Introduction Odisha State had the third worst health index ranking among Indian states in 2017–2018. Relative to India as a whole, it has significantly worse infant mortality rate, under 5 mortality rate, and vaccination coverage. Although free public healthcare should be provided for those living below the poverty line, poor and vulnerable children are often denied medical treatment due to institutional bias.

Our charity provides free healthcare, childcare and education for poor and underprivileged children. The clinic provides primary health care for children enrolled in the charity’s school and preschools; and Paediatric care for children with disabilities or chronic disease. A disproportionately high number have significant medical conditions, as they are unable to access quality health care via conventional means.

Aims To describe the epidemiology of our patients and the range of conditions seen.

Methods The notes of all Paediatric patients who attended the clinic from September 2018 to August 2019 were reviewed.

Results Over the year, there were 1008 patient encounters. 57% were by males. The age range was from 1 month to 15 years (median 6 years). 63% of encounters were for management of acute illness, 11% were due to trauma, and 23% were related to chronic disease management. The most common diagnoses were lower respiratory tract infection, viral upper respiratory tract infection, tonsillitis, gastroenteritis and dental problems. Of the acute infections, it was presumed that 49% were bacterial, 39% viral, 9% parasitic and 5% fungal. ‘Tropical’ infections encountered include typhoid, TB, dengue fever and HIV. Of the patient encounters that related to chronic diseases, the most common underlying diagnosis was cerebral palsy. Other significant long-term conditions include: sickle cell disease, thalassaemia, spina bifida, hydrocephalus, congenital heart disease, diabetes mellitus and hepatocellular carcinoma.

Conclusion Without this clinic, many of the children would have been unable to access healthcare, and may have experienced increased long-term morbidity or mortality. Children, including those with disabilities, are now able to access appropriate and prompt management of acute and chronic illness. We have demonstrated the impact a low-resource clinic can have, and hope to replicate this model across the state.