AP Projects

  • Introduction
  • Activities & Achievements
  • Future Plans & Events
  • Photogallery


About the Project: Avahan is a focused prevention initiative funded by the Bill & Melinda Gates Foundation in 2003. Alliance for AIDS Action (AAA), AP, implementing Avahan in 14 districts of Andhra Pradesh and Nirmal is one of the sites. LEPRA India implementing Nirmal project since July-2005. Its key objectives are to reduce the prevalence of STIs among key populations (sex workers, and men who have sex with men); empower and mobilize individuals, groups and communities; and support the creation of an enabling environment through individual and organizational capacity building. So far more than 1293 key population members have been reached in Nirmal Site. To guarantee the long-term future of the Avahan projects, Alliance AP will hand over their management to the government in a phased process ending in 2012.
Nirmal site falls under district namely Adilabad. The interventions focuses on community mobilization, behaviour change communications, provision of commodities such as condoms, treatment of sexually transmitted infections through program operated clinics and safe space creation through drop in centre’s (DICs). The project has major five components:
1: Outreach, 2: STI management (Mytri Clinic), 3: CLSI (Community Lead Structural Intervention), 4: Advocacy and Networking, 5: Capacity building and Project Management

Project coverage area and Map:


About Site:

The catchment area of Nirmal site is one Nirmal mandal (Urban and Rural) covering 818 Female Sex Workers (FSWs) and 275 Men who have Sex with Men (MSM). The National Highway No. 7 passes through the site. There are 11 hotspots identified by the outreach team of the project. The site has one static clinic and one DIC. This intervention has 3 Outreach Workers (ORW’s) and 11 Peer Educators (PE’s) who are from the community.
Site Name FSW MSM Total





To contribute to the reduced spread and impact of HIV in Andhra Pradesh through empowerment of key population to manage sustainable community lelvel responses.
To improve knowledge, skills and access among KP’s to adopt safe sex practices through developing effective behavior change communication.
To increase the correct and consistent use of condoms among the sex workers and their clients through appropriate social marketing strategies.
  • To reduce the incidence and prevalence of STI among KP’S with improved diagnosis and treatment and thereby reduce their vulnerability to HIV/AIDS.
  • To strengthen referral services to ICTC, RNTCP and Community Care Centers.
  • To enable KP’s to respond to their sexual health needs and respond holistically to the external environment.
  • To provide and strengthen the capacity building of the staff on various programme related issues.
  • To envisage advocacy with all stakeholders to address problems, practice and behavior change
Future Plan
  • Reach out all the KPs through one to one contacts and groups to promote safer sex practices
  • More focus on condom usage with the regular partners also
    Correct and consistent use of condoms is ensured with a special focus on the high risk areas
  • Improve the social marketing condoms through the CBOs
  • Significant expansion and access to condom outlets through appropriate NGOs and CBOs
  • The abilities and capacities of the FSWs and MSMs would be enhanced with the support of CBOs for ensuring appropriate home / community/ institutional based quality care and support services.
  • Positive living would be inculcated, positive prevention and adherence to medication among the target group through awareness & trainings.
  • Mid-media, outdoor and radio would be extensively used to carry out the campaigns.
    Provide the qualitative STI treatment with the static clinic to KPs
  • Community led advocacy and lobbying and liaison with various line departments will enhance knowledge and understanding about various grass root level issues related to sex workers and PLHIVs and thereby responding to them through strategic decisions.
  • Events/Workshops:
During this year, we have conducted advocacy meetings with the IKP, Municipal elected members, Print Media and ICTC and DMC staff to strengthen the coordination and linkages for the better environment between community and other health and non health service providers.

  • Photo Gallery


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.


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