Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.
OpASHA currently serves a population of 4.5 million slum dwellers in India, and approximately 50,000 in Cambodia. India is home to 25% of the world’s TB patients, many of whom live in highly populated areas as rickshaw pullers, rag pickers, sex workers, street children, or beggars. Their habitats consist of simple concrete or sheet metal walls and a roof, if anything at all. Additionally, these houses or apartments generally are not equipped with sanitary facilities or windows for sunlight, which kills the TB bacteria, allowing it to fester and grow. Because of the high population density and miserable living conditions in India, these individuals are especially vulnerable to contracting tuberculosis.
Once contracted, their disease is often hidden or ignored. Firstly, it is hidden due to the lack of education about the disease highly prevalent in these areas and subsequent social stigma attached to it. Secondly, it is ignored due to the need to continue to earn wages, which precludes them from travelling to a clinic every other day to receive treatment.
If they decide to seek treatment, clinics are scarce in these regions, and because DOTS requires patients to take their medicines in front of a health worker, they must often travel long distances. Because of various reasons such as TB ignorance, unbearable drug side effects or missed wages, individuals often default on medicines. To solve this gap, OpASHA has hired local counselors to run informal treatment centers in established locations such as homes, businesses, and temples.
Share the story of the founder and what inspired the founder to start this project
During a healthcare conference Dr. Batra discovered that the government of India was destroying millions of expired TB medications due to the lack of the proper channels for getting the medicine properly to the patients. Alongside her fundraising partner and today’s OpASHA CEO, Sandeep Ahuja, she conceived the idea of addressing India’s biggest problem in TB treatment: going the last mile by opening treatment centers directly in the slums to enable access to the patients within walking distance. From this conception in 2005, operations began with the first TB treatment center in 2006.
Sandeep and Shelly quickly found that a large amount of DOTS patients were defaulting on their regimen, and even institutions with good adherence records had been falsifying their reports. To combat this, they started the biometric initiative in 2010, which guaranteed accurate data. Microsoft Research and Innovators in Health joined the project and designed the software pro-bono. The pilot project launched by the end of the year, and by 2011, 17 eDOTS centers were operating in South Delhi.