Bihar

Along with Bihar, our operations extend to Jharkhand, Uttar Pradesh, and Delhi towards leprosy, lymphatic filariasis, eye-care and tuberculosis. 

  • Bihar is a highly populated state and its inhabitants are more than 103.8 million (8.1% of the country). If this state was a country, it would be the third poorest in the world as 80% of the people live below the international poverty line of US$1.25 a day. 
  • India contributes 59% of the global leprosy burden and 40% of the global LF cases. In India, Bihar alone contributes 32% of all LF cases and 15% of all leprosy cases. 
  • In Bihar, a total of 17154 new leprosy cases are detected between 2018 and 2019. 
  • 12% of child proportion in the new cases of leprosy shows that the percentage is higher than the national data. 5.5 % disability proportion among the new cases of leprosy shows late detection. 
  • An analysis of ANCDR states that 31.5% of cases are being detected in Schedule Caste (SC) population. Our reach is being extended for detecting missed out cases in these communities. 
  • Leprosy and LF diseases cause immobility, impairment, and need constant wound care, dressing and physiotherapy. For the people affected it also results in stigma, social exclusion and reduced income. 
  • With LEPRA efforts, the government rolled out a plan of action with a provision INR 750 incentive per surgery to encourage and clear the backlog of hydrocele surgeries. The strategy of incentive is being implemented in 38 districts. 
  • The World Health Organisation estimates that during 2010-2020, the cumulative impact of blindness and visual impairment in India is $162 billion. India has the highest level of blindness in the world with 15 million blind people, cataract being the primary cause. 
  • Bihar, being one of the poorest Indian states, is the worst hit with 7,00,000 blind and 4.3 million visually impaired people (1,00,000 additional people become blind every year). Prevalence of blindness was reported to be 8% in the age group of more than 50 years as per National blindness survey. 

There are a total of 10 projects in Bihar, Jharkhand, Delhi, and Uttar Pradesh, which are

Jagruti (awakening in Sanskrit) is a unique, integrated NTDs and WASH project collaboratively implemented by American Leprosy Missions, LEPRA Society and HI Rapid Lab of the Public Health Foundation of India. Piloted in Andhra Pradesh and Odisha in 2018-19, the program was scaled in Bihar in 2021. The 3-year project covers 130 villages of Kalyanpur block in Samastipur district, Bihar. The project aims to reduce risk of transmission of endemic NTDs among at-risk communities, and reduce the negative impact of chronic, disabling NTDs like leprosy and lymphatic filariasis among people affected, in this high-endemic, rural and remote Block. The project is women-led, utilizes digital technology to facilitate interventions, and employs a human rights-based approach to ensure sustainability. 130 trained women Community Resource Persons (CRPs), one from every village, lead the program interventions at the local level. They reach 63,630 households with education on recommended WASH practices and NTD prevention measures and promote behaviour change. The project works with 3815 SHGs, 38 SHG Federations, 40 schools, 31 local governing bodies, 186 village water and sanitation committee members, 782 frontline workers from government, PHC Medical Officers and government authorities as key stakeholders, engaging with local government and promoting people-led advocacy for essential water, sanitation, and health services. A baseline universal household survey completed by the CRPs in their own villages supports focused interventions and evidence-based advocacy. The project has line-listed around 5000 persons with leprosy and lymphatic filariasis for morbidity management and disability prevention to prevent new disability and worsening of existing disability, helping them avail government benefits, and advocating for primary level NTD care. The project is organizing them into 31 self-support groups at the panchayat level to facilitate advocacy and encourage regular self-care. 

Restoring Lives of Forgotten People project enables 1,20,000 people living in poverty to lead healthier, productive and self-sufficient lives through an integrated and holistic approach of tackling health issues and stigma associated with leprosy and lymphatic filariasis. The project serves 1,16,000 people with lymphatic filariasis and 4,000 people with leprosy in Samastipur district of Bihar. 

From 2015 through 2019, the project contributed 92,274 people affected by LF (89,705) and leprosy (2,569) have received treatment, care and support from the project. 62,604 people affected by LF (Grade 1,2, & 3) and 1769 Grade 1, Grade 2 affected with disabilities were trained on the self-care practices. 

Improved skills and capacities to public health staff (1350), Rural Medical practitioners (RMPs) 1525 and community-based institutions to suitably address health, social and economic need of affected people 7405 persons with LF and 1051 persons with leprosy are linked with government schemes and entitlements.

Neglected Tropical Diseases Resources Unit (NTDRU) is implemented in four districts – Bhagalpur, Munger, Begusarai and E. Champaran (Raxaul) of Bihar. The main activities of the project are done to increase case identification at an early stage, refer them to the government health institutions for treatment, organizing IPOD camps, capacity building to project stakeholders, ASHA, ANMs, MOs, General Health care Staff, observing National Health Days and IEC. 

Similarly, we are extending technical support to the District Heath Society for implementation of National Leprosy Eradication Programme (NLEP) and National Vector Borne Diseases Control Programme (NVBDCP). The resource unit caters services for preventing of disabilities of 12000 beneficiaries.

Referral Centre, Mungerprovides a wider range of services from diagnosis, counselling, treatment of reactions and ulcers, training in disability management for LF and leprosy, provision of adaptive devices/ protective footwear, follow-up of persons and sensitise the beneficiaries about government schemes and entitlement. The project intends to be a learning centre to improve quality care and enhance the capacities of government/community. The referral centre provides self-care practices and prevents disabilities of 3000 beneficiaries. 

Mobile Foot Care Unit – Provision of footwear should be considered as a ‘mandatory measure’ and not as an extra, optional rehabilitation measure. Providing protective footwear is a part of the treatment. The innovation of LEPRA – the “Mobile Foot Care Unit”, the first-of-its-kind in India, is a great success of the team. The foot care unit is supported by Pavers (UK) and delivering 3000 pairs of protective footwear to all disabled cases in 63 leprosy colonies in Bihar. The unit is providing two pairs of protective footwear to each person affected by leprosy in a year. One thousand five hundred persons disabled due to leprosy are living in 63 colonies of 38 districts of Bihar. 

Sarthak (Production of Protective footwear unit) has started the supply of protective footwear on request of government order in Bihar, Jharkhand and ILEP. This unit is supporting in providing the footwear to persons affected by leprosy in the NLEP. A total of 13091 pairs protective footwear comprising 11895 pairs footwear supply of Bihar, 1307 Pairs footwear supply of Jharkhand and 1186 pairs footwear supply of Telangana and Andhra Pradesh 

Rural Eye Health Project (Netra Vasant) is implemented in Bhagalpur, Munger, BegusaraiSamastipur and Purnea districts of Bihar. It aims to provide eye care services and control avoidable blindness in the mentioned districts. The project also strengthens the health service delivery system by improvising eye care departments in the district hospitals. 2,00,000 beneficiaries are expected to avail and get helped from this project. 

Number of people impacted through projects in Bihar

  • MMDP Centre served 2,130 people affected by LF, for treatment of acute attack/entry points and 401 people with leprosy, for diagnosis and leprosy reaction management. 
  • A total of 16,445 persons reported a reduction of the swelling in their limbs. 11,583 persons (6,826 women, 4,442 men, 315 children) with LF were treated for acute attacks, of which 84% reported a reduction in the frequency of acute attacks. 
  • The joint efforts of the Government and project team 5,726 hydrocelectomies were performed in the public and private hospitals of Samastipur District. 
  • Protective footwear made by the project was provided to 16,995 people – 14,748 with LF and 2,247 with leprosy. It has increased the mobility of 70% of affected people. 
  • Over four years, a total of 18,787 people with LF have claimed social benefits such as ration card, widow pension, or are linked with livelihood agencies. Simultaneously, 653 persons affected by leprosy linked with Bihar Shatabdi Kusth Kalyan Yojana (BSKKY). 
  • 10,963 LF cases were registered and demonstrated them self-care practices at the community level. Amongst 76% (8,332) people have reported the reduction of swelling and 81% reported a reduction of reduction in the frequency of acute attacks. 
  • 218 persons were managed for reactions and neuritis – 147 recovered after treatment and prevented their disability. 
  • 9,261 protective footwear provided to the affected persons and it supported in increasing their mobility. 
  • 1,075 persons with hydrocele are mobilised and facilitated hydrocele surgeries in government health facilities. 
  • Difficult to diagnosis cases – 248 new cases of leprosy are diagnosed at referral centre and put under the Multi Drug Therapy. 
  • 127 persons are managed with steroid therapy and prevented their disabilities. 365 persons are treated for ulcer and 74% (271) persons have reported for healing of their ulcers. 
  • 2653 pairs protective footwear provided to the affected persons and among them 663 persons have received the footwear with arthrodesis and prevented in recurrent ulcer as well as increasing of the mobility. 

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