Tuberculosis Control Programme
As TB is widespread and contagious, everyone is at risk.
Tomorrow, it could be me.
Or you……!
According to the World Health Organization, 28 people out of every lakh are dying due to TB. India has over thirty per cent of the world’s tuberculosis patients.
The usual victims of Tuberculosis are migrant laborers, slum dwellers, residents of backward areas and tribal pockets. In that sense, it is not yet a fashionable disease like AIDS that has hit the rich too. Second, TB is such a silent killer. Nobody wants to admit it and prefer to bear it. Adding to the problem is the fact that reporting of the disease is poor and many patients phase out in between the treatment process. So, they are potential dangers to others as they spread the disease wherever they go. A diseased person just has to cough in a bus for numerous passengers to soon contract the disease.
Tuberculosis Control Program is a collaborative effort of Municipal Corporation of Greater Mumbai and Navnirman Samaj Vikas Kendra. The main aim of this program is to cure and prevent Tuberculosis in western slums of Mumbai. Currently we are focussing in Malad (P/N ward) and Kandivili ( R/S ward) .Gradually we will target other suburban slums. Through this program we support Health posts for improving detection rate and decreasing defaulter rate in the areas where we work. We also conduct health awareness sessions for common people, School Students and TB patients and their families. Our field staff is involved in Defaulter retrieval and follow-up of infected patients. We have roped in about 850 General Practitioners from the target area for better coordination and effective results.From these General Practitioners ,more than 100 suspected patients are referred ,out of which 70-80 prove to be infected by T.B.We ensure that they are brought on DOTS treatment and complete their entire ccourse.Regular follow up is done by our social worker for the entire course of treatment .If there is a child below 5 years of age is administered preventive treatment to ensure its safety.
The General Practitioners are continuously kept in the loop by giving them feedback about their referred cases and their health status.Thus,under our Tuberculosis Control Programme, Navnirman works in coordination with the General Practitioners, B.M.C.Health Posts and Patients.We also give a special stress on creating awareness in general public about tuberculosis.
Steps we follow:
1) Suspected Patient visit:
Suspected patient visit is the best way to increase ongoing patients to reach to the final objective of TB control. Our field worker visit the target areas to identify the cases. We use social and audio visual program media to detect suspected cases. We also refer such patients to BMC heath post.
2) Lab defaulter visit:
Many patients phase-out after giving one or two sputum sample. Therefore every week we collect names of all lab defaulted patients from lab register and we visit those patients to identify the reason of phase out.
3) Initial [Conformation] Visit:
Conformation Visits are organized to confirm the residential address of TB patient and to have initial introduction with him and his family. Health education of patient and his family is also part of this visit. We also collect necessary information from treatment card on monthly basis.
4) Social Visit:
Social Visits are conducted to collect information pertaining to health, education, income and other general information in order to know the socio economic condition of the family. This helps in screening of patients based upon their Socio- economic and demographic condition. Accordingly our field workers follow them.
5) Intensive Phase Visit:
Many patients phase out in the period of IP [intensive phase] due to side effect of medicine and lack of information. Through these visits we motivate such patients. We collect necessary information from treatment cards every week. Also our Social workers visit such patients where again health education is provided. Some times patient’s complaints about side effects of medicines, behavior of BMC staff etc. All such issues are handled in this visit.
6) Continuation Phase Visit:
Many patients interrupt in continuation phase [CP] because of various reasons, CP visit is done in order to keep all patients on regular treatment. We collect CP patient’s information from Treatment card or Navnirman’s field book. Social worker visit such patients where he checks the medicine, gives counseling & motivate patient for continuing medicine up to till he/she gets cured.
7) Treatment Complete Visit:
We collect information from treatment card of those patients who have completed treatment but have not been given the final report from the health post.
Defaulter Visit:
Defaulter Visit is done to bring back all such patients who couldn’t complete the treatment due to various reasons.
9) GPI – (General Practitioner Involvement) Project
We work in collaboration with private practitioners, BMC hospitals and health post. The main purpose of this is to facilitate interaction between private and public health facilities in order to achieve better results.
10) Follow up Visits:
Our social workers visit the patients intermittently to continuously check their status and provide support as and when required.
Story of Change:
Mr. Baban aged 35 years originally from Maharashtra migrated to Ambojwadi, part of Malwani, Western suburbs of Mumbai withhis family in search of livelihood. With reference to his friend he decided to drive autorickshow for his survival. Due to lack of education, awareness, and bad peers he became alcohol addict. It affected his health and he got infected by TB disease. In 2002 i.e. 2 years back he was suffering from TB but he ignored it and stopped the medicines from health center of Malwani. As he stopped medicines in between the course, the health center staff refused to give the TB medicines for him. Gradually his healthbecame serious. His wife shouldered the responsibility of family. She worked hard as home servant to meet regular expenses of his family. She shared this problem with Social worker of Navnirman. With the help of STS – Madhav Joshi and Rajan – Coordinator of Navnirman, his TB medicines were arranged at Dr. Maurya’s Clinic, which was close to the patient’s residence. And from 14th September 2004 onwards his medicines were started under direct observation of Dr. Maurya and Navnirman Staff. Now baban finished his TB course. Due to slum demolition of ambojwadi he migrated to Motilal Nagar, Goregaon. Now he is cured and living happy life with his family. Whenever he is coming to malwani he is meeting Navnirman staff.