LE&RN India / SATHI  /  AIIMS Bhubaneshwar

CELEBRATE WORLD LYMPHEDEMA DAY

March 6 2017- in India

AIIMS Bhubaneshwar Odisha

Prof Sukdev Nayak ,The Department of Palliative care, arranged for talks and workshops as well as garnered support from the Odisha State Government, specifically the state branches of India’s National Health Mission, and the cell looking after Non Communicable Diseases Mission, Dr S B Gogia, president of SATHI, co-ordinated the efforts on behalf of LE&RN. LE&RN India Chapter chairperson, was not in India at that time but still helped in co- ordination and participated online.

talk by SBGThe meeting and workshop was coordinated with press releases which talked about how better care for Lymphedema will help improve India’s program for

Elimination of Lymphatic Filariasis (PELF) –

http://www.readwhere.com/read/1123056/Kashmir-Age/March-2#page/5/1and http://www.readwhere.com/read/1124122/Kashmir-Age/March-3#page/5/1

LE&RN INDIA CELEBRATES WORLD LYMPHEDEMA DAY

Dr S B Gogia introduced the concept and need for the observation of World Lymphedema Day during the Inauguration of the Palliative care conference

The formal inaugural function on 5th evening..

From left to right - Prof Sukdev Nayak, Prof S N Misra, Dr S B Gogia, Chief Guest Mr B H Sahu and MS of AIIMS hospital Dr Parida

The meeting was merged with the ongoing two day workshop for Palliative Care nurses on 5th and 6th March. Participants in the meeting were government doctors from Primary Health Centres across Odisha. We had additional presence of key functionaries of Programme for Human Development - India coming all the way from Kanyakumari District - another endemic zone in Tamil Nadu, India.

LE&RN INDIA CELEBRATES WORLD LYMPHEDEMA DAY

The session specific to Lymphedema started in the afternoon of 5th March 2017 chaired by Dr Sanghamitra Pati, Director, Regional Medical Research Centre, Bhubaneshwar with the following topics:-

Filariasis, a Malady for Odisha Dr Gogia, SATHI, New Delhi Pathophysiology of Lymphedema Dr P Bhaskar Rao Lymphedema resembles Chronic Venous Insufficiency
Conservative Treatment for Lymphedema Dr SN Mishra, Chidambaram Compression bandaging Arun Rekha (through video calling)

Online presentation by LE&RN India Chapter Chair Arun Rekha
A recorded Video message from LE&RN Executive Director William Repicci was

played to the audiences.

The live workshop was initiated. A patient with Bilateral Filarial edema was examined and the use of an Intermittent Pneumatic Compression Pump demonstrated on her. Another live demonstration was that of manual pneumatic pump by Dr S N Misra on a patient with post mastectomy Lymphoedema. MLLB was done and a compression stocking was demonstrated on her later during the inauguration.

LE&RN INDIA CELEBRATES WORLD LYMPHEDEMA DAY

Next day a formal workshop on Lymphoedema care was done by plastic surgeons, Dr Gogia, SATHI, New Delhi, Dr Sanjay Kumar Giri, AIIMS, Bhubaneswar and Prof SN Misra, from Chidambaram, Tamilnadu.

A patient with Bilateral Lymphedema was examined, and a Nodovenous Shunt was attempted and found possible as a small node draining lymph was found.

On the 4th day when her measurements were taken again and patient sent home

Results of multimodal procedures in the patient with Filarial leg edema (NV Shunt plus MLLB with addition of Mobiderm)

On the 4th post operative day, the limb had reduced in size and patient was ready to go home. The reduction in the calf alone was around 1.2 litres but since some fluid had shifted to the thigh, the overall volume decrease is only 700 ml. This is expected to decrease over time. The maximum decrease is at 20 cm – 49 to 35 cm and the folds have almost disappeared. Toe bandaging will help remove the warty lesions in the legs though a minor surgery may be required there too later.

SATHI in the wake of the Tsunami Crisis offered its services through its professional’s team to OXFAM TRUST (India) specifically their representatives in Delhi namely Ms Gurinder Kaur and Ms Meeta Parti. Following a number of meetings and discussions a comprehensive plan was made to provide a comprehensive healthcare facilities to the victims. The specific responsibilities of SATHI were stated in a formal MOU between SATHI and OXFAM.

The responsibilities assumed by SATHI requires co-ordination and mobilization at different levels. In pursuance of the same objectives, Drs S B Gogia and M R Surwade arrived in Chennai on a filed visit to Tsunami affected areas in Tamilnadu. The following is the action plan for the visit. Meanwhile our team in Delhi lead By Dr Vidya Surwade and Ms Arun Rekha are co-ordinating the interactions between the two organizations.

 
Situation Analysis
Establishment of Telemedicine System
 

A. Location of camps run by OXFAM

B. Mortality and Morbidity caused by the Tsunami in     those areas

C. Existing Health care facilities

D. Patients Profile

E. Health determinants

i. Water and Sanitation
ii. Future Economic prospects (e.g Degeneration of         Arable Land)
iii. Post Traumatic Depression Syndrome
iv. Effects of Family Breakup

F. Demographic Profile (Particularly age structure).

A. Location

B. Space

C. Person (Computer experience / Health Worker/English)

D. Electricity Supply

E. Population catered

F. Security Considerations (Prevent Stolen/damaged
    equipment)

G. Existing Health care providers and their reach

 
Strategy
Creation of Community Telemedicine Network
 

A. Build Capacity with sustainability in mind

A. Operational Cost recovery

B. Reinforce exixting referral patterns

C. Income Generation Oppurtunities

 

Mizoram TSVCP Project Logo
Mizoram State's Telemedicine Supported Vision Care Project (TSVCP)
Supported by NPCB

Mizoram TSVCP Patient Examination

 

by SATHI

What is the project?

Provision of eye equipment along with computers, connectivity and ancillary telemedicine facilities at fixed centres at block and sub block level. These are run by specially trained Ophthalmic assistants with connectivity to Ophthalmic Surgeons. The system provides

  • a. An effective system for eye care
  • b. Cost effective & efficient delivery of eye care services
  • c. Easy access to eye care services
  • c. Focus on Health care and sensitization about eye care among rural citizens

Project operations and components

  • The key resource is the link worker who maps the villages under each block and encourages citizens to visit the centers
  • The Ophthalmic Assistant (OA) uploads data into the database.
  • The doctor creates a prescription and instructs the OA on the next steps
  • Based on the findings, the doctor can then advise on how to provide treatment whether locally or at the secondary or tertiary hospital
  • Patient undergoes treatment and the patient database is updated.
  • These centres also provide spectacles; prescription medicines and routine follow up.
  • Operating Doctor is regularly updated on the progress
  • Data can be reviewed for audit.

Unlike previous projects, SATHI will own the project for three years. We are also attempting to introduce other telehealth, general health as well as IT components as a value addition. This will put the installed systems and training to better use and help to make it sustainable.

 

  A step towards Elimination of Lymphatic Filariasis  View Video
  Sitapur Model for Morbidity Management  View Presentation
  Camps held on 19th – 22nd November, 2015 & 22nd January 2017  


Lymphatic Filariasis (LF) is endemic in 51 districts of Uttar Pradesh, including Sitapur district. Here an NGO Sangtin, along with its field organization Sangtin Kisan Mazdoor Sangathan (SKMS), took up this issue due to the suffering of patients and the lack of treatment options. Their search led them to Dr. S.B. Gogia and Mrs. Arun Rekha Gogia, who have been working on the issue for decades as well as attempting to start Filaria Care clinics across India through their NGO called SATHI (www.sathi.org). Mrs. Arun Rekha operates a voluntary clinic within AIIMS Department of Surgery, where patients suffering from lymphoedema are taught self management through hygiene, exercise and compression

Patient RegistrationSangtin representatives, on the advice of Dr. P. K. Srivastava at the National Vector Borne Disease Control Programme (NVBDCP), took up line-listing of LF patients. An informal survey in 13 villages yielded a list of 262 patients – 136 with hydrocele, 121 with lymphoedema and 5 with both conditions. With this list, Sangtin representatives met the UP Principal Secretary (Health), Shri Arwind Kumar, who promised full support from the Health Department. Next, a plan was developed for a camp on morbidity management with Dr. Satya Mitra, Director Communicable Diseases.

A preliminary meeting for arranging the camp was held on 3rd November between the above government officials and their team including, Dr Saxena DDG, Dr Mithilesh Supervisor Lucknow Division and attended by SATHI (Dr S B Gogia and Ms Arun Rekha) as well as Sangtin Representatives (Ms Richa Singh and Ms Surbala). On 4th November SATHI and Sangtin held a preliminary camp at CHC Pisawan with active help from its incharge Dr Bharati. 85 patients of all the 262 invited attended it and were examined as well as counselled on the next steps benefiting from the actual camp between 19th to 22nd November, 2016

While the Health Department agreed to make all the arrangements and provide medicines for the camp, officials said that they were unable to cover the cost of the compressive bandages, which came to about Rs. 2000 per patient. Sangtin representatives then approached the local MLA, Shri Anup Gupta, who expressed great interest in the camp and the broader goal of eliminating LF in his constituency. He supported the cost of bandages through the O.P. Gupta Foundation, set up in honour of his late father.

Nurses

 

 

Other Related Links to our work in Lymphoedema and Cancer counseling

Partners in Healing Rotary International Logo

AIIMS Pilot Project

Concept note on limb care in peripheral areas
( Aided by Telemedicine)

 

Rotary Club of Delhi Safdarjang (RCDS) has initiated a project on management of post cancer Lymphoedema and other related problems in the limbs. In a series of articles starting with the current issue, we hope to Inform Rotarians on the need and rationale of such a project. This is a bid to enlist a support for funds as well as personal participation in the activities.

Lend a handHistorical imageWith progress in healthcare and improvement in death rates of many diseases like cancer, there is a real need to add the focus along with care of the dying to care of the living. And this means management of chronic problems many of them leave one with a feeling ‘I would rather be dead’

Most are related to an inability of being able to take care of one self. This is largely related to problems in the limbs.

Aum

1. Healthcare Technology Aspects of Disaster Planning – based on the post Tsunami Experience

Authors: Dr S B Gogia, Dr M R Surwade

Organization S.A.T.H.I. (Society For Administration Of Telemedicine and Healthcare Informatics)
Correspondence Address: 28/31 Old Rajinder Nagar New Delhi 110060
Telephone Number +91-11-25853090, 25852291, Fax +91-11-25860163
Web www.sathi.org E Mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Presented by Dr S B Gogia

1.1 Summary :

S.A.T.H.I. has been involved in implementing the Healing Touch Project which has been sponsored by OXFAM Trust India. This Project was started after the Tsunami disaster in Tamilnadu to bring the fruits of Telemedicine, a new thrust technology in Healthcare Informatics to the victims. Being a new field, more than expected problems were faced. However despite a delayed start (in May, this year), the project has managed to provide mental health support to the victims while they were at home.

This pilot project can show the way forward to extending the fruits of technology in post Disaster Management. For that to occur, this technology should be more widely based, awareness should be present. The systems should be existing and available for immediate use as and when disasters occur.

1.2 Introduction :

Healthcare Informatics is a new and upcoming specialization. It holds the promise of improving the healthcare scenario of our country through

  • Increased Efficiency
  • Better monitoring of health status of the community
  • Upgrading the skills of Existing Health workers
  • Telemedicine

We from SATHI have been working to provide a Telemedicine based Healthcare support system for the Tsunami victims. The project though still incomplete and under implementation shows promise in showing the way forward to managing disaster.

Project for capacity building of Healthcare workers in Information Technology

Dr S B Gogia
S.A.T.H.I.


Low Cost Solution for High End facility

Introduction and Background

Doctors in India are overworked. Not only are they seeing too many patients, but they do not have enough supporting staff who could small jobs of counselling and documentation of their patients history, examination as well as reports. Computers can make their job easier and more efficient

IT in Healthcare so far has not succeeded as much as it can. One reason for this is the lack of suitable personnel who know both (Computers and usage of specialized medical software as well as are familiar with Medical terms and workflows.).

Doctors would like that the non essential and repetitive part of their work like documentation, maintaining the register, filling up forms with the patients name, age, sex etc to be taken over by secretarial staff. Ideally each form for a specialized test like X Ray or Biopsy (ie histopathology) needs to be accompanied by a detailed history and examination. However in practice, this is rarely done due to time constrains. A good and efficient EMR software e.g. Medic Aid which our sister organization is providing - can do that. But knowing what to click on and when has to be learnt for all the screens it provides and many of them are for use by a particular speciality or situation. Thus initial training and orientation to its use is required which again the doctors do not have time for.

SATHI has now taken the lead in bridging the gap through capacity building. We introduce Vocational Training for IT in Healthcare. Our efforts are targeted at youth from less privileged areas. Once the work force is ready in quantity and quality the growing gap will start filling

Many NGOs are working in urban slums and rehabilitation colonies to provide various types of vocational education to the local young crowd in an effort to make them employable. Two such NGOs we recently came across were EDUCAN at Madanpur Khadar in South Delhi and SAKSHAM BHARTI in Raghubir Nagar in West Delhi .

Among other very impressive activities, both are already providing computer training to the locals at extremely low rates.

We believe that this is an opportunity whereby we use the existing strengths of these organizations – in the form of availability of suitable facilities, staff and computers in a location team with youth from colonies which are yet to fully experience the fruits of development.

SATHI already has a panel of staff who can train the students already undergoing computer training at the above facilities. Just a little push to Medical Software is required. Since the persons are unwilling to pay, we are providing them the training at existing low rates. As and when a job offer comes, we shall charge a small amount from the employer and provide them these persons.

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