The world that we live in isn’t the same anymore. At the beginning of this year, the pandemic came unwelcomed and unannounced. With very little information available at the time on the nature of the virus, fear and panic loomed at large.
The increase in the number of positive cases over time put immense pressure on the already burdened existing health infrastructure. What served as a silver lining were the numerous volunteer efforts that highlighted human solidarity.
One initiative that stands out among many is the Project StepOne, which is a collective of volunteers, health professionals, and technology startups working together to beat the virus in collaboration with state governments by providing free tele-medicine to citizens affected by Covid.
Timely expert intervention
“Project StepOne is an attempt to help citizens of the country get a consultation from doctors remotely from their homes, free of charge. The right consultation must come at the right time from doctors who have an understanding of how to deal with the virus. And since this virus is infectious, the best and the fastest way to do it is through telemedicine at the moment,” says Sandip Mondal, a volunteer handling the operations and one of the key founding members of the initiative.
The most significant impact of Project StepOne has been its success in reducing the burden on the health infrastructure. This is particularly evident in Delhi, where family members of patients have been running from pillar to post to secure a hospital bed.
Through Project StepOne consultations, government health bodies were able to filter and prioritise the severity of each case.
“The doctors in Project StepOne’s network were helping non-critical patients stay at home. They were advising patients on the meds they must take while also closely monitoring their symptoms. By helping these patients take care of themselves at home, the pressure on hospitals reduced substantially at a time when the whole system was crashing and overwhelmed,” states Dr Anu Chugh, a Delhi-based doctor volunteering with Project StepOne since the past four months.
The uncertainties of the pandemic can also take a mental toll on individuals, and the initiative has rightly identified the need to address mental health concerns. The volunteer organization has over 500 counsellors who cater to mental health counselling of patients. All of the services provided by Project StepOne are for free and are available throughout the day.
Founded on 27 March 2020, the initiative, at its peak, catered to over 100,000 calls in a day!
Currently, the volunteer initiative has 7000+ doctors signed up on their platform who speak 33 different languages, thereby breaking any language barrier that could impede the quality of consultation.
The volunteer initiative is currently operating out of states like Arunachal Pradesh, Bihar, Chhattisgarh, Delhi, Haryana, Jharkhand, Karnataka, Madhya Pradesh, Maharashtra, Manipur, Nagaland, Odisha, Puducherry, Punjab, Tamil Nadu and Uttarakhand.
The impact that they have made until now has been endorsed by the Deputy Chief Minister of Delhi as well as Karnataka. Moreover, the health minister of Madhya Pradesh has also spoken highly of the dynamic volunteer’s collective.
In conversation with Sandip Mondal, we look at the kind of services provided by Project StepOne, how they operate, the challenges that they may have faced and how scaling the initiative could benefit other states that are yet to collaborate with the collective.
How it began and what they do
“We started in March 2020, where a few entrepreneurs from Bengaluru got together to discuss the situation. Some of them were associated with the health sector, but most of them are technologists. It started as a WhatsApp group. Soon, we had 250 people taking up different responsibilities. And since then the number just grew, and Project StepOne took off,” informs Derek D’Souza, another volunteer managing the product team at StepOne. .
There are several vital services provided by Project StepOne, which have proven very helpful for patients, doctors and the government alike. Some of these services available on their app are:
● Pre-Covid Screening – Here, the citizens of the state can call the state helpline number and share their symptoms. Based on that, a doctor would call back and guide the citizen on the next steps. Derek mentions that this was possible with help from cloud telephony partners who made the process of consultation smoother and swift.
“Ideally, once a query comes, the doctor tries to get in touch with the patient within four hours. Queries are allocated based on language. Currently, the state cannot handle these queries effectively because usually, the people who handle helplines are call-centre agents. But, we have a team of 500 people who handle these calls and 400 out of them are health care professionals,” he says.
● Covid Positive Triaging – If a citizen has taken a Covid detection test and been tested positive, the state govt shares this information with StepOne. The doctors then call the patient, counsel them and share the next steps on medical intervention basis their severity.
Derek says patients who were critical and had complications arising from comorbidities get priority. However, non-critical patients are also closely monitored for their symptoms. This helps conserve beds and ensure that the most deserving people get access to the beds too.
Dr Anu Chugh informs TBI that she has advised patients about everything starting from the meds that one needs to take, to ways in which one should self-quarantine.
“A lot of patients didn’t know how to keep their families safe when they were at home under quarantine. So, doctors advise them on how a table must be kept outside the room, how the bathroom needs to be separate, how a patient needs to eat a protein-rich diet, and so on,” she says.
● Home Isolation Monitoring – In India, the vast majority of Covid positive patients isolate themselves and recover at home – for such people it’s important to be able to reach a doctor when their symptoms worsen. Project StepOne provides helplines where such people can reach out and also monitor their symptoms for any signs of emergencies/worsening.
● Mental Health Counselling – When many citizens are struggling to manage their mental health challenges and do not have access to professional help, Project StepOne incorporated services to address this too. The Mental Health Helpline provides counselling to citizens for expressing their issues for appropriate resolutions.
Sandip mentions that these services are available for one and all and not just limited to patients.
● Plasma Donor Management – With the Convalescent Plasma Therapy being used to treat positive patients, Project StepOne contributed by helping the government in the identification of recovered patients and counselling them to donate to save a life.
“A lot of people had apprehensions about donating plasma after they recovered. But, we have addressed all their concerns and encouraged them,” says Raghavendra Prasad T S, another volunteer and founding member of StepOne.
Dr Anu Chugh adds that this helped quell a lot of panic for plasma, especially in Delhi. “The moment the CM announced that a plasma donation bank had been set up, we were on top of it. Many lives have been saved because of the data we had on recovered individuals,” says the doctor who herself has spoken to over 40 people through the app.
Citizens of Delhi can now call on a helpline 1031 / 1800111747 to donate or make a request for plasma with the entire logistics being taken care of at The Institute of Liver and Biliary Sciences (ILBS).
● Quarantine Monitoring – This is a service for states to monitor the health of citizens under home quarantine and make sure the right treatment is prescribed. Project StepOne monitors these individuals for 14 days.
How all of this was possible
As a voluntary organization, Raghavendra adds that there isn’t much capital that they required when they started as everyone was willing to do their bit, be it medical or technical expertise. Regardless, they have gotten grants from the ACT Grants, Wadhwani Foundation and the Omidyar Network. Raghavendra is hopeful that this would help them scale operations to cater to more needy patients shortly.
So, have there been any challenges at all?
Well, although the result of their work has been positive through and through, Shashank Saini, a volunteer interfacing with governments, feels that the collective can do so much more if only they are able to reach more people.
“As an initiative that started mid-pandemic, we do not have scores of data to convince state bodies to onboard us for collaboration. The process of convincing can take a lot of time which is precious right now. But the best part is that the states we have collaborated with have seen a very positive impact and several leaders from these states have also spoken about this,” Shashank says.
Dr Anu Chugh is someone who believes that Project StepOne’s timely intervention came as a blessing when everything was in chaos.
“The entire team of volunteers and doctors have gone out of their way to address the patient’s concerns. I know doctors who would attend to queries at 2 am, or 3 am in the night. And I cannot even begin to tell you how thankful all our patients are,” she says.
Having achieved so much merely in a few month’s time, there is no stopping Project StepOne. They are now actively working on helpling recovered Covid Positive Patients, who are suffering from longer term symptoms and also working on assisting governments with a smooth vaccine roll-out when it becomes available. Raghavendra says that currently, they are also in talks with different states with whom collaborations are on the horizon. And the goal, well, it’s simple.
“We are at a point in time where saving lives is our biggest priority,” he says signing off.
(Project StepOne is actively looking for doctors, paramedics, medical students, non medical volunteers to design, develop, market and operate the platform to join this fight – to join StepOne as a volunteer email firstname.lastname@example.org or email@example.com. Corporates and companies are also encouraged to join the initiative by encouraging their employees to volunteer.)
(Edited by Vinayak Hegde)