Success Stories -2006
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Ordinary people have made extraordinary
efforts to make DOTS services available and accessible even in the most remote
corners of India. The Programme is proud of its large contingent of healthcare
providers, NGO workers, members of self-help groups, and cured patients, who
work with extraordinary commitment and dedication. Their efforts have made the
Programme a success. Their number is large, and some of their stories here
provide just a sneak preview.
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Food stall works as DOT centre - Mumbai |
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Prem Neelkanth runs a food stall in a sprawling Mumbai slum of overcrowded
shacks, narrow alleyways and open sewers. He also dispenses medicines there.
Many TB patients -mostly labourers -live there. They do not have the time to
visit the health centre for treatment. Every day, they visit Neelkanth 's stall
to take their medicines under his observation. "My shop is now like a TB
clinic", he says, pointing to a neat row of medicine boxes marked with
patients' names, given to him by health officials of the city." I know everyone
in the neighbourhood. So if someone does not turn up for their dosage, I go and
knock on their door at night. It is my duty to ensure they don 't miss a single
dose ".
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Women volunteers provide DOTS -
Jabalpur, Madhya Pradesh |
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Twelve women volunteers in the Motinala slum of Jabalpur district, Madhya
Pradesh, provide DOTS from their homes. About 200,000 people live in the slum.
The only health centre at Motinala is understaffed and is too far away for
patients to visit. The District TB Officer organised a modular training
programme at the District TB Centre for 25 women volunteers, followed by two
months' training on the job at the Motinala Urban Health Centre. Apart from the
12 active volunteers, rest of the trainees serve patients in the neighbourhood
whenever a case is detected. Each of these DOTS providers is catering to more
than 10 patients from their residence. Ten DOTS providers have already cured 15
patients.
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Taking DOTS to marginalised sections in
urban slums - Delhi |
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Half the population of Delhi comprises migrants and labourers who live in large
slums where the quality of housing is poor, sanitation facilities are basic or
non-existent, and the settlements over-crowded. The Directorate of Health
Services of the Government of Delhi operates the Urban DOTS Scheme. Under the
scheme, GLRA, an NGO working in the .field of TB and leprosy, provides DOTS in
certain slums of Delhi. Local residents who have completed school, are
available full-time and acceptable to the community, are appointed Community
DOT Providers. Shopkeepers, housewives and cured patients are commonly
appointed. The scheme has succeeded, as the patients, most of whom are daily
wagers, and it very convenient to have DOTS at their doorsteps. There are more
than 300 patients on DOTS in 20 slums. The NGO plans to extend the project to
other slums in phases.
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Anganwadi worker provides DOTS with
exemplary success - Mizoram |
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Lalthanpuii, an Anganwadi worker in
Tawipui 'N ',Lunglei district, Mizoram, also works as a DOT provider, and has
cured 16 of 21 patients under her care. As an Anganwadi worker, she has
personal access to nearly all households in the community she serves,
particularly women.
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Flexible DOTS for pavement dwellers in
Chandni Chowk - Delhi |
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The State Government of Delhi has also initiated a project to provide DOTS to
pavement dwellers in Chandni Chowk. A large number of people migrate to Delhi
for better employment opportunities. With nowhere to stay, they spend nights on
the pavements near Old Delhi Railway Station. Since they do not have a
permanent place of residence, it is difficult to verify it. In order to cater
to this section, some degree of .flexibility in the principles of DOTS has been
made while retaining the essence of DOTS. A doctor, along with a Senior
Treatment Supervisor and a Laboratory Technician, visits the pavement dwellers
early on Monday, Wednesday and Friday mornings, before they leave for earning
their livelihood, and provides DOTS to them according to RNTCP recommendations.
Delhi TB Association, an NGO, has been entrusted with this project.
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NGOs working in largest urban slum -Pilkhana,West Bengal |
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Pilkhana,the second largest slum in India, under T L Jaiswal Hospital TU in the
Howrah Municipal Corporation, had a high default rate (23%)and high death rate
(9%)in the initial years after programme implementation. A NGO, Paschim Banga
Ganatantrik Mahila Samity,with its community-based partner Pilkhana United
Club, started a DOT centre in the slum area. Till date, they are providing DOTS
to more than 100 TB patients with great dedication. Retrieval and early
diagnosis through their own network and word of mouth has helped the good name
of RNTCP to seep in to the urban, marginalised and migratory population of
Howrah. This community-based DOT Centre run by Mahila Samiti is highly
acceptable amongst the conservative Muslim population (especially the females),
which is predominant in the Pilkhana area.
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Evening DOTS centre of the Urban DOT Project - Mumbai |
INTERAIDE has started many DOT centres in the slums of Mumbai through its
partner NGOs to provide convenient DOTS to the TB patients. One such NGO is
Maharashtra Janavikas Kendra, which is currently operating seven DOTS centres.
An important feature of this is that five of these are 'Evening DOTS Centres
'.As most of the TB patients started on treatment are able to go to work or
become capable of doing so soon after starting treatment, they find it
difficult to attend the regular morning DOTS centres (9:30 am to 4 pm).Hence
the Evening DOTS Centres were started to cater to the working patients. The
timings are also
suitable for students and some housewives who prefer to come to the centres
after finishing their daily work. Another interesting feature to note is that
one of the DOT Providers is herself a cured TB patient. |
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From despair to hope for an HIV-positive
mother - Karnataka |
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Pre-operative screening for surgery of a 30-year-old mother of three from a
backward rural area of northern Karnataka, revealed her HIV-positive status.
Four years after surgery, she developed severe breathing problems and high
grade fever, and was admitted to a hospital where doctors confirmed that she
was immuno-compromised and transferred her to a TB sanatorium near Bijapur. On
learning about her serious condition, her family abandoned her.
Her X-ray revealed a massive right side pleural effusion and her sputum tested
positive for TB. She was put on DOTS, and in a fortnight, her face carried a
radiant smile as her pleural effusion was resolving. She was re-united with her
family and designated to a TU to complete her TB treatment. Life is full of
hope for her now.
This is one of the examples of reassurance to PLWHAs that TB is curable.
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NGO 's Mission to Control TB - Punjab |
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The Lions Club has been working with a missionary spirit for TB control for
last two years in 11 districts of Punjab. The Club has launched, 'Mission - TB
Control ' for supporting RNTCP. The NGO is mainly undertaking activities for
awareness generation about TB among the public, conducts seminars and publishes
brochures on TB. In recognition of the services of the Club, the State TB
Society has conferred an Appreciation Award to its chief coordinator Dr
Singla.The Club is committed to continue the work in this direction.
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Efforts to provide DOTS by an NGO and
the Railways - West Bengal |
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The Ramakrishna Mission, headquartered at Belur Math in Howrah district of West
Bengal. medical and healthcare activities in West Bengal and other States of
India. They have been participating in the RNTCP since November 2003 as a
Microscopy Centre and Treatment Centre in Scheme IV for NGOs under T L Jaiswal
Hospital TB Unit in Howrah. One Laboratory Technician and four DOT providers
have already been trained as per RNTCP guidelines. They are providing DOTS to
more than 100 TB patients.
The Eastern Railway Hospital at Liluah in Howrah district of West Bengal has
been implementing RNTCP as a Microscopy Centre and Treatment Centre under T L
Jaiswal Hospital Tuberculosis Unit since August 2002.There are around 10,000
workers in Liluah Railway Workshop (population of 40,000).of Railway employees
and their dependents. The centre has a chest clinic and indoor beds. The DMC of
this hospital has a room dedicated for for RNTCP work. Before the beginning of
work , two Laboratory Technicians were given a thorough 10-day Modular Training
on RNTCP at the District Tuberculosis Centre inside the Howrah District
Hospital campus from 14 August 2002. All medical officers are participating
actively in the RNTCP by referring the chest symptomatic for sputum
examination. Around 80 TB patients are on DOT Retired Railway employees and
volunteers of Railway Scouts have been trained to act as DOT providers.
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Pharma firm serves the community - Uttar
Pradesh |
Jubilant Organosys, a pharmaceutical research and manufacturing company, called
Sarvajanik Medical Centre in J P Nagar district of Uttar Pradesh. the
Government in providing diagnosis, identification, treatment and control
activities for TB in 20 villages. This NGO runs one of the 12 DOTS centres in
the district. The DOT centre has improved the reach and depth of the company's
effort at serving the community. |
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Community volunteer promotes DOTS -
Chandigarh |
The success of DOTS depends, ultimately, on an army of health workers, social
activists and community volunteers, who spread the message of TB services, and
counsel chest symptomatic patients to get themselves diagnosed and take the
full course of treatment.
One of the unsung heroes of the RNTCP is Mrs Harish, a community volunteer in
Chandigarh. She has provided the full course of treatment to 306 patients since
2002, when the Programme and is currently treating 65 patients. She retrieved
three defaulting patients by two of them are now cured, and one is now taking
medicine |
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Popular DOT provider becomes municipal
councillor - Chhattisgarh
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Mithileshwari Vaishav, councillor of Ward No.29 of Rajnandgaon district, used
to be DOT provider in Lakhauli. Very popular among her patients, she was
elected a councillor recently. She credits DOTS with providing her with an
opportunity to serve her community, made up mostly of labourers, first as a
community worker, and now as a councillor.
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Hospital creates TB awareness among
school children through health festivals - Delhi |
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St.Stephen 's Hospital (CHD- organised Health Festivals in 15 schools of East
Delhi. The Health festival are held for a day, which includes Health
Exhibition, Awareness Sessions on DOTS, Quiz, Poster competitions and training
of DOTS Ambassadors. A total of 11,372 school children have been covered under
this programme.
Health talks followed by a small exhibition are organised at assembly time for
two hours in schools not covered under the School Health Programme. Trained
volunteers answer queries of children visiting the exhibition.
The CHD-SSH runs a Community Based DOTS Programme in collaboration with State
TB Cell (STBC), Delhi, to create awareness among the residents and school
children of slums and resettlement colonies regarding DOTS. A team of CHD-SSH,
along with volunteers from the community organise street shows in the evening
hours using multimedia approach in Street Plays, Dance Shows, Health talks and
road side exhibitions. They have created awareness in 15,660 residents of slums
and resettlement colonies.
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