This case study was compiled by IMA World Health as part of the lymphatic filariasis morbidity management programme. We’ve included an excerpt here, but you can can access the full case study at this link. See Monday’s blog post for more about the program.
Above) Debraj Behra and his wife. (Below) Debraj along with Asst. Project Coordinator Soumendra Dhir (facing) and Govind Panda
CASA staff and volunteers have been working to provide care and support to LF patients in Orissa state, these patients have often been left behind and hidden away by families and communities. CASA visit patients regularly to check their health and emotional status.
Pictured to the left is Debraj Behra, a man in his late fifties. Some 20 summers back, when he was at the peak of his youth, one day he fell sick.
‘I was around 30 years then,’ he said in a dry voice, ‘and was married already, when suddenly one day I had a pain in my left leg.’ He paused for some time, wiped his sweat from his forehead and continued, ‘my feet had become red and then there was fever.’
Debraj used to work as daily labour and he was the only source of income in a family with his wife and a son. ‘I thought it was normal pain, which must have happened accidentally due to work,’ he observed.
But it wasn’t, he came to know that was infected with a parasitic disease known a Lymphatic Filariasis. Lymphatic Filariasis locally known as ‘Baatjor’ initially didn’t cause any alarm to him. ‘I didn’t know how serious it was,’ he remarked. But when he realised, he understood it was an end to his working life.
‘I was very sad to learn that,’ he paused, ‘since I knew I couldn’t do hard work anymore.’
Lymphatic Filariasis is caused due to parasites spread through mosquitos. It’s a silent disease that though does not lead to death, but can seriously impair the mobility of a person to the extent that he or she can be permanently bed ridden. Chronic cases lead to a major swelling of limbs called Elephantiasis. According to a survey conducted by CASA, there are approximately 23,000 patients affected by Lymphatic Filariasis in Khorda district of Orissa.
Rajdeep Puri (right) interacting with Debraj
The Church’s Auxiliary for Social Action or CASA, a non government voluntary organisation is working to bring relief to Lymphatic Filariasis patients since 2003.
‘Initially we worked only on generating awareness,’ remarked Rajdeep Puri, the Health Supervisor of the current project named Lymphatic Filariasis Morbidity Management Programme.
From 2003 to present, CASA has been working in different phases, in different parts of Orissa to ensure that the spread of the disease is arrested and provide Home-based Foot Care Management to the patients affected by Lymphatic Filariasis. Till 2010, the programme worked in all 10 blocks of Khorda District on generating awareness on the disease and providing Home-based Foot Care Management. Currently a follow up programme is running here.
‘From 2011 we have begun the programme in Khallikote Block of Ganjam District,’ said Soumendra Dhir, the Assistant Project Coordinator. ‘One part is the awareness,’ said Rajdeep Puri, ‘where we use IEC materials to spread knowledge about different aspects of the disease, organise medical camps, give trainings etc. but the other part is more critical.’
The other part is the Home based Foot Care Management. In this, the affected patients are taught and trained to take care of their affected limb so that the condition does not worsen. This is done mainly by training the grassroots level staff like the health workers and the Task Force members who in turn demonstrate and train the patients on taking care of their affected limbs.
‘The purpose of Foot Care Management is to see that the leg and foot is kept clean so that no infection can take place,’ said Rajdeep. ‘When the leg and feet swell up, knobs and folds are formed,’ added Arjun Muduli, a supervisor of the project, ‘it is in between these folds that chances of infections increase.’