MSF continued to focus on improving diagnosis and treatment of HIV, tuberculosis (TB) and kala azar (visceral leishmaniasis) for people unable to access healthcare in India.
Due to poverty, social exclusion and an under-resourced health service, basic medical care is out of reach for a significant portion of India’s population. MSF works to fill some of these gaps and to increase capacity in the system.
MSF continued to run weekly mobile clinics providing free basic healthcare to villages in southern Chhattisgarh, and to displaced people in Andhra Pradesh and Telangana. These communities have limited access to medical services because of the ongoing, low-intensity conflict in the area.
In Chhattisgarh, the mother and child health centre in Bijapur district provides obstetric, neonatal and paediatric care. MSF teams run mobile clinics offering basic and specialist medical services to people living in the surrounding area. More than 56,400 consultations were carried out and over 13,800 patients were treated for malaria.
Extending care for HIV, TB and hepatitis
MSF’s clinic in Mumbai provides psychosocial and outpatient medical care to patients with HIV, drug-resistant TB (DR-TB), hepatitis B and C, and those co-infected with any of these diseases. The team also supports infection control activities for DR-TB and works closely with staff at Sewri TB hospital to increase treatment capacity. Towards the end of the year, MSF started working with the Revised National Tuberculosis Control Programme to find ways to reduce the number of people contracting and dying from TB in eastern Mumbai, where the number of cases is particularly high.
The northeastern state of Manipur has some of the highest rates of HIV in the country, and in mid-2015, MSF began treating HIV patients co-infected with hepatitis C – more than 25 per cent of all patients. The comprehensive care programme for HIV and TB patients continued in Churachandpur, Chakpikarong and Moreh, as did MSF’s work supporting a local NGO with oral substitution therapy for intravenous drug users.
Fighting infectious diseases in Bihar and West Bengal
Kala azar is endemic in the Vaishali district of Bihar, and patients with HIV are particularly susceptible to the disease. After sustained lobbying by MSF, the Indian government rolled out a new first-line treatment in the form of single-dose liposomal amphotericin B in October 2014. In 2015, MSF treated 582 patients for kala azar, half the number in the previous year.
In November, a fever management project was set up at Asansol district hospital in West Bengal, in collaboration with the state health department. By the end of the year, MSF had treated 178 children for acute fever. The project provides free diagnosis, treatment and referrals for children aged between two months and 14 years. Common causes of acute fever are diseases such as dengue and chikungunya.
Mental healthcare in Kashmir
MSF currently runs mental health programmes in the districts of Srinagar, Baramulla, Bandipora, Pattan, Pulwama and Sopore. To increase awareness and the visibility of mental health issues, MSF worked with a Kashmiri production company to produce a TV soap opera called Aalav Baya Aalav. It was first broadcast in late 2014 and continued into 2015. The programme highlights the free counselling services run by MSF that are available to everyone.
Also in 2015, a mental health survey was conducted, in 10 districts in Kashmir in collaboration with the psychology department of Kashmir University and the psychiatric hospital. The survey aims to estimate the prevalence of mental health-related problems, including depression, anxiety and post-traumatic stress disorder in the area. The findings of the report were published in May 2016.
Treating victims of sexual and gender-based violence in Delhi
A new 24-hour treatment centre for victims of sexual and gender-based violence opened in Delhi in November. Unmeed Ki Kiran clinic in the north of the city provides medical care to people who have been sexually assaulted or subjected to domestic violence, including children.
Patients’ physical injuries are treated, and they are provided with post-exposure prophylaxis to prevent transmission of HIV and sexually transmitted infections. They are also offered counselling, and pregnancy tests, if relevant. A referral process is in place for patients needing additional services, such as legal advice or emergency accommodation. The team also raises awareness within the community through education and outreach activities on the importance of seeking timely medical and psychological care.
Emergency response in Chennai
Heavy rain led to widespread flooding in Chennai in December, and many people were forced from their damaged homes. MSF teams distributed 500 hygiene kits (containing toothpaste, washing powder, soaps, towels, etc) and 500 shelter kits (containing ground mats, blankets, etc), as well as 1,000 mosquito nets.
Darbhanga project handover
In August, MSF handed its nutrition project over to Darbhanga medical college and hospital and the health ministry, as community-level care had been successfully integrated into the public health system. Between 2009 and 2015, more than 17,000 children under the age of five suffering from acute malnutrition received treatment through the programme.
No. staff in 2015: 588 | Expenditure: €11.7 million | Year MSF first worked in the country: 1999 | msf.org/india