TB, meet your match in NGOs
For long, NGOs and the BMC worked separately to tackle the spread of TB in slum settlements. But the two have now combined their forces; while NGOs are designing creative campaigns to get the message across, the civic body is pumping in more funds. We finds out how effective such measures are to contain the deadly disease
Donna Thakur has a finger on the pulse of the tuberculosis (TB) campaign. The field officer with Lok Seva Sangam (LSS), a non-governmental organisation (NGO) involved in the health sector, knows which strategies for creating an awareness about TB will work and which will fall through in slum pockets.
And her expertise - and that of many health workers associated with NGOs - is exactly what the Brihanmumbai Municipal Corporation (BMC) needs. The civic body has woken up to the fact that NGOs are their best bet to get to the growing numbers of TB patients in slums, as they have a wider reach. It even increased the funds for such NGOs by 100% last week to help them diagnose and treat TB patients through their grassroots-level network.
Winning the trust
Over the years, several NGOs in and around the city have launched various campaigns to raise awareness about health issues - ranging from HIV to nutrition in pregnant women. Some of them have chalked out refined, localised strategies which work like clockwork in reaching out to those on the fringes.
Take the case of the LSS. It conducts a number of IEC (information, education and communication) programmes, such as door-to-door campaigns, street plays, megaphone announcements in slum settlements and group discussions within communities, rallies, slideshows and film screenings, and even takes the help of general practitioners to create awareness about TB.
Thakur, who has been working in the health sector since 1977, believes that communication is the key to containing TB, which kills more than 1,000 people in the country every day. In time, she has come to understand the importance of teachers and children in the campaigns. “The TB campaigns we conduct in schools are very effective. Kids are good messengers. What we tell them, they take home with themselves. We’ve also found that children also confide in teachers about the problems they face. So, we decided to involve them too. This is how we reach families,” she explains.
Some NGOs even convince TB patients who approach them for treatment to spread the word about their intervention. “We found out in 2005 that Rajasthani workers in a colony at Kurla suffered from chest complications because of their exposure to leather and foam. Every house there had a TB patient. Their women, who were always veiled and not allowed to talk to us, had also been afflicted with TB. We managed to reach them through the male patients,” says Thakur.
In the same migrant group, Thakur noticed that the workers stopped their treatment after their health improved — marginally — in two months. “Back then, we had a default rate of 40%. Then we started our IEC campaigns. These days, the default rate is between 5% and 7% in the same community.”
Missing from the true picture
This year, 1,554 referrals were made to the revised national tuberculosis control programme (RNTCP) for diagnosis through IEC activities — a 10% increase from those made last year under the TB control project. “The detection rate at individual ward levels varies from 5% to 6% and amounts to only 2% of the total TB cases registered in Mumbai. These are on-the-spot referrals. We are yet to devise a method to record the number of people who approach BMC or NGO centres much after they attend an IEC activity. It’s not possible to track these referrals,” says a source from a conglomeration of NGOs.
To each, his own
But, not all NGOs swear by the same approach to getting the word across. Representatives of the Maharashtra Janavikas Kendra (MJK) feel that in a city like Mumbai, community meetings are largely ineffective. “People here are always in a rush. They have a short attention span and are unable to retain all the information. We had to find other ways to convey our message,” points out the NGO’s coordinator, Syed Ali Akbar.
The MJK covers slums from Walada to Sion, Dadar to Mahim, Bandra to Santa Cruz, as well as at Kurla, Virar, Vasai and Nalasopara. With 25 centres in the city which cater to the working class early in the morning and late in the evening, it even arranges for technicians to be sent to the 17 municipal laboratories in the city which work with a skeletal staff.
Akbar, who has been working in this field for 12 years now, feels that the best way to involve a community is by getting members to talk to TB patients. At such a meeting, a patient shares his feedback with members of community and answers their questions. “The patient highlights the importance of treatment and this helps cut down the default rate.”
Another method, says Akbar, is to set up stalls in particular areas, and to distribute pamphlets and posters containing first-hand information. “We also point patients in the direction of the nearest municipal laboratory in the area to let themselves avail of free treatment.”
Shilpa Kamble, co-ordinator of Malvani-based Navnirman Samaj Vikas Kendra (NSVK), which centres its campaigns on HIV-positive migrants and the health of children from Malad to Dahisar, goes by the credo of reaching “the maximum people in minimum time”. “We recently conducted a street play competition at the Malad station, in collaboration with other NGOs, and we were thrilled with the response,” she says. She adds that college students and curious passersby who had questions about TB approached the organisers after the street plays.
Her trump cards during interventions are elders of a community.
But, collection of data much after a campaign isn’t a smooth process with the NSVK either. “Some symptoms of TB surface two or three months later. There’s no way to get to know the accurate figures,” shrugs Kamble.
ALERT India designs IEC programmes with an aim to change the attitude of the masses. Its TB campaigns lay stress on misconceptions about the disease and the stigma associated with it. Prabha Mahesh, the director of its TB control department, explains this is because “a clinical approach is a patient’s last resort, as he/she prefers to go to babas instead.”
ALERT India reviews its communication tools and their impact after each campaign. “We design them with specifics in mind. For example, if we are working in an industrialised area, we educate the workers by comparing their bodies to machines. We decided to exploit their understanding to what they were already exposed to in order to make our point. Till we put the person on treatment, our job is not over,” says Mahesh.
The NGO covers Ghatkopar, Kanjurmarg, Bhandup and areas from Vikhroli to Vidyavihar.
For long, NGOs and the BMC worked separately to tackle the spread of TB in slum settlements. But the two have now combined their forces; while NGOs are designing creative campaigns to get the message across, the civic body is pumping in more funds. We finds out how effective such measures are to contain the deadly disease
Donna Thakur has a finger on the pulse of the tuberculosis (TB) campaign. The field officer with Lok Seva Sangam (LSS), a non-governmental organisation (NGO) involved in the health sector, knows which strategies for creating an awareness about TB will work and which will fall through in slum pockets.
And her expertise - and that of many health workers associated with NGOs - is exactly what the Brihanmumbai Municipal Corporation (BMC) needs. The civic body has woken up to the fact that NGOs are their best bet to get to the growing numbers of TB patients in slums, as they have a wider reach. It even increased the funds for such NGOs by 100% last week to help them diagnose and treat TB patients through their grassroots-level network.
Winning the trust
Over the years, several NGOs in and around the city have launched various campaigns to raise awareness about health issues - ranging from HIV to nutrition in pregnant women. Some of them have chalked out refined, localised strategies which work like clockwork in reaching out to those on the fringes.
Take the case of the LSS. It conducts a number of IEC (information, education and communication) programmes, such as door-to-door campaigns, street plays, megaphone announcements in slum settlements and group discussions within communities, rallies, slideshows and film screenings, and even takes the help of general practitioners to create awareness about TB.
Thakur, who has been working in the health sector since 1977, believes that communication is the key to containing TB, which kills more than 1,000 people in the country every day. In time, she has come to understand the importance of teachers and children in the campaigns. “The TB campaigns we conduct in schools are very effective. Kids are good messengers. What we tell them, they take home with themselves. We’ve also found that children also confide in teachers about the problems they face. So, we decided to involve them too. This is how we reach families,” she explains.
Some NGOs even convince TB patients who approach them for treatment to spread the word about their intervention. “We found out in 2005 that Rajasthani workers in a colony at Kurla suffered from chest complications because of their exposure to leather and foam. Every house there had a TB patient. Their women, who were always veiled and not allowed to talk to us, had also been afflicted with TB. We managed to reach them through the male patients,” says Thakur.
In the same migrant group, Thakur noticed that the workers stopped their treatment after their health improved — marginally — in two months. “Back then, we had a default rate of 40%. Then we started our IEC campaigns. These days, the default rate is between 5% and 7% in the same community.”
Missing from the true picture
This year, 1,554 referrals were made to the revised national tuberculosis control programme (RNTCP) for diagnosis through IEC activities — a 10% increase from those made last year under the TB control project. “The detection rate at individual ward levels varies from 5% to 6% and amounts to only 2% of the total TB cases registered in Mumbai. These are on-the-spot referrals. We are yet to devise a method to record the number of people who approach BMC or NGO centres much after they attend an IEC activity. It’s not possible to track these referrals,” says a source from a conglomeration of NGOs.
To each, his own
But, not all NGOs swear by the same approach to getting the word across. Representatives of the Maharashtra Janavikas Kendra (MJK) feel that in a city like Mumbai, community meetings are largely ineffective. “People here are always in a rush. They have a short attention span and are unable to retain all the information. We had to find other ways to convey our message,” points out the NGO’s coordinator, Syed Ali Akbar.
The MJK covers slums from Walada to Sion, Dadar to Mahim, Bandra to Santa Cruz, as well as at Kurla, Virar, Vasai and Nalasopara. With 25 centres in the city which cater to the working class early in the morning and late in the evening, it even arranges for technicians to be sent to the 17 municipal laboratories in the city which work with a skeletal staff.
Akbar, who has been working in this field for 12 years now, feels that the best way to involve a community is by getting members to talk to TB patients. At such a meeting, a patient shares his feedback with members of community and answers their questions. “The patient highlights the importance of treatment and this helps cut down the default rate.”
Another method, says Akbar, is to set up stalls in particular areas, and to distribute pamphlets and posters containing first-hand information. “We also point patients in the direction of the nearest municipal laboratory in the area to let themselves avail of free treatment.”
Shilpa Kamble, co-ordinator of Malvani-based Navnirman Samaj Vikas Kendra (NSVK), which centres its campaigns on HIV-positive migrants and the health of children from Malad to Dahisar, goes by the credo of reaching “the maximum people in minimum time”. “We recently conducted a street play competition at the Malad station, in collaboration with other NGOs, and we were thrilled with the response,” she says. She adds that college students and curious passersby who had questions about TB approached the organisers after the street plays.
Her trump cards during interventions are elders of a community.
But, collection of data much after a campaign isn’t a smooth process with the NSVK either. “Some symptoms of TB surface two or three months later. There’s no way to get to know the accurate figures,” shrugs Kamble.
ALERT India designs IEC programmes with an aim to change the attitude of the masses. Its TB campaigns lay stress on misconceptions about the disease and the stigma associated with it. Prabha Mahesh, the director of its TB control department, explains this is because “a clinical approach is a patient’s last resort, as he/she prefers to go to babas instead.”
ALERT India reviews its communication tools and their impact after each campaign. “We design them with specifics in mind. For example, if we are working in an industrialised area, we educate the workers by comparing their bodies to machines. We decided to exploit their understanding to what they were already exposed to in order to make our point. Till we put the person on treatment, our job is not over,” says Mahesh.
The NGO covers Ghatkopar, Kanjurmarg, Bhandup and areas from Vikhroli to Vidyavihar.
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