annual report 2011 - swissemmausindia€¦ · annual report 2011 | 3. swiss emmaus leprosy relief...

ANNUAL REPORT 2011SWISS EMMAUS LEPROSY

RELIEF WORK INDIA

Message from CEODear Colleagues,

It gives me immense pleasure to be writing this note to share some of the highlights during2011. One of the biggest highlights has been the establishment of Swiss Emmaus India’s (SEI)new office in Gurgaon (part of the National Capital Region-NCR). After collaborating with theGLRA for the last 5 decades, it was time for us to plan ahead for the future by creating newopportunities and approaches to development work in India. This gave us the uniqueopportunity to be autonomous and promote our mandate, mission, and vision, which is primarily‘people’ centric and revolves around their physical, psychological, emotional, and social well-being. The decision to establish the office at Gurgaon was with keeping in mind the long termorganizational plans along with the fact that majority of our work entails advocacy and liaisoningwith the Government of India (GoI), and other institutional donors who have their respectiveoffices in the NCR.

The establishment of the office also involved recruiting new staff to manage our operations inIndia. Specifically, we recruited 2 additional staff at the senior management level along withfurther reinforcing our fundraising team. Three colleagues continued with SEI from the erstwhileteam that operated from Chennai. Cumulatively we currently have a staff strength of 10colleagues that includes both programmatic and administrative staff.

I’m glad to report that we were able to accomplish all our planned activities in spite of all thetransitions and movement from Chennai to Gurgaon. Most interestingly, one of our major activitythat is, fundraising was really gratifying. For the first time since its short existence, thefundraising unit of SEI was able to generate income over expenditure. Following our discussionwith our funding agency we have further reinforced some of our key activities that’ll hopefullyyield encouraging results in the future.

I would also like to sign off by sharing another major milestone and that is, my colleague Mr.Rene Staeheli (Managing Director, FAIRMED, Berne) being elected as ILEP President for thesecond term, which by itself is a huge achievement and acknowledgement for his invaluablecontribution towards the fight against Leprosy globally.

As we embark on another year of exciting work, I would like to wish you and all our projectcolleagues the very for 2012.

Thank you,

Sincerely,

(John Kurian George)Annual Report 2011 | 2

Swiss Emmaus Leprosy Relief Work India Operations 4Activities in India

Leprosy 5Support for NLEP interventions Hospital services Output Based Aid (OBA) & Quality circle meetingsDisability Prevention and Medical Rehabilitation POID-AP project

Tuberculosis 10Link workers intervention in GoaLSS Mumbai

Hospital Information System 12

Fund Raising Activities 12

Financial report 14

SEI India Team 18

Contents

Annual Report 2011 | 3

Swiss Emmaus Leprosy Relief Work India Operations

Swiss Emmaus Leprosy Relief Work India(SEI) is a registered Trust supported byFAIRMED formerly known as LeprosyRelief Work Emmaus Suisse (LRWES)situated in Switzerland (Bern). Theorganization launched its activities inIndia in 1960 in the field of Leprosy andin 1976 it established the RegionalSecretariat for India and Sri Lanka atChennai. Globally and in India, SwissEmmaus is one of the foundingmembers of International Federation ofAnti-Leprosy Associations (ILEP).Due to the constantly decreasing trendof new cases of Leprosy, SEI changed itsstrategies to focus on newer areas likeTB and Urban health. In June2011, Swiss Emmaus India had relocatedits Indian Headquarter from Chennai toGurgaon, NCR (National CapitalRegion), Delhi.

Activities in IndiaSEI India was involved in the Leprosy andTB control activities in partnership withthe Government of India’s (GoI) theNational Leprosy Eradication Program(NLEP) and the Revised National TBControl Program (RNTCP). Besides, SEIalso supported urban slum basedinterventions for holistic development ofthe urban poor. In 2011, SEI supported22 NGOs/ programs across the countryto work in the field of Leprosy, TB andurban slums. SEI could detect and treataround 3.2 lakhs people affected byleprosy over a period of five decadesthrough these NGO partners. Afterclosure of the Technical Coordinationoffice at Mumbai in December 2010, alloperations of Swiss Emmaus India wasactively monitored from the centraloffice in Gurgaon.


LeprosySupport for NLEP interventionsSEI India and its partners have been engaged in various interventions as apart of the NLEP to eliminate leprosy, to reduce stigma and discriminationand empowering the affected communities to live a dignified life with theirfamily.As the country changed its strategy to mainstream Leprosy activities into theGeneral Health Care system, the NGOs’ role of active case finding andtreatment was also changed to more of Rehabilitation and Prevention ofdeformity (RPOD). The NGO partners were more focused towards providingboth out-patient (OP) as well as in-patient (IP) services to the leprosyaffected patients for ulcer management, management of reactions, othercomplications, reconstructive surgeries and other non-leprosy relatedillnesses.

Details of the services TotalNo. of leprosy patients treated for complications 36,682Number of patients treated for reactions 775Self reported new leprosy cases diagnosed and referred to Govt. centre

950

Patient with disability among new referrals 725


Table No. - 1: Current trend of new case detected and services provided by partner projects for 2011

Hospital ServicesHospital services have been one of the key areas of support provided by the NGOpartners of Swiss Emmaus India. These include both out-patient and in-patient careto the persons affected by Leprosy. In 2011, SEI supports 6 referral hospitals in 4states for providing care to the affected groups for managing Leprosy relatedcomplications like reactions, ulcers, pre and post surgical care, and other non-leprosy related ailments etc.

Details of the services

RISDT, Kathipudi

ESLP, Palamaner

SHLC, Kumbakonam

HHH, Hubli

Gretnaltes, Morampudi

Sevadham, Pune

Total

Beds 60 60 115 30 31 6 302Admissions 2205 1367 1563 211 947 26 6,319Completed treatment

2158 1220 1480 204 930 26 6,018

Bed days 19727 46299 27299 4305 10935 156 1,08,721

Average length of stay

9 42 17.5 11.79 11.55 6 16.3

Table No . - 2: Details of Services


Output Based Aid (OBA) & Quality circle meetings

SEI India had introduced the concept of OBA from 2006 onwards for reimbursingthe Leprosy activities by the local NGO partners in India. To startwith, RISDT, Kathipudi was considered the platform to pilot test the concept andthe costing of each category was calculated with the help of a SwissManagement student and an Indian Costing consultant. Over the years theprocess was evolved and in the mid 2011, Mr. Tinu Joseph from Switzerlandalong with SEI OBA consultant, the process was further fine-tuned based on theactual expenses incurred by the partners towards Leprosy services providedexclusively in the hospitals in the calendar year 2010. In the QC meeting of Sep.2011, held in Vijayawada the revised unit costs of all the OP and IP categorieswere shared among all the 5 OBA partners, which would form the basis forfunding in 2012. There were concerns among the partners regarding the revisedcosts, more specifically due to the fact that these costs were to be used forcalculating the budget for 2012 and is devoid of the inflation factor of 2011.Later as per the earlier understanding, all the partners were requested todevelop their budget for the year 2012 based on the revised unit costs. Duringthe 3rd QC meeting held in Nov. 2011 at Bangalore the performance of the 3quarters of 2011 was analyzed and presented to all the partners and alsopartner-wise targets / budgets for all the categories were discussed at length.


Disability Prevention and Medical Rehabilitation In the post-elimination era, the local NGOpartners have realigned their priorities tomeet the changing needs of the NLEPprogram and have geared up theirservices to provide tertiary care servicesto the people affected with Leprosy.Among the partner hospitals supportedby Swiss Emmaus India, 5 of them listedbelow have been recognized by Govt. ofIndia’s National Leprosy EliminationProgram (NLEP).1. Swiss Emmaus Referral Hospital –Palamaner, Andhra Pradesh.2. Gretnaltes Hospital – Tenali, Andhra Pradesh.3. RISDT – Kathipudi, Andhra Pradesh.

4. Sacred Heart Leprosy Hospital,Kumbakonam, Tamil Nadu.

5. Hubli Hospital for the Handicapped,Hubli, Karnataka.

As a part of DPMR services, our centersact as referral facilities for all the primaryand secondary level health institutions inthe state towards:(i) Preventing disabilities and worseningof existing deformities in all needyaffected persons including both patientson treatment as well as those releasedfrom treatment.(ii) Developing a referral system forproviding POD services to all leprosydisabled persons in an integrated set up.


Details of the services TotalNumber of patients with Gr.I & II disabilities 9,833Patients underwent physio assessment 17,358No. of patients received MCR footwear 5,373No. Of reconstructive surgeries performed 412

Table No . - 3: Performance of the hospitals

POID Project – Andhra PradeshAs part of the POD services, SEI India hasalso launched a pilot project in the twohigh prevalent districts of Andhra Pradesh(East Godavari and Guntur) since2010, which will be implemented for 3years in collaboration with the Departmentof Health, Government of Andhra Pradesh.The project is aimed at preventing thedeformity by early detection of newleprosy cases even before the disability hasset in the patients and among old patientsthrough training the patients on home-based self care. For all these it is envisagedto strengthen the mainstreaming of theLeprosy interventions at primary healthsystem level, involve the ASHA workers inthe districts not only for identification ofthe suspects and referring them to thenearby primary health centre, but also forfollow up of the old disabled patients forulcer care at home and selective referral.

As part of this project, 110 PHC / servicedelivery points have been chosen in boththe districts and at each point a camp isheld every 2 months to attend to thepatients (New & Old). Two teams havebeen formed with a physiotherapist, acounselor and a cobbler in each district tovisit all the service delivery points onceevery 2 months to counsel and train thepatients on self care and home-based ulcercare. This camp is also utilized forscreening of the patients forReconstructive Surgery (RCS), follow up ofold cases of RCS, provision of microcellularrubber (MCR) footwear and referral ofcomplicated ulcer / reaction cases forappropriate management to the higherreferral centers.


Link workers intervention in GoaSwiss Emmaus India has been animportant partner to the Govt. of India’sRevised National TB Control Program(RNTCP). In order to strengthen theintervention in the state of Goa, SEI Indiaunder the banner of Goa Urban HealthProject provided its support in the formof outreach services in one of the biggestslum in Chimbel. The project was aimedat bridging the gap between the RNTCPand the TB affected and related programcomponents in the field. There were 11link workers engaged in this project toassist RNTCP for the following:1.Identification of Suspects2.Delivery of DOTS3.Drug Compliance & defaulter retrieval4.PPM promotion & execution5.Special assistance for pediatric TB by

grass root level support.6.ACSM - Awareness programs by

IEC/IPC7.Regular feedback & necessary action in

discussion with STO office8.Microscopy services by sputum sample

delivery.

Evaluation of the POID project wasconducted at the end of 1st year for twokey components of the project;Community based rehabilitation (CBR)by Ms. Valerie from Switzerland andMedical Rehabilitation by Dr. S. AnandaRamakrishnan. The evaluators visitedthe project sites at length and suggestedcertain recommendations to beincorporated in the ProjectImplementation Plan (PIP). Based on therecommendations, the projectImplementation plan was modified andrevised plan after approval from the

FAIRMED –Headquarters was sharedwith the project partners forimplementation. Based on therecommendations, a training programhas been planned for the PHC staff ofboth the districts to build theircapacities in Nerve Function Assessmentand Self Care, who in turn will train thegrass root level health workers like ASHA(Accredited Social Health Activist) andANMs (Auxiliary Nurse Midwife) in theirjurisdiction.

Tuberculosis


LSS MumbaiBainganwadi has Mumbai's oldest andlargest waste dumping ground. Withthe help of our local partner Lok SevaSangam (LSS) a comprehensive projectis being implemented from 2009onwards for the slum dwellers. As apart of this project, it is aimed to thehealth care delivery forimprove theslum population especially forTuberculosis.

In this regard, 5 DOTS centres and 1sputum collection centre and 1Designated Microscopy Centre arebeing run for the control of TB for thepopulation of 2 lakh in collaborationwith RNTCP.In 2011 total 164 TB patients wereprovided DOTS treatment through ourcentres from the community.

Urban HealthThe Baignawadi project executedthrough our local partner LSS inMumbai aimed at Improving thesocioeconomic status of thecommunity,Improvement of health standardsthrough better hygiene and sanitationmeasures and Strengthening thehealth care delivery services throughcommunity participation.Most of these were achieved throughformation of self-help groups. Lastyear total 12 Self Help groups were

formed led by Mrs. Seema Patil, Theresidents were trained in life-skillseducation that improved theirconfidence and enthusiasm to initiatetheir own income generating ventures.Among the members, 95% were ableto sign and 30 - 35% were also able toread and write at the end of the yearthrough our intervention and all thegroups put together were able togenerate an income of around 1 Lakhthrough various income generationactivities.

They were also resourceful inAwareness programmes, provision ofDOTS, patient follow-up, sputumcollection and transport, motivatingthe patient to come for regulartreatment, referring leprosy patientsfor follow-up treatment,accompanying patients to the nearestmunicipal dispensaries, distribution ofAlbendazole and Vit A.


Hospital Information System (HIS)

The existing system of HIS was found tobe having a lot of limitations, especiallyin terms of data retrieval and datatransfer, due to which the entered datacould not be put to much use by theprogram managers at all levels.Considering the importance of databased monitoring required for theOutput Based AID (OBA), it was decidedto go in for a completely newer versionof the HIS, which would be web-basedand will have no limitations regardinginstallation of the software by anypartner and will provide the data on areal time basis. This would also attendto concerns regarding data transfer asthe same data would be available for all

the partners at any point of time. It hasalso been envisaged to import the datafrom the old HIS to the newone, wherever available. The new HISwould be the available for use by theend of 2011, so that necessary pilottesting, training of the data managerscan be completed and the HIS can berolled out from the beginning of 2012.

Fundraising Activities

The year 2011 was eventful and wemade some significant strides in localfundraising. Following are thefundraising activities conducted duringthe year 2011.

Direct mailing (DM)Direct mailing is one of our corestrategies. It has dual benefits as inimproving visibility for SEI India as wellas sensitizing people about thecause of Leprosy. Direct mailing hasbeen one of our core strategies as itfacilitates in fulfilling fund raisingobjectives. Through our experiences in

DM we intend to reinforce this activityso as to reach out to more numbers ofpeople across India.

TelemarketingTelefacing is the hybrid of telephone andface to face fundraising. It is a modifiedextension of the major donor process toencompass cold solicitation. Theobjective of outsourcing this activity isto expand the warm & cold donor baseand simultaneously encourage monthlygiving.


Lucky Draw EventLucky Draw as a tradition started as ateam building exercise among groups.SEI India planned Lucky Draw as one ofits activities to raise funds dedicated tosupport the medical care and socialrehabilitation of people affected byleprosy, tuberculosis and other povertyrelated diseases through its supportedprojects in India. The learning from thelucky draw event held during the year2010, was incorporated for betterperformance.

The lucky draw event was conductedon 29th June 2011, at our office atChennai. The whole program wassponsored by a local corporate.

School FundraisingDuring the year 2010, we conductedfew College Fundraising programs butsince it was not cost effective, wedecided to test the School Fundraisingwhere more young volunteers could beinvolved for raising funds for our cause.

The test was conducted in two schools.All the students above the primaryclass were involved. Apart from raisingfunds, these young ambassadors willalso provide a platform to SwissEmmaus India to educate mass aboutour initiative for Leprosy. The principaland staff of the School extended theirfull support throughout the campaign.

Corporate FundraisingIn India there is a growing realizationthat the corporate bodies are createdby the society and must thereforeserve it, not merely profit from it. Thecorporate bodies in India woke up to areality where they work towardsachieving social and environmentaloutcomes in the society.With the changes in the governmentalpolicy more corporate bodies extendtheir hands towards Swiss EmmausIndia to create a better world for thosepeople affected with leprosy, TB andother poverty related diseases.


Financial report


Balance Sheet Liabilities 2010-11

Capital Fund 19,79,735.80 Project Fund 1,71,02,197.95

Total 1,90,81,933.75

Assets 2010-11Fixed Assets 19,79,735.80 Advance & Deposits 6,62,961.54 Cash and Bank Balance 1,64,39,236.41

Total 1,90,81,933.75

Consolidated Receipt and Payment accountReceipts 2010-11

Opening Balance 1,85,79,189.72 Grants from Fairmed, Switzerland 1,54,20,259.00 Grants from Idea India, Erode -Donations Received 35,46,695.00 Grants Received 14,74,968.00 Income from Events / Exhibitions 95,156.00 Income Received from Banks 5,94,202.00 Dividend on ICICI Mutual Funds 19,346.10 Profit on redemption of Mutual Funds -Sale proceeds from mobile phone 5,902.00

Total 3,97,35,717.82 Payment 2010-11

Management expenses on co-ordinating leprosy projects 13,19,001.16 Management development expenses 5,32,118.00 Urban health Mumbai 9,18,365.00 FRU Expenses 66,14,507.68 ATCOM Expenses 22,86,890.40 TST Goa expenses 6,61,765.00 NLEP ExpensesHubli Project 21,39,583.00 POID AP 26,86,251.19 Grants to other projects 4,57,500.00 Fund raising expenses 1,32,480.00 Grants to other projects from LC 48,65,283.00 Indirect expenses 19,775.44 Closing Balance 1,71,02,197.95

Total 3,97,35,717.82

Financial Support to Projects during the Year 2011

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Amount In Rupees

Amount In Rupees


Trend of support for the last five years

6,80,92,071.00 7,71,04,808.00 7,38,11,626.00

6,38,79,468.00 6,46,48,030.00

0

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2011


Swiss Emmaus leprosy Relief Work India: Human ResourceSlab Of Gross Monthly Salary Male Staff Female Staff Total Staff

5,001 - 10,000 1 - 110,001 - 25,000 1 1 225,001 - 50,000 2 2 4

> 50,000 3 - 3Total 10

Human Resource - Year 2011

60.05%

3%

2%

3%

1%

7%

1%6%

16%

0.95%

Hospital School DPMR

General TB POID

Health Education Activities Field Based Activities Administrative

NLEP

Deployment of funds

The year 2011 was significantlytumultuous for the India CCM sincethe call for proposal under round-12was cancelled soon after itsannouncement. The reason cited wasthe lack of funds, which has left amajor gap in financing healthprograms in India. Fortunately, theGoI has assured the CCM that thevacuum created from this scenariowill be filled and attended to by theGoI. It is still very ambiguous whenthe Global Fund will resume itsfunding mechanism. In any case, wehave to brave this challenge andcollective work towards providing themuch need access to the vital careand treatment under all health domainthat fall within the Global Fundmandate.Additionally, the INP+ audit report wasmade public that created a lot of furorlocally as well as internationally. Itwas regarding mismanagement of the

grants provided by the Global Fund.Besides tarnishing India's image, theGF processes will become morestringent so that such episodes arenot repeated. As SEI is the electedmember from the TB constituency, wewere involved in monitoring theGlobal Fund grant to implement theACSM project in India. Three suchvisits were undertaken to Chennai,Bhopal, and Kolkata. As the namesuggests, the ACSM project isintended to create awareness amongpeople about TB and the serviceoffered by the public health system.This is all geared to scale up TB careand treatment across India. Themonitoring visit revealed that peopleare being sensitized but not enoughthat'll tantamount to 'scale-up ofservices'.

We highly benefitted from the coupleof visits of our colleagues Mr. ReneStaeheli and Dr. Thomas von Stammfrom the funding agency undertooklast year. The first visit was crucial aswe were recruiting new staff for ournewly established office in Gurgaon.Additionally, the visit was also coupledwith finalizing the new office inGurgaon. We were able tosuccessfully accomplish this task.Subsequently, Rene and Dr. Thomasalso visited during the mid-year to

provide the much need guidance andtechnical support for the India team.This visit was also meant to providethe necessary capacity building forthe India team with regard tostrengthening the internal processesand systems. Additionally, we alsoorganized theme based meeting withfew of our key partners mainly to dowith the direct project, the ‘preventionof impairment and deformity POID)’,being implemented in the state ofAndhra Pradesh.

Partnerships: CCM & NTC

Visitor’s to India


SEI India Team


We acknowledge with deep gratitude the support of all our donors, friends and wellwishers for helping us to work towards eradication of leprosy, control of TB andother poverty related diseases.

Swiss Emmaus India would like to thank the functionaries of FAIRMED (Switzerland)for their continued support and guidance.

We would also like to acknowledge the support of the Government both at theCentral and at the States. We are also indebted to ILEP India, CCM and NationalTuberculosis Consortium (NTC) for their valued inputs and we realize theimportance of working together to achieve ‘a world without leprosy and TB’.

We would like to record our sincere thanks to our project partners working at thegrass-root level for their dedication and effort at all times.

Finally, our sincere thanks to our trustees, colleagues at central office who haverelentlessly helped us to serve better for the benefit of most in need.

Acknowledgements

Abbreviations

ACSM : Advocacy. Communication, Social MobilizationANM : Auxiliary Nurse MidwifeASHA : Accredited Social Health ActivistCBR : Community Bases RehabilitationCCM : Country Coordinating MechanismCO : Central OfficeCSR : Corporate Social ResponsibilityDPMR : Disability Prevention and Medical RehabilitationDOTS : Directly Observed Treatment Short-course GOI : Government of IndiaHHH : Hubli Hospital for HandicappedIEC : information, Education and CommunicationILEP : International Federation of Anti Leprosy AssociationIP : In PatientIPC : Interpersonal CommunicationLSS : Lok Seva Sangam MCR : Microcellular RubberNCR : National Capital RegionNGO : Non-Government OrganizationNLEP : National Leprosy Eradication ProgramNTC : National TB ConsortiumOBA : Output Based AidOP : Out PatientPHC : Primary Health CentrePIP : Project Implementation PlanPOID / POD : Prevention of Impairment and DisabilityRCS : Re-Constructive SurgeryRISDT : Rural India Self Development TrustRNTCP : Revised National TB Control ProgramRPOD : Rehabilitation & Prevention of DeformitySEI : Swiss Emmaus IndiaSHLC : Sacred Heart Leprosy CentreSTO : State TB OfficerQC : Quality Circle



State Wise Partner NGOs

SWISS EMMAUS LEPROSY RELIEF WORK—INDIAJ-17, First floor, South City –I,

Gurgaon—122 007, Haryana, India Telephone: +91- 0124-2384224, 2581224

Website: www.swissemmausindia.org, www.healthfirstindia.org Donate Online: www.healthfirstindia.org/donate.php

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