Prabir

HIV Screening for Every Mother

2011-03-18T21:39:00.000+05:30

HIV Screening using blood from a finger prick in resource poor settings- See http://cid.oxfordjournals.org/content/50/Supplement_3/S77.full for more on use of these easy finger prick HIV screening tests in other countries.
Whole Blood Finger Prick HIV Screening Tests are being kept in Vaccine ILR-s in some blocks
Health workers have been instructed to take these tests in Vaccine Carriers on Immunization Day and do the tests on pregnant women. Opt-out verbal consent system is being followed.

This will identify mothers for screening at PPTCT centres/ ICTC

Institutional deliveries are on the rise. The same pregnant mothers are rarely weighed at sub centres. Their BP is often missed and fundal height is also missed. Pregnancy test and Hemoglobin test are done by ASHA workers usually. Some of the waste from testing is disposed of outside the centres. VDRL testing is unheard of at the level of State General Hospital and Blood Group or Rhesus testing has never been done. There are frequent shortages of Hepatitis B vaccine. There is a doubt about the quality of maternal mortality data.

So malnutrition, miscarriages, anemia, malpresentation, eclampsia and rhesus incompatibility might be missed.

Our slogan- HIV screening for every mother!

New TB Treatment Guidelines

2010-02-02T18:55:00.000+05:30

Given the availability of funding from international financial mechanisms, lack of resources for MDR (multi drug resistance) treatment is no longer an acceptable rationale for providing a retreatment regimen of first-line drugs (formerly called the “Category 2 regimen”) to patients with a high likelihood of MDR.

The previous edition recommended the 8-month retreatment regimen with first-line drugs for all TB patients returning after defaulting or relapsing. By contrast, this edition allows for the possibility that, in some countries, these patients may have levels of MDR-TB that are high enough to warrant an MDR regimen while awaiting results of DST.

Third Time Regular

2009-03-25T23:19:00.000+05:30

He used to drive a "408" (a mini-truck). He was irregular with his treatment. This time he is really ill. He is 37 kg now, though he was 45kg in 2008. He wants to be in a hospital. His daughter is in class 11 now. His wife said she would be happy if he went for a few months to the Missionaries of Charity clinic near Hemtabad. He is taking Streptomycin injections this time.

Amader Hospital at Phulberia

2009-02-25T23:14:00.007+05:30

Bankura is one of the most economically backward Districts in West Bengal, India. The town of Bankura, which has a hospital, is about 30 KM away from Phulberia and there are very poor transport facilities. There was no qualified doctor in 10 sq KM. The nearest metalled road is about 4 KM away.

Milestone-I(Completed in April 2007)
a) Selection of the site: Foundation for Health Action wanted to start the project in an economically and socially backward area where healthcare is hard to come by. After long search, FHA zeroed in on Phulberia. The area is primarily inhabited by tribal and low caste people who can hardly afford two square meals a day, cannot give their children any education worth the name. The quality of life in this semi-arid, one crop area with no industry or job opportunities is deplorable to put it mildly.
b) Acquiring a small plot of land : FHA have bought about 7 acres of fallow land for a Hospital cum Training Center, a hostel for the trainees, an out-patient clinic and residential quarters for doctors and paramedical staffs.

Milestone-II (Completed in February, 2008)
a) Water supply : The area is arid and water is scarce. FHA dug a 8-ft wide dug well in July 2007 for the construction work of the hospital and the training center and the inmates.
b) Greening of the project area has been started in a modest way with an eye on both economic and ecological objectives.
c) Housing: A modest residential house for doctors with accommodation for guests
d) Electrification: Electrical connection obtained in March 2008. An alternative source of power supply such an old diesel generator has been purchased to get round the problem of power cuts for long hours.

Milestone –III
Outdoor Clinic and one class room for trainees with a hall for waiting patients was opened to the public in October 2008. Dr PK Sarkar is the first doctor.

Rama Improves

2008-11-15T20:36:00.001+05:30

Rama weighed 6.25 kg on 11th November. He has gained 750 grams. He is seen here with his parents at the PRADAN office in Sundarpahari

Husseinpur Diara

2008-11-15T20:30:00.002+05:30

This Free Primary School (under Beniagram GP of Farakka) was founded in 1979. It was washed away in August-September this year. On a visit there we found that children who used to get immunization from Kuli Diar Char sub-centre (under Nayansukh GP) had received vaccines up to the end of April. An outreach camp at both these points was planned for Children's Day 14th November. We went there on the evening of 14th November and met some children and their parents. Bulbuli Mandal of Kuli Diar has returned after compleing her training as ANM (R). She will be posted to her home sub centre. This area neighbours Chak Bahadurpur and Chak Sujapur in Malda's Kaliachak III block. Husseinpur is barely 35 minutes drive from Purbachal (PTS) township and 45 minutes from Kaliachak town.

Children are Hungry

2008-10-24T22:38:00.000+05:30

Rama Paharia, S/o Bandra Paharia & Jabri Paharia M-1, Sidler (Upar Tola)Panchayat: Bara Sindri, PO-Chandna, Sundarpahari, Godda-814153,Jharkhand (Photograph taken on 24.10.2008 with permission of parents)

--- On Fri, 24/10/08, Soumik Banerjee <soumix2002@yahoo.co.uk> wrote: Dear Haldharji, Please find photo of 1 year old Rama Paharia of Sundarpahari, Godda who is severely malnourished weight 5.5 kg in Grade 3. The family has AAY card but says they have lifted grains only 3 times in 3 years. Their card was given as mortgagefor Rs 100 to one Phaguram Paharia of the same village whohas not returned thje card since then as the family failed to pay back Rs 100. ICDS does not function in the village in spite of regular fund release.When taken to PHC no medicines were given and refered to Sadar Hospital-Godda. We provided Horlicks & Vitamin syrup. She did not havethe money to pay for the same. THere are many such examplesand there is NOTHING anybody is doing about them. We are also at a loss as what to do and where to take up such isues ? No one seems to realise or understand such issues or do anything substantial.Wherever such things are raised locally there is only discouragement. In another case a 1 month old child was given 3 tablets of Ciprofloxacin 250 mg & 3 tablets of Resule CC and was asked to buy Canesten Cream from the market on reporting a fungal infection. How can a 1 month old child take tablets that too Ciprofloxacin ?? when they along with the Sahiya went back to ask for syrup they were told there is no syrup and asked to leave. She had to take medicines worth Rs 30 from the market.
Child's Name: Chandi Paharin, S/o Maghe Paharia, F -1 month, Sahapi (Bara Tola) Sundarpahari, Godda, Jharkhand. Regards Soumik

Panchanandapur

2008-10-23T19:32:00.002+05:30

The two CRY schools at Khatiakhana serve 300 children of the diara (Char) areas. Another school at Subhanitola Char serves 50 more in a new island which has re-emerged near Dakshin Polashgachi in Udhuwa Block of Sahebganj District (Jharkhand). Kedar Nath Mondol and the volunteers of the Ganga Action Committee have got help from benefactors like Kalyan Rudra and doctors from Kolkata to undertake some of their projects. The teachers seen here Rabi Ul Alam and Rajendra mondol also doubled as Pulse Polio volunteers this Wednesday. Subhanitola is over an hour's boat ride from Panchanandapur. The local people are all Bengali speaking, as are most people in Phudkipur, Radhanagar and the neighbouring areas. Patients go to Dr Ajit Sheet at Udhuwa for primary care, but deliveries, TB patients and even a few AFP (limb weakness) cases get admitted at Bangitola Hospital in Kaliachak II. GPAC has an ambulance to ferry the patients after they reach the Panchanandapur Ghat and maintain contact by mobile phone. They hope to expand the use of ambulance boat facilities soon. Those interested can contact them at Bangitola.

Mosaraf Weds Irene

2008-10-23T19:15:00.001+05:30

District Extender (Uttar Dinajpur) Md Mosaraf of the West Bengal Immunization Support Cell got married to Irene at Baroduari on 20th October. District Extenders Chitta Saha, Milan Sen, Md Samaun as well as the entire NPSP family, the CMOH, Deputy I, DPHNO and many Health Department friends and Mosaraf's classmate Dr Ashok Dutta attended the reception at Mukunda Bhaban, Raiganj. Most of the pictures in the album are taken by Piali.

Khorda Babupur

2008-10-23T19:10:00.001+05:30

The Trained Dai welcomed us here. The HA F ("ANM-R") has gone to Asansol for training to be a Supervisor. Since the neighbouring Misirpur centre is also vacant the Health Supervisor alternates between the two centres. Village Dhamua is under this centre. We know that Marium Besra, wife of a retired Customs officer, and mother of a local school teacher lives in Dhamua. Marium used to work as an ANM in St Luke's Hospital, Hiranpur. We have suggested that she be invited to tide over this difficult time.

Nichamari Diarrhoea

2008-10-23T19:03:00.001+05:30

Upen Kormokar had a free operation to correct his lagophthalmos last year. His daughter was one of those in Damdama village near Nichamari who had diarrhoea after the Puja holidays. She was lucky. One Bhima Mardi, aged 60 years died in the outbreak and many were admitted at Karandighi Hospital. The local Choprabakhari Health Centre is vacant for many months. There has been an outbreak of deaths close by at Gopalpur in June as well as numerous Measles outbreaks and deaths. One of these was described in an earlier Blog.

Behrampore District Hospital

2008-10-11T08:59:00.003+05:30

Yusuf Kabir and I visited this hospital on 10th October. It is an old building with a children's ward with 25 sanctioned beds and enough staff for this number of patients. There are on an average 70 children admitted here with their mothers. This number increased to 148 on 3rd October when there was an outbreak of pneumonia following a few days of rain. Sick Newborns from the Matri Sadan (which has an average of 50 births a day) were also kept in the same ward. The acute crowding was resolved on the 5th when a new ward space was created downstairs and some children were shifted to a closed verandah above an ICU. The ADM Health , Deputy CMOH I (Dr Santra) and Swasthya Karmadhyaksha (Mrs Jyotsna Sen) requested help to permanently increase the number of children's beds in the hospital. There is also a need to prevent seepage and improve the structure in the Children's Ward. There is another hospital area (New General Hospital) which houses surgical patients and Blood Bank. Along with Md Samaun (District Extender WBSISC) and Abhijit Lahiri (District Coordinator TSC) we met the Deputy Superintendent, who was running the Out Patient services there. We later visited Nadia, where a Sick Newborn Care Unit is being set up.

IMNCI Training at Raiganj

2008-09-17T21:42:00.001+05:30

Training of Trainers for managing neonatal and child illness (IMNCI) started on 14th September. The course continues till the 21st. The trainers are Debashis Das, Moushumi Basu, Tapas Sarkar and 3 doctors from Uttar Dinajpur. This is skill based training. There are hospital clinics, community visits and home visits. Videos, role plays and modular teaching methods are also used. Over 3000 Anganwadi (creche) and health Workers will be trained over the next few years in Uttar Dinajpur. Training will begin in October in Goalpokhar II block (Chakulia), which neighbours Kishanganj. Thanks to Dr SS Sahoo (CMOH), Swapan Ghosh (DPO) and others for making this possible. UNICEF and the State Government are providing technical assistance.

Mothers Die

2008-03-23T00:18:00.000+05:30

There were 2 deaths of Malto mothers in pregnancy recently in Sundarpahari (Godda). Soumik lists 2 other mothers dying in Sundarpahari and 3 more recent Malto deaths in other areas. 4% of Malto mothers in Sundarpahari die due to prolonged labour (no caesarean operations) and lack of blood or antibiotics. this picture is of another Malto (Paharia) lady with goitre.

Measles in Chakulia

2008-03-11T00:27:00.002+05:30

Raiganj - 4th February 2008
The MNGO St John’s Ambulance discussed the measles outbreak at Kahalgaon village (Bidyanandapur GP of Chakulia Block). They decided to survey under 5 children at the FNGO supported sub-centre of Toriyal.
The MNGO staff met the CMOH, DMCHO later. The DMCHO requested them to do IEC for immunization in a ring of villages around Kahalgaon.
There is a statewide shortage of DPT vaccine. U Dinajpur still has some supplies. However 0.1 ml syringes for BCG have not been picked up yet. Hepatitis B is still in short supply at the state.

6th February 2008
RI Monitoring
U Dinajpur
There was a Bangla Bandh and so the CMOH office could not open. However some sub-centres ran. The Kamlabari-I GP HQ sub centre was open and the Dai and Link Volunteers were present. Vaccine was available in good condition. The HA F was present on time.
The Chotporua HSC was closed at 11.30am.
The Mirwal HSC was open. The HA F could not reach so vaccines were absent. Immunization will take place tomorrow. Dai/ link person and AWW were helping the HA M. Patients from Maheshpur and neighbouring villages came for treatment.
.
7th February 2008
Measles Monitoring
U Dinajpur
Chakulia- I visited the BPHC and spoke to the BMOH Dr Chinmoy Barman and the BPHN and PHN. They said that of the 77 surveyed houses in one village (Korma with 410 population) of Toriyal GP there had emerged 44 children below 5 years (and over 9 months) un-immunized with Measles. 57 were immunized there with help from the FNGO and MNGO.
Up to 600 un-immunized children are expected in this GP (the GP has 6359 population) alone.
In Bidyanandapur village (GP HQ) I met the ASHA Coordinator Raktim and staff of Amanat Foundation. They had surveyed some mohallas and found 21 children un-immunized with measles and 47 or so who were immunized. Another team was working in the neighbouring Samaspur village (which also has an HSC and neighbours Kahalgaon- where the outbreak of Measles occurred).
Toriyal has been vacant for 3 years. Samaspur is currently vacant; since the HA F has been promoted to HS F. Bidyanandapur was unattended for 2 years (2003-05) when a previous HA F took leave.
Sahapur I (Bara Sahapur of Chakulia) had a Measles outbreak in May 2005 which was reported.
Chakulia currently has 7 HA F vacancies. A request to fill this gap was submitted to the state in October 2007.
From Bidyanandapur I proceeded to D.Rampur. An building was constructed here by the Zilla Parishad in 2003. It is used once a month. The Pradhan has been asking that it be used at least once a week. The HA F had hired a Maruti and proceeded to Bhabanigaon. We met her with her Link Volunteers and Dai at the Primary School. They had immunized 20 children, of whom about 7 received Measles. However we also met Monika, a 3 year old with fever and cold. This child had not received Measles vaccine. We advised the HA F to actively seek un-immunized children in this village. It is only 2km from Rampur or Kahalgaon, but the road winds for 5 km along the River Pitauni.
Goagaon GP of Lodhan neighbours this village. Goagaon II has a border with Bangladesh.
We turned south from Goagaon and crossed Konatola before entering Karandighi Block. Here we visited Nichamari Mission near Damdama High School (Bazargaon II GP). The mission has 300 hostelites. Around 8 of them had measles last week and were sent home.

ISSUES
Vacancies of HA F, PHN
Supply of 0.1ml Syringes, Hepatitis B, DPT
Annual List of National and clinic Holidays– with alternate Vaccination Day