Success Stories in Care Giving for HIV/AIDS: South Asia

1. Success Stories in Care Giving for HIV/AIDS: South Asia Presented by FEZANA (Federation of Zoroastrian Associations of North America) at the UN 53rd Commission on the Status of Women -March 4, 2009

2. Introduction of Presenters Farah Minwalla: Columnist for the FEZANA Journal. Trity Pourbahrami: Community builder and Past Youth President of FEZANA. Kamalrukh Katrak: Member of Bel-Air Benefit Foundation, Participated in an advisory roll for the new College of Nursing construction. Deena Patel: Member of Bel-Air Benefit Foundation. • Presented at the UN 53rd Commission on the Status of Women -March 4, 2009

3. FEZANA • Federation of Zoroastrian Associations of North America • Umbrella organization for 26 Associations in North America • Equal sharing of responsibilities between men and women is central to the Zoroastrian faith • Supports humanitarian efforts internationally including the Bel-Air project • www.fezana.org

4. The Success Story: Bel-Air Hospital in India

5. BEL-AIR • “…some say is a model for AIDS care in the developing world” • NPR morning Edition, July 6, 2007 • Project of • Indian Red Cross Society, Maharashtra State Branch • Managed by • Missionary Congregation of the Blessed Sacrament

6. Bel-Air Contact Information Mrs. Homai N. Modi Hon. Secretary Indian Red Cross Society Maharashtra State Branch Tel: + 91 22 22 64 46 41 Fax: + 91 22 22 693956 E-mail: homaimodi @ yahoo.co.in Father Tomy K. MCBS Bel-Air Hospital Mobile Tel: +91 9422606672 Tel: + 91 2168 – 241109 / 240639 Fax: 241897 E-mail: belair @ vsnl . com Website: www.belairpanchgani.org • Prof. Minu K Patel & Dr. Mehroo Patel • Bel-Air Benefit Foundation, • (708) 409-9361  • E-mail: mkp @ uic . edu • Dr. Manohar Jethani, • Ribbon Foundation, Chicago • 1977 Quincy Ct, • Glendale Heights, IL 60179

7. Why Bel-Air Hospital? NPR morning edition July 6, 2007 “Health care professionals come from all over the world to see how Father Tomy Karyilakulam has transformed a rundown hospital into an advanced-care facility for AIDS and TB Patients”

8. HIV IN INDIA STATISTICS: • 2 to 3 million people infected with HIV in India • 38% are women • TB is the leading cause of HIV-related deaths source: UNAIDS/WHO 2008

9. HIV in Maharashtra source: UIC 2005 Bel-Air

10. HIV in Maharashtra • It is one of the worst hit states in the country. • Satara district has 4% prevalence rate. • (India: 0.3% prevalence rate) Bel-Air source: UIC 2005

11. HIV in Maharashtra • Migration to big cities is linked to unsafe sex practices. source: UIC 2005

12. HIV in Maharashtra • Long distance truck drivers having sex with female sex trade workers contributes to the spread of HIV in rural areas source: UIC 2005 Bel-Air

13. HIV in Maharashtra • Estimated 40% of female sex trade workers are HIV positive. source: UIC 2005 Bel-Air

14. LOCATION OF BEL-AIR: PANCHGANI, SATARA DISTRICT, MAHARASHTRA

15. Bel- Air Sanatorium- • “…amidst thick forest on top of a mountain”

16. Bel-Air Hospital in Panchgani India MISSION PART I To provide affordable, nondiscriminatory care to people with TB and HIV/AIDS. Compassion and Care For All. PART II Hospital and community center that provides charity care when needed, without depending solely on charity itself.

17. Bel-Air History • Started in 1912 as a TB sanatorium in the hills of Panchgani: 44 acre “health resort” • Handed over to the Indian Red Cross Society in 1964 • Started admitting HIV/AIDS patients in 1994 play first part of video “ Vision and Mission of Bel-Air Panchgani (0-3.50 mins)

18. Bel-Air Hospital in Panchgani India • ACHIEVEMENT • As Noticed by NPR, Morning addition, July 6, 2007 • “… Bel-Air… has achieved what no other rural hospital in India has done:.. has assembled the latest technology and doctors needed to practice sophisticated Western-style medicine. This led to (the) ability to get access to government-controlled supply of drugs to fight HIV”

19. MISSION: PART I • To provide affordable, nondiscriminatory care to people with TB and HIV/AIDS. • Compassion and Care For All.

20. BEL-AIR: Facilities Provided • 250 bed hospital • Staff of 150 including • 24 doctors (male and female) , • 60 nurses (female) • Well equipped Pathological Laboratory, CD4 Count Machine, Operation Theatre with Laparoscopy, X-ray-USG Machines, ECG, ICU, 24 hours Emergency. • Food and treatment was made available for all.

21. BEL-AIR - • Main Operating Theatre Facility – one of 4 rooms.

22. Bel-Air: 1994 • Bel-Air admitted HIV patients and did their best to treat them at a time when the country had no experience. • No support from the Government. • ART was not available. • Society was resistant.

23. BEL-AIR: 1994-2000 • People with HIV were abandoned by their families. • Bodies were not claimed.

24. BEL-AIR: 1994-2000 Cont’d. • Even cremation was difficult. • Bel-Air staff were forced to wash the municipal crematorium after cremation of the HIV positive bodies. • High levels of stigma and discrimination play second part of video “ Vision and Mission of Bel-Air Panchgani (7.20 mins -9.50 mins. followed by 10.20mins – 17.00 mins.)

25. Bel-Air - The Success Story • Successful in creating an environment free of stigma and discrimination in the hospital. • International schools in Panchgani send their students for treatment to Bel-Air. Students mingle with patients regularly. • Increased HIV awareness in the community

26. Bel-Air : Success Story Cont’d. • Acceptance of patients with HIV by their family members. • Patients regaining their confidence and dignity • Most patients recover and go back to lead normal productive lives. • 25 previous patients with HIV co-opted as staff.

27. Bel-Air: A Community and Family Support • Ayurvedic and Naturopathy Health Center providing alternative medicine and yoga therapy. • Healthcare for local boarding school children. • Family members required to stay with patient at Bel-Air. • Staff visit villages of discharged patients to facilitate re-entry into community.

28. BEL-AIR - • Community awareness

29. Anti-retroviral Treatment (ART) • ART is supposed to be provided free to people in high risk states like Maharashtra (UIC 2005). • India: 20% of adults who need ART have access to it (UNGASS 2008) • 25% of Bel-Air patients who need ART have access to it (NPR 2007). Bel-Air is working at increasing this number.

30. HOW? – as mentioned before “At Bel-Air, Father Tomy has achieved what no other rural hospital in India has done: He has assembled the latest technology and doctors needed to practice sophisticated Western-style medicine. This led to his ability to get access to the government-controlled supply of drugs to fight HIV “ – NPR, morning edition, July 6, 2007

31. Patients with HIV & TB treated at Bel-Air 1996-2008

32. Bel-Air patients with HIV treated in the out patient department

33. MISSION: PART II • Hospital and community center that provides charity care without depending solely on charity itself. • STARTING A COLLEGE OF NURSING • 2. PRIVATE BOARDING SCHOOL

34. Nursing • World wide shortage of nurses • US: 773 nurses per 100,000 people • India: 63 nurses per 100,000 people 12 fold difference! • In India 50% migrate to other countries: US, UK, Saudi Arabia • Many health care facilities use unlicensed personnel source: UIC 2005

35. Bel-Air College of Nursing • Started in 2006 • The first nursing program in India with a focus on HIV/AIDS. • Identified by Indian Nursing Council & NACO to train nurses in HIV. • 40 students per class; 4-year program • All nursing students are women • Most nursing students from Kerala

36. College of Nursing - • New construction – along the slopes • New construction – main entrance

37. College of Nursing “While it may turn a profit, it, more importantly, will provide 80 nurses and students to staff the hospital — nurses that will be needed as the demand for AIDS treatment continues to rise.” source: NPR July 6, 2007

38. Bel-Air College of Nursing – Created a Collaboration with University of Illinois, Chicago • Faculty and student exchange • Curriculum • Joint research activities • Participation in seminars and academic meetings • Exchange of academic materials and other information

39. College of Nursing - • UIC, Chicago Collaboration

40. Private Boarding School • Just down the road from Bel-Air is a brand new, private boarding school, run by Father Tomy's mission. The building has long, cool hallways, spacious classrooms, verandas and fans. The school attracts the wealthy from Mumbai and beyond. Its substantial profit goes to Bel-Air. source: NPR July 6, 2007

41. Other achievements: Bel-Air - National Training Institutefor HIV/AIDS Management 2003 - 2008 Bel-Air has trained: 804 doctors, 220 nurses, 41 health workers, 57 counselors and 81 faith leaders

42. Bel-Air selected to train Community Care Center nurses in the states of Maharashtra, Chhattisgarh, West Bengal, Rajasthan, Madhya Pradesh, Orissa, Gujarat, Bihar and Uttar Pradesh.

43. Future Vision:A Center of Excellence • Center for the training of doctors, nurses and other health care providers from South and South East Asia in HIV/AIDS

44. References • Epidemiological Fact Sheet on HIV and AIDS, India, 2008 update. UNAIDS/WHO Working Group on Global HIV/AIDS and STI Surveillance. Downloaded from: http://www.who.int/hiv/countries/en/ • UNGASS Country Progress Report 2008, India. National AIDS Control Organization Ministry of Health and Family Welfare, Govt of India, New Delhi. • Feasibility Study Report: Advancing Nursing Education at Bel-Air Hospital. University of Illinois at Chicago College of Nursing, 2005. http://www.uic.edu/nursing/research/bel-air/feasibilityreport_april15_08.pdf • NPR story: Priest Revives Former TB Clinic for AIDS Patients. July 2007. http://www.npr.org/templates/story/story.php?storyId=11704607 • 18 minute Video on Bel-Air Hospital http://realmedia.uic.edu/ramgen/depts/nurs/msnurs/belair.rm