HIV/AIDS Support: Outeach Program

WEIF has an ongoing collaboration with Somaiya Action for HIV/AIDS Support (SAHAS) to continue providing vital services to Persons Living with HIV (PLHIV) in the poorest areas of Mumbai. In 2010, SAHAS established a Community Care Centre (CCC) under the National AIDS Control Organization (NACO). The Centre, which provided psychosocial support, shelter and counseling to nearly 2,000 HIV-infected individuals and their families, was forced to close in April 2013 when government funding was withdrawn as NACO phased out the CCC program across the entire country. The CCC operated from the K J Somaiya Hospital near the Pratiksha Nagar slums in Mumbai and was one of the few facilities admitting and caring for poverty-stricken PLHIV who could not afford treatment. Though SAHAS no longer had the capacity to admit patients, its staff maintained contact with its 1905 clients, as well as 500 HIV infected and affected children and is continuing to provide outreach support to communities in all ways their limited funding allows.

WEIF and SAHAS have continued to reinvent the program to ensure the support we offer is effective, broad, and sustainable. Our activities have included investing in technology, personnel, patient care and a multi-faceted outreach program that will include a 24-hour helpline. As part of the program's sustainability strategy, WEIF is assisting SAHAS in establishing a production program to generate revenue and provide training and employment opportunities for PLHIV. WEIF is supporting a community outreach program for PLHIV, and with the support of our generous donors we hope to scale up the level of support we are able to provide.

The activities of our outreach program include:

  • Increasing access to health care in the slums through home-based counselling and monitoring by Outreach Workers (ORWs). Many of these ORWs are HIV-positive women with a strong understanding of HIV/AIDS, available treatments, and the social hardship that can accompany the disease. ORWs provide home-based counseling and follow-up on adherence to antiretroviral therapy (ART). ORWs will admit PLHIV to Somaiya Hospital for short-stay treatment of opportunistic infections and other medical conditions requiring immediate intervention. An additional 16 women registered in the program in 2016 and received prenatal care including blood tests, prenatal vitamins, and counseling sessions. In 2016, 245 one-on-one counseling sessions, 84 group counseling sessions (including mother-in-law's, husbands and caregivers), and 595 telephone counseling sessions were conducted in total, and 157 visits to the anti-retroviral treatment center were completed by outreach workers. SAHAS has a registered client base of 2,379 PLHIV as of January 2017, and of these, 463 are children.
  • Reducing mother-child transmission of HIV. ORWs employed by SAHAS reach out to pregnant women in the community and encourage them to be tested for HIV so that immediate action may be taken to prevent mother-child transmission. SAHAS provides critical support to pregnant women with HIV, including individual and family counseling, monitoring of ART, supplementary nutrition for children and access to government food card programs. In addition, ORWs counsel HIV positive pregnant women on delivery by caesarean sections, and best feeding practices following delivery to further reduce the chances of transmission. Since this program was initiated, 39 women have been registered for antenatal care, and 91 have registered for post-natal care, and 91 children have received vaccinations delivered by SAHAS ORWs. In 2016, with support from WEIF, there were seven caesarean section deliveries at the Somaiya Hospital, and 11 SAHAS clients delivered by caesarean section at other hospitals and received follow-up care. All children delivered in 2016 were HIV-negative and have received ongoing follow-up from SAHAS outreach workers to ensure appropriate vaccinations and nutrition. In total, there are 66 children enrolled in the SAHAS nutrition program; these children are all attending school and have the option of coming to SAHAS for meal supplementation if desired.
  • Promoting education and awareness of HIV/AIDS in communities. In 2014, WEIF and SAHAS focused on providing information to school and college students through HIV/AIDS awareness workshops conducted by SAHAS. SAHAS and ORWs have continued to develop and informally disburse Information-Education-Communication (IEC) materials and conduct information sessions on HIV/AIDS for vulnerable community members, including men, women, adolescents, and migrant workers. Social workers and counsellors worked with the ORWs to provide accurate information about HIV/AIDS to youth in municipal schools in slum areas, to migrant workers on construction sites and in factories, and to the general populace to reduce misinformation and promote understanding and acceptance for PLHIV. This education program has continued to grow, and in 2016, we held 10 sessions covering nutrition, treatment adherence, prevention of transmission, hygiene and water treatment, with 226 women in attendance.
  • Improving access to Government Public Welfare Programs. SAHAS works closely with Government agencies to facilitate access to various public welfare programs for its clients and has obtained ration cards for more than 200 women heads of households. This ensures food security with subsidized food grains under the Public Distribution System for PLHIV.
  • Supplementary nutrition for children and nutritional counselling. SAHAS provides supplementary nutrition to children up to age of 17 on a monthly basis. The Somaiya Trust sponsors the cost of nutrition. In addition SAHAS provides nutritional counselling to prolong pre-antiretroviral therapy phase. That is, it counsels its clients who are not on antiretroviral therapy to remain healthy and active with better nutrition and prompt treatment of opportunistic illness so they prolong the phase before they are put on ART. This results in improved health and ensures longer periods of employment.
  • Educational Support for HIV Positive Children. Children from impoverished families are expected to begin working once they have completed 10th Grade, rather than continuing their education, and HIV-positive children find it even more difficult to continue attending school. If these children are given the opportunity to pursue diplomas in professional skills, they improve their earning capacity and can better support their families on an ascent out of poverty. In 2015, WEIF supported seven students continuing on to the second year of their program, as well as six students who completed their programs. In addition, WEIF began supporting three new students in 2015, and each of them is doing well in their current program.

WEIF Volunteer and Nurse Jennifer Dodd visits the Somaiya Action for HIV/AIDS Support Project

In September 2013, WEIF volunteer and Masters of Nursing graduate student Jennifer Dodd travelled to Mumbai for two weeks to learn more about the partnership between WEIF and SAHAS, as well as contribute her knowledge and skills to the outreach program. Jennifer’s visit, in her own words:

"I arrived in Mumbai on a scorching hot September morning. After travelling 24 hours over several continents, I was exhausted and overwhelmed by the caucophony of sights, sounds and smells of the city. Travelling from the Somaiya College campus where I resided for my stay in India to the Somaiya hospital on a daily basis was an adventure each and every time. Riding in a motorized Rickshaw was a first for me, and experiencing the Mumbai morning traffic meant an assault on the senses. The sweltering heat, the endless honking of horns, the smell of diesel fuel, the congestion of vehicles and the occasional animal at the side of the road became routine. At stoplights the street children would come out to vehicles begging for money, some victims of leprosy, others abandoned, exploited and homeless. Poverty was all around and could not be ignored. I became acutely aware of my North American privilege.

The first day the Project Director Dr. Patricia Gokhale took me to visit the project, I was humbled by the kindness and generosity of the SAHAS staff. Staff included a project manager, counsellor, nurse, administrator and outreach workers. All embraced me as one of their own and I was immediately invited to witness their work in action. Throughout the day, a parade of clients would visit SAHAS. Clients would come to have their three-month check-up with staff, which included measuring height, weight and counselling to see if HIV medication was being adhered to. Nutritional counselling was provided and rations such as lentils and rice were also given to clients. SAHAS cares for over 2,000 clients who are infected with or affected by HIV/AIDS and 500 of those clients are children. I often saw grandparents with young children at SAHAS and was told that many of these children have lost one or both parents to AIDs related illnesses.

I spent a day doing home visits with SAHAS outreach staff in the slums. I walked through the slums between narrow passageways that were dark, damp and dirty. I stepped over a dead rat and walked beside mounds of garbage. The families that I met who live in the slums kept their homes very clean – despite having no running water, no bathrooms, no beds to sleep on, or tables to eat on. They seemed excited to have a visitor from Canada and I was humbled to have been received so kindly.

Throughout my stay in Mumbai I had feelings of intense joy and sorrow. I thought about the struggles facing the SAHAS children and their families while my own children were safe and healthy back home in Canada. I felt proud to be in Mumbai on behalf of WEIF and was honored to have had the opportunity to participate in such a life altering experience. I would like to thank Dr. Patricia Gokhale and all of the SAHAS staff for their willingness to embrace me whole-heartedly during my visit. I am forever grateful to the children and families that I met along my journey and vow to return to India one day. In the end, I could not wait to get back home to my own family and share what I had witnessed. I wanted to hold my children a little tighter and tell them how much they are loved."
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