Disable and destitute welfare program
Under the guidelines laid down by the Kashag, Central Poverty Alleviation Committee was formed and conducted intensive survey among exiled Tibetan population. The reports of the committee were further reviewed by the Review Committee Members of the Tibetan Parliament in Exile. The destitute were categorized among four groups to be taken cared of by three concerned departments: home, education and health. So far as of 2021, 268 cases fall under the jurisdiction of the health department.
As per Kashag’s policy and guidelines, department of health provides monthly stipend and bears all the medical expenses of the poor and needy Tibetan people identified by the committee.
Besides, the department undertook a major survey on physically challenged people in Tibetan community in exile in 2002. Survey identified 406 people facing severe challenges relating to speech, mental, visual, hearing, physical movement, and epilepsy. To look after the welfare of these people at their own respective settlements, the department has established 11 rehabilitation committees in 11 different settlements. To further elevate the capacity of the concerning staff to deal with such population, the department provides training to community health workers (CHWs) from different Tibetan Settlements on Disabled Management. The trained CHWs should be included compulsorily in the above said committees to give guidelines and idea to the members. The department provides stipends to around 98 differently abled Tibetan people to meet their medical expenses and bears the expenses of aid and appliances devices like wheelchair, hearing aids, leg brace etc.
The department of health has recently introduced Community Based Rehabilitation Program (CBR) in our settlements to give extra care to our disabled people and to make them self-sustainable through rehabilitation.
The department of health is currently working towards the integration of traditional Tibetan medicine with the allopathic medical approach in order to provide maximum benefits. It works to increase the frequency of referral process between the two health care systems, the medicines of which run parallel to each other and are used equally by the people.
After a few studies regarding mental health in the early 1990s, the Department of Health felt need of implementing primary mental health care program to solve problems of individual or family in the community. Therefore, the community health workers are provided with basic training on mental health care and the selected mental health field workers are given intensive training on mental health. References are made to local Indian physicians and psychiatrists if further medication is felt necessary. In addition to psychotherapy, the Department conducts training, gives refresher course and mental health awareness talks in the communities from time to time.
Under this program, Department takes care of the mental and epilepsy patients. The Department Reimburse 50% of the mental expenses to all the patients and 100% to those registered under CTA destitute list. The Department also provides more than fifty percent of reimbursement to those having special recommendation from respective Representative Office. Till date as of 2021, 200 mental health beneficiaries which also includes Epilepsy patients from various Tibetan settlements rolled up in the program and continue to benefit from it.
Viral Hepatitis Program
Hepatitis B infection is caused by the hepatitis B virus (HBV), an enveloped DNA virus that infects the liver, causing hepatocellular necrosis and inflammation. Among the communicable diseases, hepatitis B and tuberculosis (TB) are the two diseases that plaque the Tibetan Refugee communities living in India & Nepal. The prevalence of hepatitis B is estimated to be much higher among the Tibetan refugee population living in the Indian subcontinent as compared to the local host population. The findings from a study carried out in the Bylakuppe Tibetan settlement in South India jointly by DoHe-CTA and Johns Hopkins University (JHU) in 2014 suggests that Tibetans living in India has about 9 % prevalence of chronic Hepatitis B infection.
DoHe-CTA has been working in the area of hepatitis B with a focus on prevention; the key intervention strategy being the universal vaccination against hepatitis B virus for under-5 children and the prevention of new infection through three/four dose hepatitis B and they will continue to be the key intervention strategies.
Screening for Hepatitis B infection results in identification of people with chronic hepatitis B infection who are undiagnosed earlier. With the funding support from the US PRM, Department of Health, CTA has started Hepatitis B screening, vaccination and Treatment support for Tibetans in India. In 2019, a people of about 11000 has been screened for Hepatitis B and C.
Primary health accounts for 70-80% of health problems and burden of health expenditure on any given society. These issues may be further lowered by initiating targeted preventive healthcare among the community.
A key finding of Tibetan health system assessment was the underutilization and limited reach of DOH facilities, in large due to lack of an effective community outreach strategy, because Tibetans in South Asia are highly mobile and often seek health care outside DOH facilities, DOH has partial information about the health status and health seeking behaviors of the community it serves.
One of the most effective mechanisms of preventive and primary health service is through effective community outreach program. Community Outreach is an activity of providing services to any population who might not otherwise have access to those services. The practice of offering support to community members. A key component of outreach is that the groups providing it are not stationary, but mobile; in other words they are meeting those in need of outreach services at the locations where those in needs are. In addition to delivering services, outreach has an educational role and raising the awareness of existing services. Community outreach provides basket of health services to community to ensure health service and information that should reach to each and every one. The CCOCC program particularly deliver primary and preventive health services for the community.
Objectives for Community Out reach
- Comprehensive coverage of community – facility visitors & non-visitors
- Complete health information coverage
- Information on community health profile
- Early detection and care – life style and infections
- Proactive behavior change – Education and knowledge about emerging health issues
- Continued care and follow-up
The nurses and Community health workers who are the back bone of CCOCC program continues to carry outreach activities in settlements of India and Nepal. Services offered during outreach visits include household visits, home based diagnostic services, Carry out Surveys, data collection and provide medication support and referral.
During visits they follow up on ANC, PNC, Immunization, TB, Hepatitis B and other symptomatic ailments. The nurses also provide door step health awareness with education tools like Pico projector, Flipcharts, Tablet etc.