Disease is rife in the slum camps. Respiratory conditions, malnutrition, vitamin deficiency disorders, and blood-borne diseases are widespread. Polio, leprosy, and tuberculosis are not yet eradicated. During the winter months, temperatures can drop below zero, and in the summer heavy monsoon rains and flooding exacerbate the situation. The basic shelter comprising make-shift tents of polythene draped over flimsy wooden supports is unable to withstand these extreme climatic conditions. Many children died in infancy and mothers frequently died in childbirth.
In the beginning, access to health care was limited due to fear, myths and a sense of powerlessness in many of the slum families. Hygiene and sanitation were very poor and needed to be addressed. The priority was to maintain life and reduce disease. Tong-Len began a small health project in 2006, run by a western volunteer. This provided general medical care, medicines, health awareness, wound dressing and access to hospital for the seriously ill. Today Tong-Len has its own health team with five full-time staff. They visit the Charan slum every day and hold general clinics, pre-natal and post-natal clinics as well as special clinics for the under-fives. In addition, there is a programme of immunisation run in conjunction with government doctors. 70 per cent of the Charan babies are now born in hospital. Deaths have decreased and life expectancy has increased.
Tong-Len also has a mobile health clinic which provides a service to other slum camps in the Kangra valley.