CHETANA; Awareness Campaign for Cancer - a Lifestyle Disease
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Transcript of CHETANA; Awareness Campaign for Cancer - a Lifestyle Disease
CHETANA
Awareness Campaign for Cancer – a Lifestyle Disease
Institute for Sustainable Livelihood and
Entrepreneurship Development An initiative of Durgapur Institute for Sustainable Livelihood
Acknowledgements
CHETANA – 2013, the maiden advocacy program of DISL has been launched on
17th
March, 2013. We wish to thank and acknowledge the contributions of various
people who made this program and this report presentation possible. We heartily
appreciate the contribution of Dr. Runu Mukherjee for her moral and technical
support about the domain of cancer control. We thank Mr. Rupak Das and the
members of The Lions Club, Durgapur Steel City Chapter for their motivation and
support all the way. We pay our special thanks and gratitude to the sponsors who
extended their generous help and assistance without which the project could not be
materialized. Finally we appreciate all the participants of CHETANA whose
presence and involvement has been instrumental in enriching the program.
Let us Pledge to Hold Hands and Fight Cancer
Together
Prologue… The need for statistics sometimes comes from the daily lives,
incidences and surroundings. A few years back, may be when
we were in our college days, we hardly came to know about
someone dying of cancer. The reason may be two – the
disease itself was not that common or the facilities of treatment
were such that it could not be detected. Compare that with
today’s scenario. In many families, among their relatives or in
known circles we get to know about the prevalence of cancer. It
is almost everywhere and increasing. The very next day after
our first interaction with Dr. Runu Mulkherjee at Breast Cancer
Awareness Clinic of DSP, one of our students applied for leave
in college as her mother was to be taken for a treatment of
breast cancer. We preferred not to waste time and looked into
the data, facts and tried to get the big picture about the
problem. The questions were basic. Can we prevent it? Can an
early detection save lives? CHETANA has been launched on
the affirmative answers of these questions. This report
presents everything about the journey called CHETANA. The
goal can only be reached with your support and good wishes.
“One in Two Countries Unprepared to Prevent
and Manage Cancers” - WHO
Background Note…
Cancer is a leading cause of death worldwide. The World Health
Organization estimates that 7.6 million people died of cancer in 2005
and 84 million people will die in the next 10 years if proper action is not
taken. In India the situation is grave. In 2010 around 555,000 people
died of cancer in India. Out of this tobacco-related cancers represented
around 42% of male and 18% of female cancer deaths. Cervical,
stomach and breast cancers accounted for 41% of cancer deaths in
women in urban and rural areas.
So, it is high time to combine our voices to deliver the powerful
message for comprehensive and integrated cancer control.
Detecting Cancer Early Can Save your Life!
Cancer is to a large extent avoidable. Many cancers can be prevented.
Others can be detected early in their development, treated and cured.
Even with late stage cancer, the pain can be reduced, the progression
of the cancer slowed, and patients and their families helped to cope.
More than 70% of all cancer deaths occur in developing countries,
where the preparedness for prevention, diagnosis and treatment of
cancer is limited or nonexistent.
So the primary step should be early detection and for that extensive
awareness about the disease is a must.
“Cancer should
not be a death
sentence
anywhere in the
world as there are
proven ways to
prevent and cure
many cancers” –
Dr Oleg Chestnov,
Asst. Director-
General,
Noncommunicable
Diseases and Mental
Health, WHO.
Contribution of Selected Risk Factors to all Cancer Deaths
Cancer Prevention:
Cancer prevention is an essential component
to fight against cancer because about 40% of
all cancer deaths can be prevented. Many of
the important cancer risk factors arise due to
lifestyle problems such as tobacco use,
alcohol use, unhealthy diet including low fruit
and vegetable intake, physical inactivity,
overweight and obesity.
Other risk factors include physical
carcinogens like ultra violate and ionizing
radiation, chemical carcinogens that may
come from contaminated food and biological
carcinogens such as infectious virus, bacteria
and parasites (WHO report on Cancer
Control: Module – 2; 2007).
The following graph clarifies it all by
showing the contribution of selected risk
factors to all cancer deaths:
Source: WHO report on Cancer Control: Module – 2 (Prevention)
The prevention of cancer should be
considered in the context of actions to
prevent other chronic lifestyle diseases such
as diabetes, cardiovascular diseases, chronic
respiratory problems and alcohol
dependence. This is because cancer shares
common risk factors with these lifestyle
diseases.
The interventions should be aimed at the
reduction of these risk factors in the
population that will not only reduce the
incidence of cancer but also prevent other
lifestyle diseases. The relation between these
lifestyle problems and cancer is evident. For
an example we have put forward the graph
showing the relation between tobacco
consumption and death rate of lung cancer
using US data from 1900 – 2006.
Tobacco Use in the US, 1900 – 2006 and Lung Cancer Death Rate
Source: Outdoor of Breast Cancer Awareness Clinic, Durgapur
Steel Plant Hospital
“My mother died
after having been
detected of
Cancer Breast
within one month.
I don‟t want to die
the same way.
Please help”
Prevention and Early Detection is the Key to Effective Cancer Control
WHO has set a goal of reducing
death rate of chronic diseases by 2%
per annum, over and above projected
trends from 2006 – 2015. Achieving
this goal means avoiding 8 million
cancer deaths over the next decade.
The control of major cancer risk
factors and early detection will have
a major role in achieving this goal.
Source: Cigarette Consumption – US Department of Agriculture, 1900 – 2007. *Age-adjusted to 2000 US standard population
Project CHETANA – 2013 Purpose and Goal
“Health is an area of great promise but also great frustration.
There seems to be plenty of „low-hanging fruits‟ available, from
vaccines to bed nets, that could save lives at a minimal costs,
but all too few people make use of such preventive
technologies” – A V Banerjee & E Duflo, Poor Economics.
Project CHETANA has been
undertaken as a year-long activity for
2013, focusing on the issues of chronic
lifestyle problems that lead to cancer
and other lifestyle diseases.
The treatment or cure of cancer is often
expensive. Preventive measures by
following healthy lifestyle means a lot
to the control of cancer and other
lifestyle diseases. Controlling tobacco
use means reducing 1.5 million cancer
deaths per year, 60% of which accounts
for people from low and middle income
countries. Leaving harmful alcohol
completely, increasing fruit and
vegetable consumption, avoiding
overweight, obesity along with physical
inactivity can reduce as much as 15%
cancer deaths worldwide.
So the primary thrust of CHETANA
has been to understand the gravity of the
problem, to formulate policy through
advocacy and to identify the
implementation strategy for the outreach
programs. The ultimate goal of
CHETANA is to reach out to the target
population as much as possible and
aware them about lifestyle problems,
preventive measures and early detection
to combat cancer.
Gathering
knowledge about
the area of
intervention (Cancer
& Lifestyle diseases)
Advocacy to share
the problem with
key resources and
decision makers
Output:
Implementing
outreach programs
as the outcome of
advocacy
Purpose:
Reaching out to the
people at different
pockets of the
society
Goal:
Creating awareness,
Helping early
detection, reducing
cancer deaths
Components of
CHETANA
Plan and implement in controlled environment
Intended
results in
uncontrolled
environment
CHETANA – 2013 Our Maiden Advocacy Action…
With the thematic priority of cancer
control the strategic advocacy of
CHETANA is synchronized with non-
communicable lifestyle diseases and
other related problems. The basic
objective of the maiden campaign has
been to share the problem with the
people from different sectors like
healthcare professionals, academicians,
corporate and NGOs. The success of
the program greatly depends on how
stakeholders value the action for
comprehensive cancer control and
become the catalyst for the effective
outreach programs to reach out to the
maximum number of beneficiaries in a
cost effective manner.
So for the very nature of advocacy, we
have done this program in a controlled
environment. First ‘Why CHETANA’
and what is expected from the event is
explained to all the participants.
Broadly the program was devided in
two segments – one for doctors
elaborating on the issue technically and
the other segment belongs to the
trainers as well as motivational speakers
to see the other facets of different
lifestyle issues. The technical keynote
lecture is given by Dr. Runu Mukherjee
followed by Dr. Alok Sanyal and Dr.
Sudipto Ghoshal. With great clarity the
speakers explained about lifestyle
diseases, lifestyle problems of younger
generation, and increasing concern for
cancer. Several vital statistics on cancer
“Advocacy is the effort to
influence people, primarily
decision-makers, to
create change”
Topic of the Event:
CHETANA Awareness Campaign for Cancer – a Lifestyle Disease
Venue: Bonolata, City Centre, Durgapur Date: 17th March, 2013; Time: 10:30 AM
Goal of the Event: Advocating for Creating awareness about lifestyle diseases, taking preventive measures and helping early detection to combat cancer.
Target Population of the Event: Healthcare profs, Corporate, academicians, NGOs Technique of Interaction: Participative management Technique Communication Method: Barrier free two way communication method
Total no of Participants: 54
Reflection of the Event Schedule
Sequencing of the
Events Sessions Focus of the Sessions
I Registration/Networking
II Inauguration of the Event Purpose of the event explained
A brief background note on DISL
III (Keynote Speech)
Presentation by Dr. Runu Mukherjee, Dy Director, DSP Hospital, In charge Breast Cancer Awareness Clinic, DSP Hospital
Thoroughly explained about lifestyle diseases.
Shared statistics on cancer and other lifestyle diseases
Special focus on breast cancer with cases and examples
I V Feedback slips on the events are distributed to the participants which is to be collected after next two sessions and will be distributed to the presenters.
V
Presentation by Dr. Alok Sanyal, a renowned Gynecologist at Durgapur
Lifestyle problems of the younger generation is emphasized
Focused on increasing concern for cancer
VI Presentation by Dr. Sudipto Ghoshal, Paramedical College, Dgp
Cancer awareness in general Lifestyle diseases and remedies
VII Feedback slips are collected from the participants and given to Dr. Runu Mekherjee to check participants’ suggestions and takeaway.
VIII
Art papers titled “Janchetana: the most desired action area” are given to participants for putting down pictorial/schematic presentation of problems and action area. These to be collected after next 2 presentations Purpose: Thematic Apperception Test
IX
Presentation by Mrs Manisha Hati, International Trainer
Mostly focused on urban lifestyle problems
Do’s and Don’ts of living Focused on addictions and diseases
X Presentation by Mr. Jiban Banerjee, Faculty of Stats, Bidhan Institution
Motivational speech to reinvent the way of life by healthy living
XI Open discussion Forum Brief open discussion about future roadmap
XII Concluding speech by Mr Pravat Chatterjee, Hon. Mayor in Council, DMC XIII Vote of Thanks
and other lifestyle diseases has also been
shared. Dr. Mukherjee specially emphasized
on the breast cancer problem and expressed
her concern that the cases are increasing
rapidly. All the healthcare experts emphasized
that it is better to go for cheaper prevention
than expensive cure and at the same time for
many types of cancer, early detection can save
lives.
After first presentation gets over feedback
slips were distributed to the participants and
collected after third presentation and shared
with the presenters. A few glimpses of
participants’ take-away and suggestion are
shared here.
Take Away:
“A very good learning platform,
an awareness campaign, about
the hazards of modernized
lifestyle and what preventive
measures we can adopt” – Dr.
Arindam Modak
Take Away:
“Dr. Sanyal‟s
warning that
industrial
emissions have
become more
dangerous
than personal
habits like
smoking” –
Shankha Guha
Take Away:
“1. Knowledge about cancer
2. Present scenario of cancer
3. Preventive measures” – Dr
Debdas Karmakar
Suggestions:
“It requires more people of
every walks of life to associate
with the whole venture. Thanks
to CHETANA” –Mr. D. D. Sen
Suggestions:
“More initiatives should be
taken to communicate the views
and suggestions through the
media/NPO/NGO/Govt.
institutions…..” – Mr. Soumen
Routh
Suggestions:
“Vulnerable group
like students, how
can be stopped
from such risks
can be elaborated”
–Dr. Srikanta
Banerjee
The two final presentations by Mrs Hati and
Mr. Banerjee were a change of taste and
proved equally effective like other
deliberations. Mrs Hati on the capacity of an
international trainer interestingly focused on
more of urban lifestyle problems and
elaborated ‘Do’s and Don’ts’ of living. She
also focused on addictions and related diseases.
The speech of Mr Banerjee has been truly
motivational. The core of his entire discussion
was actually reinventing the way of life by
healthy living. His presentation was backed by
examples and full of enthusiasm all through.
Thematic Apperception Test:
A Thematic Apperception Test has been tried
in one of its form to get inputs from
participants about the most critical points of
concern. The seating arrangements were in
groups according to tables. Each table/groups
were provided with sketch pens and a colored
art paper with a heading ‘JanCHETANA;
Lifestyle Problems: The Most Desired
Action Area’. The papers were given
before the final two presentations and
collected it back after the deliberations of
speakers Mrs Manisha Hati and Mr Jiban
Banerjee. The outcome of TAT was quite
interesting. With pictorial and schematic
presentations participants has raised several
actionable issues of lifestyle, such as long
working hours, fast lifestyle, smoking habits
etc. One sectoral or macro view was also
presented in the way that low back pain, eye
disorders, vascular diseases for people from
IT sector; chest or lung diseases for people
in construction fields; stress for healthcare
providers. The fast-food habits of young
generation is also considered by the
participants as the immediate actionable
area, as comes out from TAT.
.
Open Discussion Forum:
The final but very important part of
CHETANA as an advocacy program was a
brief but effective Open Discussion Forum.
The idea central to this discussion was how to
take the campaign to the maximum number of
people in an efficient and cost effective way.
The contribution in this open discussion by
the participants was rich and practical in terms
of efficient and cost effective implementation
of the outreach programs for CHETANA.
Participants or rather stakeholders of our
maiden advocacy initiative have expressed
their willingness to take this campaign to
their own field of operations, may it be
academic institutions, shop-floor of
factories, business executives and
panchayats.
The program finally concluded with the
concluding remarks of Mr. Pravat
Chatterjee, Mayor-in-Council, Durgapur
Municipal Corporation. The organizers
expressed their sincere thanks and gratitude
to all the participants for their inclusive
cooperation and enthusiasm for effectively
carrying out the maiden advocacy
campaign.
CHETANA – 2013 Implementation Modules for Outreach
Focal Point
CHETANA
Advocacy Action
Doctors NGOs Academicians Corporate Civil
Servants Others
Planning for Outreach
(Bottom-up Approach) Facilitating Outreach
Reach out to maximum number of beneficiaries
Purpose: Prevention and Early Detection
Implementing
Outreach for
CHETANA
“Save Yourself by Yourself” - Swami Vivekananda
Interventions for Prevention:
The comprehensive prevention of cancer
requires a range of interventions at individual
as well as population level in a stepwise
manner – core activities, expanded activities
and finally to include all other desirable
activities. Interventions those are immediately
feasible and at the same time areas of highest
concerns are to be implemented first as the
immediate core activities. The expansion of
activities comes in the next step. The
campaign CHETANA – 2013 desires to focus
on some core risk factors for cancer control as
its immediate priorities. The schematic flow-
chart shown here presents a systematic
implementation module for a campaign
focusing cancer prevention. All the outreach
programs will be joint initiative of
CHATANA and the implementing agency.
The outreach model of CHETANA is based
on the intensity of communication of the
partner organization with their immediate
beneficiaries. For example if a college
becomes a partner organization for outreach
then students become the beneficiaries. As the
epidemic of cancer is prevalent among the all
sections of the people irrespective of their
culture, education and economic strata, so
wider the scope of partnership, better will be
the outcome in the sense that larger number of
people can be reached. The campaign for
prevention is less resource intensive and
advocacy and planning is the prerequisite for
the successful implementation. The chart
beside is only an indicative one and feedbacks
will be taken to make it more meticulous.
Lifestyle diseases in General
Unhealthy diet, physical inactivity,
overweight and obesity
Tobacco and alcohol use
Environmental and occupational
exposure to carcinogen
Decide the form of intervention:
Meeting, Seminar, Media
campaign, survey, workshop,
others
Decide target population:
Estimate number of beneficiaries
to be addressed
Program Design
Exploring sources of funding
Budget allocation
Admin Support
Media Relations and
communications
P
L
A
N
N
I
N
G
Implementation of
Outreach Campaign
Short Term Outcome: Public awareness, Engagement, Strategic
communication of the message, Media
coverage, increased capacity, trust,
cooperation, new partnerships (including
govts.)
Long Term Outcome:
Achieving Cancer Control
CHETANA for Cancer Control (CCC)
Priorities CCC Outreach
Interventions for Early
Detection: There are various
interconnected components in an early
detection program that makes it really complex
to implement. This complexity further
intensifies in a resource constrained
environment. The early detection program of
CHETANA intends to intervene at the
community level and the primary level only
looking at the feasibility which depends on the
resources, skills and infrastructure available.
Given the present constrained resource setup,
low cost approaches to early diagnosis and
screening is to be taken up for breast and
cervical cancers initially as the core/feasible
activity under early detection campaign.
The high mortality of the breast and cervical
cancer can be attributable to the fact that
more than 80% of the patients are diagnosed
in very late stages due to late referral from
primary health centers and late healthcare
seeking behavior among women. So,
CHETANA ideally promotes to focus on
the activities of early diagnosis and
screening of breast cancer and cervical
cancer in 2013 and to expand the campaign
in 2014 onwards.
Scope of Intervention for CHETANA
Example: Cervical Cancer
Intervention for CHETANA in
Early Detection Programs
Source: Cancer Control (Early Detection), WHO Report
CHETANA Focus for Early
Detection Campaign
Breast Cancer Awareness
and Early Detection
Cervical Cancer Awareness
and Early Detection
The Journey Begins… The problem may be huge but a systematic approach towards the problem is
always helpful. Knowledge is the key to success. The campaign CHETANA is all
about transforming this knowledge into action. The ideation of CHATANA has
been materialized following a bottom up approach which, we believe, is going to
be helpful throughout the lifecycle of the comprehensive cancer control, may it be
planning, implementation, monitoring or evaluation. The critical success factor of
CHETANA solely depends on the partnership with different stakeholders. We
value our partners as the primary change agents and key stakeholders of
CHETANA. We believe that, regardless of the resource level, by joining hands
together, we can take actions to curb cancer epidemic, save lives and prevent
necessary sufferings.
References:
Planning; Cancer control: knowledge into action: WHO guide for
effective programmes (module 1)
Prevention; Cancer control: knowledge into action: WHO guide for
effective programmes (module 2)
Early Detection; Cancer control: knowledge into action: WHO guide for
effective programmes (module 3)
Policy and Advocacy; Cancer control: knowledge into action: WHO
guide for effective programmes (module 6)
Selig W et al. (2005). Advocacy and comprehensive cancer control.
Cancer Causes and Control,16(Suppl.1):S61–S68
‘Indian cancer statistics, a model to be followed‟, Press Release by
International Agency for Research on Cancer. Date: 28th
March, 2012
American Cancer Society, www.cancer.org
Be Clear on Cancer: Know 4 Sure Campaign,
www.cancerresearchuk.org
ANNEXTURE – 1.1: Campaign for Prevention:
Template for Deciding on the Possible Areas of Concern to be taken up by
Partner Agency for the Outreach of CHETANA -2013
Concern areas to be
covered
Target
Population
Your strengths
in this issue Weaknesses
Required
resources
Cancer in General
Lifestyle Diseases
in General
Breast Cancer
Cervical Cancer
Colon and Rectum
Oral Cavity
Larynx
Other related
areas
ANNEXTURE – 1.2: Campaign for Prevention:
Template for Post-Decision Administration of the Outreach Program by Partner
Agency for CHETANA - 2013
Area finalized for the
outreach program
Total
estimated
cost of the
program
Possible
sources of
fund
Means to make
it cost effective
Risk factors
Cancer in General
Lifestyle Diseases
in General
Breast Cancer
Cervical Cancer
Colon and Rectum
Oral Cavity
Larynx
Other related
areas
ANNEXTURE – 2: Format for Post-program Report or Documentation for
the outreach of CHETANA - 2013
The Event:
CHETANA Awareness Campaign for Cancer – a Lifestyle Disease
Venue: Date: Time (from – to):
The Areas of Concerns Addressed: eg. General, Breast cancer etc………
Goal of the Event:
Nature of the Event: eg. summit/workshop/camp/campaign etc.
Technique of Interaction: Communication Method:
Target Population:
Total Number of Participants:
Physical Resources used (for early detection campaign):
Key Resource Persons: 1. 2. 3. Non-technical Resource Persons:
Reflection of Event Schedule
Sequencing of the Event
Activity Focus of the Activity
Short Term Outcome of the Event:
Expected Long Term Outcome:
Future Prospect of the Event:
An Initiative of
Durgapur Institute for Sustainable Livelihood
Durgapur, West Bengal
Registration No: 99167 under West Bengal Societies
Registration Act, 1961
Contact: + 91 9434250582
+ 91 9614588301
Email: [email protected]
Author of the report: Abhijit Roy
Event Ideation and Coordination: Bhaswati Roy
Abhijit Roy
Technical Consultation about the Domain: Dr. Runu Mukherjee
Special Thanks to: Arnab Kumar Mondal
Swastika Banerjee
Mohana Majumdar
Prasenjit Sahoo
At the Back Stage