Posts filed under ‘HIV/AIDS diagnosis facilities’
Orissa govt. to connect the district headquarters hospitals with premier government medical colleges through telemedicine network
Bhubaneswar, Nov. 7: All district headquarters hospitals will be connected with the three premier government-run medical colleges in the state through telemedicine network.
“The work has already begun and the network will be functional by December,” said chief nodal officer of the Orissa telemedicine network B.N. Mohanty, who is also head of the department of experimental surgery of SCB Medical College, Cuttack.
Telemedicine is an emerging field that combines advances in computer and communication technologies with the practice of clinical medicine.
Through this medium, diagnosis and treatment of diseases can be conducted with the patients and doctors sitting at two ends.
District hospitals of Jajpur, Puri, Kendrapara, Jagatsinghpur, Dhenkanal and Keonjhar will be connected to the SCB Medical College. District hospitals of Cuttack, Rayagada, Koraput, Bhawanipatna, Sundergarh, Baripada and Capital Hospital, Bhubaneswar have already been connected to SCB.
The SCB Medical College has, in turn, been connected to the Sanjay Gandhi Postgraduate Institute of Medical Science (SGPGIMS), Lucknow.
Nayagarh, Gajapti, Boudha, Kandhamal, Nuapada, Malkangiri and Nabarangpur will be connected to MKCG Medical Collage and Hospital at Berhampur.
Burla-based VSS Medical College will be connected to hospitals in Rourkela, Balangir, Angul, Jharsuguda, Baragarh and Deogarh.
Talking to reporters here today, Mohanty said a state-level telemedicine resources centre would come up soon at Cuttack.
With the help of the state government, the SCB Medical College is going to organise the three-day 6th International Conference of Telemedicine Society of India (TSI) from November 14. Distance education in health science is the theme of the conference.
Representatives from ISRO, Space Application Centre, ministry of health, department of IT, Union government, AIIMS¸ IIT, Kharagpur, C-DAC-Pune, SGPGIMS, Lucknow and Central Law University, Cuttack would attend the conference.
“Around 2,567 critical patients had already been cured through telemedicine. Patients, suffering mainly from thyroid cancers, arthritis and rheumatism, are opting for telemedicine consultation. With these facilities, we have been able to be in touch with the SGPIMS, Lucknow,” Mohanty said.
The state government has also asked all additional district medical officers of all district headquarter hospitals to attend the meeting.
“We have invited students of medical and engineering colleges of the state to attend the meeting. They’ll get an opportunity to listen to nationally and internationally reputed telemedicine experts,” said Mohanty.
Ask anybody about western Odisha, and the answer would be of a backward area where concentration of poverty, mass migration and malnutrition is high, even though it has a high concentration of mineral and mining is common. Unfortunately, western Odisha is also lags in healthcare facilities.
Recent reports of HIV/AIDS spreading its tentacles here with as many as 184 persons succumbing to AIDS in 12 backward districts of the State have made the situation grim. There are around 2,400 HIV positive people in this region, even as the United Nations has declared combating HIV/AIDS as one of its Millennium Development Goal (MDG) and universal access to health services as one of the basic human rights.
According to a report of Odisha State AIDS Control Society, there are a total of 17,708 people living with HIV in Odisha out of which 11,052 are men and 6,656 are women. Out of 1,407 AIDS patients, 1,109 have succumbed to the dreaded disease, says the report.
In 12 districts of Odisha – Jharsuguda, Sambalpur, Deogarh, Bargarh, Kalahandi, Nuapada, Nawarangpur, Rayagada, Balangir, Sonepur, Boudh and Kandhamal – a total of 184 persons have died and 2,395 people are HIV positive.
In Jharsuguda district, a total of 114 cases have been detected so far while four have died from AIDS. In Sambalpur district, there are 673 HIV positive cases and out of 39 AIDS patients reported, 33 have succumbed to the disease. In Bargarh district, 180 HIV positive cases have been detected and six have died from AIDS. In Nuapada district, 150 persons have are HIV positive and 19 people have died from AIDS. In Kalahandi district, 264 people have been detected as HIV positive and three have succumbed to the decease. In Rayagada district, 431 have been identified as HIV positive and 51 have died from AIDS. In Nawarangpur district, 409 have been identified as HIV positive and 15 have died from AIDS. In Boudh district, 326 persons have been identified as HIV positive. In Kandhamal district, 32 have been identified as HIV positive and 15 have died from AIDS. In Sonepur district, 17 persons have been identified as HIV positive.
Balangir, which is known for its acute poverty and mass migration, has now 465 HIV positive cases and 39 have died so far. However, official figures state that 327 people have been identified as HIV positive.
Counselors have been appointed in all the 14 blocks of the district but there are only five technicians.
It is futile to expect a person of Tureikela or Muribahal to come to Titlagarh for blood test. The appointment of laboratory technicians is done by the Odisha State AIDS Control Society. We have nothing to say, says an official here. We are trying to manage by imparting training to our technicians on HIV testing and posting them in migrant-prone blocks of the districts, said CDMO Dr PC Sahu.
The second ART centre in western Odisha was opened in Balangir after Burla in May this year. But it has not opened in a full-fledged manner as there is no permanent staff and only one medical officer and a pharmacist has been posted.
According to reports, the ART centre at Burla is not functioning effectively. We have to inform officials of the ART centre about the patients. Patients who come here are allegedly harassed by the officials. The drug adherence centre at Burla does not function and patients face a lot of inconvenience. There is a network of HIV positive people in Balangir which is called the Balangir Network of Positive People but they are not able to do anything.
Even as 327 people have been detected HIV positive, this is just the tip of the iceberg given the mass migration. The number of infected people can go up to one per cent of the total population or 1,500 people of the district.
Ignorance among people, lackadaisical attitude among personnel involved in combating HIV/AIDS and absence of laboratory technicians fail to give the real picture. After the ICTC centre started in Titlagarh, the number of HIV positive cases went up rapidly. If the ICTC centres function with full-time laboratory technicians, the number is expected rise.
There is every possibility of the number of HIV positive cases going up to 1,500 in Balangir district alone and other migrant-prone backward districts like Nuapada, Kalahandi and Rayagada are equally vulnerable, points out an NGO activist.
The integrated counseling and testing facility (ICTC) has been provided only in districts belonging to A and B category in HIV prevalence while the C category districts are being overlooked. It must be noted that the prevalence of HIV is high in regions where there is acute poverty and migration, argues an official here.
Ironically, even after six years of elapse of the OSCAS, its website does not provide any data or information about the prevalence of the disease.
According to reports, major modes of transmission of HIV/AIDS are unsafe sex followed by blood transfusion and it affects mostly the youth in the age group of 14 to 35 years.
Migration has been one of the major factors in western Odisha for the spread of HIV among the rural people. The spouses of migrant labourers of western Odisha are vulnerable to the disease but neither they can challenge and defy the patriarchal system nor can get rid of the infection without preventive measures.
The health rights of the rural poor need to be addressed through inclusive approach. The HIV testing facility is still not available in all CHCs. The absence of laboratory technicians in ICTCs makes the entire system non-functional, said Sashikant Mallick of ActionAid.
Changing lifestyle, poverty, mass migration and lack of access of universal treatment of HIV people have worsened the situation, besides the stigma and discrimination attached with the disease.
While the big bosses implementing the projects are getting huge salary and luxury, bottom level workers are fed up with heavy work entrusted by their officers, rued an NGO activist.
Worse, even as the United Nations has put combating HIV/AIDS as one of the millennium development goals (MDG), and India is a signatory to it, it has not even started and even worse, it is spreading and absence of testing facilities and personnel has been causing much inconvenience.
Asking a person to give his blood for HIV/AIDS testing and that too in a village is a tricky proposition which is likely to evoke a negative response.
However, much to the pleasant surprise, around one hundred of villagers, including pregnant women, migrant labourers, students and TB patients turned up voluntarily to get their blood tested for HIV at a camp held at village Salepali in Chandanbhati Gram Panchayat, 10 km from here, earlier this week. A meeting of Panchayati Raj representatives of Chandanbhati GP was held wherein they were sensitised about HIV/AIDS and its prevention.
Ward member of village Salepali Chandrashekhar Dharua, who attended the meeting, laid stress on voluntarily testing for a HIV-free village. The meeting was sponsored by Action Aid, which is implementing the Link Worker Scheme (LWS) in Balangir district.
Besides holding a rally on the World AIDS Day to sensitise villagers about HIV/AIDS, a series a meetings were also organised at the village. There is no treatment for the dreaded disease and the only remedy is prevention, said a Link Worker, Panchannan.
Members of Jaibada Deo Adivasi Yubak Parishad held a meeting and sensitised villagers about the blood checking camp and the villagers agreed to get their blood tested, said president of the Parishad Baishnab Pradhan. Anganwadi and Asha workers also motivated pregnant and other women of the village to go in for HIV testing.
As villagers are facing difficulty in going to Balangir for blood test, they demanded holding of a camp in the village. As a result, the camp was held in the village.
Before going for blood test, the villagers were counselled about why their blood would be tested and what HIV/AIDS is. They were advised for blood test again in the next three months at the ICTC Balangir for future confirmation. This is because a person even if contacting HIV the test result would come out negative as the window period of HIV/AIDS is three months and only after donating blood or checking blood in next three months a case of HIV/AIDS infection would be confirmed.
Baba (22), (name changed), along with his wife, volunteered for blood test as he believes prevention is the best method. A 14-year-old boy, Krish (name also changed), also turned up for blood test. Besides, a TB patient too came for his blood checking.
All the collected blood samples would be put to further test through rapid kits, explained a counsellor, Alok.
However, the crucial aspect of this blood test lies in organising another such camp in the village for a second checking of their HIV status and removing the fear of HIV/AIDS, failing which the entire effort would end in vain. Will the villagers test their blood status again? Time will say.
Even as the whole world observed World AIDS Day on December 1 with ‘Universal Access and Human Rights’ as this year’s theme in order to provide equal rights, opportunity, entitlement and healthcare facilities to people living with HIV/AIDS so that they can lead a dignified life, a cursory glance at the healthcare facilities available for people living with HIV/AIDS in Balangir reveals large-scale vacancies of laboratory technicians who ultimately and clinically declare whether a person is infected with HIV or not.
According to sources, out of the 14 blocks of the district, only five Integrated Counseling and Testing Centres (ICTCs) located at Balangir, Titlagarh, Patnagarh, Kantabanji and Chudapali are having a counsellor as well as a laboratory technician.
In the district headquarters hospital, there is only one lab technician who looks after both the sections of the ICTC. While ICTC-I looks after blood testing of male patients, ICTC-II looks after all ante-natal cases of pregnant women.
As a single lab technician in the hospital manages both the sections of the centre, the work load on him is very high and whenever he goes on leave the entire unit comes to a grinding halt.
Besides this, in Tureikela, Saintala and Tusura there is only counsellor which puts further burden on the lab technician of the nearby centre. Ironically, in the migrant-prone blocks of Loisingha, Muribahal and Khaprakhol, posts of both the counsellor and lab technician are lying vacant.
“As there is no testing facility, we are not getting any report of HIV-positive cases though the possibility is very high. Mere counselling is not enough and it is futile to expect poor persons to go to distant places to test their blood. When a poor person comes to ICTC after much counseling but returns empty handed or goes without testing, it becomes very difficult to bring him again to the testing centre mainly due to pessimism, poverty and other factors,” said an NGO worker. We regularly get reports of people returning back without having the necessary tests, he said further.
This is the sorry state of affairs when more and more HIV-positive cases are being detected after referral by link workers to nearby ICTCs after counseling. After the intervention of link workers of Action Aid, a number of referral cases are coming up even from areas like Tureikela, Belpada, Tusra and Gudvela blocks where requisite healthcare facilities are not available.
In the migrant-prone Belpada block there is only one counsellor. The post of laboratory technician is lying vacant. People from this block referred for HIV testing either go to Kantabanji or Patnagarh. The link workers scheme advocates for quality and effective health services. As a result, the district health administration and district AIDS prevention and control unit have taken alternative measures like deputation of technicians from other ICTCs.
“To partially ease their burden, we have imparted training in HIV blood testing to malaria technicians who are now able to manage emergency situations, said an official here. It is an ad hoc approach and permanent posting of personnel is very much required, commented an NGO activist. The appointment is done by Orissa State AIDS Council. A total of 135 posts of lab technicians are lying vacant in the six high-prevalence districts of Odisha,” disclosed a medical official.
The ART centre would come up by the end of this month, informed CDMO PC Sahu. Moreover, a community care centre would also be opened, he added. Already 247 people have been identified as HIV-positive and 35 have died of AIDS in the district. This is nothing but just the tip of the iceberg. Once NGOs involved in targeted intervention projects work properly, the number would go up to 1,500, warned Sahu.
Balangir district has been put in the ‘A’ category of high HIV-prevalence districts of Odisha in view of high migrant population, lack of awareness and ignorance and absence of treatment facilities. While crores of rupees are being spent on awareness, the vacant posts are not being filled up immediately. Once the vacant posts are filled up it would go a long way in detection of HIV, treatment of infected persons and awarding them a chance to live as guaranteed in the constitution, pointed out an NGO worker.