Infectious Disease Control and Treatment

TB & Leprosy Control Program

Tuberculosis (TB) continues to remain as one of the major health problems for exile Tibetans in India and Nepal. Unhygienic surrounding, refugee life, low nutritional diets, lack of awareness, stress and change in living conditions from the cold climate in Tibet to hot weather of the Indian subcontinent adds up to factors responsible for high numbers of TB incidence in the Tibetan community. Poor treatment compliance on the part of TB patients and their families are factors that account for high incidence of disease.

The TB Control Program of the Department is implemented in conformity with the treatment guidelines laid down by the WHO and that of the host nation, India. As per the guidelines, Directly Observed Therapy Short course (DOTS) strategy is the general practice to keep TB incidence in the settlements under control. The PHCs and Hospitals serve as first referral centers for patients within the settlements. Hospitals are provided with all the basic diagnostic and treatment facilities to deal effectively. To further reduce the spread, isolated TB wards for positive smear was constructed at hospitals. Special diet and recreational facilities are other parts of the program.

Leprosy is an infectious disease caused by the bacteria Mycobacterium leprae. Most people have a natural immunity to the disease, and those that do develop leprosy can be cured with modern Multidrug Therapy Treatment (MDT). The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and also the eyes, apart from some other structures. Leprosy has afflicted humanity since time immemorial. It once affected every continent and has left behind a terrifying image in history and human memory - of mutilation, rejection and exclusion from society.

At present, we have 13 patients on roll at the Palampur Leprosy Home and we provide them with medical assistance, monthly pocket money, clothing and dry ration for their living.

Drinking Water and Sanitation Program

By the WHO definition, sanitation is safe management of human excreta and includes the provision of latrines and promotion of personal hygiene. Environmental sanitation is a broader term, encompassing excreta disposal, solid waste management, waste-water disposal, vector control and drainage.

Diarrhoea and skin disease jointly account for 25% to 30% of the disease burden in the Tibetan settlements and the scattered communities. On the average, the settlements are able to get 70 to 75% of their safe drinking and washing water requirements. The community and beneficiaries contribute towards the cost of the project wherever possible depending upon condition of the settlements.

Water:

Water is the key source of infection. As per WHO guidelines we have made policy to provide pure drinking water free of germs. Thus we have streamlined this in our health programs and given priority to facilitate safe drinking water. We have been building water tanks to store the water for supply to the public as per system adapted by local users as per availability of water quantity.

We have been supporting drilling to set up underground water supplies in various settlements based on water sources. We have also provided training on water management and cleaning system and chlorination of water from time to time so that water will be free of germs for family consumption.

We have also undertaken ground water investigation to check the availability of underground water source for drinking purposes. The ground water availability was checked in the plain areas with just 20 to 50 feet depth to 300 feet in mountainous regions like Leh, Ladakh where the average height from the sea level is above 13,000 feet.

The coverage of water supply includes people living in various Tibetan settlements, monks and nuns living in the monasteries and schools in the settlements.

Sanitation:

The Department of Health, CTA has funded numerous toilet projects in the Tibetan settlements, scattered Tibetan communities living in various places, including monasteries and schools. We are supporting public toilets project with septic tanks in schools and monasteries to keep the local environment clean. We have also supported drainage projects in the settlements to improve overall environmental condition.

We have built public toilets to improve environmental cleanliness and to prevent people from suffering water- related diseases.

Mother and Child Health (MCH) and Reproductive Health (RH) Program

Through constant and informative programs, many mothers are now well aware of the need to immunize their babies to prevent disease and for their proper growth. The program has achieved outstanding results with pregnant women, taking extra care in getting immunized well in time. Before the launch of this program, the situation wasn’t the same as today. Ignorance and traditional methods of delivery were the normal practices, putting risks to both mother and child. The Health Department now has many service packages in the pipeline to further improve the health of the community by providing services under traditional Tibetan medicine.

The immunization program is designed to give free vaccinations to all Tibetan children under five years of age, to protect the main communicable diseases. All new born babies in the settlements are given MMR, Hep-B vaccination, BCG, Immunoglobulin and anti-polio drops while all the pregnant mothers are provided free micronutrients for a period of nine months and free Hep-B testing. The project also includes free distribution of traditional Tibetan medicines such as life-prolongation pills and intelligence-enhancing pills to the students of class I to IV.

The scope of our maternal health component under MCH has widened with the introduction of the new RH project. This project aims to provide comprehensive, culturally acceptable and accessible reproductive health care services to all the Tibetan refugees of reproductive age. With the introduction of MISP (Minimal Initial Service Package), the RH project has expanded the primary health care services to include safe motherhood, STD management and sexual/gender violence counseling and establishment of referral network for higher-level care.