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  • 1. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI Report on Implementation The First IMPACT in Rajasthan July 2008 to March 2009 TB Project GFATM Rd -4 CTD-CBCI-CHAI Yr 2008-2009 In Partnership with –State Program Committee(TB) & State Health Society, Rajasthan
  • 2. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI Acknowledgements The credit for the achievements of the project during the first FinancialYear of implementation in the State of Rajasthan is shared by the leaders &functionaries of the RNTCP team in Rajasthan as well as those of the CatholicHealth, Social & Education Networks. The constant inputs from the Central TBDivision and the Health Commission of The Catholic Bishops’ Conference ofIndia as well as concerted support from the Catholic Health Association of India &the RUPCHA Regional office have helped to pave the way & to move towards theattainment of the project objectives.Sincere thanks are offered toDr. L S Chauhan, DDG TB, Dr Shruti Sehgal, Consultant CTDDr K N Gupta, the State TB Officer, Rajasthan, all the officers at the State TB Celland the STDC, Ajmer, Distinct TB Officers and other officers at the District TBCentres, MO-TCs and their teams of STS & STLSRNTCP Consultants of Rajasthan- Dr S K Sinha, Dr Vivek Mishra, Dr UmeshAlavadi & Dr Simi Roy MisraMost Rev Ignatius Menezes, Most Rev Joesph Pathalil and Most Rev OswaldLewis, the Bishops of Ajmer, Udaipur & Jaipur, respectively, the Social directors ofall Diocese, the Fathers , Sisters & the team of animators and other field workersFr Sebastian Ousepperampil, Fr Mathew Abraham and Dr John Tharakan forconstant support & encouragement. Mr. Sebastian Kunneth for facilitating theinitial meetings with the Member Institutions. The CBCI & CHAI offices foralways being there and for their prompt troubleshooting.Dr Reuben Swamickan for providing leadership & direction, and the State TBProject Consultants from all the other States for sharing their experiences,perspectives and approaches.Thanks to all members of “The Team” Dr Neerja Arora State TB Project Consultant, RajasthanYr 2008-2009 Page 2
  • 3. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI IndexS.No. Subject Page No1 Introduction to the Project 4-52 Infrastructure in Rajasthan, Listing & Contacting 63 Possibilities of Involvement of Centres of Catholic 7-8 Health & Social Networks4 State Level workshop on Launch of the project in 9-12 Rajasthan5 Current Status of Involvement 136 Sensitisation Sessions 14-157 Training Sessions 16-178 Implementation as per Action Plan 189 ACSM- Community Meetings, Group 19-31 Sensitisations, School Activities Community Meetings 19 9A Domestic Workers’ Union 20-21 9B Roman Catholic Diocesan Service Centre, Ajmer 22 9C St Francis Hospital, Ajmer 23-24 9D Success Stories 25-27 9E World TB Day Activities 9F Sarvadharma Maitri Sadan, Community Meeting 28 9G School Activities 29-3110 Annexure Ann.1- Contact Information of Member Institutions 32-34 Ann.2- Summary of School Activities 35-36 Ann.3-DOTS Story- DOTS dh tknqbZ dgkuh 37-40Yr 2008-2009 Page 3
  • 4. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI Introduction to the First IMPACT Project(The First Innovative Mobilization of Private Actors & Church against TB) This project has been launched with the objective of improving the accessto the diagnostic and treatment services provided by the RNTCP within andthrough the Catholic Health Network and thereby improving the quality of carefor patients suffering from Tuberculosis in India. For this project the HealthCommission of the Catholic Bishops Conference of India (CBCI-HC) haspartnered with the Central TB Division (CTD) under GFATM Round IV. Theproject will be implemented in 11 States of India in the first phase. Theimplementation will be through Member Institutions (MI) of Catholic HealthAssociation Of India (CHAI) in 7 States (Andhra Pradesh, Assam, Chhatisgarh,Jharkhand, Karnataka, Orissa, and Rajasthan) & MIs of Catholic ReliefServices (CRS) in 4 States (Bihar, Madhya Pradesh, Uttar Pradesh, and WestBengal).The Catholic Healthcare Network in India consists of about 5,994 health carefacilities, 85% of which are in rural areas. The Catholic Nurses Guild of Indiaand the Sister Doctors Forum of India have about 40,000 & 600 membersrespectively. Almost all facilities in the Catholic Health Network (CHN) come incontact with patients having TB. Though at present accurate data on thenumber of patients catered to by the CHN are not available, there is no doubtabout the need for better services and access to treatment for people having TB. The Catholic Health Association of India (CHAI) was established in theyear 1943 and has its Headquarters in Secunderabad (AP). It is the world’slargest NGO working in the health sector. CHAI has 3273 Member institutes(MI’s) under 11 Regional Units (RU) across India. The RU for Rajasthan isRUPCHA (Rajasthan & UP Catholic Health Association), which caters to MIsin 9 Northern States and has Headquarters in New Delhi. CHAI’s Thrust areasare in the field of Community Health, Communicable diseases includingHIV/AIDS and Disaster intervention.Yr 2008-2009 Page 4
  • 5. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAIThe project has been modelled with the following features:-  RNTCP services will also be  The MIs will be involved extended through the MIs of under appropriate RNTCP CHN. Schemes for NGOs  CBCI- Health Commission  All identified centers will will be main coordinator and participate in Awareness CHAI and CRS will be the programs, serve as Referral implementing partners centers for TB suspects and most MIs will serve as DOT  The MIs of CHN will provide Centres better access to RNTCP services in the areas of their  Larger centers can become activity especially in remote, DMCs / TUs rural & tribal regions.  There will be optimal resource utilization from CBCI and RNTCPExpected Value addition by the RNTCP- CBCI partnership  Number of new TB of facilitators & patients detected will material from RNTCP improve substantially in and facility & provider areas of activity as network from CBCI more institutions partners become part of RNTCP  The MIs will facilitate and there is distribution of uniform strengthening of the IEC material from the involved centres. RNTCP throughout the  Defaulter rate will network and in the field decrease significantly  All MIs will facilitate due to improved access diagnosis & provide & acceptability of the drugs as per RNTCP RNTCP services, Guidelines and follow especially in under- RNTCP in letter & served & difficult to principle. reach areas.  Training of Health Care providers through RNTCP modules will be conducted with the helpYr 2008-2009 Page 5
  • 6. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI Infrastructure in Rajasthan- Listing & Contacting The State of Rajasthan includes three Catholic Dioceses. The Ajmer diocese includes the districts ofAjmer, Barmer, Jalore, Jaisalmer, Pali, Jhalawar, Jodhpur, Sirohi, Tonk, Kota, Baran and Bundi. The JaipurDiocese includes Jaipur, Ganganagar, Hanumangarh, Bikaner, Jhunjhunu, Churu, Sikar, Alwar, Dausa,Karauli, Nagaur and Sawai Madhopur and the Udaipur diocese includes Udaipur, Banswara, Bhilwara,Chittaurgarh, Dungarpur and Rajasamand At present there are 66 listed Catholic Health Care Facilities in Rajasthan, 55 in Health Sector + 11in Social Sector)Type of Institution/ Ajmer Jaipur Udaipur RajasthanName of DioceseHospitals 15 1 6 22Dispensaries & Health 8 5 11 24CentresNursing Schools 1 0 0 1Rehabilitation centers 2 1 0 3for disabledHome for the Aged 0 1 0 1Counseling Centres 2 0 0 2Home for the 0 1 0 1terminally illCare Homes for 1 0 0 1PLWHASocial-work Centres 2 2 7 1157 Catholic Health Care Facilities were listed in Rajasthan in CBCI Health Directory 2008; more centreswere added to the list- 11 from the Social Sector and 1 from health sector. 3 names were listed twice underdifferent categories and the duplicity was discounted. Hence there are presently 66 listed centres.12 centreshave been found to be either non-functional or present in the same premises or adjacent to another CHNcentre or Government centre hence suitable only for Referral of patients and may not be signed under any ofthe existing RNTCP Schemes, as per the decision taken by the DTO after their preliminary visits. 5 centreshave not been visited yet hence their suitability has not been ascertained. Therefore presently 49 centres aredeemed to be eligible for involvement under new RNTCP SchemeYr 2008-2009
  • 7. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI Possibilities of Linkage of MIs under Revised RNTCP NGO-PP Schemes 1. Referral & DOT Centres & Sputum 5. Designated Microscopy Centres- St Collection Centres- All institutions Francis Hospital-Ajmer, Holy Family Hospital-Kota, St Teresa’s Hospital- 2. School & Church Activities- All Udaipur institutions 6. Urban Slums Scheme – Kiran 3. ACSM Scheme- Domestic workers Union, Udaipur and i. Social Networks in Ajmer, Dausa, Karuna Domestic Workers Union, Banswara and Udaipur Udaipur, ii. St Francis School of Nursing, Ajmer which 7. TB-HIV Scheme- Asha Niketan, has also included Kanakheri, Holy Family Hospital, Kota RNTCP in curriculum 4. Sputum Transportation Scheme in 8. Adherence Schemes with DOT Kota, Banswara and Ajmer Provider networks in Ajmer, Bandikui, Banswara, Udaipur Clockwise from top left- Meeting with Bishop of Ajmer, DTO Kota during field visit to slum area in Kaithoon with sisters, DTO Banswara meeting a patients at Amlapadi centre, DTO Jaipur during visit to Mother Teresa’s centreYr 2008-2009
  • 8. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAIYr 2008-2009
  • 9. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI Report on the State Level Workshop organised on the occasion of Launch of “The First IMPACT Project” in Rajasthan At Jaipur on 27 th August 2008 In accordance with the PIP of the First IMPACT Project & the detailed Action Plan for theState of Rajasthan, prepared at the time of National level meeting in New Delhi on 6th & 7th July2008, in consultation with the State TB Officer Dr K N Gupta & WHO Consultant Dr S K Sinha; aState level Workshop was organised to officially launch “The First IMPACT Project” in Rajasthan.This workshop was jointly organised by the State TB Cell, Rajasthan & the Catholic HealthAssociation of India (CHAI), Rajasthan office, with support from the Central TB Division (CTD) ofthe Government of India & the Health Commission of the Catholic Bishops’ Conference of India(CBCI-HC). The workshop was expected to provide a platform for the meeting of the State authorities &District programme managers with the dignitaries of the Catholic Church of Rajasthan andrepresentatives of the Catholic Health & Development Network to deliberate and collaborate uponthis joint Public-Private- Partnership initiative.The definitive objectives of the workshop were- 1. To orient the Catholic Health Facilities and District TB Officers about the First IMPACT TB Project 2. To orient the Catholic Health Facilities about the RNTCP and the need of involvement 3. To explore the possibilities of involvement with RNTCP under the Revised Schemes for NGOs and Private Providers 4. To prepare a broad action plan for the involvement process.Venue: The workshop was organised in at the Club Lounge in Hotel Golden Tulip in JaipurParticipants: The workshop was well attended by representatives from the Government of Rajasthan,including the Chief Guest- Director of Medical & Health Services, Dr.O.P. Gupta; the State TBOfficer- Dr K N Gupta; DTOs of Dausa, Jaipur & Kota and the State TB Cell officials. Dignitaries from the Church of Rajasthan included the Guest of Honour, Most Rev. IgnatiusMenezes- Bishop of Ajmer, the Special Guests, Most Rev. Oswald Lewis-Bishop of Jaipur and Sr.Isabelle- Provincial Superior, FSMA. The Directors of Social work from Ajmer, Banswara & Dausa & Sisters from CatholicHealth & Development Network participated in the proceedings Sr Augusta & Sr Sunita represented CHAI & RUPCHA and Sr Maria Joseph representedCARITASYr 2008-2009 Page 9
  • 10. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI Dr Mala Srikanth & Dr Shruti Sehgal, both WHO Consultants from Central TB Division; andDr Sanjay Sinha, Dr Vivek Mishra & Dr Umesh Alavadi, all RNTCP Consultants of Rajasthan, alsoparticipated in the workshop Dr Reuben Swamickan, National Coordinator, First IMPACT Project, CBCI-HealthCommission; Dr Kalpesh Rahevar, Regional Coordinator, CHAI and Dr Neerja Arora, StateCoordinator, Rajasthan facilitated the activities with the support of Mr Shaju & Mr. Antony ofRUPCHA, DelhiInauguration: The workshop was inaugurated with a hymn sung by Sr Pushpika followed by a reading fromThe Bible by Sr Sunita and the lighting of the inaugural lamp by the dignitaries on the dais. Theguests were given a floral welcome by the Sisters. Dr K N Gupta, State TB Officer, Rajasthan, welcomed all the participants. He shared that theState had recognised the strength of the Catholic Health Network and had already initiated itsinvolvement as a PPM initiative. The First IMPACT Project will strengthen the process of linking themember institutions with the RNTCP network. The Guest of Honour, Most Rev Ignatius Menezes, Bishop of Ajmer related his experiencesregarding the reach of Catholic Health Network in remote areas and the challenges encountered inthe service of the poor & the sick. He reiterated the commitment & dedication of the nursing sisterstowards this noble cause. The Special Guest, Most Revered Oswald Lewis made a thought provoking speech on theapplication of the religious learning for the service of mankind, specially in relevance to the personssuffering from Tuberculosis Sr Augusta, Director of St Francis Hospital, Ajmer, which is already doing remarkableservice under the RNTCP Scheme of DOT Provision, put across facts & figures from the Hospital’slong association with the programme. The Chief Guest, Dr O.P Gupta, Director, Medical & Health Services, Government ofRajasthan, congratulated the gathering on the beginning of a new era in the Public- PrivatePartnership and, having been closely associated with the programme in the State over many years,expressed his confidence that this will add to the consistent list of achievements of RNTCP inRajasthan.Scientific Session: The Scientific Session included presentations covering the following topics 1. Revised National TB Control Programme - An Introduction: by Dr Sanjay Sinha 2. First IMPACT TB Project - An Introduction: by Dr Reuben Swamickan 3. Catholic Health Association of India- An Overview of Activities: by Dr Kalpesh Rahevar 4. Challenges in RNTCP: by Dr Mala Srikanth 5. Status & Achievements of RNTCP in Rajasthan – Role of CHN & Role of DTOs in the First IMPACT Project: by Dr K N Gupta 6. Situational Analysis & Field Experiences by Dr Neerja AroraYr 2008-2009 Page 10
  • 11. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAIPost Lunch Session on new NGO-PP Schemes: The post lunch session was reserved for the deliberations on the CTD guidelines regardingthe involvement of NGOs & PPs under new RNTCP Schemes Dr Shruti Sehgal made a comprehensive & interactive presentation about the new NGO-PPSchemes.Group Work on preparation of Action Plan: The participants then segregated into district-wise groups to discuss the feasibility ofinvolvement of the different Health & Developmental facilities under the various Schemes and toframe Action Plans for the speedy, efficient & effective involvement with the RNTCP. Each groupconsisted of the representatives from Catholic Health/ Social facilities, DTO/ State TB Cellrepresentatives & the WHO Consultant, responsible for the district. The outcome of the group-workwas the on-the-spot submission of 24 proposals from catholic institutions in 7 districts of Rajasthanfor involvement with RNTCP. The proposals from the remaining centres will be submitted byOctober 2008. The submitted proposals were forwarded by the State TB Cell to the respective District TBCells with the direction to organise visits to the centres, to assess the suitability of the centre withrespect to the need of the programme and the eligibility for the Scheme/ Schemes applied for. TheActivities planned include the training of the DOT Providers/ Community Volunteers for the eligibleDOT Centres by October 2008 and LTs & MOs for DMCs at the earliest. Prompt action has beenadvised on receipt of future proposals as well. The service delivery of RNTCP services will startimmediately after fulfilling of eligibility criteria. A Memorandum of Understanding will be signed between the District Health Society & theNGO applying for involvement, as per the Revised NGO-PP guidelines.Closing Ceremony: The meeting concluded with a vote of thanks to all invitees, participants &facilitators.Report Submitted by:Dr Neerja AroraState TB Project CoordinatorFirst IMPACT Project, RajasthanYr 2008-2009 Page 11
  • 12. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAIYr 2008-2009
  • 13. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI Current Status of Involvement under NGO-PP SchemesDistrict-wise Status of Project Implementation in Rajasthan upto March 2009(No. in bracket indicates ineligible centres)(?) indicates centres not visited yetName of the No. Of No. Of No. Of Centre with No. Of DHS No. Of ServiceDistrict Listed proposals Centres only Centres approval MoU Delivery M Is submitted with sensitisation visited under Signed ongoing Trained by process DOT DTO / Providers MOTCAjmer 16 (4) 14(2) 15(4) 1 15(3) NA 9 3Alwar 2 1 0 1 1 1 0 0Barmer 1(?) 1 0 0 0 0 0 0Banswara 11 9 11 0 11 9 0 2Bhilwara 1 0 0 1 1 0 0 0Bikaner 2(?) 0 0 0 0 0 0 0Dausa 2 1 1 1 1 1 0 1Dungarpur 2 2 2 0 2 2 0 0Jaipur 2(1) 1 2(1) 0 1 NA 1 1Jaisalmer 1(?) 0 0 0 0 0 0 0Jodhpur 1(?) 0 0 1 0 0 0 0Kota 8 7 7 1 8 7 0 5Sikar 1 1 0 1 1 0 0 0Sirohi 4 (3) ? 0 0 0 0 0 0 0Udaipur 12(4) 8 8(2) 4(3) 6 5 0 0 66(12 Total +5?) 45(2) 46 (5) 11(3) 47 (3) 25 10 12 Yr 2008-2009 Page 13
  • 14. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAIList of Sensitisation Sessions organized upto 31st March 2009 Name of No. of Diocese/ No. No. of para-S.No Date Place Region sensitised Doctors medicals St Pauls School, 1 29/7/08 Udaipur Udaipur 16 0 16 Kota Stone Marium 2 6/8/2008 Hospital Ajmer 7 1 6 Jeevan Deep, 3 7/8/2008 Banswada Udaipur 37 0 37 RUPCHA AGBM-CME 4 22/8/08 Delhi for nurses 50 5 45 State level Launch Golden Tulip workshop , 5 27/8/08 Hotel, Jaipur jaipur 53 23 30 Christ Raj 6 5/9/2008 Ashram Ajmer 4 0 4 7 15/9/08 Madri, Udaipur Udaipur 10 0 10 8 16/9/08 Jhadol, Udaipur Udaipur 6 0 6 9 16/9/08 Oghna, Udaipur Udaipur 5 0 5 Sensitisation Workshop for NGOs & Heerabagh, PPs of 10 11/11/2008 Jaipur Jaipur 48 10 38 St Francis Hospital, 11 20/11/08 Bandikui Jaipur 11 0 11 St Xaviers 12 9/12/2008 School, Bhiwadi Jaipur 16 0 16 Sewa Sadan, Seemalwada, 13 11/12/2008 Dungarpur Udaipur 8 1 7 Jeevan Deep, 14 12/12/2008 Banswada Udaipur 30 0 30 St Pauls School, 15 21/12/08 Udaipur Udaipur 40 0 40 St Marys School 16 17/2/09 Dispensar. Sikar Jaipur 4 0 4 Jeevan Deep, 17 19/3/09 Banswada Udaipur 27 0 27Yr 2008-2009
  • 15. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAIYr 2008-2009 Page 15
  • 16. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI RNTCP Modular Training organised forCatholic Health Network-upto 31st March 2009 Name No. ofS.N of No. No. of para-o. Date Place Diocese Trained Doctors medicals Jeevan Deep, 1 8/8/08 Banswada Udaipur 36 0 36 Kota Stone Marium 2 22-23/9/08 Hospital, Kota Ajmer 11 2 9 Holy Family 3 24-25/9/08 Hospital, Kota Ajmer 18 0 18 St Francis Hospital, 4 26-27/9/08 Ajmer Ajmer 47 0 47 5 20-21/9/08 DTC, Jaipur Jaipur 2 0 2 Training of STS & STLS at DTC Jaipur in “compilation & preparation of RNTCP Quarterly 6 22/9/08 PPM Reports" Jaipur 27 3 24 14- Mother Teresa 7 15/11/08 Ashram Jaipur 1 0 1 St Pauls 8 9-10/1/09 School Udaipur 38 1 37 Total Training Sessions 8 Total Persons Trained 174Yr 2008-2009 Page 16
  • 17. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAIYr 2008-2009 Page 17
  • 18. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI Activities undertaken as per the State Action Plan up-to 31st March 2009S. No. Activity Status of implementation Line listing of MIs, Situational Analysis & Prioritisation for 1 involvement Completed Organisation of State Level 2 Workshop Completed Sensitisation of staff of MIs of 17 Sesnsitisation Sessions held to-date, several one-to one 3 CHN sensitisations held Submission of proposals for 45 centres have submitted the proposals ( including 2- not involvement under RNTCP eligible & 1 not visited) 10 social centres & 3 health centres yet 4 Schemes to submit proposals, 11 centres not eligible 60 centre have been visited by STPS, 44 centres have been visited by DTO/MOTC. All centres in the respective districts have been visited by DTOs/MOTC of Ajmer, Bhilwara, 5 Visit of MIs by DTOs Banswara, Dungarpur, Kota, Jaipur, Sikar, Dausa & Udaipur 8 sessions of Modular Training for DOT Providers have been facilitated. Most of the centres in Banswara, Kota, Jaipur & Ajmer have trained DOT Providers in place. 46 centres have trained DOT Providers One session of “Training of RNTCP personnel at DTC Jaipur in “compilation & preparation of RNTCP Quarterly PPM Reports" 6 Training of staff of CHN facilitated. 174 persons have been trained under the project MoUs signed after DHS approval for 10 centres- 1 in Jaipur & 9 in Ajmer 25 proposals are under process to be signed after 7 Signing of MoUs approval by respective District Health Societies Initial supply of drugs & Immediately after signing of MoU and before start of service 8 logistics delivery. 12 centres are functioning as DOT Centres- 1 in Jaipur, 1 in 9 Service Delivery Dausa, 5 in Kota, 3 in Ajmer & 2 in Banswara Drug Supply, Recording & Reporting and Supervision & 10 Monitoring In place in centres where service delivery has started Yr 2008-2009 Page 18
  • 19. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI Community Meetings on RNTCP_DOTS organised by Catholic Health & Social Networks in Rajasthan-upto 31st March 2009 Name of RNTCP Resource No.S.No Date Organiser Place Diocese person Sensitised Kiran Dr Dinesh Kothari -DTO, Domestic Dr Simmi Misra-consultant, Workers Ms Sanjana-IEC Officer, Union, Sr Kirti, Dr Ravi-Alert, Alert 1 11/1/2009 Udaipur Gramin Haat, Udaipur troupe, Dr Neerja-STPC 1200 Karuna Domestic Government Workers School, near Dr SN Jakhetia-DTO, Dr Union, Krishna Kataria-DTC, STS, STLS, 2 18/1/2009 Bhilwara Hospital Udaipur TBHV, Dr Neerja-STPC 250 Abdul Waheed Abdul Waheed Hospital, Hospital, Dr SN Meena, Mr Ganesh 3 18/2/2009 Kotarhi, Kota Kotarhi, Ajmer STS, Sr Wilcy 52 Jeevandhara Balaji ka Samaj Kalyan mandi, Sanstha, Jatwara, 4 7/3/2009 Jaipur Bassi, Jaipur Jaipur Dr Neerja Arora, STPC 400 St Xaviers ST Xaviers Social Service School, STS Mr Satpal Chaudhary, Centre, Bhiwadi, STLS Mr Padam Singh, 5 8/3/2009 Bhiwadi Alwar Jaipur Fr Jabamalai 300 RCDSS DOT RCDSS, 6 21/3/2009 Centre Madar Ajmer Sr Kusum PSA 33 RCDSS DOT RCDSS, 7 22/3/2009 Centre Madar Ajmer Sr Kusum PSA 45 Dr Dinesh Kothari -DTO, Maitri Sadan Macchla Ms Sanjana-IEC Officer, & Kiran, Magra slum Fr Norbert, Sr Kirti, 8 22/3/09 Saveena cluster Udaipur Mr Anoop STS 200 RCDSS DOT RCDSS, 9 27/3/2009 Centre Madar Ajmer Sr Kusum PSA 12 St Francis of Dr SN Sharma, MOTC Assissi Bandikui, Mr Sushil Kumar, Hospital DOT Nayavas, STS, Sr Teena PSA, 10 28/3/2009 Centres village Jaipur Mr Raghuvir 72 Yr 2008-2009 Total Meetings 10 Total Persons sensitised Page 19 2564
  • 20. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI Involvement of National Domestic Workers’ Movement with RNTCP & CBCIThe National Domestic Workers’ Movement was established in 1985 in Mumbai,(Maharashtra) in India by Dr. (Sr.) Jeanne Devos. Sr. Jeanne is a Belgian missionary who firststarted work with domestic workers back in 1966 in the state of Tamil Nadu, India. From a smallestablishment in Mumbai, the Movement has spread into 23 states, organizing domestic workers,building their capacity for efficiency of work and awareness of rights and providing a platform tovoice their struggles and demand for dignity of labour and proper legislations that will benefittheir workforce. To this end, domestic workers in the different states of India are organized intogroups and a strong solidarity is created, where, together, the women can stand up for justice andrights of domestic work. Regular meetings and training sessions are conducted to help build theconfidence of the women not only in the work but also in them. Leaders are drawn out fromthese groups to help carry the work of the Movement deeper into their areas, further organizingwomen of the trade. The National Domestic Workers’ Movement is endorsed by the Catholic Bishop’sCommission of Labour (CBCI)Sources: http://www.domesticworkerrights.org/ http://www.ndwm.orgMerging of Synergies- Involvement of CBCI with RNTCP in Udaipur andBhilwara districts of RajasthanThe Rajasthan Chapter of National Domestic Workers’ Movement has taken root through thetireless efforts of Sister Kirti, PSA, who belongs to a CBCI-HC member institution “St TeresaVidya Deep” in Udaipur. Sr Kirti is the State Coordinator of the movement in Rajasthan. Shehas been instrumental in collecting the Domestic Workers under a united umbrella organization-:” KIran”- Domestic Women Workers’ Union. Presently there are about 2000 members inUdaipur & about 500 members in Bhilwara Districts. The workers hail from Slum bastis in andaround city and are working in households scattered all over the city.A sensitization session on RNTCP was organized for 40 Leaders on 21st December 2008from the Udaipur group jointly by DTO Udaipur and CBCI-HC. The DTO spoke to them inthe local “ Mewadi” dialect. Since many of them cannot read properly, pictorial flipcharts,courtesy ALERT Sansthan were provided to them as take-home literature. Some of the Leadershave now also been trained as DOT Providers with view of opening DOT Centres in the slumareas inhabited by them.A large scale meeting organized by Sr Kirti on 11th January 2009, served as an ideal platformto convey the key messages of TB control through DOTS, to a gathering of about 1200Domestic Workers. The DTO, Dr Dinesh Kothari, spoke to them in a simple & effectivemanner. His talk was followed by a cultural programme by tribal artistes belonging to AlertSansthan, an NGO focusing on RNTCP ACSM activities in Udaipur. The tribal artists held theaudience spellbound with their songs, dances and skits conveying the salient messages in anYr 2008-2009 Page 20
  • 21. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAIunforgettable manner. The event turned out to be an epitome of inter-sectoral co-ordinationwherein the merging of synergies resulted in an outstanding outreach activityAnother such meeting was organized by Sr Kirti on 18th January 2009 under the aegis of“Karuna” Domestic Workers’ Union in Bhilwara. The meeting was well attended by about250 members of the union, local politicians, Lioness Club Members and Doctors & Field staff ofDistrict TB Clinic, Bhilwara. An IEC Display about TB & RNTCP DOTS was put up by theDTC and the DTO, STS and the STPC, Rajasthan discussed various aspects of TB disease & itscontrol through RNTCP with the gathering.Yr 2008-2009 Page 21
  • 22. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI RCDSS DOT Centre, AjmerThe Roman Catholic Social Service Centre at Madar, Ajmer has been associated withRNTCP since Yr 2002, More than 124 patients have been put on DOT at this centre which issituated in a sparcely populated area. During all these years there has not been a singlecase of default by a DOT patient. The secret of excellent case holding & treatment outcome isthe single-minded dedication of Sr Kusum, the DOT provider. The RCDSS also supports thenutrition of the TB patients.Sr Kusum has also been contributing towards Awareness generation about TB and its controlthrough RNTCP DOTS through organization of Community Meetings, School Activities &meetings of Self Help GroupsYr 2008-2009 Page 22
  • 23. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI DOT Centre at St Francis Hospital, AjmerSt Francis Hospital, Ajmer is a 150 bedded hospital and has 6 associated dispensaries and onehospice for HIV positive/AIDS cases. Involvement with RNTCP began in November 2000under NGO Scheme II and a DOT Centre was started at the hospital premises.From November 2000 till March 2009, 542 patients have received DOT at this DOTCentre.Sister. Sr. Dr. Melba, a physician, takes active interest in the programme. Sr. Daya, atrained nurse, supervises the RNTCP services. She is assisted by trained DOT providers and afield worker. Trainee nurses from the attached nursing college are also posted at the DOTCentre and interact with TB patients during their field work. A warm & loving care to thepatients receiving DOT, commitment to RNTCP guidelines and meticulous record keepingare the hallmarks of this DOT Centre. Sr Sunita, Principal, St Francis Nursing School,ensures that all the students have good exposure to the programme and are well equipped tocarry out mannagement of TB suspects & patients as per RNTCP guidelinesYr 2008-2009 Page 23
  • 24. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI DOT Centre at St Francis Hospital, AjmersYr 2008-2009 Page 24
  • 25. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI Success Story- RCDSS, AjmerSubmitted by Sr Kusum PSA, Roman Catholic Diocesan Social Service Society, Ajmer Case study Banshilal received new life Banshilal s/o Raibachan, age 40yrs.TB No. 195/08, Nehru Nagar Madar. Banshilal is from a BPL family. He is disabled due to hunch back. He is living with his wife & two children. Due to his disability he is unable to do hard work. So he does tailoring to earn his living. On January 2008 suddenly he became sick. Started fever with chill followed by cough. He took treatment from two doctors. But got no relief. Fever controlled but cough remained the same. The Doctor advised him for X-ray, Sputum test and blood test. The patient did the same. In the report proved that he is having TB & pleurisy. The doctor admitted him in the hospital for one week and did the treatment. After one week the doctor told him that you are having TB. So gave Referral form and discharged. His relatives brought him to RCDSSS DOTS center. The Patient was very week & and was not able to stand, depressed, disappointed and no hope to live. The DOTS provider took his weight. It was only 34 K.G. Gave him instructions and started DOTS treatment. This patient took the treatment regularly. Along with the medicines nutritious food also provided for him. Slowly his health improved. After six months completed the course and got cured from his sickness. His weight became 40 K.G. Now he is happy and grateful. He went back to his tailoring work and startedearning money. Mr. Banshilal is grateful to RCDSSS for his new life.Yr 2008-2009 Page 25
  • 26. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI Success Story- Mother Teresa’s Ashram, Jaipur The Mother Teresa’s Ashram in Jaipur has been involved with RNTCP very recently.From 3Q08 to 1Q08, 41 TB suspects have been referred for sputum examinations, 11 foundto be positive and 14 patients have been started on treatment at the DOT Centre. Zaffarullah Khan was taking treatment for his chest pains & general weakness whenone day he had severe back-ache and his legs gave away. He was diagnosed as havingdiabetes & TB spine at JLN Medical College, Ajmer. He had no family to take care of himand was abandoned as a crippled destitute on the pavements in Jaipur. He was in great painwhen he was brought to the Mother Teresa Ashram. Here he was provided tender and lovingnursing care and started on DOTS treatment. Zafar is a Commerce graduate and is very conscious about his health. Therefore he isregular with his treatment, follows the dietary advice for managing his diabetes and givesphysiotherapy to his legs. While he could not even turn in the bed without assistance at thetime of his admission, today after two months of treatment, he sits upright in the bed and canfeel power returning to his lower limbs. The Sisters at the Mother Teresa Ashram areconfident that he will start walking by himself within a couple of months. Zafar is sure that he will complete his TB treatment. After getting better, he has plansto stay back in the Ashram for few months & to provide his services to others like him.Yr 2008-2009 Page 26
  • 27. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAIAbdul Waheed Memorial Hospital, Chhawani, KotaAbdul Waheed Memorial Hospital, a well known maternity centre in the heart of the city ofKota has recently been involved under the RNTC P Adherence Scheme.. Within 6 months ofinvolvement 39 patients have been started on DOT. Sr Wilcy and other sisters take keeninterest in the treatment & welfare of TB patients inspite of their busy schedules. An awareness session organized at this centre with the full support of the District TB Clininc, on 18th February was attended by 52 persons . Dr SN Meena MOTC, Kota & Mr Ganesh, STS, Kota addressed the gathering and provided detailed information on various aspects of diagnosis & treatment of TB Ravi was seriously ill and admitted in the hospital with cough, fever and weakness. His body was absolutely limp and his mother had given up hope for his survival. Sr Wilcy visited him in the hospital and as she had undergone training in RNTCP, she was quick to suspect that he was suffering from TB. In fact Ravi had lost his father, sister and an aunt to TB. Sr Wilcy referred him to the District TB Centre, where his diagnosis was confirmed and Ravi was started on CAT I treatment at Abdul Waheed Hospital, Kotari, Kota. With regular treatment under the loving care ofSister Wilcy PSA of Abdul Waheed the Sisters, Ravi has recovered fast, gainedHospital,Chhawani, Kota with Ravi and weight and can now come walking &his Mother. running to the DOT Centre for his weekly visit to receive Continuous Phase TreatmentYr 2008-2009 Page 27
  • 28. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI World T.B. Day celebrated at Sarvadharma Maitri Sadan, Udaipur- a report International T.B. day was celebrated by inter-religious group members atMaitri Sadan. Dr. Norbert Herman SVD, the director of Maitri Sadan welcomedall the distinguished guests and the people gathered for the occasion. Dr. DineshKothari along with his team addressed Kachi Basti residents (slum) and madethem aware of the dangers caused by Tuberculosis. In his awareness speech hegave information about DOTs where a patient can get free treatment. The program hadcolorful Rajasthan Folk dances and street play to make people understand theseriousness of this disease and avail the free treatment at the DOTs centers inthe rural as well as slum areas of Udaipur. After the program a medical checkup was carried out for the people. Sr. Kirti proposed the vote of thanks.Yr 2008-2009
  • 29. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAI World TB Day- 2009 in Catholic SchoolsThere was a blitzkrieg of activities on the occasion of the WTB Day -Talks, Rallies,Storytelling, Drama, Drawing, Quiz, Essay writing etc were organised in 24 Schoolsacross the State, in which 6851 students participated enthusiastically. The facilitatorscomprised of personnel from the District/ TU and trained Sisters of the Catholic HealthNetwork. They were met individually by the STPC and various modalities forinvolvement of the students were discussed. A package consisting of DOTS Storybooklets, Drawing sheets, Certificates and prizes was provided for each school. A tokenamount was also provided to cover expenses such as postage & photography. There wasa hearty response from all stakeholders. All schools submitted reports on the activities,some included samples of students’ outputs and photographs too.Yr 2008-2009 Page 29
  • 30. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAIYr 2008-2009 Page 30
  • 31. The First IMPACT TB Project GFATM Rd -4 CTD-CBCI-CHAIYr 2008-2009 Page 31