Dr. Shelly Batra and Operation ASHA’s (OpASHA) work is nothing short of awe-inspiring. OpASHA began with one tuberculosis treatment centre in 2006, and now serve a population of 18 million across India and Cambodia. Third party replication has been done in 6 more countries.
Tuberculosis (TB) has been called ‘India’s silent killer’ as many of the millions diagnosed with it succumb to the disease. In India’s crowded cities and towns, it is easier than ever for the bacteria to spread. TB is contagious, meaning that any patient who has an active strain can infect others. Any stoppage in the course of medication can derail recovery. It even results in a nightmare scenario of multi-drug resistant TB, a strain of TB which a number of drugs can no longer cure.
Yet OpASHA has consistently reported exceptionally high detection rates, treatment success rates and also low default rates. Their operations combine treatment, technology and a willingness to adapt in response to the situation on the ground. Their work has without doubt reduced pain and suffering for patients in need. It has reduced the disease burden for the individual and their family. It will also go a long way to reduce the spread of this disease to others. Through their work, we can truly hope to see a TB free India one day!
We spoke with Dr. Shelly Batra, co-founder and President of OpASHA to find out the story behind their success!
OpAsha had sufficient support from the government in terms of free hospital infrastructure, medicines and diagnostics. But the core problem was of delivery. Hospitals were open from 10am to 5pm, which was inconvenient for those who were working. Daily wagers, labourers at construction sites and others could not benefit from the programme since their working wages were at stake.
If the mountain cannot come to Muhammad…
We developed medical centres within local community centres. OpAsha appointed community partners deep within disadvantaged areas. These centres were located at convenient locations, and kept open early in the morning and late at night to encourage people to seek treatment at their convenience. This was a milestone in itself. However, we soon realised that counselling patients and keeping track of them, especially those who did not come to the centre, was becoming a hurdle. So, we introduced ‘ TB Providers’, community members who were educated to act as health workers. This helped expand the reach of the programme, and increased tracking as the providers were able to monitor who was taking their medicine and who wasn’t. Not only did the count of patients seeking treatment increase, but the dispersion of disease reduced too!
In villages and tribal areas, where patients are scattered, we have TB Providers go on bikes or motor cycles from door to door to meet with patients. In the Mekong delta of Cambodia, our health workers go from island to island on boats to serve the needy.
Turns out there is an app for that!
Technology helped us to widen our horizon. We came up with an Android app which made screening of patients easy and encouraged them to come to the public hospitals and get their diagnosis and treatment done for free. This further provides surety to them that we are there to help the affected.
OpASHA’s app records a fingerprint from a patient and health worker every time a dose is taken. A fingerprint is proof of visit to the treatment centre by the patient. Medicines are given only after the patient gives the fingerprint. If a dose is missed, the system provides an alert to the health worker and his/her supervisor. The health worker then has to meet the patient within the next 24-48 hours, repeat the counselling, give the medicine, and take the finger print as proof of home visit. The app has been rolled out for 16000 patients in India. It has resulted in 12 times less of a default rate as compared to a WHO consultant’s report on the standard in India
On her values
You learn from every person you meet. My parents have been a great influence in my life. They lived their life with great simplicity, humility & service. My father was an IITian and a Class 1 government officer. He was absolutely honest, and lived with absolute integrity in a world full of corruption. This had a great impression on me. I have memories of my father teaching underprivileged kids in his spare time, one of whom went on to go to Harvard.
When I was studying at King George’s Medical College I used to get free samples from pharma companies of various medicines. When I returned home, my mother would distribute them for free to the underprivileged people in our area. She started this back in the 70’s. However, with changing reforms these samples were no longer available since pharma companies were not allowed to give them away. Ever since, my mother started buying them at cost and till date does so.
Advice to a younger generation
Have courage, be brave! Coming up with something new and then taking the idea to completion can be overwhelming. It takes a lot of patience to excel. The fruits of your hard work will take time to develop, and might at times even wither away. But staying strong is what will keep you afloat. Also trust in the few people who prove to be steadfast in their support. As you grow older, you will realise that you will only be able to count the people who will believe in you on your fingertips. These are to be valued.
We are all alike
Sadly, in this materialist world, people from a well-off backgrounds are more important than those who are poor. In today's day this has changed in the medical profession. It’s a shame that the disadvantaged often get a raw deal. When I was in Medical College, my professors always encouraged me to follow one thumb rule - that every patient deserves the best - and I have inculcated this very strongly in my life.