In the times of Corona, Tele-health and Tele-rehabilitation have emerged as alternative strategies to support people with visual impairments in accessing healthcare and rehabilitation services.
In February 2019 a Vision Rehabilitation and Training Centre (VR&TC) was established in Community Ophthalmology Section of Dr. Rajendra Prasad Centre for Ophthalmic Sciences (Dr. RPC), All India Institute of Medical Sciences New Delhi. Since then through this initiative, vision rehabilitation services are being provided to people with visual disabilities (Low vision and blindness). Services being offered to patients and their family members include Orientation & Mobility, Reading and Writing rehabilitation, counselling on vocational training, activities of daily living (ADL), instrumental ADL, issuance of disability certificates and advice for environmental and lighting modifications. Information related to various government schemes and assistance in availing them along with support and assistance for community-based rehabilitation and vocational training through NGO networking also forms an important aspect of this initiative.
COVID-19 lockdown and its ramifications on patients with disabilities.
In January 2020, the first case of COVID-19 was detected in India. Since then the number of COVID patients have been growing enormously. In an attempt to control numbers, the government imposed a nationwide lockdown which still continues in parts of India in various degrees. People with disabilities, particularly those who require personal assistance and daily support have been facing great challenges as they are more susceptible to contract the COVID 19 and at higher risk for mortality due to their physical requirements and underlying associated health conditions. For example, people with visual disabilities use the sense of touch to accomplish their daily chores. This practice leads to them becoming more vulnerable and unable to follow social distancing norms. Their susceptibility added to compromised health care access, due to the lockdown, is generating catastrophic results.
Intervention of Dr. RP Centre for Ophthalmic Sciences through CBM support.
Understanding the ground situation Dr. RP Centre for Ophthalmic Sciences requested CBM, Bangalore to support the centre with smartphones and tablets for an applications-based training programme (SUPERSENSE or VISOR applications) for people with visual disabilities.
In early April 2020, it was brought to the notice of the team of Vision Rehabilitation & Training Centre (VR&TC) that many students with visual impairments were stranded in blind schools or NGOs in National Capital Regions due to abrupt implementation of the nationwide lockdown. The team under guidance of Dr. Suraj Senjam, Additional Professor, Community Ophthalmology, AIIMS decided to start Tele-health and Tele-rehabilitation using references from national tele-medicine service guidelines. A few successful trials were conducted leading to launching of “Tele-Health and Tele-Rehabilitation” on 15th April.
These services are making immediate healthcare needs (general health and vision related) accessible during COVID times, using Information Communication Technology. Two mobile phone numbers procured by AIIMs have been shared with various representatives of NGOs and schools to support them in reaching out. As of 31st May 2020, the team has received around 250 calls from People with disabilities, caretakers, family members and wardens from across India for support and guidance
Services offered through “Tele-Health and Tele-Rehabilitation Programme” include: –
1. Information and education about COVID 19 disease
2. COVID 19 pandemic: Safety and Precautions
3. Psychological counselling
4. Discussion about food safety and personal hygiene
5. Consultation about common health and eye problems
6. Sharing of practical experiences and coping strategies with each other through zoom meeting
7. Support in finding accommodation for people stranded in Delhi
8. Support in emergency health care access
9. Information about follow up services
10. Coordinating with NGOs for further training of Person with disabilities
11. Providing Information about admission to schools for the blind
12. Information about Arogya Setu App.
13. Utilities of smartphones applications.