MP Projects

  • Introduction
  • Activities & Achievements
  • Case Study

Introduction

Spandana Community Care Center (SPANDANA CCC)

People living with HIV/AIDS (PLHA) require a range of HIV services including care, treatment and support depending on the progression and stage of the HIV infection. The progression of the infection and consequent weakening of the immune system will result in PLHA being vulnerable to various opportunistic infections. The PLHA will require care and treatment for opportunistic infections (OI) and some of these illnesses may require in-patient care in a hospital or other centres that provide this facility.


Under the National AIDS Control Programme Phase- II, 122 Community Care Centres (CCC) were set up to provide treatment for minor OIs and provide psychosocial support through sustained counselling. CCC was intended to function as a bridge between hospital and home care. Hence, CCC was envisaged as stand-alone short-stay homes for PLHA. These were not linked to other activities of the programme. The introduction of Antiretroviral Therapy (ART) has brought about a change in the role to be played by the CCC. The CCC needs to be transformed from a stand-alone short-stay home to playing a critical role in enabling PLHA to access ART as well as providing monitoring, follow-up, counselling support to those who are initiated on ART, positive prevention, drug adherence, nutrition counselling etc. The monitoring of PLHA who do not require ART yet (Pre-ART care) will also be a critical function that needs to be carried out by CCC.


Under NACP III, it is proposed to set up 350 CCC over the period 2007-12. PLHA networks, NGO and other civil society organizations need to promote setting up of CCC to strengthen community care and support programmes. The CCC will be established on priority, in districts which have high levels of HIV prevalence and high PLHA load and will be linked to the nearest ART centre.

 
Areas of Operation : Indore district in Madhya Pradesh
 
 

Goal

To reduce HIV related morbidity and mortality in adult and children and mitigate the impact of HIV on children and women headed households.

Objective

• To provide clinical as well as psychological care and support
• To reduce the load on tertiary hospitals and provide cost effective Treatment.
• To introduce the concept of home-based care among PLHAs and their families.
• Helping them and their families to prepare for coping with life after HIV.
 
 
 
Case Study

Ms. Rekha (name changed) is 50 years old housewife. She continuously fell ill and got admitted in a private hospital for treatment. But the doctors found that the treatment was not working on her. They then advised her to go for HIV testing in the Integrated Counseling and Testing center. On July 2009 she was diagnosed of being HIV positive and also underwent CD4 count which was 359.
She approached Spandana CCC as outpatient case. She was counseled by CCC trained counselor and was advised to call her husband for partner testing. After the test her husband was found to be HIV negative. The couple was advised of safer sex practices in this situation of discordance in their status.

She was also treated for Opportunistic infection on STI. But her health was deteriorating; her CD4 testing in October was as 258. She was advised and put on ART treatment. She was then admitted in Spandana CCC where she received Nutritional and other counseling. Our Outreach workers actively monitor her drug adherence and carry out regular counseling. Last month in September her CD4 count has improved significantly to 428. She feels very happy now with her health and good support from her family.

 

Events

  • Mega Cataract Surgery Camp

    Mega Eye Surgery Camp held at Mahanadi Netra Chikitsalaya (MNC) in collaboration with the Zilla Swasthya Samittee & District Adminsitration of Sonepur from 20th to 24th January 2009. A total of 437 cataract surgery performed out of which MNC have done 260 cases. The District Collector & District Magistrate Aswathy S.,IAS inaugurated the camp with one women cataract patient at base hospital , Mr.Shyam Sunder Nayak, Addl.District.Magistrate and Dr.Harihara Dora,CDMO, Subarnapur were present in the inaugural session. In the valedictory session Mr. Jagannath Panda, Project Director, District Rural Development Agency (DRDA) & Mr.Arun Behera, Deputy Collector of Sonepur were present thanked to the surgeon Dr.D.K.Sahu, Dr.P.K.Patnaik, Mr.. N.K.Rath, Hospital Administrator and all staff of MNC.
    Philanthropist Meet at LMEH

    On 14th February 2009 a Philanthropist Meeting on Perspective Development of MNC was held at conference hall. Local Philanthropists, Snior Citizens & Members from Marwadi sangh of Subarnapur District had participated the meeting. Sri Er. Ajit Mohapatra, Hon’ble Board Member of LEPRA Society inaugurated the meeting and addressed the participants. Mr.S.Rath, F& AO and Mr. M.Ch.Mishra, Project Coordinator also participated in the meeting. Mr. Radheshyam Agrawal, a local philanthropitst agreed to construct a Dharmasala (Patients Attendant Rest Room). Many philanthropists assured to support the MNC in future. In this occasion free spectacles distributed to the 65 number of school children having refractive errors with socio- economic poor.

     
    External Evaluation
    A clinical review by an external consultant namely Dr. Anurag Mishra of JPM Eye hospital, Cuttack along with Mr. Sudipta Mohanty, Programme Manager of North East Area Office of SSI and a financial review by Ms. Bandana Srivastav of North East Area Office of SSI have been conducted by Sight Savers in September 2009. The project Hospital has been practising the clinical protocol circulated by the Sightsavers. The clinical review provided some more informations to strengthen the same practice in the hospital those are in the areas of patient counselling, few renovation measures in OT and OPD areas. The finance review supported in the process of streamlining the stock taking of different department in the hospital as well as it is strengthening the capacity of project staff in finance and administration.

    Inauguration of 2nd Vision center at Dunguripalli on 11th August 2009

    The 2nd Vision Center was inaugurated by Sri Ajit Mahapatra, hon’ble Board member, LEPRA Society at Dunguripalli of Subarnapur District on 11th August 2009 in presences of M.O. I/c, CHC, the CDPO, Dunguripalli,Director Orissa Region & Programme Coordinator of LEPRA Society.
    This vision center will cater the accessibility of primary eye care services to many blindness people who are living in the inaccessibility area.

    World Sight Day

    LMEH observed the Block wise Eye Care awareness rally on 8th October 2009 on World Sight Day in both the Subarnapur & Boudh District. The main objective of the programme of this year was to sensitize women group on eye care and the theme of World Sight Day 2009 (WSD09) was “Gender and Eye Health – equal access to care”. LMEH organized block level rally for women group and Girls High School Students in all 09 blocks of Subarnapur & Boudh District. The stakeholders supported in the progragramme are community based organization, Kalyani club, Youth Red Cross, SHG members and women group of different blocks participated and raised the awareness.
    Celebration of the Annual Day of the Mahanadi Netra Chikitsalaya
    The 5th Anniversary day of the Base Hospital was celebrated on 20th December 2009 in the Project Campus. On this auspicious day, a seminar on Childhood Blindness was organised participated by ophthalmologists, ophthalmic assistants, PHC medical officers, DPEP coordinators, school teachers and media persons of the area. In the after noon, a public meeting was conducted followed by cultural programmes. On the same Day, the donated Dharmasala (Rest shed for patient attenders was inaugurated. Prof. Nirnanjan Panda, Chairman of Western Orissa Development Council, Mr. Bhabani Sekhar Panda, District Magistrate/Collector of Sonepur District, Dr P.N.Senapati, CDMO, Subarnapur, Prof.Guna Sagar Dash, HOD of Ophthalmology & Superintendent of V.S.S Medical College Burla , Dr.P.K.B. Patanaik, State Leprosy Officer, Er. Sri.Ajit Mahapatra, Board member of LEPRA Society were the guests on this occasion.
    The Western Orissa Development Council (WODC) has contributed one staff quarter building and one Inpatients Building where post operative patients can stay, besides this a rest house has been donated by a local philanthropist for the visitor with the patients has been inaugurated on 20th December 2009 on the occasion of the Annual Day of the Project Hospital.

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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