MFCM031: medico friend circle annual meeting 1985 - TB and Society.pdf

Media

extracted text
;)

medico friend circle
annual meeting 1985
1 TB AND SOCIETYr

; Venue; Indian Social Institute
24 Benson Road, Benson Town
Bangalore 560046

Preliminary Note

The mfc annual meet is an important event
in the evolving perspective of the circle
and hence its objectives are more than just a theoretical
discussion around a relevant theme. The event is an
opportunity for friends to -

1. Objectives;

get to know each other;
share our field experience and grass root perspectives;
analyse together in a spirit of dialogue;
build a critique of the selected aspect of health
care within the overall vision of the circle;
v. identify areas of action, small scale field level
studies, and programmes for further involvement;
vi. attempt to internalise the perspectives gained
at the meeting in our varied work situations.

. i.
ii.
iii.
iv.

.2. Methodology; The meet will consist of a series of
informal small and large grop discussions around
various aspects of the theme. There ^111 bo no reading
of papers or formal presentations. A few members of the
circle and some invitees will act as coordinators of
group discussion but.every participant who has reflected
on the theme and on his/her own field experience will
be a resource person for the session.

3. Background; Some background materials have been published
in the bulletin and three sets have been despatched
on request to participants (see Appendix II). An important
pre-requisite for the discussion is the understanding
of the problem in its national/epidemiological perspective
which many of us may not have. To facilitate this, we
have included two articles of Dr GVJ Baily and Dr Banerjee
and a selected reading list which will help participants
to understand the official status/revicw of TB and its
control against the background .of which the discussions
will proceed. Some of our members have offered a critique
of certain aspects -nd some others have sent related
comments z all of which have been sent. Many areas are
not covered because some background papers have not yet
come in. All these should be ready by the 26th and will
be distributed at the meet. If any friends have additional
material relevant to the theme, please bring it along
to the meet (copies if possible).
P r o g r a m m e

This is a tentative one and will be further modified after
the first session on the 27th sc that participants/members
can build the meet together enhancing dialogue and discussion.

26 Jan 85
Saturday

4.30 p m

Planning Session (Executive
Committee/Core Group)

27 Jan 85
Sunday

8.30 a m

Introductory Session
a. Self-introduction by. participants
b. Introduction to mfc/meet/theme

p.t.o.

rt
2

27 Jan 85
Sunday

11.00 am

Session I (four groups)

Small group discussion ons

a. ■expectations of participants;
b. focus/scope of discussions;
c. issues in tuberculosis and its control
2.00—
2.30 pm

2.30—
4.00 pm

28 Jan 85
Monday

Final outline of programme

Session II

4.30—
6.30 pm

a. Critique of National Tuberculosis
Control Programme
i. conceptual; ii. organizational
b. Identifying true/false limitations
in studying the programme

8.30 pm

Getting to knew the Circle I
(sharing of experiences/action)

8.30 am
to
9.30 am

Plenary Session 'A1.
(putting together the critique)

9.30 am
to
11.30 am

Session III (small group discussions)

11.30 am

Plenary Session ’B’
(reporting and discussion on group
reports of Session III)

1.00 pm
&
2.00—
3.00 pm
3.00—
5.30 pm

a. Case finding/Case holding
b. TB - rational therapy and rational
drug policy
c . TB awareness building (professional,
para professional education and
public education)
d . TB and Socio-economic and political
factors

Session IV (Alternative Approaches)
Two Groups

a. Alternatives in TB Control - 1
(diagnostic, treatment regimes,
patient compliance at field or
project level)

b. Alternatives in TB Control
2
(at non project levels ie.,
awareness building, raising issues
with government and in mass media
etc.)

5.30—
6.30 pm

8.30 pm

Plenary Session ’ C*
.....
(future strategy/fed low up/action
pinn r.-r members/participants)
Getting to know the Circle II
(sharing of experienccs/action)

3

r
4'
3
29 Jan 85
Tuesday

9.00 am

Annual General Body Meeting
MEMBERS ONLY
The Agenda has already been circulated

All India Drug Action Network Meeting
(same venue)

30/31 Jan 85
Wed/Thvrs

Appendix I

/

Seme questions for discussion?.

Scope/Fecus of Meeting

Session I

a. What is the expectations of participants from the
discussion on TB?
b. What is the minimum that we should achieve?

- a better academic understanding;
- a better grasp of grass root level realities;
- a more concerned view of people’s sufferings;
- a better understanding of related socio-economic
and political factors;
- all or a combination of the above.
c. Do we want to discuss?

f

i. how we can lend cur helping hand to improve the
working of the existing strategy of TB control
in India?
ii. how to link up the question of the strategy
of tuberculosis control with the question of
social revolution? Is the question of social,
roveluticn really involved? how? why?
iii. how tc evolve an alternative people-oriented
scientific strategy if we find the existing one
fundamentally misconceived?
d. what can be the role of such a meeting?.,
‘ ”
—evolving a critique, ev'-lving <-n alternative
approach, both-, any other?

Session II

s

Critique of N T P

a . Is the existing strategy of tuberculosis control
working properly in India? If yes, what evidence?
If net, why not?
b. Is the failure because of some flaws in the strategy
itself? Conceptual/technical?
c. Is it because cf lack of implementation? If yes,
which factorr iwithin the medical/hcalth care system
and outside it act as impediments?
d. Even if the constraints put by the existing
vested interests are removed, would there be any
problems in the strategy cf control of TB in India?
What arc these? Can these be isolated in practice? How?
c. Are- there ;any regional differences in programme/performance/
imp1ernent ati on?
0 If so, how and why?

4

1
4

Scssi n Ill:

questions for group discussions will be
circulated cn the 27th. Depending on
oxpecoticns of.participants some other aspects
may be added.

Session iV

Al to rn ?. t i ve Appro ache s

a. The aim cf the session is to identify various alternative
approaches tc- the problem cf tuberculosis utilising
newer technological as well as sociological insights.
Those could involve intensive small scale field level
studios or field projects; eg

C:uld surveys bo undertaken to better
understand the TB epidemiology at field
level? including much neglected implications
of primary tuberculosis in pre-schccl
children and extent/implications f drug
resistance?
b. Could government programmes be monitored intensively
including actual execution of treatment guidelines,
patient compliance/follcw up etc?

c. Could alternative approaches
be tested cut in
— case finding;
— newer ways to improve patient compliance;
— newer treatment regimes;
— newer diagnostic approaches including approaches
t^ diagnosing drug resist:nee?
d. Can awareness of programme be increased .among the
general population? Can potential/actual TB patients
increase the demands on the system in terms of not
only utilisation but efficiency etc? Can any further
measures be demanded of the government?

ii. How can different-mfc members involved in
different situations contribute tc some or
more the approaches (to help in analysing the
existing strategy and forging an alternative
in the context cf fundamental social • change?
What could be the role cf a mc-dical student/
• •
intern/a socially concious doctor/a government
medical‘officer/hcalth workers/a community h-"al.+-^
project team mcmbcrs/teacher in a medical college/
a journal istya development or political activist?

Appendix II

Background-papers for meeting on 1 TB AND SOCIETY'

1. National Tuberculosis Programme:
Seme problems and Issues—Binayak
Sen, Dalli Rajhara

: mfc bulletin 105
(September 1984)

2. Tuberculosis and Society—
Mira Sadgcpal, Bankheri'

: Circulated at Wardha
Meeting—July 1984
(available from author
at Kishorc Bharati,
PO Bankcri, Dist.
Hoshangabad, MP 461990)
. .. .5

.

r

4

5
3. Discussing Tuberculosis
Ccncr 1—Why?—Anant Phadke,
Pune

s mfc bulletin 108
(December 1984)

mfc bulletin 103
4. The National Tuberculosis
(December 1984
Programme—What cur experts
say?
(on sociological basis,
epidemiological dimensions,
organisational plan, evaluation,
anti-to drugs, political
eclnorr^ and ultimate solution)
5. Understanding TB - a check list
of questions
(under;tending the situation,
assess .ng awareness, understanding
technic, lities,. discovering bottle­
necks, Lq.‘‘or st ending the health
system, discovering new approaches)
6. Selected heading List
(NTI VHA1, Indian Journals,
WHO)
7. Case Finding and Case
I Ic 1: ■’
* n g i n TB contro 1
programme—UN Jajoo, Wardha

mfc bulletin 107
(November 1984
Supplement)

s

mfc bulletin 107
(November 1984
Supplement)

s

Background Paper I

8. Cass Holding and Patient
Compliance and Motivation—
Marie D* Souza, Nandurbar

Background Paper II

9. Puolic Health Perspectives in s
tie formulation of NTP of
I:<dia—D Banerji, JNU, New Delhi

Background Paper III
(Sources NTI)

10. TB in Ayurvedic system of
N?dicine—Dhruv Mankad, Nipani

Background Paper IV

11. 13 in Siddha—Prabir, Nemur

12. tuberculosis Control in India
--current problems and
possible solutions
—GVJ Baily, NTI, Bangalore
13. A Perspective for Discussion
of NTP in India—D Banerji,
JNL, New Delhi

s

Background Paper V

Background Paper VI
(SourcesNTI)

Background Paper VII

14. Comments on Perspective
Paper No.3—Anne, VC Talwarkar,
S Kashalikar

15. Options on TB Chemotherapy—
Paul Shears, Oxford

16. Tuberculosis in Children
(Susannah Graham Janes, Nepal)

. ; .6

1
&

6

From br.ck issues of mfc bulletin
17. Health Care Vs. the Struggle
fcr Life--Mira Sadgcpal

mfc bulletin 93 and 94
VHAI Special Issue

IS. is BCG vaccination useful?
—Kamal a Jaya Rae, Hyderabad

2 mfc bulletin 89

19. Is anti-tubercular treatment
really very expensive? N N Nagar, Dahod

s mfc bulletin 96

Additional background papers and case studies which will
be available at the meet arco
TB an'-. Sccicty - a historical review - Mira Sadgc.pal
ii. TB and Immunity (Anil Patel)
iii. TB and Homeopathy (Amravathi group)'
iv. Rational TB Therapy and Rational Drug Policy Issues
(Mira Shiva)

Position: 378 (7 views)