You are on page 1of 37

1

Archives 2007 to
2008

Community Health Education Society


198, Rangarajapuram main road
Kodambakkam
Chennai -600024
Email:ches_cheschennai@yahoo.co.in
Phone: 044 – 24731283 or 24726655

Achieves 2007 to 2008 by CHES Page 1


2

Community Health Education Society – CHES


Nurturing, partnering to bequeath dignity and Hope

Our Vision

To be a leading health system providing care to children and


women.

Our Mission

The fundamental mission of our organization is to develop and


disseminate solutions to major health-related crises the world
faces today- with emphasis on simple and cost-effective
methods of prevention and management with an eye to improve
the health outcomes of children, women and men by providing
and promoting innovative services, research, education and
advocacy which could be done alone by our organization, or in
partnership with other health providers and the community

From Project Director Desk

I have great pleasure in providing this annual report of CHES.


3

This year was a great year for us because we have got support from Emirates
Children foundation to build a spacious home for the children of Anandha illam. I was
at Dubai and made a presentation on behalf of CHES. The board members have been
very considerate in agreeing to our concept and had advised us to go for a bigger
place.

Our program has shown a lot of quality work. I would at this juncture thank my entire
staff team for putting the feather on our cap.

There has been a major change in the organisation staff pattern. The management
has been strengthened. There are 3 managers who will shoulder my responsibilities
namely the manager technical who takes care of training, staff capacity and sending
monthly technical and financial reports on time. The manager administration takes
care of staff leave, attendance, behaviour while manager management takes care of
organizing all events or other project related meeting etc; next to these 3 managers
we have the finance manager who takes care of the entire accounts department and
Office manager who is the point contact person for staff. This is helping in not only
strengthening the management system and brings transparency but also work more
simplified and clear. This also will lead to second level officer who can further lead
CHES.

The orphans have been mainstreamed and have been taking part in stage
performances

Corporate support to children, both as resource and also as volunteers have helped
the children a lot.

Dr.P.Manorama; MD;DCH;DM

President CHES

CHES AN INTRODUCTION

Community Health Education Society {CHES}, initiated in 1994 to


cater to two AIDS orphans has completed 14 years and has scaled up
as a key NGO in AIDS prevention and HIV Care in Tamilnadu under the
guidance of a eminent medical doctor. During this year the NGO has
continued the project with great zeal and this year motto was “Quality
Care to People”.
4

The Project Director of the Organsation has been involved as honorary


member in various committees of Government of Tamilnadu and other
private agencies this year. These include the following:

National/
S. Name of the
Internation Type of Membership
No. Agency
al
1. Social Defence District Chairperson Child Welfare
Level committee
2. Social Welfare State Level Eunuch rehabilitation
committee
3. State Planning State Level Member 11th Planning
commission commission
4. Hindu College District Member prevention of women
Level and child harassment
committee
5. National District Member prevention of women
Institute of and child harassment
Fashion Design committee
6. Child Rights State Member NGO core committee
Convention
7. Juvenile system Ex-officio member of Juvenile
Guidance bureau
8. Social welfare State Level Member -Review committee
Board for various counseling
centers
9. She continues to be a member of the Tamilnadu State, and
Chennai district women and child anti traffic committee,
member of the non official committee to judiciary in Chennai
and member of the HIV care consortium

The organization is lead by a very competent medical doctor. The


management of CHES has been strengthened by developing
managerial staff as shown in the Organogram given below.
5

HIV

PREVENTION PROGRAMS Fo und


6

Project Nanban
The spread of HIV and AIDS is one of the biggest challenges facing the
country today. The scourge of AIDS poses a serious threat to the
economic, social and health sectors of the country. Urgent measures
are needed to control the spread of HIV and AIDS especially in
Tamilnadu, which has been identified as one of the States with the
highest rate of spread of the disease. The spread of AIDS has been
more homosexual behaviour and among young people. Hence CHES
has started Project “NANBAN”.
7

This project reaches to 2000 male sex workers including Aravani,


Kothis, Double Decker’s in Tiruvallur district through an intervention
program which aims to reduce STI/HIV/AIDS among male sex workers
and to improve the quality of life led by this population since 2004.

During this year, which is also the Second Phase of the intervention
supported by TAI-VHS- Bill and Melinda Gates, the Target to be reached
has been increased from 1350 to 2000 and the project has shifted to
19 key areas grouped into 6 clusters in Tiruvallur District covering all
the areas as mentioned below:

1. Red Hills
2. Ambathur
3. Padi
4. Villivakkam
5. Tiruvattiyur
6. Tollgate
7. Ennore
8. Manali
9. Mathur
10. Mathavaram
11. Minjur
12. Ponneri
13. Gummidipundi
14. Kavarapettai
15. Arani
16. Uttukottai
17. Periyapalaiyam
18. Thamaripakkam kut
road
19. Cholayara

The 4 field officers cover all the 6 clusters and 3 sites in each cluster.
They visit the field daily , identify the Hot spot, conduct 1 to 1 and 1 to
Group sessions, do Condom promotion, refer based on needs for
counseling or to higher institutions for management of STI or HIV,
enroll KP in program, do IPC dissemination and form SHG among them.

The project has reached around 2209 male sex workers since the start,
of which 10 have dropped from the intervention. Of the 2209, 1375
have visited the clinic for the first visit and 1876 have reached as RMC.
Of the 1375 who have visited the clinic 76 have been treated for STI.
8

1109 have been referred to VCTC and 14 have been identified as HIV
positive.

Besides the routine 7 staffs there are 2 additional staffs namely the
beautician who takes care of beauty clinic and an advocate who works
on case by case with regards to advocacy.

The biggest success of this project is the vocational training offered to


male sex workers helping to decide an alternative life. Various kinds of
skill trainings have been offered such as briyani making, Videography,
computer skill, beautician course, driving, dry flower bouquet making
etc; Out of the 40 male sex workers referred for such training, 38 have
completed the course and all of them have been placed on jobs and
the behaviour change noticed was that these male sex workers who
were full time sex workers have now reduced their sexual activity
limiting to few know friends alone leaving the commercial part. Of the
38 just one had discontinued.

Other high lights of the project include

A} the beauty center where the target community are not only
provided beauty care but also general health care, tips regarding
cleanliness and daily routine for personal health and specifically
knowledge about STD/ HIV/AIDS prevention,

B} SESA clinic is a special STD clinic for the community, where male
sex workers have free STI screening and treatment and go for regular
medical examination

C} Natpookudam where the community members meet every day and


ventilate.

Four different need based activities are carried out daily by the
community themselves namely Akshayapatram, Vasthradanam, Irai
Arul Neram and Sevi sayukum neram

Given below are the names of people who have been trained and their
placement details.

S.N Training
o Name Age Sex given Income
1 K.Maya 30 Kothi Beautician 4000/-
.

2 D.Muthu 33 Kothi Beautician 3000/-


9

3 Suresh/Saravana 25 Kothi Fashion 2500/-


. Design

4 RANI 41 Aravani Catering 3000/-


.

5 Suresh 25 Kothi Catering 2000/-


.

6 REMASH/RAMYA 26 Kothi Housekeepin 3000/-


. g

7 Vikram 21 Kothi Housekeepin 2500/-


. g

8 Mary/Manogar 21 Kothi Discontiued


.

9 GUGAN 21 Kothi Videography 2500/-


.

1 Mageswari 24 Aravani
0 TAI KAVIYA Salary
. provided by
TAI
1 Theanmozhi 20 Aravani
1
.

1 Sabana 18 Aravani
2
.
3
1
3 Basic
42 DD 3000
. Computer
Vijayakumar
1
4 Basic
27 Kothi 4000
. Computer
Balamani
1
5 Basic
22 Kothi 2500
. Computer
Muthukumar
10

1
6 Basic
22 Kothi 2500
. Computer
Rudhramoorthy
1
7 Basic
30 Aravani 4000
. Computer
Rajakumari
1
8 Basic
25 Kothi 2500
. Computer
A.Senthil
1
9
.
Raji / Rathika 22 Kothi Driving 3000
2
0
.
G.Ravikumar 29 DD Driving 2000
2
1
.
Anbu/Saritha 32 Kothi Driving 2500
2
2
.
Krishnan 26 Kothi Driving 3500
2
3
.
Sendhil 22 Kothi Driving 3000
2
4
.
Thirunavukarasu 29 Kothi Driving 2000
2
5
27 Kothi Briyani 1500
.
Karthik/Kowsalaya
2 Nil
6
31 Kothi Briyani
.
Raja
11

2
7
22 Kothi Briyani Nil
.
Muthukumar
2
8
32 Aravani Briyani 4000
.
Radha
2
9
24 Aravani Briyani 2700
.
Selvi
3
0
23 Kothi Briyani 3000
.
Nandhini
3
1
24 Aravani Briyani 1750
.
Ramya
12

Project “Thooli - Tamilnadu”

HIV CARE

AND

SUPPORT PROGRAMS

This is a special program for children infected, affected and orphaned


by AIDS in three high prevalence districts in Tamilnadu. This special
program has been designed in a way to have triangle partnership,
where AIF will fund and provide technical assistance, CHES will be a
13

mentoring organization extends technical assistance to their 3 sub


partners in the 3 district. Each district will have one implementing
partners. This project was established in September 2007.

This project which aims to create an enabling environment for children


infected, affected and or orphaned by AIDS by providing care and
support services in 3 districts in Tamilnadu covers 3 different
components based on 3 different objects namely

1. Shelter care for AIDS orphans – addressing gaps in existing


services to orphaned children at CHES Anandha Illam, ensuring
their RIGHTS and participation.
2. Educating families and community, advocating throughout reach
for keeping children in community through community home
based care program in 3 districts in Tamilnadu
3. Strengthening socioeconomic status of grannies and widows
caring for children is a new pilot initiative, where we work with
the grannies in Chennai under the care of project Thooli at
Chennai.

Addressing Anandha Illam gaps and ensuring CHILD RIGHTS the


children have been given additional educational support towards
tuition fees for the teacher and procurement of educational materials.

Classical dance classes have begun for children and 10 of them are
getting trained in the same. Children performed this at the “TAI
Vizhudhugal” – Annual meet organized by TAI – VHS – AVAHAN at
Chennai. Children earned name for themselves. This special concept
was appreciated by everyone and this team has been invited for
couple of meets.

Children reading habits have been strengthened by providing them


different kinds of children magazines.

Celebration of their birthdays makes each and every child happy. This
special new initiative has come true by AIF. Children birth list have
been developed using their admission dates as an indicator especially
for children who have no actual birth dates or record. 18 children have
celebrated their birthdays since September. On birthdays, children
wear new dresses (they themselves do their birthday shopping), go to
temple for special pooja, have their breakfast at hotel, visit to an
orphan home – distribute sweets to the people live there. Lunch is
14

being prepared as per their request. Birthday celebrations happen in


the evening with cake cutting.

Five more part time baby sitters are being supported through this
project. Now the children and baby sitters ratio is 5:1.

CHES had taken a lot of efforts in selecting 3 districts where the


community home based care program had to be initiated. The process
of district selection was started in the mid of September 2007. Two
consultants hired for this process have identified Tiruvannamalai,
Cuddalore and Ramanathapuram as the districts where this new
project could be initiated. One NGO was selected for each district out
of the 40 NGOs who submitted their application after a strenuous
screening by the selection committee formed for this purpose. 3 NGO’s
from the 3 districts have been finalized. Selected organization’s are
Association for Rural Development (ARD) – Ramanathapuram
District, Rural Education and Action for Liberation (REAL) –
Cuddalore District and Rural People Educational Development
Trust (RPED Trust) – Tiruvannamalai District. MoU has been
signed on 15th of December 2007 at Chennai.

Basic training
program has
been
organized in
two capsules
for the
recruited
staff
members of
NGO’s.
Module has
been
developed by
the project
director, CHES. First training program has been organized between 28th
and 29th of Decembers at Asha Niwas training center at Chennai while
the Second training program has been organized between 7th and 8th of
February 2008 at Hotel Brown star at Chennai.
15

The trained NGO staffs were asked to identify 6 high prevalent blocks
in their district where they could start their work.

The partners have reached to 80, 26 and 32 families and 48, 30, 42
children at Ramanathapuram, Tiruvanamali and Cuddalore
respectively. Of these 48 at Rameshwaram 12 and of the 30 at
Tiruvanamalai
7 are HIV
infected
children. All
infected
children have
been linked to
ART centers at
Madurai and
Adukamparai

Program
manager and
District officer
have visited all
the project
sites in
January and
February 2008. During their monitoring visit, review formats, proposal
and other project related formats have been introduced to the staff
members and there were discussion on project performance.

Strengthening socioeconomic status of grannies and widows caring for


children was a new pilot initiative and was initiated on February 23
2008 and CHES could offer services including income generating seed
money, first-aid kits, free medical check-ups, educational support, and
assistance obtaining old age/widow’s pension, ration cards, and
guardianship legal aid.
16

Anandha illam
The Shelter home was CHES's initial project and was started as a home
for AIDS orphans. CHES has been doing a pioneering work and has
addressed every issue with reference to child rights. Children are now
cared through a community care center where in infected and affected
orphans are provided tender lovin g care, safe space to live, medical
care including HAART, educational
support [ in to regular schools],
psychosocial support, recreational
activities.

During this year 13 new children were


admitted and at the end of the year
there were 48 children who were
provided services at Anandha Illam.
Mainstreaming children is one of our
successful initiatives and nearly 100%
of children have been mainstreamed
through reintegration, adoption, and
sponsorship. 11 children were
discharged of which 8 were sent on
adoption and 2 children were
reintegrated with their family. There
was only one death this year.

Children birthdates have been celebrated and each child plans on his
birthday, selects his favourite dress and cuts a cake with special iceing
of his or her choice the same evening. Children are studying in general
schools of which 5 are infected while young children attend the
inhouse school at CHES

Mainstreaming efforts have been successful. Children have been taken


on picnics to various places by different group of people besides the
management there. The lists of picnic spots visited by children include
the following:

Pictures at cinema
1 halls
2 Dhakshin chitra
3 Marina beach
17

Aringar anna zoological


4 park
Ayanavaram tirupathi temple
5 festival
6 Christmas celebrations
Adiyas hug program at
7 kamarajarangam
8 seasons of love
Melmarubvathur
9 temple
10 Chennai museum
German hall dance
11 program
12 Hotel saravan bhavan
13 Games show

Different kinds of volunteers have poured in to bring smiles on these


children faces.

Colleges students from


1. Maduravoyil Muthukumarasamy College
2. Stella Maris
3. Sri Ramachandra Medical college
4. Loyola college
5. Ethiraj college
6. MAC College of nursing
7. Hindustan College of ARTs and science

From service organisation

1. Leo club

2. Lions club

3. Southern railways
4. CMC doctors
18

5. Tirisulam SHG group

Corporate friends from

1. FORD

2. Sathyam foundation

3. Tata consultancy

4. Standard chartered Bank

5. Inforces

6. Cognizant

From FBO

1. Nesapakkam Sayee samithi

2. Kodambakkam sayee samithi


19

Besides these the project had VVIP visitors like the sailors of NIMITS
WAR SHIP, Officials from NACO, UNICEF, American Indian Foundation,
Emirates airline children foundation and from US congress.

Given below are the admission and discharge graphs.

Admission vs discharges

Discharge analysis

Details of discharges

Project Tamilnadu Family Care continuum


20

Tamil Nadu has pioneered several initiatives and been a step ahead in
HIV/AIDS prevention, care, and support. It has the distinction of being
the first state to respond aggressively to demands placed by HIV
epidemic on both government and other structures. Owing to high
degree of political and administration commitment to control the
epidemic and improving quality of life for existing PLHA, several
initiatives such as ICTC, PPTCT, targeted interventions, Community
Care Centres and ART services have been initiated in the past few
years. Tamil Nadu Family Care Continuum
program initiated in September
2005 across 12 districts was
conceptualized with the
objective of accelerating access
to treatment and providing
treatment and support services
employing a comprehensive
approach.

The program aims to prevent


children from being orphaned,
reduce HIV related mortality
and morbidity, and improve the
quality of life of infected
individuals and families. Initial results of first follow up of clients
indicates positive progress and achievements on enlisted parameters
thus strengthening the objective of expanding the model to other
districts incorporating the lessons learnt from its implementation over
a period of 20 months.

CHES provides clinical support


services at the Kilpauk medical
college and has been closely working
with 4 district field NGOs namely from
Chennai, Villupuram, Tiruvallur and
Kanchipuram.

Besides running the support for


clinical care services the project has
conducted Hospital sensitization
program, Nutritional Demonstration,
holds Local operational committee
meetings, NGO coordination
meetings, PCO’s Review meeting,
Weekly staff meetings, conducts
important events like World AIDS Day Observation and regular monthly
21

field visits at all the four district NGO sites and and takes care in
information Sharing
There was one Hospital sensitization program which concentrate more
on basic facts awareness, reduction in stigma and discrimination and
information on Post exposure prophylaxis.
TNFCC ART QUIZ - 07
The TNFCC ART quiz was
started on I st June ’07.
The quiz was open to all
the medical and
paramedical staffs of
Kilpauk Medical College.
Each day one question
related to HIV / AIDS was
displayed at TNFCC ART
KMCH center. The
participants left their
answers in the box in
front of the center. At the
end of every month the
participants who gave
maximum correct answers were ewarded. A bumper prize at 3 months
and 6 months ere also given to the maximum scorer during that
period.

There have been regular ongoing


capacity building for staff members
including Informal case discussions
with team by the medical officer,
regular weekly meeting and case
discussions, structured case
conferencing for challenging cases,
regular discussion on strategies to
improve ART adherence, strategies
for reducing ART LFU were
discussed along with new NACO
guidelines. Such onsite trainings
have lead to early detection and
effective managements of
opportunistic infections, assessing
clinical staging, early initiation of ART, effective monitoring of ART
adherence and it improved the confidence level among staffs in
working together
22

MICRO AND MACRO SUPPLEMENTS AND ART AHERENCE MONITORING

Over the last few years, there has been a rapid change in treatment
strategies for HIV infection. Importance to Care, support and treatment
component is emphasized more especially PLHAs and their family
members are followed up through community and home based care
program in addition to the services provided at the hospital. Regular
health care, psycho social support, early identification and
management of OIs, adherence to nutrition supplements (micro and
macro), drugs (ART, AT T, and OIs), capacitating PLHAs and family
members on HBC are considered as the prime factors for improving the
quality of life. TNFCC program ensures the above mentioned
components through its integrated hospital and field components.

One of the foremost concerns identified at both sides are the PLHIV
ability to maintain near perfect adherence over the long term. On the
other hand the providers ability to monitor adherence to ART, ATT, OIs,
Macro and Micro. In addition updating staff knowledge and developing
skill to educate the importance of ART, nutrition supplements (micro
and macro), OIs, monitoring and calculating adherence is very
decisive. TA team’s site
assessment reveals that this
component should be strengthened
immediately to better monitor,
document and ensure adherence.

There was a session on


psychological problems related to
HIV infection held on 12th October
2007 at TNFCC – ART centre in
KMC hospital where HIV related
psychiatry problems such as HIV
related disorders, negative emotion, anxiety, stress, pathological
anxiety, generalized anxiety, panic anxiety disorder, post dramatic
stress disorder, depression, hopelessness and psychosis were
discussed. Psychiatry department provided anti psycho drugs and
patients were referred there.

A Nutritional Demonstration was held at the Hospital Site for PLHAs


hospital staff and General public. Nutritionist explained how to
prepare nutrition food with SATHU MAVU and also they discussed with
cost effective nutritional foods. The Nutritionist demonstrated the
following recipes
23

1. SATHU MAVU SPRING


ROLL
2. SATHU MAVU CUTLET
3. SATHU MAVU VENNAI
PUTTU
4. SATHU MAVU PORRIDGE
5. SATHU MAVU SAMOSA
6. FRUIT SALADS &
SPROUTS
7. SATHU MAVU
KOLUKATTAI
8. SATHU MAVU PUTTU
9. VEGETABLE SALAD
The procedures for the recipes
like, KOLUKATTAI, LADDU,
RAVA LADDU, PUTTU, DOSAI, SAMOSA, and BISCUT & CUTLET were
exhibited, and also we distributed the nutritional recipes booklet. This
program was presided by Dean of Kilpauk Medical College and TNFCC
ART centre Nodal officer

A Mini Magic Cooler Water Dispenser for patients to provide Hot and
Cool water and mineral water supplied on daily basis to patients.

The coordinator of the project visits all the four districts along with the
monitoring and evaluation team so as to improve the Follow up
practice of Lost follow up(LFU) Clients, to reinforce hygienic behavioral
practices of the Clients, to improve the Adherence level of both the
Care support and ART follow-up Clients, to Educate the client on
Nutrition and Safe sexual Behavior, to Educate and enable the Clients
to have a Clean and Hygienic living environment, to improve the
follow-up Counseling of care&support and ART follow up clients, to
have a Real picture of the Client and their living environment, to
Provide Home based Psychological support to the client, to better
understand about client needs and to improve a client friendly
environment between the ART center and the Client.
24

TNFCC – CHES ART Centre Data

Details Chennai
No. of new patients registered (All patients, including non-ART-
naïve transfer patients from other hospitals) 2179
No. of new patients registered (CIFF patients, including non-ART-
naïve transfer patients from other hospitals) 1641
No. of CD4 results available (All patients) 1982
CD4 < 200 (All patients) 666
CD4 < 200 (CIFF patients) 485
No. of patients started on ART
(All patients, including non-ART-naïve transfer patients from other
hospitals) 728
No. of patients started on ART
(CIFF patients, including non-ART-naïve transfer patients from
other hospitals) 567
No. of registered patients reported died 195

TNFCC – CHES ART Centre Children Data

Particulars
KMC
(As on April 2008)

Number of infected children registered 282

CD4 results available 272

Number of children started on ART+ 122

Number of affected children 1690

Project Sprout – A support program through Elton


John AIDS Foundation, UK
25

Project support was initially approved for one year since October 2005 and
December 2006. Based on the left out funds in the project, same has been
extended to 13 months from January 2007 to March 2008. Activities remained
the same. No new funding was supported by the EJA Foundation. Planed
activities of the Project included Educational support to be provided to
children affected and infected by AIDS, OI services to be given to children
affected and infected by AIDS and Supporting infected affected families to
initiate Income Generation Program (IGP)

During the 3rd week of January 2007, Task force committee have met and
reviewed the process of the project. This review looked over the process
involved in the selection children and families for extending educational and
Income Generation Program (IGP) respectively. Committee had another look
at the proposal and it decided to include Children who have been given
educational support to be followed and their academic performance to be
monitored.

A need assessment was executed during the home visit and the support
needed to establish IGP were ascertained. Families were explained about the
support and requirements needed. Follow up of cases for where support has
been provided as part of monitoring and evaluation.

All the 70 children who have been given this support are being followed by
our social workers. Their academic performance has been monitored through
grade sheets given by the school authority. 80% of the children are
outstanding where as rest stays in above average. The educational support in
this current academic year (2007 -2008).support has been extended to 20
children

From our existing home care follow-up, 50 needy infected children have been
identified for OI support based on our medical screening. New case sheets
have been developed for these children and they are being supported with
various OI drugs as per health expert’s recommendation. These children are
being monitored by our health professional squad’s in standard intervals.

25 widow mothers from our home care families were provided IGP support
after careful scrutiny of the Steering committee. Home visits were done to
assess the circumstances to initiate the program. Families who have made
their move are being monitored by the assigned team in regular intervals.
26

Project “Thooli” Chennai - An OVC program


CHES has been running this pioneering program since 2000. The
project had faced a lot of changes and different funding. He project
aims to provide HIV/AIDS prevention, care and support services to
HIV/AIDS affected, infected, orphans and vulnerable children and their
families in five selected zones in Chennai city.

The overall objective were aimed to strengthen community response


to address the needs of OVC and to implement behavior change
communication (BCC) for HIV prevention and care and support of OVC
in identified slum communities in Chennai; to provide home-based care
for OVC and to address the needs of Families affected by AIDS by
strengthening the linkages and networks with health care structures,
schools, childcare institutions and PLHA and to strengthen project
management system and implement sustainability plan.
Existing three FRC’s have been continued at Otteri, Vadapalani and Saidapet. Apart from the
existing 30 slums (10 from each zone), 15 new slums have been identified in the nearby areas.
30 new stakeholders have been identified and registered. These stakeholders have been trained
through various educational and sensitization meetings. These stakeholders have supported us in
organizing community events and BCC program at the above said community. Apart from this, 30
adolescent children (15 boys & 15 girls) have been identified and trained on Peer Educators
concepts.

Around 1163 (465 male & 698 female) people have been reached through the above said
activities during the project period. Monthly meeting have been conducted with these peer
educators. These monthly meeting helped both peer educators and social workers to assess their
performance and to provide on site support to perform better.

Children clubs have been formed at all the three zones in 3 different age groups. 340 children
have registered so far in all age groups. Regular series like sports, cultural events, competitions
were organized. These programs have lent a hand in facilitating child to child interaction to
address stigma & discrimination. Apart from these monthly events, we have organized and
conducted 3 Mega Events in December 2006, February & March 2007. Children Rally with
Cultural program, Children Fashion show and a Mega on spot competitions were conducted
respectively. Children from OVC families and from the community participated enthusiastically.
Detailed reports of the same have been developed and they are enclosed.

All the project staff was oriented on LSE concepts & roles and responsibility of an effective
facilitator at the beginning of the project. One day training was organized for the selected peer
educators & community volunteers. Regular sessions have been conducted at Shelter, FRC and
Community. Counselors and Social worker supported LSE Coordinator to carry out the sessions.
Around 150 new children have been reached through LSE sessions. Children from Corporation /
Government schools and from networking NGO’s have been reached. Apart from this new
children, 40 old children from OVC families have been reached through Roja Kootam (Group of
Children who have undergone the process of Disclosures) sessions.
27

Each social worker has made at least one visit to each of the family. Based on the referrals,
Counselors made single / joint visits to the families with the social workers to identify the need
assessment and also to support the family with their emotional needs. When Social workers
visits a family they have been asked to talk to the children, parents and family members, make
referral wherever possible for medical and support services. The Social workers was also asked
to discuss short and long term plans about their children and initiate life book for the children. The
team spends time with children playing with them and encourages them to talk with them freely.
Discussion with parents may be centered on the physical and mental well being of the child, his
day to day activities, needs of the children, support services requested, follow up of referrals
education on health and hygiene including personal and environmental hygiene, nutritional care,
immunization and prevention of spread. All children have been visited at least once a month.

S.N Particulars No .of Boys No. of Girls No. of PLHA No. of Family
o
1
. Old Follow-up 159 187 293 247

2
. New (Identified) 22 29 43 25

Total 181 216 336 272

Home Care team had conducted 2 nutritional demo with explanatory sessions every month
during caregivers training and hope club. 210 people from CAA families & PLHA have Scholarly
on low cost nutritive diet food for children & adult through 10 training program. Apart from this we
have extended nutritional support to 10 positive sex workers (through our ongoing WIP program)
family.

Monthly meeting of the trained Peer Educators and Community Volunteers have been executed
Zone wise. During these meetings, some of the members came forward & visited the CHES
“Aanandha Illam” – care home for OVC. Our continued community mobilization activities have
successfully established a linkage to the Home care. The rice, which is being mobilized from the
SHGs and the children’s clubs through, “Handful of Rice”, scheme is also being distributed to
the needy HIV infected families, which are being identified by the concern social workers. Regular
contact with the volunteers by the Social Workers is going on.

The Hope Club initiative was started on the October 1997 by CHES when five PLHA members
attended the same. The main aim of the Hope club is to bring people living with HIV together,
create an enabling environment and a positive living. It was a platform for PLHA to discuss
among them and develop positive living.

Hope club was held on the last Sunday of every month. Sunday was selected because most of
PLHA were working and hence to facilitate them to attend the meeting Sunday was chosen. Each
month when PLHA and children meet each other, friendship and PLHA came to understand the
epidemic much better, they were able to understand that there are many more like us and this
28

build in confidence in them to live. During the meet the families were provided one meal on that
day and this was provided through local religious group. From October 2006 this HOPE club
became an activity of Project Thooli through APAC support. 10 such meetings have been
organized since November 2007 until December 2007. Through this program travel allowance to
the families for coming to the Hope club. This increased the number of families coming to the
Hope club. Recreation activities are planned during the meeting for children, psychosocial
support is provided to the parents and their children, LSE session if taken during this meet for
children of ROJA KUTTAM. 10 HIV infected sex workers children are provided nutritional support
for the month through our networking with another NGO called ICWO and this support is provided
by Elton John AIDS foundation.

Two caregivers training program were conducted every month since April 2007. 80
Representatives from PLHA family & community have participated. Experience resource persons
handled sessions in the Nurtured Hope care manual. This training program was held at CHES
Training Center. At the end of the training program, all the participants were given a medical care
kit (consist of First aid materials). Review meetings of the same were executed in November &
December.

Six sensitization programs have been organized at the corporation and government schools at
Namalwarpet, Otteri & Vadapalani respectively. School authorities were very much keen to us &
they have accepted our request and permitted to have the meeting at their school premises.
Around 25 teachers per program have participated in the meeting. At the end of the program,
teachers have come forward to take this information to their children (students). They have also
requested us to handle sessions with children on sex & sexuality, HIV/ AIDS etc. All the school
has assured us to support the CAA’s referred by CHES. Two schools have given their
acceptance to take-up the LSE program to their children in partnership with CHES and the same
was initiated from February 2007.

Project Thai Seye Nalam

Under the Global fund for AIDS, Tuberculosis and Malaria round 2 was allotted
towards prevention of parent to child transmission of HIV. CHES provides support to
center of excellence the government institute of Obstetric and gynecology in
prevention of parent to child transmission program. Here we cover over 4 corporation
zones in Chennai district covering around 67 corporation health out posts and work
closely with the community such as SHG, antenatal, post natal and lactating women.
29

The goal of the project is to work towards a future without prejudice for children and
their families infected, affected due to AIDS so as reach their fullest potential by
offering a quality of life. This project aims to improve the ANC strength through
community based awareness and education and bring in women for institutional
delivery and to improve the follow up care of children through home-based care for
CAA and their parents with out breach in confidentiality.

The Strategic directions of the


projects are involving women
self help groups, Mahalir
mandram, or community
based organization in
dissemination of information
about PPTCT and utilizing
their services to reach all
antenatal women in the
4corporation zones,
strengthening of existing
PPTCT services at IOG,
utilizing the out reach
program to offer follow up
care of children and their
parents through home based
care, create an enabling environment to address the needs of CAA and FAA in
identified slum communities in Chennai through the existing services already
rendered by CHES, Building capacity of various stakeholders, Strengthening support
services to families affected by AIDS through referrals, network with out breach in
confidentiality and providing psychosocial counseling to antenatal mothers, couples
and children

At the institution the pregnant women are offered HIV screening and tested with
consent. Those who test positive for HIV are followed provided ART drugs and
adherence is followed. This challenging project has multifaceted and each and every
part of it is important. Counseling services are offered to couples and pregnant
women. CHES works with Institute of obstetric and gynecology, Egmore.

The team links with corporation health post, balwadis, ICDS, VCCTC, positive network
and NGOs providing support services. The infected pregnant women are followed
through home based care and are empowered through providing health education,
linking them to the various need based services including ART services, testing
services, other medical services, TB screening and other support services. Their
husband and children are also addressed through this program.

This project is supported by Tamilnadu state AIDS control society through the Global
fund round 2 and 3. Under round 3 the PLHA identified through round 2 are referred
to TB care center to identify this common Opportunity infection and manage the
same.
30

Over the last one year the project team have identified and registered 10118
pregnant mothers who were motivated for HIV screening of which 10096 were
counseled and referred to Integrated counseling and testing centers. Of this 10096,
only 8769 reached the testing centers and the project has identified 43 new pregnant
women. Along with the 8769 women referred for testing 8592 spouses were also
referred of which 6826 attended the testing facility and 27 were identified as HIV
positive. With this 70 PLHA identified this year nearly 194 PLHA in total are followed
by the project.

155 PLHA have been referred to RNTCP, 135 to Screen for sexually transmitted
disease, 78 PLHA for OI management, all PLHA have been linked to ART centers and
8 to care centers. The project had conducted 53 ANC meetings in which 1514 ANC
mothers took part, 22 PLHA meetings in which 742 took part, 5 anganwadi meeting in
which 325 took part and 46 SHG meeting in which 1398 took part.

Nevirapine was given to 32 mothers, ART regime to one mother, 32 deliveries were
conducted of which there were 31 live births, one was a still born and Nevirapine was
given to 31 babies.

Under Home based care 261 PLHA were followed, who were offered counseling
services, 15 were given economic support, 4 children were referred for shelter care, 3
PLHA were referred to care center, 10 PLHA were linked with Positive network and 4
women were referred for legal support.

ANC r e ac he d
12 0 0

10 0 0

800

600

400

200

0
1 2 3 4 5 6 7 8 9 10 11 12

To t a l A N C 10 2 937 1 05 8 92 90 3 707 8 19 5 14 59 8 386 443 4 96


re f e r r e d 0 4

A N C r e g is te r e d , 95 8 868 1 07 8 45 78 4 587 7 01 4 47 49 6 325 347 4 45


c o u ns el a nd 8
te s t e d
Sp ou s es 12 5 104 2 04 2 50 20 6 334 4 73 4 47 40 4 672 958 9 42
c o u n s e le d a n d
te s t e d

T o t a l A N C r e f e r re d A NC re g i s t e r e d , c o u n s e l a n d t e s t e d
31

Additional verity of CHES

1.CHES is governed by a 12 member board

2.CHES has been registered under the society’s Regulation act

3.CHES has Income Tax exemption

4.CHES has been registered under the Foreign Currency Regulation Act
of India

5.CHES has been offered the Fit institution Status by the Government
of Tamilnadu

History of CHES
1994 - Registered as a NGO under societies act and started d the first
HIV care home for HIV infected orphans.
32

1995 - Concentrated on awareness creation on HIV/AIDS. Initiated


the first HIV/AIDS awareness campaign during the Koovagam festival.
CHES started to identify sex workers who came as HIV infected and
destitute to our shelter home. CHES learnt from the target community
that condom use was low. Number of referrals to CHES shelter home
increased. CHES worked with school students creating awareness
during the WORLD AIDS day event

1996 - Conducted a baseline survey on condom use among sex


workers and found it to be just 7%. Started an STD clinic for high risk
population at Chennai. APAC-VHS-USAID provided fund for a STD care
program. TANSAC provided support a Sex workers intervention
program along the sea coastal region in Chennai. CHES shelter home
care continued. CHES along with APAC- VHS-USAID conducted the
Beauty Contest for eunuchs at Koovagam festival. Tamilnadu Governor
donates Rs. 50,000 to CHES

1997 - CHES was the first agency to appoint PLHA on Job. The first
Home based care program called VIDIYAL was initiated by CHES in
Chennai with resource from TANSAC. TANSAC supported yet another
project called “ Vellicham” STD/HIV/AIDS awareness among slum
dwellers in Chennai. CHES scaled up its counseling services by getting
its grass root workers trained in counseling through CMC Vellore. The
APAC- VHS-USAID supported WIP intervention project was started this
year in Chennai. As an outcome of the Round table conference
conducted by CHES Villupuram collector allotted free land to eunuchs

1998 - Projects Vidiyal, Vellicham and Thozhi continued. CHES assisted


the sex workers to register a CBO with the objective of taking up
routine medical check up / rehabilitation.

1999 - Projects Vidiyal, Vellicham and Thozhi continued. Started


Counseling services at Government Hospital for Thoracic medicine, a
project called “ Pathukappu”. CHES assisted the eunuchs to register an
organization for them called “ THAA”.

2000 - Started a care program for children infected, affected and


vulnerable to AIDS called “Thooli” with support from FHI. The first 18
months of the project called Thooli, focused more on institutional care.
Developed the first manual to train caregivers on care of children
33

called NURTURED HOPE. The APAC- VHS-USAID supported WIP


intervention Project “Thozhi” continued

2001 - Thooli project focused on home based and community based


care along with institutional care. The APAC- VHS-USAID supported WIP
intervention project Thozhi continued.

2002 - Conducted Situation assessment for FHI on Impact of HIV/AIDS


on children and PLHA at Nammakkal. Project Thozhi and Project Thooli
continued. CHES developed gate keeping criteria to restrict admissions
in to CHES shelter home. CHES formed a pediatric forum to address the
issue of children affected by AIDS. CHES succeeded in sending infected
children to normal schools.

2003 - CHES started work at Nammakkal “project Mottukkal” with a


local NGO called WORD. This project again supported by FHI, where
CHES role was a mentor organization. First two positive children given
on unrelated Foster Care. Orphans affected by AIDS sent for adoption
to normal families. Project Thozhi and Project Thooli continued. A pilot
social marketing of condoms initiated through petrol bunks and
supported by APAC – VHS- USAID. CHES conducted A situation
assessment on impact of HIV/AIDS on children in 4 high prevalent
districts namely Trichy, Theni, Salem and Tirunelveli in Tamilnadu,
supported by TANSAC.

2004 - Condom social marketing project continued. Developed a


manual to training doctors on care of children infected by AIDS. CHES
Project Director appointed as member of women and child ant
trafficking committee both for the state and Chennai. CHES visited
Cuddalore Pudhukuppam village and provided psychosocial support to
Tsunami affected children. CHES conducted a survey to identify people
eligible for widow pension and old age pension. CHES assisted social
welfare department by training teachers on counseling people affected
by tsunami. CHES started to work among male sex workers a project
supported by TAI. In continuation to the above work CHES did a
situation assessment on families affected by tsunami at Pudhukuppam.
CHES with support from TAI- Gates foundation started an intervention
program among male sex workers in north Chennai. Project Thozhi,
Project Thooli and Project Mottukkal continued.
34

2005 - CHES identified as NODAL agency by National Institute of Social


Defense to collect information about CAA/CIA in Tamilnadu. CHES
conducted a RAAP study for Futures group on impact of HIV/AIDS on
Children in Tamilnadu. CHES was recognized as a Fit Institution to
handle Orphans by the government of Tamilnadu. CHES had an
additional project “ Thai Sayee Nala Thittam” from TANSAC{ PPTCT
intervention} where CHES started to work with IOG, Chennai. CHES did
a Policy document for UNCEF on “Issues related to AIDS Orphans”.
CHES also did a Policy document for Tamilnadu on CAA. Developed the
counseling training manual to train counselors on Child counseling.
CHES started to work with Kilpauk medical college on children ARV
program. CHES is the NGO at main site supporting clinical care. This
project is called the Tamilnadu family care continuum. CHES started
the project Malarghal – psychosocial support to tsunami affected
children. Project Thozhi, Project Thooli, Project Nanban and Project
Mottukkal continued.

2006 - Shelter home for AIDS orphans has got support from TANSAC
as community care center. CHES supported by Social welfare board for
the children in special needs – HIV infected through the cradle baby
scheme. CHES along with Save the Children UK conducted a situation
assessment on children’s vulnerability to HIV at 5 districts of
Tamilnadu. CHES has started a foster care program for AIDS orphans
with the support of Alliance youth foundation. CHES has started an IGP
program for AIDS widows a project supported by Elton John Foundation.
Project Thozhi, Project Thooli and Project Mottukkal continued. Project
Malarghal – psychosocial support to tsunami affected children
continues. The support is provided by SCARF and Plan International.
Tamilnadu family care continuum project supported by TANSAC
continues. Project “ Thai Sayee Nala Thittam” from TANSAC{ PPTCT
intervention}continues. Students of Anna University Guindy
Engineering College donate a Maruti Omni van

2007 – Emirates Children Foundation has agreed to build a shelter


home for children of Anandha Illam. Two acres of land was purchased
the same year. Project Director of CHES was appointed as chairperson
of CWC, vested with powers of 1st Magistrate. She was also appointed
as the member of eunuchs rehabilitation program of the government
of TN. OVC Tamilnadu program started and CHES has extended its
work to three more districts in Tamilnadu namely Cuddalore,
35

Tiruvanamalai and Rameshwaram. Project Malarghal got over and a


final report was brought. Project Thooli , Project Thai sayee nalam,
Project Nanban, Tamilnadu family care continuum project supported by
TANSAC continues.

Members of the Board

1. Dr.P.Manorama; MD;DCH;DM; Founder President and


Project Director

2. Dr.V.Sivakumar; MD; Vice President

3. Mr.Mohan Babu; Secretary

4. Mr.M.S.Pinagapany; MA; Treasurer

5. Dr.N.C.Nayak; MBBS; Member

6. Dr.Nallanayagam; Member

7. Ms.Shantha; Member

8. Ms. Vasantha; Member

9. Ms.Latha; Member

10. Ms. Kalyani; Member

11. Mr.Jagadeesan; Member

12. Ms.Bhanumathy; Member


36

Who all have recognized CHES services?

1. Tamilnadu State AIDS control society

2. APAC – VHS – USAID

3. FHI – USAID

4. TAI – Bill gates foundation

5. Save the Children UK

6. OXFAM – GB

7. CAPACS

8. MBC university Australia

9. Alliance Youth

10. Elton John Foundation

11. SCARF – Plan International

12. Dept. Of Social Welfare

13. UNICEF, Chennai

14. Plus individual donors /and Universities who supported


smaller initiatives
37

Contact Person and details of contact:

Dr.P.Manorama; MD; DCH; DM

PRESIDENT CHES

198, Rangarajapuram Main road

Kodambakkam

Chennai – 600024

Email: pmanorama@yahoo.com

Mobile: 9444077177

* Donation can be sent as crossed cheque to be drawn in favour of


“CHES”.