AP Projects

  • Introduction
  • Activities & Achievements
  • Case Study & Photogallery

Introduction

LEPRA PREVENTION OF PARENTS TO CHILD TRANSMISSION PLUS OUTREACH WORK PROGRAMME
PPTCT plus project is an outreach programme which focuses on reaching out mainly antenatal cases, infected ANC and PNC cases, infected and affected children and affected families. The intervention has been planned to bridge the gap between the target segment and PPTCT Programme through it’s out reach component and in the process minimize the rate of transmission of infection from parents to child.
In 2006, LEPRA India & Network of People Positive, Hyderabad, with the support of APSACS under GFATM round II has implemented the PPTCT out reach programme in all the slums, UHCs, PHCs, AWCs, NGOs, GOs, Self Help Group members, Union members, and Youth Association members apart from the sensitizing of hospital staff. At present PPTCT Plus is working in 8 Districts of Andhra Pradesh namely, Ranga Reddy District Mahaboobnagar, Adilabad, Medak, Bodhan, Hyderabad, Srikakulam, Secunderabad and Nuzvidu at Krishna District.
Aim
To enhance the access to HIV services among general population & promote follow up services for the positive women.
Objectives:
  • To enhance institutional positive deliveries

  • To nurture positive mothers with child rearing information

  • To increase linkages for Positive cases  management by enhancing follow up services

  • To work towards developing sustained linkages at the community level.

  • To effectively implement Nave rapine administration in institutional & non institutional deliveries

 

Case study – 1 

Leela a 22 year old woman married to Ravi, a driver, since last three years. Their life was a smooth and happy till Leela conceived her first child. The couple belong to Khammam and came to Hyderabad after their marriage, here Leela got pregnant. She was prescribed some routine tests including HIV test. She tested negative. However the baby was born dead. Leela got pregnant for the second time, in the 3rd month of her pregnancy she underwent HIV test and at that time she tested positive. Her husband also tested positive. Their dreams were shattered; they were not ready to reveal their HIV status to their parents. They were utterly depressed they were worried about their unborn child, they wanted it to live. At that point they met Ms. Surekha a Senior Outreach worker under the PPTCT plus Project. Ms. Surekha counseled them and provided emotional support to them. She informed them about the proper nutrition, hygiene, safe sex and treatment for opportunistic infections. She also told them about Nevirapine administration and how it can reduce the chances of their child being positive by 80%. They got a new lease of hope. The couple was happy and shared their problems with Ms. Surekha. They followed her advices and went for regular check ups. Leela delivered a baby and NVP was administered. She was informed about the effects of breast feeding. Leela wanted to breast feed her child. She was provided with a baby kit and explained about the immunization and the HIV test for the baby when he is 18 months old. At present the baby is 5 months old. Leela and her husband have accepted their status and have been motivated to take a positive look at life. They are leading a happy life they come to the drop in center regularly for treatment and also attend all the meetings organized under the PPTCT plus project.

Case study –2

Ventrapati Sujatha w/o Venkagteshwara rao, aged 22 years old resident of Atlapragada of A.Konduru Mandal, Krishna, got registered as positive mother with PID No 1050/09/P00106 at FI ICTC A.Konduru Krishna Dt, on 9/11/09 mobilized by AASHA volunteer, denied HIV test report issued by Staff nurse which torn at the home by husband and stopped to visiting PHC for regular checkups by Medical officer and got tested PVT hospital at Kambhampadu again result was Non reactive followed based on report given at PVT hospital and refused when home visited by ORW, this issue brought to the notice of ORW during the staff meeting by concerned ORW, home visit done by her, while she was alone, explained her about difference test methods variation between PVT and ICTC labs and revealed importance a pregnant women go under HIV test at ICTC and mode of HIV transmission form Mother to child in the process of delivery and told her get test once at nearest ICTC and we would follow as per result, expressed her willingness to get retest at AH, Nuzvidu, and gave Phone number to her. After 20 days a call received from husband to get test, visited AH, Nuzvidu along with wife where blood drawn for HIV test and for other clinical investigations also in presence of ORW, took them medical officer for checkups, referred her scanning and expressed willingness to do delivery at the Institution, but both became reactive, there some doubts related to HIV/AIDS were clarified and medical officer referred her to GGH Vijayawada due to paralysis of nerves before and for further precautions during the delivery, intimated to concerned Coordinator of the PPTCT plus for support and NVP administration ,as per EDD this has to be delivered on 18/2/10 but got delivered normal on 19/2/10, both MB pairs received NVP administration at the institution.

Out come:

My interventions helped her of risk conditions for baby and by giving effective counseling and efforts (frequent follow up home visits, regular phone contacts) by me led to institutional delivery with NVP administration.

Photo Gallery

Advocacy meeting conducted for Medical officers and para medical staff in Chevella Division, R.R.Dist.

Nutrition distribution programme for Infected children in Nuzvidu Division , Krishna district

PPTCT Plus staff  health clinic 

 
  • Case Study

    Emerging Winners – A Story of Unity

    Mr. Shashank (name changed) is a thirty eight year old and hails from Brahmapuram village in Pedana Mandal, Andhra Pradesh. He is married to a beautiful young woman called Ms. Lalita (name changed) and they have two children. The first child is a fourteen year old boy, who suffers from Muscular Dystrophy and is unable to walk, while the second one is a girl, who is studying in the nearby village school.
    Mr. Shashank is a weaver by profession and is not very well to do, but together with his wife, they made ends meet and were a relatively happy family. However, his health began to deteriorate, as he would get fever and cough frequently. Worried about the state of his health, Mr. Shashank visited the nearby Government Hospital and tests showed that he was HIV positive. Shattered and upset, he did not know what to do. At a time, when most walk away, Ms. Lalita was a pillar of support to him.
    The doctor at the Government Hospital referred Mr. Shashank to the Community Care Centre in Assisi hospital on 5th February 2009 and was registered under Samastha-AP Project. Mr. Shashank met the Samastha project staff for the first time. Samastha is a rural HIV/AIDS prevention, care and support program funded by USAID implemented in Karnataka’s twelve high prevalent districts, three urban centers and five coastal districts of Andhra Pradesh (AP). The lives of many HIV positive persons have been changed through the project’s activities.
    Mr. Shashank was admitted to the hospital for two weeks where he underwent various tests to understand his current medical condition. Investigations showed that he was suffering from a co-infection and had abdominal TB. He was then referred to the DOTS center in Pedana for treatment of his TB in the abdomen.
    Within a month of starting the treatment, Mr. Shashank’s medical condition started improving. The project also provided him with regular counseling services and nutritional support, which enhanced his recovery. In the meanwhile, the staff suggested that even his wife and children get tested for HIV. As a result, all the three of them were sent for testing and they were found to be negative.

    While Mr. Shashank was recovering his health in hospital, the family began to face a financial crisis, as he was the bread-winner for the house. Ms. Lalita was finding it very difficult to manage the house and the children’s education with just one person’s salary. Thus, they requested for an IGP revolving loan to buy a hand weaving machine for a sum of Rs. 3000/-, which was provided for, by the Samastha project.

    Now Mr. Shashank and his wife are working with the new machine and making sarees as well as bed-sheets and selling it in the market. They earn enough to maintain their family and their children’s education is being looked after by the Samastha-AP educational funds. Despite all the turbulence in their lives, this family has emerged as one unit and is grateful to the project for all the support.
    At the End of Every Long Night, There is Always Dawn
    Ms. Janaki is twenty five years old and her husband is Mr. Bhaskar (names changed). The couple hails from a small village in Pedana Mandal, Andhra Pradesh and have two children. The boy, Sree is five years old and is studying in the first standard, while the girl Anisha, is seven years old and is studying in the second standard (names changed).
    Mr. Bhaskar would frequently fall sick and one day, he died. After her husband’s death, Ms. Janaki also began to have recurrent fever and body pain. She was taken for treatment and was diagnosed as being HIV positive at the Government Hospital in January 2008. She was depressed and refused to take any treatment, despite many suggesting that she should not delay it any more.
    Ms. Janaki was scared of being stigmatized and discriminated against and as a result, she wanted to keep her positive status a secret. It was around this time, when she first heard of the Samastha project. Samastha is a rural HIV/AIDS prevention, care and support program funded by USAID implemented in Karnataka’s twelve high prevalent districts, three urban centers and five coastal districts of Andhra Pradesh (AP). The lives of many HIV positive persons have been changed through the project’s activities.

    The Samastha project outreach workers (ORWs) visited Ms. Janaki in her house. She was very hesitant and did not entertain them. But gradually, as the ORWs made regular visits, she began to trust them. Finally, after immense efforts, Ms. Janaki was ready to break the ice. She agreed to visit the Assisi Hospital, get registered in the Samastha project and started taking treatment.
    Ms. Janaki now actively follows up her medication and has become a member of a support group. She also regularly attends these support group meetings, which give her immense strength to deal with all the challenges posed by life. Even though her life had turned a new leaf, she was under going a major financial crisis. Her salary, which came as a daily wage laborer working in a Kalamkari cloth printing factory, would not suffice in running the household and looking after the several needs of her children. Ms. Janaki therefore expressed her wish to get a loan from the Samastha project to facilitate an increase in income. As a result, she was granted a sum of Rs. 3000/- as a revolving loan. Currently, she is doing the Kalamkari work in her own house and earns anywhere between Rs. 80/- to Rs. 100/- per day and manages to run the household successfully.
    Photo Gallery
    APD, APSACS inaugurated IMAI training program PD, APSACS interacting with team of Samastha & CCC in Krishna
     
    Advocacy with DAPCUs Facilitation on Infection Prevention practices
     
    Support group meetings with PLHIV ADMHO & DPM in Samastha training

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.

 

Photo Gallery