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Interview with Deepak Arora, Nayara Energy: Breaking the cycle of TB, poverty and undernutrition

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Nayara Energy is an international energy company which owns India’s second largest and one of the world’s most modern and complex single-site refineries at Vadinar, Gujarat. The company has over 6,000 operational retail outlets spread across India. It has also been implementing extensive CSR programs in Gujarat across various domains. In this interview, we discuss one of their major health initiatives, the Nutrition Support Program for Tuberculosis (TB) patients, in detail.

Recognizing the critical role of nutrition in TB recovery, Nayara Energy had launched this program in Jamnagar and Devbhumi Dwarka districts in 2017. The company collaborated with the Government of Gujarat to address the comprehensive needs of TB patients. A key insight revealed the significance of aiding not just the patients but also their families, which led to the creation of family nutrition kits. With an impressive 87% of patients showing weight gain and improvements on different indicators, the program's impact is clear. This endeavour aligns seamlessly with Nayara Energy's CSR vision which emphasises community well-being and sustainable development. It is also in alignment with the Prime Minister’s TB Mukt Bharat program.

In this interview with TheCSRUniverse, Mr. Deepak Arora, President, Public Affairs, Nayara Energy delves into the details of this program and discusses every aspect including planning, execution, monitoring and impact. He also explains how their strategic partnership with the government has helped in amplifying the reach and outcomes.

Scroll down to read the full interview:

Q. What motivated Nayara Energy to come up with the nutrition support program for TB patients in the districts of Jamnagar and Devbhumi Dwarka? What were the key factors or insights that led to the identification of this specific need?

A. Nayara Energy embarked on a compassionate journey to develop a ground-breaking nutrition support program for TB patients in the districts of Jamnagar and Devbhumi Dwarka, driven by profound insights and a deep sense of responsibility. Recognizing the challenges faced by TB patients in India, including delays in diagnosis and treatment initiation, Nayara Energy understood the crucial role of nutrition in facilitating their recovery. Through careful observations, it became clear that personalized interventions focusing on holistic care and improved nutrition were essential.

One key insight gained was the importance of addressing the nutritional needs not only of the patients but also their families for successful recovery, survival, and the prevention of TB transmission. In collaboration with the Government of Gujarat, Nayara Energy launched the Nutrition Support Program in 2018. This initiative aims to enhance nutrition indicators in Jamnagar and Devbhumi Dwarka districts, complementing existing government efforts in treatment and nutrition support. By providing an additional pillar of support, the program offers a renewed hope and improved quality of life for TB patients and their families.

Q. Please provide an overview of Nayara Energy's Nutrition Support Program for TB patients- what are the key components of the program and how has it been implemented?

A. Nayara Energy's Nutrition Support Program, in partnership with the Government of Gujarat, aims to strengthen nutrition indicators for TB patients in targeted districts. The program was initiated through common workshops, and establishing collaboration with the District Tuberculosis Center (DTC). This nutrition support program was then launched for the TB patients in the district, including a family nutrition kit. Monitoring indicators such as BMI, weight gain and treatment adherence were established to assess progress and impact. The program ensures that TB patients receive vital nutritional support for their recovery and well-being.

Overall, Nayara Energy's Nutrition Support Program is being implemented through collaborative efforts, including workshops, information sharing, and the establishment of monitoring indicators. This comprehensive approach ensures that TB patients in the targeted districts receive the necessary nutritional support for their recovery and well-being.

Q. This initiative was launched in partnership with the Government of Gujarat- how has this collaboration helped in with the reach and impact of the program?

A. Our collaboration with the Government of Gujarat has been instrumental in enhancing the reach and impact of Nayara Energy's Nutrition Support Program. Working together, we have made a significant difference in the lives of families affected by TB in Gujarat. Our nutrition support has not only helped patients improve their BMI and enhance treatment adherence & outcomes but has also relieved the financial burden on these families, which are often low-income households.

An impressive 87% of patients gained weight after receiving Nayara’s nutrition support. This indicates the effectiveness of our program in addressing the nutritional needs of TB patients.

Overall, our partnership with the Government of Gujarat has been imperative in amplifying the effectiveness of the Nutrition Support Program, as it is complimenting the ongoing efforts of the government in a substantial way. Together, we are making a significant contribution towards combating TB and improving the well-being of those affected by this challenging disease by avoiding relapses, strengthening patient health and providing an enabling environment for patients’ healthy future.

Nayara Energy's pioneering TB eradication initiative has garnered widespread appreciation and recognition for its remarkable achievements. As the first mover among private partners in the collaborative effort to combat TB, the team's exceptional efforts were recognized and appreciated at various occasions.

Q. How did Nayara Energy and the district TB unit collaborate to implement the nutrition support project?

A. The implementation process began with Nayara Energy's CSR representatives engaging with the District Tuberculosis Center in Devbhumi Dwarka. As part of this collaboration, a workshop was held to identify areas of intervention that aligned with both the district TB eradication efforts and Nayara Energy's CSR priorities.

To ensure effective implementation, the District TB Center exchanged information with other states that had existing nutrition support projects. This knowledge exchange led to inputs that helped us in devising the most appropriate mix of food-grains and essential items necessary for the patients’ dietary requirements. The family nutrition kit was subsequently designed based on calorific values with recommendations of government appointed dietician and government medical college. The kit is designed keeping in view the local palate, food habits and locally available items. To provide technical support, monitoring indicators were established. These indicators encompassed key factors such as BMI, weight gain, treatment adherence, and treatment outcomes. By defining and monitoring these indicators, the program aimed to assess the progress and impact of the nutrition support initiative.

Q. Please share some insights into the selection of items of the nutrition kits and the considerations taken to ensure they meet the high calorific value and nutritional needs of TB patients and their families.

A. When selecting the items for Nayara Energy's nutrition kits, careful consideration was given to ensuring they meet the high calorific value and nutritional needs of TB patients and their families. The kit was designed in a manner as to intercept the cyclical relationship between TB, poverty, and undernutrition. The composition of the nutrition kit includes - rice and multigrain flour, chickpeas, pulses, groundnut oil, and organic jaggery. The weight of the nutrition kit, weighing 17 kg, was determined to ensure it lasts for more than a month, covering not only the TB patient but also the entire family. This comprehensive approach recognizes that the nutritional needs of the patient is closely interconnected with the well-being of their family members.

By including a variety of essential food items with high calorific value and nutritional content, Nayara Energy's nutrition kits aimed to address the nutritional deficiencies often faced by TB patients and their families. These kits provide a balanced and diverse range of nutrients, promoting improved health outcomes and helping break the cycle of TB, poverty, and undernutrition.

Q. How does Nayara Energy assess the impact of the program? Could you give us an overview of how indicators like weight gain, treatment adherence, and outcomes of TB patients have improved over the course of the program?

A. Nayara Energy assesses the impact of its Nutrition Support Program for TB patients through various indicators, including weight gain, treatment adherence, and treatment outcomes. The program acts as a safety net for disadvantaged families in local communities. With 2,650 patients and 4,929 nutrition kits delivered, the program has made significant improvements in the health of patients in the Devbhoomi Dwarka and Jamnagar districts. In the past year, we have been able to bring more than double the number of patients under the program. Nayara is committed to greater efforts in this arena as a part of our long-term partnership towards the TB eradication mission.

Q. What are some of the major challenges or obstacles faced during the implementation of this program, and how has Nayara Energy addressed them? Have there been any lessons learned that have influenced the program's strategies and operations?

A. Throughout the implementation of our TB program, we encountered several challenges that required thoughtful solutions. One significant hurdle was the difficulty in obtaining patient feedback due to the social stigma surrounding the disease. To address this, we adopted a patient-centric approach, and to avoid unwarranted attention, the team refrained from making home visits. Instead, as was convenient to the patients, they were given medical attention, counselling and medications at health centers (PHCs or CHCs) by our dedicated TB department personnel.

The challenges are not just limited to the disease, its management and treatment, but also, often include the patient’s inability or limitations in accessing and availing the services that they are entitled to. Towards this, Nayara has built in the provisioning of logistical solutions where necessary to enable patients to access the services timely and regularly. 

Poor dietary habits and living conditions linked to poverty contribute significantly to transmission of tuberculosis (TB), often termed as the "poor person’s disease." Nayara addresses the nutrition needs of not just the patients but also their immediate families, by providing comprehensive 17 kg nutrition kits, ensuring food supply for periods of six to eight months as indicated by their condition & recovery time. Including all family members in the nutrition kit ration is a big step forward in ensuring entire family’s health, thereby supporting them in their fight against TB, and preventing transmission to other vulnerable members. The kits are customised with recommendations and flexibility based on the specific needs of each patient and their preferred diets. This approach not only fostered trust but also provided patients with a comfortable environment to seek help and support.

Q. Are there any specific success stories of patients that you would like to share with us?

A. While there are many success stories stemming from our initiative, here two particular cases of patients who have successfully overcome tuberculosis and achieved remarkable recoveries.

One inspiring success story is that of Bhavesh (name changed), a 49-year-old resident of Manekpar Village, Jamnagar. Initially Bhavesh, a migrant agricultural labourer, had persistent symptoms such as chest pain, cold, and cough, which was later diagnosed at the Community Health Center, Dhrol as Tuberculosis. He immediately received both medication and nutrition kits provided by Nayara Energy, which played a pivotal role in his recovery journey. These interventions ensured that his dietary needs were met, contributing significantly to his swift and successful recovery. Throughout his treatment, Bhavesh’s weight increased steadily from underweight to a healthy level, besides improvement in BMI, reflecting the positive impact of the comprehensive support he received. Bhavesh began treatment on October 13, 2021, at the Physical Health Center, Latipur and successfully completed his treatment eight months later, on June 3, 2022. He now leads a healthy life and thanks the timely interventions and close monitoring of indicators.

Another success story is the remarkable journey of Rupesh (name changed), a one-year-old residing in Tarana Dhar Village, Jamnagar. Rupesh’s battle against TB began on May 21, 2021, when he commenced his TB medication at the Physical Health Center in Pithad, Jodiya. After 15 months of perseverance and continual care, Rupesh emerged victorious, fully recovering and free from TB on August 22, 2022.

Rupesh's initial symptoms included difficulty in breathing, leading to his diagnosis with TB at Ashirwad Hospital in Rajkot, where his treatment commenced. The district TB personnel provided regular follow-ups, ensuring Rupesh's progress was monitored closely. In addition to the medication provided by the Primary Health Center, Rupesh received invaluable nutritional support from Nayara Energy’s nutrition support program. This support played a vital role in rejuvenating Rupesh's appetite and facilitating significant weight gain to healthier levels during his treatment period. Notably, Rupesh's weight increased from a meagre 5 kg to a healthy 10 kg within a 15-month period, marking an impressive 100% increase by the time he successfully completed his full recovery.

Such encouraging stories highlight the positive impact of timely diagnosis, effective treatment, and comprehensive support, and proper nutrition, in the recovery process for tuberculosis patients.

Q. How does this nutrition support program align with Nayara Energy's broader CSR vision and goals? Does the company have a specific focus on healthcare or community well-being within its CSR framework?

A. The nutrition support program of Nayara Energy aligns perfectly with the company's broader CSR vision and goals. Nayara Energy places a specific focus on healthcare and community well-being within its CSR framework. The program addresses crucial issues such as poverty, malnutrition, and accessibility, demonstrating the company's commitment to promoting inclusive and sustainable development. Through this program, Nayara Energy actively contributes to improving the well-being of communities and fulfilling its CSR mission.

Nayara Energy has greatly expanded its CSR efforts over the years, demonstrating a strong commitment to the development and growth of the communities it operates in. Through its CSR initiatives, Nayara Energy has diligently worked alongside communities across various states, leading to long-term and sustainable benefits.

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