Orissa Projects

  • Introduction
  • Objectives & Activities
  • Achievements
  • Case Study

Introduction

BOLEP

Bolangir Leprosy Eradication Project (BOLEP) is situated in the western part of the Orissa State and covers 5, 40,659 population (2001 census). Of which, 82% live in rural areas and 73% of families live below the poverty line. BOLEP was launched in 1990 when, Sonepur was the highest leprosy affected area with the Prevalence Rate of 228/10,000 population and the New Case Detection Rate 130/10,000population.

Over the years, the project contributed to reduce the prevalence rate to 3/10,000 at the end of December 2009. Since inception to end of December 2009, 25433 numbers of leprosy cases were registered. Out of them, 24050 numbers were cured and released from treatment. By the end of the same period, the disability load in Sonepur district remained at 2461 (G - I: 786 and G -II: 1675).

After integration, the activities of the project were focussed on disability management and supports to government in the leprosy elimination programme. Comprehensive disability services, socio-economic rehabilitation of leprosy affected people, IEC and capacity building of different stakeholders improved the health and social life of the people with leprosy in the region.

In the year 2009, the Project supported the district health department in malaria prevention activities under the NVBDCP in the areas of monitoring the IRS in selected villages, training/sensitising the selected school teachers, GKS members of targeted villages and IEC in all the villages of the Sonepur district

In the current year, the project is working as a Referral Centre to support the Government in prevention of disability and prevention of worsening of Disability of the people with leprosy and is covering 5 districts such as Sonepur, Bolangir, Boudh, Baragarh and Sambalpur situated in the western part of the Orissa State. The total population of these 5 districts is 4,530,633 (Sambalpur- 935,613, Baragarh- 1,345,601, Sonepur- 5,40,659, Bolangir-1335760 and Boudh- 373,000).

 
Achievements inLeprosy supportive Activities:

In 2009, project had supported government in the process of case validation and monitoring the programmes. Total 298 leprosy cases (172 PB and 126 MB) were detected by the General Health System of Sonepur district during the year. By the end of the year, total 182 (69 PB and 113 MB) cases were under the treatment after 261 (150 PB, 111 MB) cases made RFT (released from treatment) and 5 (3 PB 2 MB) cases deleted as other wise.

In 2009, the project supported DPMR clinics in Sonepur, Boudh and Bolangir district. 697 numbers of cases befitted through these DPMR clinics conducted in primary health care centres. The table below describes about the beneficiaries of these DPMR clinics supported by the project.

 
Name of the District No of Clinics conducted
Clients attended for Clinic
Male Female Total
Sonepur 81
394
130
524
Boudh
10 32 9 41
Balangir 25 108 24 132
Total 116 534 163 697

534 male and 163 female were benefited through these clinics. Out of them, 183 cases attended first time, were from the outreach area and motivated by the project.

 
Details NFI/Reaction
management
Pre & Post
Operative care
Ulcer care Other Total
Patients at the beginning of the period 1
8
10
0 19
New admissions during the year 2009 4 169 24 1 198
Total cases treated 5 177 34 1 217
Total patients discharged during the period 5 151 31 1 188
Patients under treatment at the end of 2009 0 26 3 0 29
 

As per the description in the above table, 177 cases were in the IP ward for pre & post operative services and out of them, 151 were released after due provision of the services. Out of 34 ulcer cases treated in the centre, 31 could be healed with due treatments and were released from the IP ward by the end of the year.

In the field level, 67 ( 53 male and 14 female ) ulcer/NFI cases (5 cases from other than Sonepur district) were treated during the year out of them 60 cases (46 male and 14 female cases were recovered from ulcer/NFI and 7 (male) cases remained under treatment at the end of the year.

41 numbers of cases have been facilitated by the project to under go re-constructive surgery at Bargarh, Jharsuguda VSS Medical College Burla and MKCG Medical College.Berhempur Out of them 10 cases, 26 cases, and 5 cases were from Sonepur, Bolangir,and Boudh districts respectively. Among all the cases supported and provided RCS, 37 numbers were male and 4 numbers were female.

In the year 2009, the Project followed up 137 cases provided RCS. Out of the 137 RCS operated cases 134 (106 male and 28 female) cases found with desired and good results (97.8%) and restored their functional ability through RCS. 3 (Male) cases were with fair result.

As a whole in 2009, 1135 numbers of people with leprosy disabilities benefited from different disability services of the project that includes 10 cases in for RCS, 101 cases in NFI/Ulcer treatments, 252 cases under G-I foot wear provision, 408 cases under G-II foot wear provision, 227 cases under adaptive devices provision, 137 cases under RCS post operative follow-up. Among all, 217 cases (as mentioned above) were treated in the IP ward of referral centre for intensive care and 188 cases were discharged from the IP ward after due recovery.
During the year 83 SER beneficiaries have been followed up and were given necessary advice to develop and sustain their trades.

Achievements in Malaria supportive Activities:

  • 176 Numbers of BRCC,CRCC,KGBV teachers and other teachers (150 male & 26 female) were sensitized and trained on Malaria in 6 numbers of sensitization programmes conducted by the project.
  • 1750 Numbers of GKS members (1400 male & 350 female) were sensitized on Pre & Post IRS programme in 58 numbers of programmes.
  • 40 numbers of street plays were conducted and covered 40 numbers of villages and about 34,000 (18,000 male and 16,000 female) numbers of population. The Malaria Rath moved all the 959 numbers of villages of the Sonepur district in 30 days during the designated malaria month.
  • 9 monitoring meetings were facilitated and guided by the project at the village level targeted for IRS during the reporting year.
 

Case Study

  • Ms. Surekha , 16 years Female, is 3rd daughter of Ramji and Srabani a couple of Barkani village, Badabairao Gram Panchayat, Tarbha Block of Subarnapur District. Ramji blessed with 4 daughters and only one son. Surekhas elder sisters have got married. The younger brother and sister are studying 7th and 5th respectively. Surekha’s parents are doing labour for their daily bread which has not been sufficient but managed just for hand to mouth.

    In the year 2005, when Surekha is studying in 6th class, she notices a skin lesion on her fore arm of right hand which has no itching or pain. She or her parents do not bother about it because of ignorance. Later, the little and ring fingers of right hand become weak and starts clawing.

    Then, parents take her for check-up to the Tarbha Block CHC which is 6 km far from their village. The hospital staffs do a provisional diagnosis and call her in a specific date i.e. at the time of the visit of the validation team to the CHC. On 16-12-2005 the team confirms her as a case of leprosy PB with ulnar neuritis. They put her on MDT Treatment as PB child case for 6 months, and keep her under keen observation of neuritis. And later on start steroid therapy simultaneously with the anti leprosy drugs (Prednisolone for 3 months started with 30mg and tapered for every 14 days). She taken treatment for 6 months regularly and made Released From Treatment (RFT) on 29-04-06. The skin lesion subsides completely and anaesthesia is remaining on the part.

    After completion of the treatment she gets claw of four fingers of her right hand which does not respond to the steroid therapy. By looking her hand, herself and her parents become worried and being a parents of a female child they become very upset regarding her future. In the village the people do not comment directly, but they discuss regarding her future marriage. Surekha discontinues her studies due to her mental and physical condition.

    Referred by Block CHC, they came to LEPRA referral Centre (BOLEP). On 19-06-2007 she is assessed for RCS and admitted for pre operative therapy. On 28-07-2007, she undergoes the RCS surgery facilitated and supported by the BOLEP for the correction of her four fingers. After post operative therapy at BOLEP, she regains the cosmetic look as well as her functional ability with good results. She is now attending regular post operative follow up to keep her functional ability. Surekha has again continued her studies by going to school. Now she is studying 8th class and wants to study more. The parents are very happy and always says that LEPRA has brought back the hope and future of their daughter.

    Seeking for better future

    Ms Bhagyasini, 19 years old girl passed 10th class in second division and discontinued her study due to her physical and financial position. She belonged to a poor family and was residing in a remote village Bendra of Balangir District with her parents, grand parents who were totally depending on agriculture labour Her elder brother was studying +3 final and younger brother was studying in 10th class. Though she was very interested to study further but discontinued due to the above reasons. If we see her flash back, in the Year 2002, when she was studying 6th class she noticed a skin lesion with no sensation, and the same was identified in the school survey, and again PMW came to her house and examined but they did not confirmed as a case of Leprosy. After one year (2003) they revisited her house and examined and started MDT (PB) for 6 months. Later on after completion of treatment, she developed claw fingers of her left hand little and ring finger.

    In the year 2005, when she entered in to the class 10th, the PHC staff called her to PHC at the time of visit of DTST to the PHC. The DTST team assessed her and selected her for RCS, and furnished all the relevant papers and referred to the LEPRA Society BOLEP for pre operative therapy. Then, she was referred to HOINA at Muniguga for left hand ulnar claw correction. There she underwent surgery (RCS) for four fingers and came back to BOLEP for post operative therapy. In the mean time she could not able to go to the school, she discontinued her studies. She completed her post operative follow up in regular intervals. Again she joined the school in next academic year and studied class 10th and passed in second division. She is very happy with the LEPRA’s intervention in her surgery; she is helping her parents in house hold activities.

    With the earlier experience she herself visited Referral Centre BOLEP for her Thumb correction of the same hand in the month of October 2009. After completion of pre operative therapy she under went for RCS of thumb correction of her left hand, on 23rd November 2009 the RCS held at District Head quarter Hospital Jharsuguda through TRU. And also she received incentive of Rs. 3000/- at discharge under Central Government Scheme.

    She regained her loss of functional ability of her affected limb, she got hope for future and she can live with dignity. She shared her feelings and gratitude towards LEPRA. And also she is willing to continue her studies further …if LEPRA supports by money or kind.

Case Studies

The support restored the Childhood

Kumari Jyotsna sethi, 14 years old, daughter of Banamali sethi belongs from Rajanpali village of Boudh district. She is the only child of her parents and that is why she gets all the affection from her parents. She grows up with much love in the family. She studies in class 8th at Butupalli, High school of Boudh district.

Her father is a small farmer with one acre of agriculture land. The annual income is not sufficient to manage the family economy. However, with the income from his own agriculture land as well as labour work sometimes, her father manages the family and the education of Jyotshna.
Time passes and one day her mother observes that Jotshna is not able to tracing the things and domestic appliances properly and father also observes the same. School teachers complains that Jyotshna is not keeping any interest on study. Her father also observes the same. The school teacher says that she is not able to look at the black board and reading properly. Subsequently, friends and neighbours starts to address her as the blind Girl in the community. Gradually Jyotshna becomes depressed and stops going to play with her friends and avoids the gathering in the community. She also expresses her unwillingness for study. One of the neighbors observes a white spot on the right eye pupils. Her father contacts the local traditional healer for treatment who fails to recover the same through his treatment. The parents make lots of expenses for the treatment of Jyotshna. Then they takes Jyotshna to Boudh District Head Quarter Hospital for treatment. The doctor diagnoses her with immature cataract and asked them for contacting the Mahanadi Netra Chikitsalaya of Birmaharajpur of Sonepur district.
She comes to MNC 5th August 2009 and was admitted for cataract surgery. Her Uncle and Parents are counseled by the Ophthalmic Assistant for the surgery. The cataract surgery is conducted on her right eye on the same day through phaco with the intra ocular lens (IOL) in free of cost. Free spectacles and medicines are provided to her as per the prescription of the Ophthalmologist of the Mahanadi Netra Chikitsalaya of LEPRA Society. After the successful surgery, her parents express their happiness and gratitude to LEPRA Society as well as the person or institution who provides support for this noble work. Jyotshna is now very happy she becomes able to see. Now she has got back her earlier life stile i.e. in relation to continuing her study, playing with friends and joining the community gathering.

The support could provide relief in old age by restoring the vision

Basanti Mahananda, 65/F, she is an old widow lady belongs to very poor family of the Menda village of Tarabha Blcok of Subarnapur District. Long back her husband dies due to heart stroke. She has 3 daughters only without a son who already have married. So, Basanti is living alone and manages her by wage works in different households. She is landless.

However, she gets the oldage pension which is Rs. 200/- (Rupees Two Hundred only) per month. Suddenly, she feels vision problem which increases gradually. She becomes unable to see and work properly. Cooking for herself and earning for herself becomes difficult. As her daughter are in their in-laws’ house, there is no scope of getting support from them. In the course of time, Basanti loses his complete vision. She could know about the community eye screening camp of Mahanadi Netra Chikitsalaya of LEPRA Society at Tarava. She requests her elder son-in-law to guide her to the screening camp. Basanti attends the screening camp and diagnosed with matured cataracts. She is brought to the Mahanadi Netra Chikitsalay by the project outreach bus on 13th August 2009 and was registered for cataract surgery. On 14th August 2009, her right eye is operated through the use of phaco and operating microscope and IOL is implanted. The surgery becomes successful and Basanti gets back her vision in the right eye. After seven days of her surgery, her vision is tested and found with very good vision. She also expresses her happiness as she is able to see the things and do her daily activities independently. She is waiting eagerly for the surgery in her left eye.

Restoration of Childhood

Sumanta Beriha,7/M of C/O Bhagban Beriha, hails from Jatasingh village of Boudh District. He is the youngest son of his parents with three brothers and only one sister. Being the youngest son of his parents Sumanta is being loved by everybody in the family. His elder brother was having eye diseases which led him to incurable blindness. Sumanta was all of sudden lost his vision at the age only 4 years. His father is a farmer and also works as a labourer. The mother is a house wife and sometimes works as labourer. When Sumanta is admitted into the school, the irony that he is found to have very low vision in both of his eyes for which he faces lot of problems in reading and writing. Gradually Sumanta was pushed into more and more darkness. Sumant is not able to carry out independently the daily activities, reading and playing. Gradually he stopped school going, playing with friends. He loses his childhood. The parents have no money for the treatment of their beloved son and because of the same reason and ignorance their elder son becomes blind. They have to only cry and blame their lucks. The parents go to the District Head Quarter Hospital, Sonepur but, the treatment could not be possible as the hospital is not having facilities for children surgery.

In course of time, his uncle who is staying nearby MNC informs his parents to come to MNC for treatment. The parents come with the son on 7th February 2009 and Sumanta is registered bearing the MR No 47526/09. He is detected with congenital cataract in both his eyes. Parents and the uncle are counselled for the surgery. Sumanta is admitted on the same day. His right eye is being operated with Small Incision Cataract Surgery (SICS) with IOL on 8th February 2009. His vision is improved to 6/18 in his right eye.

Now, he is able to play, read and write and he is happier that his vision has again restored. His parents are too happy as the childhood of their beloved son is getting restored and have expressed their gratitude to MNC for great support to their child and family. After few days, his left eye will be operated.

Resources

Infrastructure: The hospital is housed in its own two storied building having a covered area of 5000 sq. ft.. MNC has accommodation for 30 beds, suitable surgical and therapeutic equipment are available for providing eye care. The hospital has a minibus for outreach activities and transportation of patients identified with cataract to the base hospital for surgical intervention.
Physicians/Staff: There are 30 full time/part time workers at the MNC hospital. These include one full time doctor, nurses, paramedical staff and non-clinical personnel. The physicians are well supported by a multitude of staff members such as nurses, refractionists and technicians who actively participate in the health care team
Work Times: The hospital works six days (Mon-Sat). Patients usually come at 9 a.m. and the work day ends at 5 p.m.
Food: Breakfast, lunch and dinner are also provided free of cost to the patients and their attendants. On an average food is provided to 30 numbers of people per day at MNC.

 

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