Orientation on RNTCP with tb Action & State T.B. Cell, Uttrakhand:

S.N.	Name of the Programme	Venue	No. of Participants
1	Uttaranchal State TB Stakeholders Meet	Hotel Pacific Dehradun	57
2	District TB Stakeholders Meet, Haridwar	AWTC, Bal Kalyan Samiti	83
3	Kumaon Division level T.B. Stakeholders Consultation	Janta Banquet Hall, Haldwani, Nainital (Kumaon)	57
4	Nainital District Level TB Stakeholders Consultation	Janta Banquet Hall, Haldwani Nainital	65

• Mamta conducted 4 consultations in Uttarakhand to promote RNTCP & DOTS with the support of tb ACTION and State TB Cell,Uttarakhand for all the stakeholders involved in TB work.
• A state level TB stakeholders meet was organized by Mamta Samajik Sanstha in Collaboration with tbACTION and State TB Cell, Uttarakhand at Hotel Pacific, Dehradun on 16th June 2005. There were all together 57 participants from Government Health Department, WHO, Private Doctors, NGOs, DOTS providers, Cured patients, local print and electronic media etc. The NGOs participants were from 11 districts out of 13 districts of Uttarakhand. Dr. Joanne Carter of RESULT Education Fund, USA, Dr A.P.Mamgain, State Director, TB, Dr Rajan Arora, Consultant, WHO and Mr John Mathai, Country Director, tbACTION were among the key resource persons of the consultation.
• A divisional level TB stakeholders consultation was organized by Mamta in collaboration with a national level organization tbACTION and district TB cell, Nainital for the stakeholders of Kumaon division at Haldwani, Nainital on 19th December, 2005. There were 57 participants from govt health department, NGOs of Kumaon, private practitioners, DOTs providers, cured patients and media persons. The participants were from 4 districts out of 6 districts of Kumaon division. The participants included 22 NGOs representatives, 20 govt health department officials and TUs staff, 2 PPs, 5 DOTs providers, 1 cured patient, and 6 media persons. Additional Director, Medical, health and family welfare, Kumaon Division, Dr. (Mrs.) Premlata Joshi was the Chief Guest. Mr. John Mathai, Country Director, tbACTION, Dr. D.S. Kanyal, Senior District TB officer, Nainital, Dr. S.M. Shukla, DTO, Champawat, Dr. L.M.Upreti, Senior Medical officer, Dr. K.C.Sharma, Secretary, IMA, Haldwani, and Mr. J.M.Singh, Chief Functionary, Mamta were among the dignitaries and resources persons who attended and addressed the consultation.
• A district level TB Stakeholders consultation was organized by Mamta at Haldwani,Nainital for the stakeholders of district Nainital on 20th December,2005. Total 65 stakeholders participated, including 26 NGOs, 5 PPs having separate Private Hospitals, 6 DPs, 6 Cured and under treatment Patients, 19 Government Officials and ICDS workers along 3 media persons.
• A district level TB stakeholders consultation was organized by Mamta in Collaboration with tbACTION and Distt TB cell, Haridwar for the TB stakeholders of Haridwar at AWTC, Dadu Bagh on 21st November, 2005. There were all together 83 participants from Government Health Department, WHO, Private Doctors, NGOs, DOTs providers, STS, Cured patients, patients, local print and electronic media etc

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OUTCOMES

1. A strong triangle was established as Govt. officials (District TB Cell) NGOs and Private practitioners made up their mind to abolish TB from the state and their respective districts.

2. A comprehensive future strategy was discussed and decided.

3. This consultation rejuvenated the enthusiasm of NGOs, PPs and district TB Cells who were working on TB elimination in their respective districts.

4. Core-groups under the able chairmanship of senior DTOs, were established

5. All the participants took an oath to eliminate the curse of TB from their respective district and all were unanimous on the view point that such encouraging consultation should be held again and again.

6. Sr.DTOs informed the participating NGOs that soon they will conduct a separate meeting of NGOs to ensure their participation in RNTCP through various NGO schemes.

 

 

Mamta’s Contribution in Prevention of HIV/AIDS

HIV/AIDS has been integral part of our comprehensive health care programmes, particularly with women, adolescent girls and college students in more than 600 villages of two states i.e. Uttarakhand and western U.P. in North India. We have also addressed this issue with some high risk groups like truckers, professional blood donors, migrant communities etc.
Our approach has always been to integrate HIV/AIDS as one of the component of RCH, keeping in mind the stigma about the disease. One should not have a feeling that we are targeting him as suspected HIV case. Rather they should get feeling that we should fight HIV/AIDS like any other dreaded disease with sensitivity. Our senior staffs have been in the field of community health for more than 20-25 years. We are giving our services as Master Trainers and Resource Persons to the State government, NGOs and civil Society Organizations and conducting various training programmes, seminars, and workshops on different health topics including HIV/AIDS for managers, middle level workers and grass root level workers. In the past 16 years Mamta has conducted trainings and taken awareness drive in more than 600 villages of Uttarakhand and western U.P., India on various components of RCH and Primary Health Care. HIV/AIDS is one key component of our programme. We provide trainings to community health workers and college students and teach them to integrate HIV/AIDS in their RCH programme. There is social stigma, misconception and terror about HIV/AIDS among the people. We deal with this issue with great care and sensitivity. So that people should take it as any other disease. It is challenging and sensitive if we deal with HIV in isolation. It gives better understanding of the issue if we deal it in integration with other issues. It helped us a lot with high risk groups like truckers, migrant communities, slum dwellers and youth.

We have conducted a training on HIV/AIDS and The Law in our city Dehradun, Uttarakhand(India) on 20 th June,08.There were 50 participants from NGOs ,government representatives ,advocates and one HIV + person. We discussed in this meeting as how we may provide legal support to HIV+ persons in our state? We are identifying HIV+ networks and if no network exists, we will form network. We will also be in touch with HIV+ people through ICTCs and ART Centres in our state.
Future Initiatives in the field of HIV/AIDS:

Goal: To shut down one big window for HIV/AIDS to enter in Uttarakhand by providing safer sex techniques and risk reducing options to all high risk groups/population.

Objectives:

• Creating environment in the state of Uttarakhand and western U.P. with the help of HIV/AIDS stakeholders to combat HIV/AIDS together.
• Developing and using effective tools of ACSM to create awareness among the masses, particularly among high risk groups about HIV/AIDS, reduction of stigma and rapid HIV Testing Initiative.
• Developing cadre of Stop AIDS counselors & volunteers, particularly to work with high risk groups to encourage them for voluntary HIV counseling and rapid testing through HIV testing kit and ARTC.
• Providing HIV counseling and testing facilities to the suspected people at the place of their choice with confidentiality and maintaining their dignity.
• Referring the people found HIV+ through HIV rapid testing to their nearest ICTC and ART Centre for CD 4 Test and treatment services.

Our state is a hilly state. Where many people, particularly youth and male members of the families migrate to big cities in search of job. Also it is a place of temples and tourist destinations from India and abroad. So it is a high risk state as far as HIV/AIDS is concerned.
We wish to learn more about programme and approaches as how to deal with issue of HIV/AIDS in our state and how to make migrants, youth and other high risk groups of our state more sensible and responsible towards their own health and their family health.

We are drawing an action plan of our organisation to sensitize the community about HIV/AIDS and increase their participation to identify HIV cases and provide them proper health care with dignity. Simultaneously, we will mobilize youth power to stop HIV/AIDS in the state by preparing them as catalyst of change and using them in activities like advocacy and lobbying with government and concerned officials and campaigning and social mobilization for the high risk groups of the society. We will also develop a network of NGOs and concerned departments and link them with national and international networks on HIV/AIDS for regular interaction and update on the issue.
Issues:
i. MSM:
We all know that it is a problem in our society but we don't have courage to talk about it, particularly in country like India .It is easy to talk about the problem globally with professionals, experts, leaders etc rather than talking about it locally with the people where problem exists.
This is also a misconception that this problem exists in metro cities or big towns. It is very much in small towns and rural areas as well .If we wish to reach out to MSM groups, we have to target it everywhere in the society, particularly in youth hostels, Jails, hotels, dhabas ,work places where young people work as labourers etc. There are more chances of MSM among the people and young boys who migrate from their small towns or villages to metros and indulge in unsafe sexual activities .Uttarakhand is one of the states of India from where many young people migrate in search of employment. We don't have any data available about their sexual behaviour. We should conduct survey at all places where men stay with men or youth stay with youth and should have regular interaction with them.

ii. Mamta’s Exhibition and Counseling Cell during Tourist Season in Uttarakhand:
Mamta will put up exhibition; organize talk, audio-visual show and counseling Cell in key places of Uttarakhand like bus stand, Railway station and central place of the city of Dehradun ,Haridwar, Rishikesh, Sahastradhara and Mussoorie etc. to make people aware about HIV/AIDS and provide counseling to those who needs further information or clarification. Refer them to ICTC and ART Centre if needed some services. Organize talks of eminent people, local leaders and religious leaders from time to time, particularly during the peak season of the tourist and pilgrims.

iii. Go Healthy and Come back healthy:

Swasthya Jayein aur Swasthya lotein will be the name of Mamta’s intervention for the people who are migrating from Uttarakhand to various parts of the country or abroad in search of employment or youth going for higher education.
We will set up counseling cell at various entry and departure points of Uttarakhand , such as Railway station and Bus station, particularly in places like Dehradun, Haridwar, Rishikesh, Kotdwara, Haldwani and Kathgodam to educate people including youth about HIV/AIDS. We will provide them some material and guide note to help them to protect themselves from any chances of being caught with the dreaded disease. The counseling cell will work as an ICTC sub unit and person will be referred to nearest ICTC and ART Centre if need emerges. Instant HIV Testing kit will also be available with the unit. If any person shows his willingness for the testing after proper counseling; we will go for instant HIV testing. If he/she found positive then he/she will be referred to nearest ICTC/ART Centre for CD 4 test. We will provide all necessary guidance and support to the people found with HIV positive. We will ensure that person gets proper treatment, service and his/her human rights are not violated. We will try to counsel his/her family very cautiously with keeping their emotions, feelings and confidentiality intact.

iv. Safer Sex Techniques & Risk Reducing Options:
Formula Five will be the name of our technique which our workers will be using with high risk groups during individual counseling and group meetings:
1. Always ensure to use good quality Condom during each sexual act
2. Never get tempted to have sex with your client/partner without condom. It may give pleasure to you and your sexual partner for few minutes to have sex without condom. But it may increase chances of getting you infected with sexually transmitted diseases or dreaded HIV/AIDS which may permanently ruin the life of both of you for ever.
3. Ensure adequate supply of condoms from our workers as per your requirement on weekly or fortnightly basis
4. Visit our clinic and counseling centre or nearest PHC/CHC/ICTC immediately if you see any sign symptoms of STI as explained to you by our workers during individual or group counseling.
5. Be in regular touch with our workers/volunteers and counseling cell for counseling, service and care.

v. HIV Testing through Rapid testing kit:
We will conduct rapid HIV test at the places of convenience to the people who are willing for voluntary test after proper counseling. In order to give them privacy or conducive environment, we will conduct the test in our nearby testing and counseling unit. We will also develop linkages with existing organizations and institutions who are either already involved in Target Interventions or in the institutions where we see the possibility of having high risk groups like hostels. We will link our rapid HIV testing intervention with their ongoing activities. We will also try to identify HIV+ people and their networks and go for rapid testing through them. Rapid HIV testing will be done by experienced counselor of the organization. If person found HIV+, he/she will be guided to go to nearest ICTC/ART Centre for further test and treatment. Also he/she will be encouraged to bring her life partner or other partner, if any, for counseling and testing. We target at least 60 rapid HIV testing per month through our units.
Strategy:
Mamta Samajik Sanstha will develop a team of counselors and volunteers on counseling and rapid testing of HIV through specialized people in the required field and place them to work with high risk groups. Mamta will consider youth staying in hostels, places where men staying with men, migrant laborers, particularly male and youth of hills who are migrating from their villages to big cities in search of employment, truckers, sex workers, Professional blood donors, and Drug users etc as high risk groups. We will create awareness among the high risk groups through proper IEC activities and if anyone comes forward for counseling and testing, we will do the counseling and rapid testing through the HIV Testing kit. If person found HIV+, we will counsel the person once again and encourage the person to go to his/her nearest ICTC and ART Centre for CD4 Test and ART services. If person wishes, our staff will accompany him/her to the ICTC/ARTC. We will bridge the gap between HIV+ person and diagnosis and counseling services in govt health system. We will also counsel the family of the HIV+ person and encourage them to go for HIV testing as well. Currently, we will begin with two districts of Uttarakhand i.e. Dehradun and Haridwar and expand the programme in other transit districts and difficult to reach districts after having some experience in the field. Initially, Mamta will appoint 6 counselors and 30 volunteers for the programme.5 volunteers will be attached with one counselor. The work and performance of each staff will be monitored and evaluated from time to time by the Chief Functionary and Chief Coordinator of the organization. Proper MIS will be developed with the help of AIDS Healthcare Foundation.