The award is sponsored by the United Nations Development Programme (UNDP), the World Bank and some public institutions from the USA, Germany and Japan. The president of the World Bank, Mr James Wolfensohn, will declare the winner in Tokyo on December 13.

The finalists have been invited to Japan from December 10-13 in order to deliver presentations on their projects. Mr S R Mohanty, managing director of the MP State Industries Development Corporation, and the driving force behind the RKS project, will represent the government of Madhya Pradesh at the event.

Mr Mohanty, who was district collector in 1994, explains the nature of the RKS movement: "The movement was an offshoot of the plague that hit Surat. It was started from the Maharaja Yashwantrao (M Y) Hospital in Indore." He adds, "A lot of people who were fleeing Surat were passing through Indore.

So there was the danger of the epidemic spreading to our city. Moreover, there were half a million slum dwellers in the area that needed to be cleaned up. The situation was deplorable. You will be horrified to know that we cleared the M Y Hospital of over 12,000 rats during the early days of the RKS initiative."

Mr Mohanty got the 900 beds in the hospital evacuated so that the place could be "sealed, sprayed and fumigated" to get it into shape. And the effort continued. "The Rogi Kalyan Samiti is a self-sustaining, autonomous body even though it has been set up by the government of Madhya Pradesh," says Mr Mohanty. "We have trustees who oversee its running. We do not depend on the government for the upkeep of the RKS. We raise funds for the project by collecting user charges and donations."

The RKS has also leveraged funds from the Red Cross, and the local area development fund of some MPs and MLAs. Private organisations that offer high-tech services like MRI, catscan and sonography are allowed to set up their facilities in the hospital premises. Of course, these services are subsidised so that patients get access to them.

Mr Mohanty says the RKS has generated a whopping Rs 37 crore in Madhya Pradesh. These funds have been spent by its executive committee to purchase medical equipment, medicines and other hospital material, apart from augmenting and maintaining infrastructure.

The initiative has been shortlisted for the GDN Award for the manner in which it has benefited the local population and, of course, the innovativeness and creativity that has gone into making it successful. "It was a question of prioritising one's efforts," says Mr Mohanty. "Someone who is suffering a minor ailment and lives in a village with little access to medical help can still travel to a city hospital to seek a cure. But a patient who has had a cardiac arrest will not survive the journey. It is here that we step in."

Mr Mohanty adds that the RKS has 68 centres in the backward region of Bastar and a total of 597 centres across the state. Around 65-70 million people benefit from its services. No less than 6,000 RKS workers have helped in the management of government hospitals in Madhya Pradesh.

The RKS model was adopted in other districts in 1996, and the government issued fresh guidelines for its uniform functioning in 1999. Now the RKS is a registered society constituted separately for every government hospital.

The managing committee comprises people's representatives, health workers, community leaders, representatives of the Indian Medical Association (IMA), members of Panchayati Raj institutions and urban civic bodies.

Going by its apparent success, the RKS effort should have been replicated by other governments. In fact, knowledge sharing and knowledge generation are other criteria for the GDN Award which the RKS might win. Mr Mohanty says that Rajasthan, Karnataka and Orissa have shown an interest in the example and have opted to duplicate this simple but model effort. He is quick to confirm that this project has no precedence in the country.

However, given the poor image of healthcare services in Central India, it seems the RKS initiative has a lot of work left to do. And some conviction to instill. Seeing is believing, is Mr Mohanty's suggestion. "Look at some old pictures of the bad hospital wards we had earlier, and take a tour of Madhya Pradesh now. You will notice the difference. Of course, we don't claim to offer facilities like those at Apollo Hospital, but we have arrested the downward slide. A certain minimum standard is being observed.

It will take some time for a complete turnaround."