The WHO-ILAR (International League of Associations for Rheumatology) COPCORD (Community Oriented program and control of Rheumatic Diseases) has completed 10 successful years. COPCORD was meant to target rural communities in developing countries using low cost low infrastructure design. Begun in over 19 countries Worldwide, India was the seventh country to initiate its maiden COPCORD in village Bhigwan (Pune). And unlike every other COPCORD which completed the initial population survey stage only, the COPCORD Bhigwan was continued in a predetermined planned manner to fulfill all the requirements of the parent WHO program that is not only to measure the prevalence of rheumatic symptoms and ailments but also to determine risk factors, identify new cases and disease profiles, impart health education to the community and recommend strategies for disease control. Till date, the project has provided free of cost diagnosis and treatment services to over 1100 patients in Bhigwan and acquired community research data from a 9000 plus population. COPCORD Bhigwan is the only program of its kind to have provided treatment. As a goodwill measure, over 45,000 population residing in the neighboring 187 villages have been allowed to seek free of cost advise on their arthritis ailments. Having deviated in several ways and advocating a fast track research design, the COPCORD Bhigwan model has been adopted by several countries post 1996, and is the basis of an ongoing development program for a future COPCORD. In a seminal WHO technical research series publication (The Burden of Musculoskeletal conditions at the start of the new millennium ; TRS 919, 2003), the Bhigwan data on rheumatoid arthritis and knee osteoarthritis was used to project the scenario in South East Asia.
Announcing this and much more, Dr Arvind Chopra, the chief Bhigwan project investigator and currently the international COPCORD co-ordinator, in a specially convened BJD (Bone and Joint Decade) India activity week program in Bhigwan on 15 Oct 06 summed up the 10 year COPCORD trek by declaring three key messages for the Government based on the Bhigwan COPCORD experience (1) promote community health programs based on partnership between expert private medical practitioner/specialists and Gram Panchayat (2) train rural doctors adequately and appropriately, irrespective of their academic qualifications, so as to bring them into the fold of Govt health programs (3)reduce the communication gap between the Government and the public health consumer through sensible advocacy.
The meeting was addressed by several patients, health workers and rural doctors to demonstrate the impact of the Bhigwan project in reducing pain and suffering due to arthritis and further improve quality of life. Almost a revolution to fight arthritis and rheumatism had erupted in this small village because of a tremendous gelling between the suffering community and the caring project health care providers. A galaxy of experts from Delhi (including ICMR & AIIMS), Calcutta, Bangalore, Chennai, Hyderabad, Mumbai, Coimbatore, Lucknow, Aurangabad and Pune (that included AFMC, BJ medical college, DY patil Medical college, NIV, University of Pune) actively participated to gather first hand information about this unique community health model and answer queries from the large gathering of villagers. Dr Mahendranath, Chairman BJD India and a renowned rheumatologist from Bangalore, stated that the Bhigwan COPCORD today had acquired international fame and had been accepted and acclaimed, probably much more in the international arena of Rheumatology. Dr Mahendranath announced an ambitious BJD India sponsored research road map where-in the Bhigwan model has been adopted to launch several similar population based rheumatic musculoskeletal studies in Jammu, Chennai, Delhi, Calcutta and Pune. Already, 20,000 population had already completed the surveys. Prof Shubhada Jawdekar (HOD, Community Medicine, BJ Medical College) declared that the Bhigwan COPCORD was an outstanding example of a public- government partnership wherein Dr Arvind Chopra a renowned practicing Pune Rheumatologist had expertly and compassionately combined his skills with that of the Bhigwan Gram Panchayat, a Govt functionary, to create an exemplary community model. Prof S L Jadhav (HOD, Community Medicne, DY patil Medical college) and several experts from similar medical institutions and government bodies described Dr Chopra and his Bhigwan model as a real practical field expression of an otherwise theoretical class room teaching and routine work that unfortunately continues to be the focus of community health and medicine in the current Indian perspective, more so in the Govt sector.
Dr HS Tandale, the Bhigwan COPCORD co-ordinator and a senior retired PHC medical officer, narrated the key milestones of the project especially the fact that several international experts had visited Bhigwan to ascertain facts. Dr Tandale, despite his age and failing health, had worked tirelessly and was the real force behind the success of COPCORD Bhigwan, declared Dr Chopra. Sh Ramesh Jadhav, a renowned local politician, bravely asserted that any community and village would go out of the way to co-operate and work with programs like COPCORD Bhigwan and dedicated caring doctors like Dr Chopra. He further said that projects like this need urgent recognition from Government and should be adopted as the model for large scale use to serve community and acquire useful data. In 1996, when COPCORD Bhigwan was begun Sh Ramesh Jadhav as the Sarpanch had provided excellent administrative and logistics support . Sh R Jadhav had continued to be the dominant supporter of the Bhigwan project till date, said Dr Chopra.
The annual MAI magazine focused on osteoarthritis, and edited by Dr Kalindi Phadke, was distributed to all. MAI (Mission Arthritis India) is a Pune based patient support group and one of the founders of BJD India.
The Bhigwan program was chiefly organized by BJD India and CRD, Pune. These programs also received significant sponsorship and contributions from Arthritis Research & Care Foundation, Pune, and Unichem Pharmaceutical and were co-ordinated and conducted by Ms V Anuradha and Ms Manjit Saluja from Center for Rheumatic Diseases (CRD), Pune.