Some of the key highlights/accomplishments during the year: 1. Statistical updates on the progress of the project: The ground level awareness programmes conducted through gaon kalyan samiti (GKS) and community events have created demand of health services among the unreached pockets and urban slums. Specific achievements during this period are: VHAI Axshya project covers a population of 82585809 in 46 districts of 8 states of India. The sub district level activities (Gaon Kalyan Samiti-8529 and Mid Media Events 2047) led our outreach to almost 2.5 lakh families with awareness to over 5 million populations. With a network of 184 NGOs, 458 CBOs and the Rural Health Care Providers across the project area, the mass awareness programme had contributed treatment of 408 TB patients through Axshya. With the soft skill training of the government health staff an atmosphere is created for TB prevention and reduction of stigma from TB through Axshya. Overview of activities 2012-13 Activities Total Community Engagement (by NGO/CBOs) # GKS meetings 8146 # SHG meetings 270 # PRIs 79 # CBOs 25 # Other interventions (in slums/prisons/schools etc.) 29 # Mid media activities 2047 Advocacy # District TB Forum meetings 118 # ICTC with DTO meetings 121 # CBOs with DTO meetings 118 # RHCPs with DTO meeting 120 Capacity Building # State level TOT trainings for NGO/CBO/PP 0 # NGOs Sensitized on RNTCP schemes 89 From above, # NGOs that applied for RNTCP schemes 11 From above, # NGOs that signed any RNTCP scheme 01 Health System Strengthening # TB symptomatics referred for sputum examination 7057 # Sputum examinations completed 2728 # Positive 408 # Positive on DOTS 314 1
# Sputum samples collected and transported for 23479 diagnosis # Positive 1922 # Positive on DOTS 1882 # Patient retrievals # Initial defaults retrieved 127 # Retreatment defaults retrieved 102 # Patients Interrupting treatment (missed doses) 174 2. VHAI had an opportunity to conduct one MLA Sensitization workshop in Goa on 12 th March 2013 where TB prevention and advocacy issues were discussed at the State level in the presence of the Chief Minister, Deputy Speaker, Chief Executive VHAI and the Sr. Consultant, Dr.L.M. Nath and the important state dignitary. The platform was used on how TB patients take their normal lives and ensure that full treatment is ensured. The health sector attitude towards TB patients was to be taken up with more sympathy and the patient benefit approach which had been a challenge at the patient care level. 3. The intervention in jail premises was another area where the TB symptomatic were found considerably. The health seeking behaviour, facilities at the jail premises for the treatment of communicable diseases and the attitude towards the prisoners were little aback. Continuous liaison of Axshya Team and the RNTCP visits led these areas consider the prevention and treatment on time. 4. Bachda community of Nimuch (Madhya Pradesh) was adversely deprived from the TB treatment being remote and unreached area. Through Axshya intervention and the initiative of the District Coordinator the TB symptomatic were identified and the positive patients were treated. The sputum collection initiative was started from Nimuch and it was appreciated and replicated with other pockets of Madhya Pradesh and Axshya project areas in many ways. 5. Slum interventions in Amritsar (Punjab), Indore (Madhya Pradesh) were some examples of mass awareness of specific interventions through ACSM. The efforts took a way to emphasize activities at the urban pockets as well where the TB awareness and treatment was a challenge. Even the District TB Officer, Ludhiana (Punjab) expected Axshya Project making intervention in the urban pockets only with a urban and industrial population (including labours and the industrial area) with a population of 1.5 million. 2
6. World TB day, World Women s Day, World Health Day were the specific occasions making outreach to the masses through mass awareness and public gatherings, both from Axshya and in collaboration with the RNTCP in almost all the districts covered. Success Story # 1 3
Project AXSHYA Success Story: Mr. Aklu RNVSS, Darbhanga organized a VHSNC meeting at Anganwadi Centre, located at Md. Rafiq s house in the village of Manihas Panchayat- Bharathi Block- Singhwara. This is located in the Darbhanga district of Bihar, which is on the left (South) side of the Darbhanga-Muzaffarpur Road NH-57. On September 1, 2011 during the Sevika meeting, Mrs. Shama Perween informed us about a suspect TB patient Mr. Aklu (aged 40) who had not consulted anyone for treatment despite coughing for more than three weeks and having a loss of appetite. We talked to Mr. Aklu who lives in the village of Manihas and explained about the free investigation provided at the PHC on Singhwara Block. We explained that he would be provided free medicines by the hospital if the PHC test indicated that he had TB. Our volunteers had to inform and persuade Mr. Aklu about the treatment and cure medications supplied by the PHC under the RNTCP scheme. Mr. Aklu s test confirmed his TB and medication was started. Mr. Aklu is a laborer, so he could not work and earn money for his wife, four sons and two daughters while undergoing treatment. His entire family was starving because of this and also had no money to pay for the treatment. After completing his treatment, Mr. Aklu is now back to his normal life and can look after his family properly. Our volunteer Mr. Ravinder Singh played a vital role in convincing Mr. Aklu to visit the PHC and undergo treatment which has allowed him to live a happy life now. Success Story # 2 4
Project AXSHYA saved one more life In association with Danik Bhaskar, Project AXSHYA launched a TB awareness campaign programme which received a very good response as the District Coordinator received about 50 inquiries about TB. Prominent among these inquiries is the story of a 17 year old girl, Bhagya Shree. She had been suffering from TB for about 3 years and was a defaulter for about 1.6 years. A private doctor diagnosed her TB, but due to a lack of funds, advised her to take normal medicines. However, as time passed, the disease became serious. The news of the TB awareness campaign by Project AXSHYA was published by Danik Bhaskar and included the mobile number of the District Coordinator. After Bhagya contacted him, she was examined at a district TB hospital. After, she started DOTS TB treatment. VHAI staff following Bhagya Shree on her journey to healing making sure that she taking her pills every day, having good portions of food to eat and helping her get to the health centre for follow up. Success Story # 3 Home Visit Proves Effective in Enlisting Patient for DOTS Umesh Saket (son of Sarju Saket, of TB-Lab 31, Village & Post Khamahria) is a patient of Rewa District. Mr. Saket lives 10 km from the Semaria DMC and belongs to the vulnerable community of acute alcohol users. Our NGO volunteers tried many times to collect his sputum sample but he refused because of the stigma associated with TB and its treatment. Ultimately, an active volunteer Mr. Dheeraj Singh collected the sputum sample and took it to Semaria DMC where it tested positive. Mr. Saket was not ready for DOTS even after repeated discussions between his family, STS and volunteers. After the issue was shared with DTO by the District Coordinator, we went for a home visit and discussed with the patient about proper treatment. Mr. Saket is now taking DOTS under the observation of Mr. Dheeraj Singh. This is a great example of efficient and successful teamwork under the guidance of the DTO. Success story # 4 Project AXSHYA Helps Mr. Billu Return for TB Treatment This is a case study of TB patient Mr. Billu (aged 21). During the District Coordinator s visit to the DOT provider, it was found that Mr. Billu was diagnosed with TB and medication was started four months earlier. However, Mr. Billu had missed his treatment doses after 1.5 months of treatment. During the District Coordinator s visit, both Mr. Billu and his family were 5
convinced and motivated to continue DOTS to ensure proper treatment and cure of his TB. Mr. Billu has resumed his treatment and has promised to continue treatment until the last dose. Success story # 5 Regular Visits by District Coordinator Improves TB Treatment Implementation Dr. RP Paroha is one of the first batch-trained RHCPs under the project. He has a well setup clinic where he treats about 600 patients a month. However, he was not regular in taking the proper records of TB patients referred and treated. The District Coordinator discussed the issue of TB notification with Dr. Paroha and motivated him to cooperate with the government rules in TB notification and proper record keeping of the patients referred to the DMC. Now, Dr. Paroha is a good DOT provider. He is treating 4 TB Positive patients with DOTS. He has been an example of caring for the TB symptomatic and motivating other RHCPs and private clinics. This could only be possible by the District Coordinator s regular visits, motivations to Dr. Paroha, and interaction with him about the proper care of TB patients through RNTCP. 6