CHETNA Non communicable Disease Project

Team Chetna
Goal of the project :
To prevent Non- Communicable diseases and improve the quality of life of people with chronic and life limiting illnesses in 07 Panchayats
of Raxaul block in East Champaran district of Bihar by the end of
March 2021.
Objectives :
- To raise knowledge and awareness on NCDs (Diabetes, Hypertension and Cancer) among various stakeholders in Raxaul block of East Champaran District.
- Provision of holistic palliative care with both community and hospital based components to about 30 patients and their families each year.
- Management of NCD through detection and access to affordable and holistic clinical services.
Strategies :
- Home based care / Nursing care
- Counselling
- In patient services / OPD services
- Screening camps
- Capacity building and Awareness
- Networking and Advocacy with government officers
- Establishment of Wellness Canters
- Collaborations with Faith Based Organizations
Outcomes / Changes :
- Family members of all our patients (35/35) are now aware that cancer is a non-communicable disease and therefore they are now taking caring of their patients in their homes without any fear.
- Patients started sharing their house hold responsibilities before departing from this earth as a sign of prepared and peaceful death.
- Patients and elderly people are now availing facilities from the wellness centers (12 Wellness centers).
- Increased number of people who have started walking/running in the morning and doing exercises.
- Increased number of people who have started walking/running in the morning and doing exercises.
- People are now going to proper doctors for treatment and not to Ojha / quacks.
- Many families have started consuming less salt in their diet.
- Varied groups formed such as Care givers group, Support groups and Seva dals to support the NCD project.
- Communities benefited through effective tools of communication in the form of big flax boards, Pamphlets and other audio visual aids.
Story :
The Story of Chhotelal Paswan (Original Nagender Paswan)

This story is about Mr. Chhotelal who died with mouth cancer and left behind three sons and his wife. He did not possess any land. He was a daily wage laborer and the only earning person in his family. He was living with his family in a hut made by straw.
Mr. Chhotelal was addicted to chewing tobacco and Gutka for many
years. A couple of times, he tried his best to stop chewing tobacco and
gutka but he failed in doing so because he was addicted to it.
One day, one of his teeth started to pain. It was loose and smelly. He
went to the nearby clinic where this tooth was extracted. After a month
he went to Sitamarhi and got the duplicate tooth fixed.
After a month he developed an abscess near the duplicate tooth for which he was operated but his abscess continued growing. After a month another doctor referred him to Varanasi Cancer Hospital. A biopsy was taken and the result revealed that he had cancer. After hearing this news, he along with his family were mentally broken, fearful and depressed.

When the Chetna NCD team heard about Chhotelal, the team went to his house and found him in a miserable condition. His family thought that this was a communicable disease and if they went near him they also would get it. In fear of this false belief, Mr. Chhotelal was left alone in a corner of his house. The abscess had become big and painful. He also had developed fever and had stopped eating food. His weight had drastically reduced. For weeks together, he used to sleep all alone in a dirty bed with dirty clothes.
Due to his economic poverty, he did not take treatment for cancer.
Initially he took a loan of rupees 50,000 INR from a moneylender on a
4% interest for his initial diagnosis and treatment. The family
members left Chhotelal alone without providing him with any love
and care because they were under the impression that if they went
close to a cancer patient, they would automatically get the disease.
Even his wife did not go close to him because the abscess was very smelly.
At this point of time, Chetna staff heard about Mr. Chhotelal and visited him. On seeing his miserable condition, the Chetna staff started dressing his wound, gave him regular baths, administered pain relief medicine, cleaned his room, fed him, had his bed sheet washed and changed and had his body massaged with anti septic powder. By seeing this unselfish service to him, his whole family was shocked. The staff taught his family that this is a non communicable disease and need not be feared.

His younger son came near and wanted to learn how to serve his father. So the Chetna team taught him the process of dressing, back care, prevention of bed sores, changing the bed sheet, giving sponge baths and feeding him. The Chetna staff also gave sterilized dressing materials to do so. Mr. Chhotelal and his family were so happy with the team for providing and teaching health care.
In the next visit the Chetna team found him sitting happily with clean
clothes on a clean bed sheet. He folded his hands and welcomed the staff. The staff found that the family was regularly cleaning the house, giving him baths, feeding him, keeping his room clean and washing his clothes too.
In the third visit the staff found that Chhotelal was having enmity
with his wife, elder son and daughter in law. In the early years of his marriage, his wife had killed Chhotelal’s mother. Since then, their relationship was not good. The elder son wanted full authority over Chhotelal’s house, therefore Chhotelal did not have a good relationship with his elder son and his daughter in law. When the Chetna staff saw the broken family situation, the staff started praying to bring back unity among the family. The staff provided him home based care , prayed and left their home.

In the fourth visit the staff prayerfully talked to the family members regarding the importance of family unity. After the long discussion, they all agreed to ask forgiveness from Chhotelal. The Chetna staff also talked to Chhotelal about his short life on earth and need to forgive his family.
During the fifth visit, staff gave good home based care to him and then called his family members near Chhotelal’s bed. The staff facilitated an open discussion between all of them. As a result of this, his elder son and daughter in law asked forgiveness from their father by touching his feet. Mr. Chhotelal forgave them. They all were filled with joy.
During the sixth visit, while he was bed ridden and serious, the staff gave him back care and again prayed. We sang a song and ten minutes later he peacefully passed away. Mr. Chhotelal’s elder son was addicted to drinking alcohol. The Chetna team counseled the family regarding addictions, diabetes and hypertension. He realized and reduced cold drinks and sweets. He has also started exercising and cycling.