Success Stories in Care Giving for HIVAIDS: South Asia

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Success Stories in Care Giving for HIV/AIDS
South Asia
Presented by FEZANA (Federation of Zoroastrian
Associations of North America) at the UN 53rd
Commission on the Status of Women -March 4, 2009
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Introduction of Presenters
Farah Minwalla Columnist for the FEZANA
Journal. Trity Pourbahrami Community
builder and Past Youth President of
FEZANA. Kamalrukh Katrak Member of Bel-Air
Benefit Foundation, Participated in an
advisory roll for the new College of
Nursing construction. Deena Patel Member of
Bel-Air Benefit Foundation.

• Presented at the UN 53rd Commission on the Status
  of Women -March 4, 2009

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FEZANA

• Federation of Zoroastrian Associations of North
  America
• Umbrella organization for 26 Associations in
  North America
• Equal sharing of responsibilities between men and
  women is central to the Zoroastrian faith
• Supports humanitarian efforts internationally
  including the Bel-Air project
• www.fezana.org

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The Success Story Bel-Air Hospital in India
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BEL-AIR
some say is a model for AIDS care in the
developing world NPR morning Edition, July 6,
2007
Project of Indian Red Cross Society, Maharashtra
State Branch Managed by Missionary
Congregation of the Blessed Sacrament
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Bel-Air Contact Information

• Mrs. Homai N. Modi
• Hon. Secretary
• Indian Red Cross Society
• Maharashtra State Branch
• Tel [phone]
• Fax [phone]
• E-mail homaimodi _at_ yahoo.co.in
• Father Tomy K. MCBS
• Bel-Air Hospital
• Mobile Tel [phone]
• Tel [phone] / 240639 Fax 241897
• E-mail belair _at_ vsnl . com
• Website www.belairpanchgani.org

• Prof. Minu K Patel Dr. Mehroo Patel
• Bel-Air Benefit Foundation,
• [phone] 
• E-mail mkp _at_ uic . edu
• Dr. Manohar Jethani,
• Ribbon Foundation, Chicago
• 1977 Quincy Ct,
• Glendale Heights, IL 60179

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Why Bel-Air Hospital?
NPR morning edition July 6, 2007 Health care
professionals come from all over the world to see
how Father Tomy Karyilakulam has transformed a
rundown hospital into an advanced-care facility
for AIDS and TB Patients
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HIV IN INDIA
STATISTICS

• 2 to 3 million people infected with HIV in India
• 38 are women
• TB is the leading cause of HIV-related deaths

source UNAIDS/WHO 2008
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HIV in Maharashtra
source UIC 2005
Bel-Air
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HIV in Maharashtra

• It is one of the worst hit states in the country.
• Satara district has 4 prevalence rate.
• (India 0.3 prevalence rate)

Bel-Air
source UIC 2005
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HIV in Maharashtra

• Migration to big cities is linked to unsafe sex
  practices.

source UIC 2005
12

HIV in Maharashtra

• Long distance truck drivers having sex with
  female sex trade workers contributes to the
  spread of HIV in rural areas

source UIC 2005
Bel-Air
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HIV in Maharashtra

• Estimated 40 of female sex trade workers are HIV
  positive.

source UIC 2005
Bel-Air
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LOCATION OF BEL-AIR PANCHGANI, SATARA DISTRICT,
MAHARASHTRA
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Bel- Air Sanatorium- amidst thick forest on
top of a mountain
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Bel-Air Hospital in Panchgani India

• MISSION
• PART I
• To provide affordable, nondiscriminatory care to
  people with TB and HIV/AIDS.
• Compassion and Care For All.
• PART II
• Hospital and community center that provides
  charity care when needed, without depending
  solely on charity itself.

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Bel-Air History

• Started in 1912 as a TB sanatorium in the hills
  of Panchgani 44 acre health resort
• Handed over to the Indian Red Cross Society in
  1964
• Started admitting HIV/AIDS patients in 1994

play first part of video Vision and Mission of
Bel-Air Panchgani (0-3.50 mins)
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Bel-Air Hospital in Panchgani India
ACHIEVEMENT As Noticed by NPR, Morning addition,
July 6, 2007 Bel-Air has achieved what no
other rural hospital in India has done.. has
assembled the latest technology and doctors
needed to practice sophisticated Western-style
medicine. This led to (the) ability to get access
to government-controlled supply of drugs to fight
HIV
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MISSION PART I
To provide affordable, nondiscriminatory care to
people with TB and HIV/AIDS. Compassion and Care
For All.
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BEL-AIR Facilities Provided

• 250 bed hospital
• Staff of 150 including
• 24 doctors (male and female) ,
• 60 nurses (female)
• Well equipped Pathological Laboratory, CD4 Count
  Machine, Operation Theatre with Laparoscopy,
  X-ray-USG Machines, ECG, ICU, 24 hours Emergency.
• Food and treatment was made available for all.

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BEL-AIR -
Main Operating Theatre Facility one of 4 rooms.
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Bel-Air 1994

• Bel-Air admitted HIV patients and did their best
  to treat them at a time when the country had no
  experience.
• No support from the Government.
• ART was not available.
• Society was resistant.

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BEL-AIR 1994-2000

• People with HIV were abandoned by their families.
• Bodies were not claimed.

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BEL-AIR 1994-2000 Contd.

• Even cremation was difficult.
• Bel-Air staff were forced to wash the municipal
  crematorium after cremation of the HIV positive
  bodies.
• High levels of stigma and discrimination

play second part of video Vision and Mission of
Bel-Air Panchgani (7.20 mins -9.50 mins. followed
by 10.20mins 17.00 mins.)
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Bel-Air - The Success Story

• Successful in creating an environment free of
  stigma and discrimination in the hospital.
• International schools in Panchgani send their
  students for treatment to Bel-Air. Students
  mingle with patients regularly.
• Increased HIV awareness in the community

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Bel-Air Success Story Contd.

• Acceptance of patients with HIV by their family
  members.
• Patients regaining their confidence and dignity
• Most patients recover and go back to lead normal
  productive lives.
• 25 previous patients with HIV co-opted as staff.

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Bel-Air A Community and Family Support

• Ayurvedic and Naturopathy Health Center
• providing alternative medicine and yoga therapy.
• Healthcare for local boarding school children.
• Family members required to stay with patient at
  Bel-Air.
• Staff visit villages of discharged patients to
  facilitate re-entry into community.

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BEL-AIR -
Community awareness
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Anti-retroviral Treatment (ART)

• ART is supposed to be provided free to people in
  high risk states like Maharashtra (UIC 2005).
• India 20 of adults who need ART have access to
  it (UNGASS 2008)
• 25 of Bel-Air patients who need ART have access
  to it (NPR 2007). Bel-Air is working at
  increasing this number.

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HOW? as mentioned before
At Bel-Air, Father Tomy has achieved what no
other rural hospital in India has done He has
assembled the latest technology and doctors
needed to practice sophisticated Western-style
medicine. This led to his ability to get access
to the government-controlled supply of drugs to
fight HIV NPR, morning edition, July 6, 2007
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Patients with HIV TB treated at Bel-Air
1996-2008
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Bel-Air patients with HIV treated in the out
patient department
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MISSION PART II

• Hospital and community center that provides
  charity care without depending solely on charity
  itself.
• STARTING A COLLEGE OF NURSING
• 2. PRIVATE BOARDING SCHOOL

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Nursing

• World wide shortage of nurses
• US 773 nurses per 100,000 people
• India 63 nurses per 100,000 people
• 12 fold difference!
• In India 50 migrate to other countries US, UK,
  Saudi Arabia
• Many health care facilities use unlicensed
  personnel

source UIC 2005
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Bel-Air College of Nursing

• Started in 2006
• The first nursing program in India with a focus
  on HIV/AIDS.
• Identified by Indian Nursing Council NACO to
  train nurses in HIV.
• 40 students per class 4-year program
• All nursing students are women
• Most nursing students from Kerala

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College of Nursing -
New construction along the slopes
New construction main entrance
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College of Nursing
While it may turn a profit, it, more
importantly, will provide 80 nurses and students
to staff the hospital nurses that will be
needed as the demand for AIDS treatment continues
to rise.
source NPR July 6, 2007
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Bel-Air College of Nursing Created a
Collaboration with University of Illinois,
Chicago

• Faculty and student exchange
• Curriculum
• Joint research activities
• Participation in seminars and academic meetings
• Exchange of academic materials and other
  information

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College of Nursing -
UIC, Chicago Collaboration
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Private Boarding School

• Just down the road from Bel-Air is a brand new,
  private boarding school, run by Father Tomy's
  mission. The building has long, cool hallways,
  spacious classrooms, verandas and fans. The
  school attracts the wealthy from Mumbai and
  beyond. Its substantial profit goes to Bel-Air.

source NPR July 6, 2007
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Bel-Air - National Training Institutefor
HIV/AIDS Management
Other achievements

• 2003 - 2008 Bel-Air has trained
• 804 doctors, 220 nurses, 41 health workers,
• 57 counselors and 81 faith leaders

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Bel-Air selected to train Community Care
Center nurses in the states of Maharashtra,
Chhattisgarh, West Bengal, Rajasthan, Madhya
Pradesh, Orissa, Gujarat, Bihar and Uttar
Pradesh.
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Future VisionA Center of Excellence

• Center for the training of doctors, nurses and
  other health care providers from South and South
  East Asia in HIV/AIDS

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References

• Epidemiological Fact Sheet on HIV and AIDS,
  India, 2008 update. UNAIDS/WHO Working Group on
  Global HIV/AIDS and STI Surveillance. Downloaded
  from http//www.who.int/hiv/countries/en/
• UNGASS Country Progress Report 2008, India.
  National AIDS Control Organization Ministry of
  Health and Family Welfare, Govt of India, New
  Delhi.
• Feasibility Study Report Advancing Nursing
  Education at Bel-Air Hospital. University of
  Illinois at Chicago College of Nursing, 2005.
  http//www.uic.edu/nursing/research/bel-air/feasib
  ilityreport_april15_08.pdf
• NPR story Priest Revives Former TB Clinic for
  AIDS Patients. July 2007. http//www.npr.org/templ
  ates/story/story.php?storyId11704607
• 18 minute Video on Bel-Air Hospital
  http//realmedia.uic.edu/ramgen/depts/nurs/msnurs/
  belair.rm