, which itself is an important need,
but on evolving an integrated model for rural areas which is addressed to the needs of
energy, constructional material, engineering and fabrication processes suited to the rural
needs and resources, as well as soil and water management.

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Low-Cost Housing:

Efforts are on to develop low-cost, comfortable and durable houses for rural areas which can
be built using locally available material. Some proto-types of very cheap and sturdy housing
units have been constructed which have used only the material, even bricks, made by
patients at Anandwan.

Managerial Structure, Systems, and Processes:

At the apex level, the Maharogi Sewa Samiti is managed by a committee consisting of
sixteen members. The control, guidance and management of the affairs of the Samiti vests in
and is carried out by the governing body whose members are elected every three years. The
office-bearers of the Samiti are elected from amongst the members of the Samiti. Any
vacancy occurring amongst the office bearers is filled by the governing body till the next
election. The governing body takes decisions about the investment and utilization of Samiti's
funds and all deeds and documents on behalf of the Maharogi Sewa Samiti are executed by
the governing body. It has the power to delegate any functions it deems fit to lower
committees or to office bearers and members of the committee.

Many operational activities are managed by the cooperatives formed around major
economic activities. Management of residential areas is taken care of by the commune
structure. Typically a commune consists of a clinic, a common kitchen, residential
accommodation, septic tank toilets, storage go-downs, community hall, Water and electric
supply, community farm and a cattle shad.

Financial Management:

Each economic activity like running a dairy, raising a cash crop, running a grocery shop or
running the canteen is treated as a profit centre. Each economic activity is expected to pay
for itself, and if possible, generate a surplus. The financial accounting and control system is
simple yet very efficient. Due to heavy dependence on bank withdrawals and deposits, the
passbook for each activity presents a neat summary of day's operations. Exhibit-1 presents a
summary picture of the financial performance of some of these profit centres in 1986-87.

Presented in Exhibit-2 are various sources of funds which finance multifarious activities of
the Maharogi Sewa Samiti. As this exhibit shows financial aid for different projects comes
from diverse sources like Swiss Aid, Christian Aid, and Catholic Relief Services. German
Agro-action Grant, NCK Netherlands, and closer home from financial Indian institutions
like State Bank of India, Industrial Development Bank of India, and organizations like
Peoples for Progress in India and Shri PL Deshpande Foundation. The balance sheet and
profit and loss statement for the year 1986-87 are presented in Exhibits 3 and 4 respectively.

Human Resources Management:

Most of the people working in different capacities are either cured patients, rehabilitated
handicapped persons, or patients who are still undergoing treatment but can still contribute
to the economic activity. It is, therefore, extremely difficult to draw a dividing line between
employees and beneficiaries. We thus find the post office at Anandwan being manned by a
postmaster who is a cured leprosy patient, teachers in schools who are cured leprosy
patients, and numerous technicians, electricians, workmen, artists, gardeners, dairy workers,
cooks, compounders, nurses, clerks, attendants, etc. who are either completely cured or are

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fit enough to undertake an activity of their choice and contribute whatever they can. The
model being practiced at Maharogi Sewa Samiti believes strongly in giving the patients not
charity, bat an opportunity to work with dignity and a sense of purpose which is contrary to
the traditional approach to leprosy treatment that advocates a lot of rest and a leisurely pace
of life.

The human resources available to an institution like the Maharogi Sewa Samiti are not like
paid employees in an ordinary organization where the involvement is from 9.00 a.m. to 5.00
p.m. Their long association with the institution as patients living in the same residential area
develops in most people a sense of attachment and gratitude for the treatment and care
received by them, and generates a reciprocal commitment and a bond that is far stronger
than any that a handsome package of pay and perks can evoke in most commercial
organizations.

Long association with patients also gives the Maharogi Sewa Samiti 'an extended
opportunity to find out the aptitudes and innate preferences for most patients. It is to the
credit of decision makers that people are not just filled into slots, vacancies or 'jobs'
depending upon the organizational requirements. Rather, most jobs are designed around the
physical capacity and natural talents and potential of the patients. Cured patients holding
different positions including the administrative ones not only instill in the minds of patients
the hope that the latter too would get cured, but also generate a sense of responsibility that
everyone is expected to contribute to the community life. It also makes the observance of
discipline, rules and procedures easier. Inevitably, due to its size, some formality has crept
into the management of the Maharogi Sewa Samiti, yet it has not degenerated into an
impersonal bureaucratic organization due to a fine balance between norms and discipline on
the one hand, and sensitivity, nurturance, and role modelling on the other.

Training in suitable vocations is an integral part of the rehabilitation efforts. The training is
nonformal and skill-based and as soon as a person is able to perform a job, he is encouraged
to start work.

Except for a few trained doctors, Maharogi Sewa Samiti has hardly any professionals either
in management accountancy, architecture, or engineering, dairy farming, agriculture, etc.
The expertise in these areas is home grown. Adaptation of knowledge, methods and tools is
encouraged, but not blind institution. Probably because of the low trust of formal,
professional training, there are hardly any instances of sending people for external training
programmes.

Factors Responsible for the Growth of Maharogi Sewa Samiti:

As a development entrepreneur Baba Amte has succeeded in developing an institution

primarily around his personal values and ideology. The following factors have contributed
to the growth of the Maharogi Sewa Samiti:

1. A dedicated leadership:

The first and foremost factor is the transparent dedication of the Amte family and their
associates. It emanates not just from stories of one-time sacrifice and courage but much more
strikingly through the everyday life they lead, their concern for and sensitivity towards
human suffering, and their firm commitment to help others help themselves.

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The credibility that the leadership enjoys is reflected in the strings of prestigious national
and international awards bestowed upon Baba Amte; it is also reflected in the faith that the
common man has in Baba Amte's integrity and judgment. He is seen as one of the few
leaders who practices what he preaches.

Likewise the involvement of the entire Amte family in bettering the lot of the weakest
whether it is the handicapped and leprosy patients or the poor, illiterate tribals, gives the
family high credibility. A positive fall out of this is that the values important to the
leadership have almost become organizational ideology for Maharogi Sewa Samiti.

2. Constant communication of the central philosophy:

The belief that 'work builds, charity destroys1 which helped Anandwan acquire an identity
distinct from other leprosy hospitals, and which helped Anandwan patients to rise above
self-pity to acquire self-respect, is repeated verbally and non-verbally in numerous ways.
The patients and the handicapped receive medical attention and care. But instead of
sympathy which can weaken the recipient, there is a positive message of hope and
expectation that despite one's handicap one would do whatever work one can and
contribute to the community activity.

This message is transmitted continuously not just through posters and speeches, but in the
very way in which the institution is organized and in the manner in which the organiers
relate to people.

Also the pride of the cured patients in their work has a salutary demonstration effect upon
others. Thus in a number of ways patients get a message that they can and are expected to
enjoy a normal life of work, entertainment and rest.

3. High quality consciousness:

A major characteristic of Maharogi Sewa Samiti, deriving probably from Baba Amte's quest
for excellence, is the high quality of its produce. Concern for excellence would be an
important asset for any organization; it is much more so for an institution which has the
disabled and the castaway as its members.

The superior quality of foodgrains, high yielding cash crops, prize winning vegetables and
fruits, prize winning cows which steal the cattle shows, riot of colours in the rose garden
developed on rocky ground, everywhere there seems to be a stamp of quality. Tactically,
this emphasis upon quality has paid huge psychological dividends. The knowledge that
they can do most things that the able-bodied can, and do them in superior fashion, helps the
members of the institution in developing a positive self-image and self-confidence, which
have a high restorative value.

Also, this demonstration of their superior performance shows to the outside community that
the members of the Maharogi Sena Samiti are not passive recipients of charity but equal
partners in the process of creation of high quality goods. The effect of high concern for
quality has thus been more far reaching than in a purely commercial sense of generating
profits.

4. Beneficiary orientation:

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The policy since the early years of the Maharogi Sew a Samiti that no one who came to seek
help would be sent back, has resulted in this hospital for the leprosy-affected patients
diversifying into other activities related to the orthopedically, mentally and visually
handicapped, because sufferers other than leprosy patients also sought help from this
institution.
Strong beneficiary orientation has led to modification of existing tools and designing of new
tools which can be handled by the crippled. The design of such tools is often tailor-made
depending upon the state of health of fingers and limbs of individual operators. Thus
reaching out to individual members and designing work, tools and equipment which they
can handle has resulted in positive involvement of even the most crippled of the patients.

Responsiveness to the needs of different people has resulted in development of sections like
Gokul and Uttarayan discussed earlier.

Also this concern for giving an opportunity to the inmates to enjoy a normal integrated life
has led to traditions like marriages among cured patients, an entertainment centre where
cultural programmes are held annually, and other annual festivities like "Mitra Melawa".

5. Slogans and mottos as an inspiring force:

Talking to different members of the Maharogi Sewa Samiti, one finds a powerful use of
catchy slogans and pictorial mottos as a binding, inspirational force. These oft-repeated
slogans primarily reflect Baba Anita's personal beliefs, but they are repeated every now and
then as expressions of institutional ideology. These slogans include:

Make everyone a jack of all trades and master of one.

First we had quit India; then split India; now let's move to knit India.

The joy at Anandwan is more contagious than the disease.

Outcast people on an outcast land.

Give them a chance, not charity.

Responsibility is not transferable.

Make a pain friend, not a pen friend.

Wherever you go, go with an oil can. Don't demolish the old structure; oil it.

A tree is a pole of liberty and every leaf a flag of honour.

These and similar other expressions are used to an advantage while communicating with
outsiders or promoting solidarity within the institution.

6. Loyalty and commitment of cured patients:

As discussed earlier, in Maharogi Sewa Samiti it becomes extremely difficult to distinguish

between the beneficiaries and the employees. Because almost all the people working in

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different capacities are cured patients or the rehabilitated handicapped, they have deep
personal loyalty for the institution which put them on their way to recovery and
rehabilitation. This gratitude gets reflected in high commitment of people. Although the
institution encourages the cured patients to go back to their families, since most of them
have found long years of acceptance at Anandwan and other projects, they decide to stay
back and do a good turn to others. Many of then, however, remit money to their families in
their hometowns.

Concluding Comments:

The Maharogi Sewa Samiti has travelled a long way. Starting with a concern for individual
development through treatment, rehabilitation and active involvement of leprosy patient in
communes shunned by the rest of the community, the Samiti moved on to the assimilation
of the handicapped in the same communes. Development of appropriate tools and
technology to provide work to all members irrespective of their handicap, and the treatment,
education and training of tribals in remote areas formed the next phase of its activities. Soon
the success of its economic endeavours was so pronounced that this institution started
contributing to the prosperity of the larger society. Finally it has reached the present
juncture where in addition to its earlier objectives, topical societal concerns like protection of
the environment, awakening of the youth, integrated rural development have become its
major preoccupations.

This journey from the development of the individual to community development and area
development has been a long journey signifying the triumph of the human spirit and effort.
However, the fact that the Anandwan model of combining treatment of leprosy patients
with their vocational training and social integration within communes has not been
replicated widely could intrigue many observers.

This could largely be due to advances in scientific knowledge about leprosy. It has now been
conclusively established that leprosy is wholly curable, and not all the cases of leprosy are
contagious. This renders the running of communes for leprosy patients unnecessary. It is
now considered desirable that patients stay in their own social and economic environment
and receive regular treatment as is done for other diseases. In fact the new approach appears
to be supporting what has been a cherished practice at Anandwan namely to accept, relate
t o , and treat leprosy patients like other normal human beings, and to even encourage them
to contribute as others do. Although it appears paradoxical, yet, the increasing irrelevance of
the communes of Anandwan thus implies a greater dissemination and wider acceptance in
society of the ideology that Anandwan has stood for.

The adoption of other societal development concerns by Maharogi Sewa Samiti reflected
eloquently in its ongoing projects, shows that the institution is marching with times and is
trying to respond to contemporary crises and problems. Whether it emerges as a leader in
these areas would depend upon the quality and relevance of the solutions offered by it. It
would also depend significantly upon the robustness of Maharogi Sewa Samiti as an
institution. Like any other organization, its long-term health and contribution would rest
heavily upon the quality of its leadership. Although the commitment of Baba Amte and his
family to the causes they espouse is beyond any doubt, the leadership does appear to be in
the hands of a few close-associates who act as key decision-makers. Whereas during the
earlier phases of institutional development, namely emergence, growth and consolidation,
this centralization of decision-making may have helped the institution, at the present
juncture when it is poised for new thrusts which would entail acquiring new perspectives,

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competencies and skills, it is desirable to move towards a more broad-based pattern of

leadership. Although Baba Amte has discouraged it, yet the basis of motivation for members
is largely their personal loyalty and regard for Baba and his associates.

In the new phase which Maharogi Sewa Samiti appears to be entering now, personal
commitment to the new missions and related tasks need to replace personal loyalties. An
effective strategy for fostering such commitment would be widespread involvement of
members through effective participation in choosing new directions and courses of action.
Attracting young members who share the S3me ideology and zeal which have been
characteristic of Baba Amte and his associates, and inviting members to participate not only
in operational decision where considerable delegation exists, but in strategic matters, can
foster the growth of new leadership for the future.

Exhiblt-1
Maharogi Sewa Samiti - Income, from Departments Forming Part of income ft., Expenditure,
Account, for the Year Ended: 31.3.1987

Name Income expenditure Surplus Deficit

1. Vishwakarma Society 51,908.95 44,776.52 7,212.43 -
2. Gosewa Kendra 1,41,967.72 73,643.10 68,324.62 -
3. Mudran Niketan 6,08,341.45 3,94,879.30 2,13,462.15 -
4. S.B.I. Printing Unit 1,04,600.75 1,11,726.97 - 7,126.22
5. Anandwan Canteen 1,28,819.40 1,32,440.59 - 3,621.19
6. Anandwan General Workshop 10,42,844.95 8,34,274.94 2,08,570.01 -
Total Rs: 20,78,563.22 15,91,741.42 4,97,569.21 10,747.41

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Exhibit-2
Maharogi Sewa Samiti, Warora
Sources of Funds

Sr. No. Name of Funds Balance as on

31.3.87
Rs. Ps.
1. General Fund 35,50,000 00
2. Building Fund 13,19,213 99
3. Swiss Aid Fund 1,19,37,138 49
4. Hemalkasa Project Fund 85,00,000 00
5. Fair Price Shop Fund 1,60,941 41
6. Depreciation Fund 74,89,146 93
7. Students Aid Fund 16,432 13
8. I.P.O.P. Grant Fund 3,23,462 42
9. Lok-Van-wrench Grant Fund 18,414 27
10. Patients welfare Fund 26,68,766 14
11. Equipment Fund 14,98,044 33
12. Helpage Grant Fund 8,86,779 35
13. Agro Industries Development Fund 1,00,000 00
14. Water works Fund 4,06,180 00
15. Somnath Project Fund 1,65,000 00
16. Uttarayan Fund 2,00,000 00
17. Gokul Project Fund 15,50,001 00
16. Community Aid Abroad Grant Fund 1,46,707 76
19. Raman k Other Scholarships Fund 33,506 05
20. Peoples Action for Development Grant Fund 1,03,004 35
21. Dukan Nidhi 37,82,395 59
22. Cosip Grant Fund 12,824 54
23. Ashokwan Project Fund 80,000 00
24. Shri Babasaheb Amte Swasthya Nidhi 80,347 80
25. World Rehabilitation Grant Fund 2,27,777 77
26. Blind Boys Institute Fund 10,000 00
27. Shri P.L. Deshpande Fund 1,15,000 00

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Exhibit - 3
Maharogi Sewa Samiti, Warora
Balance Sheet as on: 31.3.87
Figures Funds & Availability Figure for Figures Property & Assets Figure for
for the year for the year
Previous Previous
year year
47145304 Funds & Reserves Fixed Assets
As per schedule 'A' 51600343.12 24105197 As per Schedule 'B' 27348261.80
1118861 Deposits & Sundry Liabilities 20116841 Investment
At Science College 137688.00 As per Schedule 'C' 22356839.77
At Junior College 68116.00 Stock & Store on Hand
Grain, Grocery, Seed, paper
90080.47 2054184.93
At Agricultural College 1860723 & Stores
Milk Coupons with customers
2027.20
deposits against printing Bills Advance & Debit Balance
Advances from Customers 1581.52 402364 As per Schedule 'D' 295877.19
Kirana Bhandar 166315.41 Security Deposits
For Gas, Telephone,
948685.25 1414872.15 108727.20
Deposits of patients & worker 43677 Electricity Water etc.
763177 Income Expenditure Account 2502385 Cash and Bank Balance
As per last Balance Sheet 763177.19 Cash in Hand 14548.47
Less: Deficit for the year 544454.73 218722.46 Cheques in hand 102796.70
Other Specific Govt. Grants With Bank 956546.67 1073891.84
Other Specific Govt.
3425 3425.00
For Bio Gass Plant Grants Expenses
1500 For Bee Kipping Unit 1500.00 4925.00 - Bio Gas Plant -
1080 Bee Keeping Expenses 1080.00 1080.00
49032267 Grand Total Rs. 53238862.73 49032267 Grand Total 53238862.7

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Exhibit - 4
Maharogi Sewa Samiti, Warora
Income & Expenditure Account for the Year Ended: 31.3.1987
Figures Expenditure Figure for Figures Income Figure for
for the year for the year
Previous Previous
year year
Expenses in Respect of Property Income from Property
36413 Building Repairs & Land Development 170423.86 309914 Building Rent 314901.00
1104234 Agricultural Expenses 1299644.14 1980624 Agricultural Income 1795716.31
64549 Dairy, Poultry & Fishery Expenses 66739.38 1536807.38 101176 Dairy, Fishery & poultry Income 158002.30 2268619.61
Establishment Expenses 2002429 Donation in Cash & Kind 1721487.04
Interest of Investment & Bank
9900 131955.00 1837419 1888372.42
Salary to Staff A/C
429738 Vehicle Maintenance 451905.74 Government Grants
22595 Machinery, & Dead Stock Repairs 38705.20 2738769 For Medical Relief Work 2433635.00
25003 Office Expenses 24183.25 For Educational Work 3715364.28 6148999.28
1714 Zoo Maintenance 2190.00 Other Grants
153846 Miscellaneous Expenses 185273.68 834212.87 - From Action-Aid 237025.00
Expenses on the Project of the Trust 236398 From Terre-Des Home 52000.00
4309313 Medical Relief Expenses 4146042.12 65000 From Swiss-Aid for Ashramshala - 289025.00
4492617 Educational Expenses 5298094.45 9944136.57 Income from Departments
Library Books Written off Depreciation on
862 - 903183 486821.80
Agents As per Schedule 'E'
1001580 As Per Schedule 'B' 1323741.80 632884 Educational Fees & Income 568670.79
Provisions for Other Sources:
102108 General Fund 48359.50 256301 Messing charger from workers 214556.25
2675000 Hemal Kasa Project 975000.00 3197 Tea Canteen Income 5175.00
200000 Gokul Fund - 262073 Miscellaneous Income 255026.20 474757.45
Adjustment: relating to previous year
200000 225000.00 - 1050.00
Aged Patients welfare Fund for Bio gas Plant
6000 Dairy Development 5000.00 1253359.50 deficit: for the year 544454.73
Surplus
13398 for the Year -

14930959 Grand Total Rs. 14392258.12 14930959 Grand Total Rs. 14392258.12

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