From our current field experinces since May 2021, we could share Operational Researches through previous posts: 1. Reverse SOP and 2. All India Solution for an All India Problem. This we shared through mail with programme implementers in the public sector from local level to National lvel, with peer performers [CVCs]. On receving positve responses we are now sharing the following [Vission in Action] for additional inputs, replication / scaling up or for similar actions.
Making of an Inter District Outreach Model for administering SputnikVTM Vaccine requiring -180C to - 250C:
Dr Narendra Kumar Arora, pediatrician, executive director of INCLEN Trust International, chairperson of the Centre’s Covid-19 working group Government of India [GoI] expressed the desire of GoI offering SputnikVTM Vaccine and also ensure reaching the country’s rural areas. He also iterated that “-18 0C to -20 0C cold chain is not a deterrent because that is also the temperature at which the polio vaccine [OPV] is stored”.
Proactively – a key trait needed for the success of Public Health Programme, Dr Anand Lakshman, Public Health Specialist, CEO of AH, Bengaluru of Karnataka State, realized the dream [vision] of GoI by putting it into action. He too from his decadal vast experience in the field of providing public health service to the community, especially >300 Schools, dreamt of operating vaccination at challenging subzero temperature [between -180C & -250C] for the first time in India both at the facility level and outreach level. This requires specially designed cold chain equipment supplied by Dr Shanmugam Subramaniam, proprietor of “Cold Chain Controls, Coimbatore, a Make In India Manufacture (MSME) with 3 decades experience in cold-chain domain – nick named by the author as C4 model. This C4 model is unique with Ice Lining in the Deep Freezer with additional unique features like SS 304 grade sliding trays for minimizing “Temperature Excursions (TE) – Thermal Assaults” to the vaccine, optimal utilization of the cabinet space for “housing” the vaccine and free space for air circulation, maintaining -250C. Currently available “Frost Loving” Deep Freezers in both the sectors in India are denuded of TE free SS trays, primarily meant for making icepacks between -150C & -200C. This injures the vaccine vials / ampoules while recovering the vaccine vials / ampoules and defrosting.
AH team has given a replicable / scalable model to the country – an invaluable gift through costly self funded Operational Research [OR] till date. From our field experiences in the first week of July 2021, we shared our OR’s as “Reverse SOP” and “All India Solution for an All India Problem”.
Currently both the fixed vaccination center at the facility [PCVC] and the outreach sessions are optimally operating – providing quality service in compliance with CDC Rights, GoI guidelines blended with DRL SOPs to the beneficiaries.
Now we wish to share one more replicable / scalable successful model through a true inter district outreach session using C4 model ILDF mounted on wheel powered by Batteries to energize the ILDF while on travel from HQ to a distant district which took ~8 hrs journey by road.
The picture [attached] shows dedicated 4 wheeler housing the ILDF and batteries which can supply power for ~15hrs. The ice-lining within the DF provides cold hold over time of 6 to 8 hrs. Thus it can maintain subzero temperature between -180C & -250C for >20 hrs journey time, enough for reaching distant districts.
In mid July, Madani Charitable Trust, Anjuman E Islam and United Way of Hubli / Dharawad twin cities through Dr Anil Bidri of Secure Hospitals contacted Dr Anand for organizing outreach session at Hubli and Dharawad. They routed the request officially through district programme managers and was parallelly communicated to DD Immunization Dr Rajini who lubricated the cogwheel jerks at the district level as the administrators were experiencing inter district intervention for the first time which delayed the operation by one day; CoWIN too had similar constraint. Enthusiastic involvement of charitable trust & Secure Hospital which is a local PCVC in providing proper premises for vaccination and effective communication made the outreach session a great success – 300 beneficiaries were vaccinated with 1st dose and 7 with 2nd dose. For assigning the achievement to the home district, vaccine was delivered through home district PCVC site.
As an outcome of this successful inter district outreach activity, AH is invited by other distant districts within the state and the district from neighboring State – Tamilnadu for conducting outreach sessions. On triangulation [DRL team, NPO team of CoWIN & AH team], the CoWIN too got more user-friendly; the achievement was credited to the ‘home district - Dharwad’.
AH is receiving request from distant states like Bihar and Uttarakhand too. CEO has to change the gear, expand & extend the capability for accomplishing these requests. Hope these will also be accomplished through the collaboration by the able AH team with Government, Vaccine Suppliers, Community organizations, Community leaders and funding partners especially for conducting Operational Researches for the global benefit.
The ‘Action’ by the AH is always in Mission mode, through tested Strategies for achieving the predetermined well defined Objectives [ViMOSA].
“All is well that ends well”; AH team was profusely felicitated in the valedictory function by the organizers.
Way forward: Organizations like AddressHealth, already a registered P-CVC, committed to provide quality public health service will get inter district / interstate VISA for conducting workplace outreach vaccination through area specific CVC to eliminate delay by the district level sanctioning authorities. This will help the country in enhancing SputnikVTM COVID vaccination coverage with “SPUTNIK” speed.
Acknowledgement: Author is indebted to the CEO for being a technical advisor of the AH team, equally to all the collaborators who made it possible including the beneficiaries, wishing them AEFI and COVID free life.
Photos with brief description is attached.
warm regards to all the viewers
Holla n AH team