Areas of Intervention : Leprosy, Tuberculosis & Malaria.
The geographical location of the project is classified into 3 sub-divisions (Jeypore, Koraput and Malkangiri), 21 blocks and 6 NACs. There are 334 Gram Panchayat (GP) covering the said 6096 villages, out of which, 424 are situated in quite inaccessible areas.
The project was launched on the auspicious day of GANDHI JAYANTI, 2nd October 1991 as a vertical programme in leprosy service. In the beginning, the strategy was Survey Education and Treatment (SET). The identified cases were provided with MDT treatment through service delivery points. In order to detect more leprosy cases different survey methods were followed as rapid inquiry survey, contact survey and school survey.
The leprosy interventions started as vertical programme, the strategy was Survey Education and Treatment (SET). The identified cases were provided with MDT treatment through service delivery points. Rapid inquiry survey, contact survey and school survey was a part of the leprosy detection drive. Subsequently, the emphasis was on services like POD/POWD, IEC and SER as a holistic approach to leprosy elimination programme. The project also supported the capacity building of the GHS in the functional integration phase. By the end of December, 2005, these districts have been declared as the leprosy eliminated district.
Strategy 2008:
* In the year 2008, the strategy is to provide direct services on special care (POD/POWD) through integrated approach. RCS and NFI management, field level mobilisation will be given due priority along with regular follow up.
* Linkages will be established at the field level for promoting general disability care services at the grass root level with community participation, involvement of family members and PRI members.
* Focus will be on networking and linkages with government, private agencies and philanthropists for socio-economic rehabilitation of needy persons.
* The In patient ward will also treat the locomotor disability cases.
* Emphasis on malaria control programmes in early diagnosis and treatment, strengthening the process of service provision (both governmentt and private) and campaign on preventive measures with community participation.
* Health Resource Centres will be promoted in the targeted villages, which will be the focal point to address the local health issues in an integrated manner.
Accomplishments till 31 March 2008:
Sl No. |
Indicators |
PB |
MB |
Total |
-
|
Leprosy Detection and Treatment |
|
|
|
i |
Total new cases detected till 31.03.2008 |
13068 |
5119 |
18187 |
ii |
Case detection before functional integration (2000) |
10522 |
3426 |
13948 |
iii |
Cases detected by GHS with the project support after functional integration |
2546 |
1683 |
34239 |
iv |
Total Cases discharged |
12935 |
4884 |
17819 |
v |
Cured |
12217 |
4200 |
16417 |
vi |
Other discharges |
718 |
684 |
1402 |
vii |
Balance as on 31.03.2008 |
38 |
86 |
124 |
2. |
Core Activities on Leprosy |
Year of starting |
2008 (up to 31st March) |
Cumulative |
I) |
Referral centre services in IP ward |
|
|
|
viii |
Admission in IP ward |
1994 |
70 |
3731 |
ix |
POD/POWD |
1997 |
G-I = 117
G-II = 316
(follow up) |
G-I = 1628
G-II = 1093 |
x |
MCR foot wear |
1995 |
G-I =41
G-II = 192 |
14194 |
xi |
Re constructive surgery |
1995 |
0 |
413 |
xii |
Socio-economic rehabilitation |
1997 |
|
|
xiii |
LEPRA Revolving Fund |
|
0 |
75 |
xiv |
Government Scheme |
|
20 |
1247 |
xv |
Philanthropy |
|
0 |
37 |
xvi |
Eye Care |
|
|
|
xvii |
Total no of eye cataract surgeries done with the support of DBCS |
|
0 |
633 |
Referral Centre (IP Ward)
In 1994,leprosy cured person with correctable deformity were referred for reconstructive surgery .In the same year a 6 bedded in –patient ward was constructed at Koralep campus at Koraput and it was converted 20 bedded in 1997, where all types of leprosy related care are provided such as POD, POWD, RCS, Complication management, ulcer, NFI, pre & post operative physio care. Addition to this adult education and vocational educations are the part and parcel of this centre for the clients.
Prevention of Disability (POD)
Project has been providing Prevention of Deformity services in a planner manner. This enabled the clients to adopt self care practices through methods like soaking, scarping and oiling etc.
MCR Foot wears
Supply of MCR foot were are the core programme of leprosy for protecting their foot & for prevention from complication as well as disability. The impact of the good quality of foot wear and involvement of GHS in the Ulcer care programme, the new ulcer cases drastically reduced and this increases the coordination with health system. At present 374 G- II & 344 G I patients also make use of the foot wear properly in their day to day life.
RCS
Reconstructive surgery cases are referred for the surgically correction of the needy clients. Looking into the RCS benefits more clients are motivated to go for surgeries.
IEC
IEC programme conducted in Malkangiri and Koraput districts at different blocks and cover almost all the approached area by involving the GHS, youth clubs, SHGs members of the community. Main focus of the program to increased the awareness on Leprosy, TB, HIV/AIDS, Malaria, in the integrated manner. During this year 199 numbers of Film show, 61 market exhibition and 233 group meeting was organized at different places in the project area. Approximately 1, 45,000 populations are covered. 172 person reported voluntarily came for self examination out of which 4 PB and 7 MB cases are conformed by the GHS and referred to concerned PHC for registration.
SER
In the SER programme, the need assessment has done for 231 cases where as 46 clients benefited under Govt. Schemes, 38 clients are incorporated in the SHG and 8 clients have been benefited in the vocational trainings. There is a good impact on SER activity in the project area.
The project conducted the vocational training and adult education for the inpatients of ward of Koralep to improve their knowledge and skill for self employment.
Inauguration of first floor of In-Patient Ward at Koraput
The newly constructed first floor to cater to more patients of the In-patient ward at Koraput was inaugurated by Ms. Jenny Barraclough Chairperson, LEPRA - UK on 20th January 2008.
India Bike Ride 2008 Programme:
India Bike Ride is an annual event for awareness and is organized by LEPRA Society since 1996 with the support of LEPRA UK. This year, a team of 10 volunteers (4 men and 6 women) led the bike ride which was flagged off by the Commissioner of Police, Vishakhapatanum on 12th February 2008. It covered a stretch of about 550 Kilometers starting from Visakhapatanum, AP to Koraput, Orissa.
Tuberculosis Programme:
After achieving notable results in controlling leprosy, Koralep is highly concentrating on the field of TB as this is the high endemic disease of the undivided Koraput district. With the result of pilot study on Joint Leprosy/TB and HIV awareness programme covering 0.26 million population in Jeypore sub-division funded by DFID by Koralep & as per the recommendation of external experts from London School of Hygiene and Tropical medicine UK after evaluation for expansion of Joint programme, Koralep worked with a coverage of 0.5 million population of entire Jeypore sub-division (funded by E.C. project). Now Koralep is running a DMC ay Jeypore with taking 40000 population under RNTCP along with Sputum Collection Centre (SCC) in inaccessible areas and operating Tuberculosis Unit at the most inaccessible & cut off area of Malkangiri under RNTCP.
Sputum Collection Centers (SCCs)
Koralep initiated the concept of Sputum Collection Centre (SCC) in the outreach and inaccessible areas in order to provide service and information relating to TB which is highly endemic and under reported due to various reasons. This is mainly to collect the sputum for testing at the PHC level and to provide treatment in a follow up phase. During the project implementation 60 sputum collection centers (SCC) were established in the out reach areas, which are managed by dedicated and motivated Anganwadi workers (AWW). These innovations are aimed at creating demand and improving the access to quality care services. The project could able to detect more number of female and aged patients through sputum collection centers who could not go to microscopy center.
TU, Malkangiri
Tuberculosis Unit under RNTCP was launched in September 2007 covering three most un-reached blocks of Malkangiri District.. The following activities and outcomes depict the achievement of the TU in first quarter of 2008.
Activities undertaken
* IEC Programmes were organized.
* Supervision and monitoring of TB activities in 4 DMCs
* Verification of Patients’ Card & Monitoring Drug
* IEC activities on Tuberculosis and TB/HIV co-infection
* Coordination with Government officials
Outcome:
* 85.1%of New Sputum Positive cases started DOT treatment with in 7 days of diagnosis.
* 14511 patients attended the T.U and 280 were found to be chest symptomatic
* 48 Male & 20 Female (Total 68) new TB patients registered in T.U.areas.
* 38 patients cured,19 were treatment completed
* Conversion rate – 63.6 & cure rate is 81.5%
Community Approach:
The project started community mobilisation activities in two blocks i.e. Borigumma of Koraput District and Korukonda of Malkangiri District. Micro plans have been developed for 40 villages of Borigumma and Korukonda block. The community members are participating in the village micro planning programmes such as sensitisation meeting on health issues, village cleaning activities for overall development of the village.
Under village level sensitisation meeting on malaria, 3 programmes were organised. 120 persons participated. Eleven wash rooms were constructed with support from DWSM.
Networking
The Project continues networking and Linkages with District Health Administration. The District Coordination Committee comprising of CDMO, DNMO/DTO, and KORALEP is being held on monthly basis to discuss on leprosy and tuberculosis activities. And also the project is keeping networking with other stake holders like NRHM, ICDS staff, ASHA and Forest Department. In this year 7 Leprosy affected children were motivated to admit at Philadelphia Hostel, Semiliguda for batter education.
Safai Abhijan:
Safai Abhijan A project on Health, Hygiene & Sanitation for four communities of Koraput & Jeypore i.e. Dongaguda, Hatpada, Indracolony & Rangabalikumbha. The project is implemented by Koralep, LEPRA Society & Supported by Mr. Graham Clark, U.K .
The project is working to empower the communities to lead a healthy life with better hygiene & capacity building, sanitary hardware construction, community mobilization and other supportive activities.
Objective:
• To ensure sustainable development of the quality of life and health of the community.
• Awareness on the need for sanitation and Hygiene and good living condition.
Outcome:
• Mass Immunization programmes were held at Health Resource Centres -175 children (92%) were taken, 30 Pregnant mothers were taken T T & counselled for institutional delivery.
• Due to regular network & advocacy by the HRC the municipality & NAC were involved in drainage and disposal of waste materials & repaired 4 tube wells , 2 tap waters & six water point established in R.B.Kumbha. HRC is also involve in different construction work and referring different patients to Koralep OPD & Govt. Hospital.
• Youth members of R.B.Kumbha HRC constructed one tube well platform and one garbage pit by contributing their own labour.
Base Hospital services with OPD, IP ward, Lab facilities and surgery facilities and medical store etc.
The access to and demand for services at this hospital is gradually increasing and this will reduce the backlog of the target area and support in reducing the blindness problem. People from poorer sections and inaccessible areas are, now, accessing the eye-care services. This has helped in reducing the avoidable blindness problem and helped in improving the socio-economic conditions of the people in the area.
From beginning to end of September 2007, about 28273 new cases were attended to and 14113 cases received OPD services. The project has restored vision of 7249 persons through cataract surgeries with IOL and 50 persons with non-IOL cataract surgeries. Minor eye problems of 664 persons were corrected with minor surgical services. Refractive errors of 3342 persons were corrected with provision of spectacles by the base hospital.
Community Outreach Camp in the remote areas
Through 276 community-level outreach screening camps 20233 people benefited and out of them 14156 received minor curative services at the camp site; 4411 cases were referred to the hospital and 3346 received appropriate services.
Health Education
In order to sensitise and popularise preventive messages and services available in the area, 42 health education programmes for women groups, 38 programmes for school students and 69 audio-visual shows for general public were are conducted by the field workers. The World Sight Day was celebrated on 14th October each year in both the districts. One of the key strategies of the project was the introduction of availing services at a cost (both fully and partially) which continued to be the strategy of the project. The Project has been fairly successful in this aspect.
The project has already been evaluated by LVPEI, one of the premier Eye-Care Institutes of India. In their opinion, the MNC has a good set- up and provides quality surgery in the rural areas.
The project has developed networking with the community-based organisations and volunteers whereby cataract cases can be referred directly to base hospital for treatment.
School Screening and Refraction Programme
As a part of school screening activities, the technical team of the project visited 108 schools and screened 8996 school children out of which 2,011 children were provided spectacle services by prescription and spectacles. Further, 225 school teachers were trained on preliminary eye screening with a view to enabling them to conduct the same in their respective schools and refer problematic cases to the base hospital.
There is also a strong advocacy with the District Administration and District Health Official for right interventions by the project in eye care.
Strategy
- To provide eye-care services free of cost or at subsidised rates to poor and needy population
- Improve staff capacity and outreach activities in community and schools for more case referrals to increase the cataract surgical rate
- To promote the prevention of nutritional blindness, detection and correction of refractive errors and enhance awareness of eye health in the project area
- To organise the capacity building for health providers in addressing visual impairment and referral of more cases
- Increasing partnership with local NGOs and CBOs and philanthropists for outreach programmes
- To conduct regular screening camps in the village/communities in the project areas providing OPD services including treatment and prescription
- To provide spectacle provision for needy persons
- Community-level IEC to create adequate awareness in villages and outreach area
- Advocacy with health authorities
- To develop the capacity of the teachers to identify the students with refractive error
- To motivate the surgically curable blind to access services at the base hospital
- Marketing strategy - Training facilities and service facilities
- Monitoring and evaluation to ensure quality
Number of Beneficiaries
