CERTH-INDIA ANNUAL REPORT 2001

CENTRE FOR EDUCATION REHABILITATION AND TREATMENT OF THE HANDICAPPED – INDIA 181, GINGEE SALAI DUBRAYAPET PONDICHERRY-605001

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DIRECTOR'S MESSAGE Thanks be to God for having let us see the dawn of another New Year, 2001. Unlike the previous two years this year New Year's Day, the First January was a holiday in deference to the wishes of the Staff desirous of entering the New Year by attending places of worship to thank God for having kindly let them pass the last year and to invoke His Blessings upon them in the New Year. The first highlight event of the year for the Organisation was the Inauguration of the Skin and Leprosy Clinic proposed in my last year's message, on Tuesday 30th January by Her Excellency, the Lieutenant Governor of the Union Territory of Pondicherry, Mrs. Rajani Rai, in the presence of His Excellency MrAlberto Escudero, the Ambassador of Spain to India, the Hon'ble Minister for Health for the Government of the Union Territory of Pondicherry, Mr.E.Valsaraj and Madam and Mr.Claiidio Satone Bonhomme, the Founder-President of JAL, Spain which ad funded entirely tine construction and furnishing of the said Clinic for which act of its generosity we remain deeply indebted and grateful to them. We pray to God to bless each and every single soul that could have contributed its mite towards this. We thank the Association Française Raoul Follereau (AFRF) for their unflinching continuous financial and moral support to continue our services to the less fortunate, down-trodden people in the areas of our activities. We pray to God to bless them all who had a role to play in enabling us to continue our services to the Community. The attendance at the Out-Patient Department and admission into the In-Patient Department of our Hospital was observed to have been showing fluctuations, depending on the seasonal atmospheric changes, nevertheless it had not been discouraging. Quite a few services being rendered to the patients attending our hospital have become possible due to the generous financial contributions made by Dr.(Mme) Monique Gely, President, ADISE, INERP, FRANCE. We thank Mme Monique Gely and each one of her Organisations for the contributions made. We could pass off the year with smooth and pleasant functioning of the Organisation as a whole, thanks to the sincerity and cooperation of all our Staff with zeal and enthusiasm in giving out their best to the utmost satisfaction of every one concerned. 1 thank them all sincerely and profusely, wishing them all the best in the rest of their lives, professional and personal.

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I thank the Almighty God for having been with us throughout the year, guiding us and leading us in every step and stage of our activities. Finally, I am cornered to end my message with profound grief over the demise of Mr. Henry Durieux and his wife Mme Nicole Durieux, who were the architects of this Organisation, which owes its present very existence very much to them. May the Departed Souls rest in peace. Best. Wishes to one and all Dr.N.Balasubramanian Director

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LEPROSY SECTION In-charge Leprosy Inspectors Lab Technician Shoe-Maker Part-Time Dressing Orderly

Dr J. KIRUBAKARAN Mr K. CHURCHIL Mrs JESUMARY Mr P. SEZHIAN Mr G. R. KANNAN Mrs FRANCOISE

As in the previous years, the anti-leprosy activities were carried out at the head-quarters of CERTH-India as well as at the project area. -HEAD-QUARTERSThe services provided at the Skin and Leprost Clinic in the premise of the head-quarters comprised of the following: 1) Total number of consultations Consultations to leprosy affected persons 2) Total number of ulcer dressings done

1724 1280 8129

3) Total number of MCR foot-wear provided

49

4) Total number of repairs of MCR foot-wear

77

5) Total number of spectacles provided

3

AT THE PROJECT AREAThe project area consisted of a rural population of 47262 and urban population of 40513. The services were delivered through four local Primary Health Centres.

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The achievements in 2001 are given below: 1) Number of new cases detected 21 MB, 43 P'B, 27 SSL. * MB Multi-bacillary PB: Pausi-bacillary

SSL. Single Skin Lesion

These cases were detected through Rapid Surveys (24 cases), By examination of 41380 persons School Surveys (0 cases), By examination of 4844 persons Healthy Contact Surveys(2 cases), By examination of 286 persons MLEC (Modified Leprosy Elimination Campaigns) 15 cases Voluntary reporting ( 30 cases), Others (20 cases) Details of new cases detected No of smear positive cases

2

No of child cases

22

No of cases with deformity

Gr I

0

Gr II 5 2) Treatment During the year 2001, 39 MB cases, 58 PB cases and 27 SSL cases were treated Regularity of treatment was 95% 16 MB cases, 32 PB cases and 27 SSL cases were declared cured. 3) Surveillance:Totally 176 persons were under follow-up to detect early any complication or elapse of leprosy. Fortunately none developed either. 4) Health EducationNo of group talks/education given in 2001 No of mass health education programmes given in 2001

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217 30

DISTRIBUTION OF LOAN BY THE MINISTER FOR SOCIAL WELFARE, PONDICHERRY AT THE INAUGURATION OF THE COMMUNITY BASED REHABILITATION PROGRAMME

STRENUOUS PREPARATIONS FOR PROVISION OF EDUCATIONAL AIDS TO THE DEPENDANTS OF LEPROSY AFFECTED PERSONS -7-

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These programmes, on evaluation, were found to have increased the knowledge of the public from a pre-test average of 36% to a post-test average of 78%. All the leprosy patients detected, under treatment or under surveillance received individual health education. 5) Prevention of disability:There are 14 patients with Gr I deformity and 109 patients with Gr II deformity in the project area as on 31.12.01. Of these, 78 have plantar ulcers. During the year 2001, 10 ulcers were healed. 6 ulcers recurred and 4 new ulcers developed. Special Events:1) A new building for skin and Leprosy clinic in the premises of our head-quarters was inaugurated on 30.01.01, the anti-leprosy day. Her Excellency Dr.Rajani Rai. Lt Governor. Pondicherry, His Excellency MrAlberto Escudero, Spanish Ambassador to India, Honourable Health Minister Sri E.Valsaraj, Pondicherry. Mr.Bader Christian, French Consul, Pondicherry. Mrs.&MrClaudio Satorre Bonhomme, President. JAL, Spain participated in the inauguration. 10 leprosy patients were given clothes. The building was constructed with full financial assistance of INSTITUT JAL, CATALUNYA, SPAIN

CUNIT.

2) Community Based Rehabilitation programme was launched in Karaiamputhur village of our project area on 11.08.01. Honourable Minister for Social Welfare Sri A.KAS1LINGAM, Pondicherry, Mr.R.RADHAKRISHNAN, M L.A., Kurivinatham constituency and Mr.Pierre Olphe-Galliard, France took part in the launching. 10 leprosy affected needy persons were given loan towards purchase of cattle to augment their meagre income. A special eye camp benefiting 23 leprosy patients was also conducted by the ophthalmic surgeon Dr.Neeraja al the same premises. 3) A special programme with full financial assistance of 1NSTITUT JAL. SPAIN was launched to provide clothes, books, note-books, tool-wear and educational expenses to needy dependent children of leprosy affected persons in June 2001. 168 students are to be benefited for the year 2001-2002

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HOMOEOPATHY SECTION In-charge: Dr.J.KIRUBAKARAN Carried out with the financial assistance of the single benefactor Mme Claudine BISSON. this service offered consultations along with medicines free of cost. Totally 81 patients were benefited. Out of these 26 were from the project area of the Primary Health Care section of CERTH-India, namely Dubrayapet and Vambakeerapalayam villages. Of these 81 beneficiaries 11 were leprosy affected persons. The treated maladies are grouped as below:

Respiratory disorders Gastro-intestinal disorders Gynaecological disorders Dermatological disorders Pain disorders Others Total

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121 80 34 64 119 9 427

PRIMARY HEALTH CARE In-charge Staff Nurse Pharmacist Multipurpose Worker Record Assistant Sanitary Assistant

Dr N. BALASUBRAMANIAN Mrs A. JEEVANA KUMARJ Mr M. KARUNANITHY Mrs C. FRANCISMARY Mr A. COULOTHUNGAN Mrs R. DHANAMARIE

AIMS & OBJECTIVES: To provide Health Care through Nicole Durieux Dispensary, situated in the middle of Dubiayapet, to achieve the goal of improving the general health of the 9000 underprivileged population living in Dubrayapet, - Vambakeerapalayam villages and the adjoining regions situated on the coastal shore of the Bay of Bengal, in the Southern suburb of Pondicherry Town. PAST ACHIEVEMENT The various activities, mentioned below, carried out during the last 18 years after the initial house to house survey in 1984, have largely contributed to the nearly 50% decrease in the total number of patients attending daily the dispensary as shown in Table 1 thereby clearly showing that the health status of the people living in this area is very much improved. a) Introduction of Family File and Individual Card system in the out-patient department b) Arrangement of mass deworming camp. construction and maintenance of toilet blocks for public use c) Health education talks in the waiting hall of the dispensary as well as in the schools and in the public places d) Full coverage of immunization schedule to all children under five e) Provision of Special Nutritious food to all undernourished children f) Care of the ante-natal women with their subsequent voluntary acceptance of permanent family welfare methods (sterilization) g) Care of the neglected and needy aged persons h) Counselling of alcoholics and drug addicts in the dead diction clinic i) Efficient care of the patient in the out-patient department

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The various activities of the Primary Health Care are enumerated below: I.

OUT-PATIENT SERVICE AVERAGE NUMBER OF PATIENTS PER DAY: 85(see Table I&II) BENEFICIARIES : Public of Dubrayapet, Vambakeerapalayam and adjoining areas Workers of different rehabilitation units(Atelier Shanthi, Atelier au Fils d' Indra) Children of the crèche run by France Pondichery Students of Sathyalayam School

II. HEALTH EDUCATION: The various health education talks given by the multipurpose workers to the patients waiting in the halt of the dispensary before the consultations in the morning and the permanent self explanatory wall hangings in the waiting hall on the various communicable diseases, personal hygiene, ill effects of Drugs, Alcohol and smoking, the dangers of Aids, form a permanent health education media, an important factor for the reduction in the number of consultations which is about 80 per day during the year 2001. III.

CHILD WELFARE (0-5yrs):

A) A well baby clinic is run every Thursday with the collaboration of Government Health Personnel and Anganwadi workers to cover the immunization schedule of the children under 5years of age as shown in Table III and to improve the child health. B) THE PULSE POLIO PROGRAMME, introduced for the first time in 1995 by the central Government, implemented by the State Government successfully in order to eliminate polio from INDIA before 2000 A.D with active participation of all voluntary agencies was continued also during 2001. This programme was held on 2P1 January 2001, 9th December 2001. during which all the children under 5years v^ere given a booster dose of polio vaccine. The Staff of Nicole Durieux Dispensary have contributed their full efforts to cover all the children under 5years living in Dubrayapet and Vambakeerapalayam villages. It is noteworthy to know that there is no single case of child affected with polio during the years 1999, 2000, and 2001 in Dubrayapet and Vambakeerapalayam villages.

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C) SUPPLEMENTARY NUTRITION PROGRAMME: This programme for the undernourished infants (6months to 3years) started and continued since 1994 with the financial assistance of Mme Claudine Bisson. In this programme about 30 to 40 undernourished children were selected and they were given every Wednesday, a supplementary nutrition food (350gms) in a plastic container at the rate of 50gms/day which provides 50% of daily protein requirement and 1/5th of daily calorie requirement of the child. The children under this programme were weighed regularly once in a month and were kept till they' attained the normal weight. During weekly visits, a health talk was given to the mothers, regarding breast feeding, immunisation, personal hygiene, family planning and care of the child. IV. SCHOOL CHILDREN(5-15YRS): Weekly health education talks on various communicable diseases and personal hygiene were organised in local schools to senior students, in order to improve their knowledge and thereby improve their health. In addition, individual health education advice was given to the school children daily by the Medical Officer during the consultations in the morning hours in connection with their ailments and personal hygiene. V. DE-ADDICTION PROGRAMME(15-50yrs): This programme, started 8 years back, to rehabilitate the Drug and Alcohol addicts of Dubrayapet and Vambakeerapalayam was continued during 2001 by visiting the addicts in their homes, by individual and group counsellings in their homely environment and by motivation of persons to come to the dispensary for treatment.

VI. WELFARE OF MOTHERS: An ante-natal Clinic cum Family Planning Clinic is run on every Friday with collaboration of Government Health Personnel for (lie welfare of pregnant mothers and prospective mothers, (see Table IV & V) VII. CARE OF THE AGED: The above programme started during 1995, was continued during 2001 with the financial assistance of Mme Nicole DELPEREE, a Gerontologist from Namur, Belgium. Under this programme, the following activities were carried out during the year 2001. a) Every day in the dispensary the aged persons suffering from chronic diseases like High Blood pressure. Diabetics, chronic [bronchitis are examined and given a week treatment after necessary investigations like X-ray ECG and laboratory investigations free of charge, (see Table VI) b) Geriatric patients requiring admission in the hospital (or IV fluid therapy or physiotherapy were admitted in CERTH-IND1A Hospital and treated free of cost.

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VIII.

ENVIRONMENTAL SANITATION:

As a part of Health Education programme at the community, the municipal toilet block, properly maintained and run successfully by the Primary Health Care Project, forms a major preventive measure in the control of communicable diseases. IX.

SPECIAL ACTIVITIES: a) Awareness of Senior Citizens:A special talk by Nicole Delperee for creating awareness about the needs of the geriatric problems and the Rights of the elderly persons was given to about 200 elderly citizens of Pondicherry on 25th March in a meeting arranged by the Senior Citizens Association with help of CERTH-INDIA. b) Mobile Dental Canip:A mobile dental camp was conducted by Govt. of Pondicherry on 26.05.01. 61 patients ueic hcnefitted by this dental camp including 9 extraction. Another mobile dental camp was conducted by Govt. of Pondicherry on 28.07.01. 38 patients were benefited by this camp including 4 extraction. c) Mother's meeting for Breast feeding day:A mother's meeting was conducted by PHC Odiansalai and with help of Nicole Durieux dispensary about breast feeding on 07.08.01. 48 mothers were benefited by this Breast feeding day mother's meeting. d) AIDS Awareness Proyramme:AJDS Awareness Programme was conducted on 07.12.01 at women's I.T.I. Campus, during which about 200 girls of women's I.T.I and Government Datchanamoorthy High School were participated. STD control Officer Dr.SeIvaraj, Datchanamoorthy High School headmistress and our Director addressed the girls about the AIDS and ifs prevention. e) Free Eye Camp for Aged persons:In order to provide clear vision to the poor aged persons suffering from mature cataract and refractory error, a special camp was arranged on 18.12.01 in the Nicole Durieux Dispensary, during which 40 aged persons were examined. Eleven were chosen for spectacles and 29 were selected for IOL operation in the future.

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FEW OF THE 200 PARTICIPANTS

IMMUNISATION IN PROGRESS

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TABLE 1 Name of the Diseases and the numbers: (1) PUO (2) Viral fever (3) Malarial fever (4) Filarial fever (5) Enteric fever (6) Others (7) UR1 (8) Acute pharyngitis (9) Sinusities (10) Acute Tensilities (11) Acute Bronchitis (12) Bronchial Asthma (13) Tropical Eosinophilia (14) Others (15) Gastritis (16) Peptic ulcer (17) Dyspepsia (18) Diarrhoea (19) Gastroenteritis (20) Dysentery (21) Colitis (22) Cirrhosis of liver (23) Haeorroldes (24) Others (25) Hypertension (26) Varicose veins (27) Hypotension (28) Others (29) Amenorrhoea (30) Dysmenorrhoea (31) Menonhagia (32) Leucorrhoea (33) Dysfunctional uterine b (34) Urinary infection (35) Hydrocele (36) Others (37) Myalgia (38) Arthralgia (39) Arthritis (40) Osleo arthritis (41) Costalyia (42) Sprain (43) Fracture (44) Tendinities (45) Lumbago

331 567 119 180 19 253 847 411 395 68 952 959 110 451 747 210 245 384 643 347 126 73 Nil 273 195 9 247 160 40 87 28 255 6 59 14 77 1052 349 122 98 57 127 2 90 686

(46) Injuries (47) Wounds (48) Others (49) Neuritis (50) Neuralgia (51) Sciatica (52) Migraine (53) Others (54) Tooth ache (55) Caries Tooth (56) Gingivitis (57) Bleeding gums .(58) Post extraction infection (59) Others (60) Conjunctivitis (61) Scleritis (62) Cataract (63) Others (64) Ear ache (65) Otitis (66) Wax in the ear (67) Ear lobe infection (68) Others (69) Scabies (70) Tinea (71) Dermatitis (72) Furinole (73) Abscess (74) Cellulities (75) Eczema (76) Psoriasis (77) Pyodemia (78) Ulcer (79) Adenitis (80) Insect Bites (81) Herpes Zoster (82) Burns (83) Others (84) Anaemia (85) Vitamin deficiency (86) Angular stotitis (87) Glossities (88) Malnutrition (89) Debility (90) Others (91)Worms Infestations

New Cases Total :

20645

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901 1234 309 23 95 118 209 130 302 208 152 76 76 118 82 221 147 111 251 147 62 83 100 269 225 165 201 118 79 94 17 251 Nil 104 194 50 85 165 39 79 121 92 32 172 107 424

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TABLE III

CHILD CARE IMMUNIZATION

Dose I II III IV BOOSTER

DPT 112 111 118 100

TABLE IV

OPV 112 111 118 -

BCG 102 -

MEASLES 121 -

ANTE-NATAL CLINIC

Immunization

I Dose

II Dose

Tetanus Toxoid

96

93

TABLE V

Total number of consultations during Ante-Natal Clinic 385

FAMILY PLANNING AUOPTERS Sterilization a) Tubectomy b) Laproscopic c) IUD (Copper T) d) Oral pills (Strip) e) Nirodh f) Vasectomy

TABLE VI

40 4 16 180 423 Nil

MOBILE DENTAL CAMP Sl No a) I Camp b) II Camp

Total Cases 61 38

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Extraction 9 4

CERTH-India HOSPITAL The Hospital, started with 20 beds on 22nd January 1997. has been functioning 24hours since IW1) and has continued the activities during 2001 with the addition of a surgery unit consisting of a Rill equipped Operation Theatre, Surgeon's preparation room. Theatre Sister's room with the necessary sterilisation equipments and a post-operative reanimation ward since 1st September 2000. A high power generator with a room for its installation, to provide power not only to the peration theatre but also to the Hospital during current cut and a canteen with the dining room to provide necessary food for the in-patients and their attendants were also added during the year. On the other hand, (lie out-patient complex continued its activities during the year 2001 as in the previous years with the Pharmacy, Medical Laboratory and X-ray unit. The Hospital is proud 10 have the following team of dedicated Staff, who provide the required medical services to the patients. In-charge Dr N Balasubramanian Director Medical Officers Dr N Balasubramanian Dr J Kirubakran Dr (Mrs ) Suzanne Dominique Dr Sinnathamby Natarajan Dr Karunanithi Nursing Supervisor Mrs. A. Jeevanakumari Staff Nurses

Mrs. Subbulakshmi Miss Mangala Gown Miss Rathi Devi

Nursing Assistants Mrs. Mariambi Mr J Prasad Mrs Rosy Mrs .Sivagamy Mrs Gowri

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X-ray Technician Mr. Abdul Rasheed O.T. Assistant Mr. A Irudayaraj Pharmacist Mr M Karunanithi Mr. S. Mathivanan Laboratory Technicians Mr. P. Sezhian Mrs. J. Hemalatha Mrs Vijaya Sanitary Assistants Mrs. Christiane Dupin Mrs. P. Vatchala Mrs. M.Sagayamary Mrs. Mariette Miss Jeannine Physiotherapist Mr.P.Ashok THE OBJECTIVES are: 1) To provide necessary medical out-patient and in-patient services to poor people at low cost 2) To provide necessary medical in-patient services to leprosy, polio and handicapped patients, geriatric patients 3) To provide de-addiction and rehabilitation services to addicts and alcoholics. The statistics of such services rendered during the year 2001 areas follows: Total number of cases for the year 2001

- 7966

Total number of out-patient consultations for the year 2001

- 6987

Total number of in-patient (admissions) for the year 2001

-

979

Total number of Physiotherapy cases for the year 2001

-

126

Total number of working days for the year 2001

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Total number of cases treated : 7966 Village-wise particulars: Year Dubrayapet 2001 1974

Vambakeerapalayam 2023

Outside 3969

Total 7966

Total number of out-patients consultations : 6987 Year Male Female 2001 2818 3005

Children 1164

Total 6987

Total number of in-patients : 979 Year Male 2001 449

Children 38

Total 979

Children 21

Total 126

Female 492

Total number of cases given physiotherapy treatment: 126 Year Male Female 2001 60 45

Total number of laboratory tests done : 3961 Year Blood Urine Stool Sputum 2001

1964

1762

Total number of X-ray cases

129

7

Pregnancy 42

Skin AFB 5

Mantaux Test 52

Total 3961

: 539

Total number of major surgical operations done: 69 We hope to render much better and more efficient services to the people during the year 2002, when almost all the medical and surgical facilities become operational and available to the public. ******

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LOWCOST HEALTH CARE - AFFECTIONNATE DELIVERY

ONE OF THE 69 SURGERIES DONE IN 2001

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DISABILITY CARE SECTION Coordinator Multipurpose Rehabilitation Technicians (MRTs) Technical Assistant Consultant Physiotherapist Physiotherapist

:

Mr LP DAS Mr. S. SAMBANDAM Mr. T. SURESH Mr. A. SEZHIAN Mr M.S. Mulhuswamy Mr .P. Ashok

The Disability Care programme delivered its services to the needy disabled through the Orthopaedic Workshop. Community Based Rehabilitation and Parrainage. Orthopaedic workshop - Situated in the premises of the head-quarters of CERTH-India. the workshop is invoked in physiotherapy, manufacture and distribution of appliances and moulds. These workshop related activities are quantified as follows.

1) Total number of consultations

882

Polio affected

:

541

Others

:

341

2) Number of new polio cases registered

0

3) Number of appliances manufactured Orthosis Prosthesis

195 3

4) Number of repairs undertaken to the already supplied appliances 5) Number of moulds fabricated

72 364

6) Number of organisations supplied with the moulds 7) Physiotherapy No of beneficiaries Total no of physio given

14 126 370

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Community Based Rehabilitation:- Five Communes of Pondicherry district namely Bahour, Nettapakkam, Mannadipet, Ariyankuppam and Oulgarpet with a total population of 537910 (1991 census) living in 115 villages were covered under this programme. There are totally 774 persons with disabilities (under our care) in this area. This programme covers mainly medical rehabilitation and to some extent socio-economic rehabilitation of these persons. The efforts are given impetus through regular house visits of these individuals to monitor disabilities, motivate for regular physiotherapy, assess the appliances and repairs if any. In the year 2001, totally 4 house visits were made. Parrainage.- Totally twelve children benefited in 2000 A. D. under this programme, continued to avail the services (his year also All these children are sponsored by sole benefactor Mme Dr. Monique Gely of ADISE & INERP - FRANCE. These children are either disabled (eight in number) or orphans. They are being provided with school books, uniform, appliances, nutritional supplements whenever necessary.

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GAIT TRAINING - A ROUTINE IN ORTHO WORKSHOP

BENEFACTOR WITH BENEFICIARIES - PARRAINAGE PROGRAMME

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LIST OF DONORS Funding Agencies: Association Française Raoul Follereau, France Atelier au Fils d’Indra, France Andheri-Hilfe Bonn. Germany INERP & ADISE, France Junta de Accion Contra la Lepia, Spain Association le Liseron, France French consulate, Pondichery

Individual Donors who have contributed more than Rs. 1,000.00: Dr Monique Gely

MrsGincttc Desnot

Monique Studer

Mme Nicole DELPEREE

Mr. Philippe

Mr. Pawela Edmond

Mrs. Claudine Bisson

Mr.Joseph Moudiappanadin

Secours Catholique

Mr Sivalingam. S.O.S. Pondichery

Mrs. Avatra Devi Euller

Miss S Bhuvaneswari

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GOVERNING BODY MEMBERS Dr. D. D. Palande. MS President

Chief Surgeon (Retd) Pondicherry-12

Mr. K. S Alva Vice-President

Managing Partner Allva Plast Pondicherry-1

Mr K. Ranganathan, B Com , B I. Secretary

Advocate Pondicherry-1 Appellate Assistant Commissioner (C. T. Retd.) Pondicherry-1

Mr M Muthiikiim;uas;imy Treasurer Mr V. Jayachander, B Sc . F C A Member

Chartered Accountant M/s. Ganesan & Company Pondicherry-1

Prof Dr. M Dhanabalan Member

Head of the Dept Social & Preventive Medicine, JIPMER Pondicherry.6

Mr K Mananathan Member

Managing Director Manatec Automations Pvt I Thattanchavady Pondicherry-9

Dr. N. Balasubramanian. M B B.S., Member

Director CERTH-India Pondicherry-1

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