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A busy month
Posted by:Philip Alex | Posted on: May 10th, 2013 | 0 Comments
April was a busy month. It sped by on wings. We had a series of camps. The first was an ENT camp, with Drs Regi Thomas, Associate Professor of Ent in CMC Vellore, and Dr. Rajan seeing over two hundred patients in three days. They also performed ear surgeries here. This has become an annual event, thanks to CMC Vellore. The next camp is scheduled in October, when Dr. George Ani will conduct it with another ent surgeon. This allows the people here to access this specialised care and even get their surgeries here. We are also thinking of making the provision for hearing aids available in the next year.
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Dr. Kenny David, orthopedic surgeon and spine specialist, also from CMC Vellore has just finished an orthopedic camp here, seeing a large number of patients and performing orthopedic surgery. Some of the surgeries he performed were a boon to patients who had been nursing orthopedic conditions for years and had been unable to go to any other centre to access the care they needed.
Suraj (name changed) was a boy who had been suffering from tuberculosis of the hip for the past two years which had eaten away the head of the femur, shortened his left leg and left him with a leg that he could not straighten out. Dr. Kenny did an excision arthroplasty by which he straightened the leg allowing healing which will allow the boy to walk, albeit with a limp. Similar corrective surgeries were performed on patients with malunited fractures of the arm and forearm. He also saw a large number of patients with backache, and operated on a young boy whose nerve was being compressed by a disc that had bulged out causing pain and altered sensation in one leg. The boy was discharged smiling yesterday.
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Dr. Judy, Kenny's wife is a specialist in rehabilitative medicine. She provided much needed input to the community rehabilitative program conducted by our physiotherapy department headed by Ms. Johanah Kancherla. They visited homes where patients who had sustained strokes or were otherwise disabled were being cared for by home carers, and provided advice and assistance to make the lives of these people a little easier, both for patient and the care giver. This program is now into its second year.
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Students from CMC Vellore are also here on their "Secondary Hospital Program". Six students have shadowed the doctors, travelled to village clinics, performed school health check ups, assisted surgery, and also gone trekking and rafting, which is a full schedule for just two weeks.
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Annual day and retirement function
Posted by:Philip Alex | Posted on: April 17th, 2013 | 0 Comments
The annual day and retirement function was held on the 13th of April in the Daystar School Hall. This was held in honor of three of our long serving staff who reached their milestone of retirement. The hall was packed, and nostalgia mingled with humour as these staff were honored and anecdotes shared. This was interspersed with a cultural feast from the staff, showcasing songs, dances, and the decibel breaking debut of the "Willingdon Wallas", a complete band that came together for the first time, and hopefully not for the last time. Mr. Thampy John joined the hospital in 1987 as radiographer, but performed many tasks, including anesthesia technician, maintainence man, electrician, sound engineer, general organiser, staff representative, housekeeping supervisor. Ms. Prema Devi joined the hospital in 1981, first as community worker, then was posted to Jibhi centre where she worked for ten years before returning to the main hospital. She retired as OPD staff. Ms. Tara Devi joined the hospital in 1980 as community worker, was trained as a Dai, and was involved in community work before joining the main hospital as a ward aide, in which capacity she has worked all these years. We thank God for their lives and service. Retirement gifts were given out to the staff who were retiring, and a fitting finale was a dinner feast featuring local Himachali food. It was a wonderful evening, and all the staff came together to put together yet another amazing program. The photographs are in the "Hospital" gallery, and when the video is made available, it will also feature on U tube, the link to which will be provided.
Life Revision seminar
Posted by:Philip Alex | Posted on: March 29th, 2013 | 0 Comments
In the press and stress of life, times to "be still and know" are few and far between. A life revision seminar was held in Manali by Dr. K.O. John, who is a regular visitor to manali and a mentor to us. Many were blessed by this, as we opened this up to the local fellowships and the school and also the dar ul fazal home. Participation in this is always selective to allow closer interactions and times of personal sharing. We thank you Dr. K.O for your consistent mentoring. [singlepic id=193 w=320 h=240 float=none]Pediatric BLS – the Aussie way
Posted by:Philip Alex | Posted on: March 29th, 2013 | 0 Comments
We were blessed to have the team of doctors and nurses from Australia come and take sessions for all our staff in basic and advanced life support for pediatric patients. Their sessions were very lively, interactive and very much hands on, and all our staff appreciated the times immensely and learnt a lot. Thanks a ton, Dr. Benjamin D'Souza and team for making this possible. [singlepic id=192 w=320 h=240 float=none]Internet fast
Posted by:Philip Alex | Posted on: March 8th, 2013 | 0 Comments
No I did not mistype it.. i did not intend to say fast internet. Today fast internet has almost become one of the basic needs of man.- Food.. optional.
- Clothing.. minimalistic.
- Shelter... variable.
- Fast internet.. essential.
Emergency – 24 hours
Posted by:Philip Alex | Posted on: January 21st, 2013 | 0 Comments
[singlepic id=188 w=320 h=240 float=center] Providing an adequate response to any medical emergency round the clock is a formidable task. It involves having a well trained team, being able to mobilise it, and respond quickly and appropriately every time. We are in a mountainous area, prone to accidents, landslides and varied presentations of trauma. Vehicles tumbling down steep ravines, floods washing bridges away and buses overturning are annual affairs. Though assaults and gunshot injuries are rare, there are enough people getting involved in fights to provide patient material to our emergency room. Besides trauma, there has been a rising incidence of heart attacks, and strokes among the local populace. Organophosphorus poisoning is commonplace, with comatose people arriving having consumed it with a suicidal intent. In many mission hospitals, there used to be a system of a call book. There was a book in the emergency room. This book used to be filled by the nurse on call, and handed over to the security guard, who would proceed to tramp through snow in winter or saunter to the doctors house in good weather. Usually the doctors quarters would be located within the campus, at a variable distance from the emergency room. Such a call system is totally inadequate in its response time to relevantly provide timely help in the narrow window period that is available to save a life. Sometimes the security guard may even decide to refresh himself with a smoke under a tree prior to delivering the call. Telephones replaced that system, with landlines interconnecting the campus. Today mobile phones have come into vogue and even replaced the earlier system of black pagers hooked to the belt which made doctors feel very important. However, even this system is awkward and expends precious minutes waiting for the doctor to arrive, which can mean lives lost. When we first arrived in Manali, resuscitation was more of a last rite than a genuine attempt at saving life. Precious minutes were lost in waiting for the doctor to arrive prior to the initiation of resuscitation. We initiated a hands on course in resuscitation for all the nurses in cpr, which did make a difference. A further obstacle was being able to have the resuscitation equipment handy. Older wards often have narrow stairs which are formidable obstacles to the emergent transport of life saving equipment. We filled a plastic toolbox, the kind that is available in any department store with emergency drugs and equipment and provided them at every station. These can be grabbed on the go and made the initial response of the nursing staff much more effective.
At code sites, having enough hands available is an essential component to resuscitation. Tertiary institutions have a “code blue” protocol, where a code pager buzzes madly summoning a multitalented team to the bedside of the patient in minutes. Other institutions have had a system of overhead announcements or lights flashing indicating the emergency. We provided a siren in different wards, with different tones indicating the location. The siren can be heard all over the campus, and proved very effective in summoning those within earshot to the location of the emergency.
Over time, with each of these developments, we have been able to revive patients who present to the emergency room pulseless or not breathing adequately for whatever reason. In fact, when when a pulseless patient was revived, one of the nurses eyes suddenly lit us as she realized that “This actually works!”
Mobilising the operating theatre within minutes is also a formidable task. Having the scrub team and the anesthesia person within a few minutes of beckoning means stationing them within the campus. Because Manali is a small place, we have been able to move massive trauma to the operating table within ten minutes, which is an adequate response by any standard. This too has resulted in precious minutes and lives saved.
Though BLS and ACLS and ATLS today are buzzwords with a large amount of documented data on implementation and protocolisation, this does mean different things to different people at varied locations. Each area will have to modify and tweak the practical outworking of the resuscitative attempts. The bottom line being, it has to be efficient, immediate and effective, all the time, every time.
Raffle..get a used maruti van for Rs 500
Posted by:Philip Alex | Posted on: January 8th, 2013 | 0 Comments
We are putting up the hospital maruti van for a raffle sale, tickets being priced at Rs 500. The van is in reasonable condition. The draw will be held on 26th February. All proceeds will go towards the poor patients fund. This fund allows us to take care of patients who cannot pay for their treatment. We fund about thiry lac worth of treatment for poor patients every year. Despite our costs being low, patients still can find it difficult to pay. Research has shown that 80% of treatment in India comes from out of pocket expenditure from the patient. (BMJ August 1999). Recent reports from the Lancet also corroborate our experience (Lancet 2011; 377: 668–79). We tread the fine line between providing our service at reasonable cost, and being self sufficient, and at the same time being careful never to deny any patient treatment on account of cost. This is where the poor patient fund comes in. Even employees pay a contribution from their salary towards this fund monthly. "Affordable, relevant and appropriate care, in the spirit of Christ".
Repair and reconstruction
Posted by:Philip Alex | Posted on: January 5th, 2013 | 0 Comments
Three boys from Punjab were brought with the history of being assaulted with a sword. One of them was in shock, with both arteries, all the nerves and all the tendons in his forearm divided. His hand was lifeless and pale, devoid of blood supply. He was taken for surgery where the arteries were joined then the nerves joined, then the tendons joined back. We thank God that the hand pinked up and became viable again. The others were also fixed up, who had similar but injuries of lesser extent. They were all discharged safely home in two days. These procedures took all night to do.Its not twins – dad’s derelict humour
Posted by:Philip Alex | Posted on: January 3rd, 2013 | 0 Comments
A snippet from outside the operation theatre recently. One of our staff was waiting anxiously outside the operation theatre while his wife was undergoing an elective caesarean. More of our staff "supporters and well wishers" who were with him during this wait used the time to convince him that his wife was actually having twins. The gag caught on, and eventually they managed to sow this seed of doubt successfully, reinforcing it by drawing allusion to his wife's "huge" tummy and the necessity to perform an elective caesaran. The poor father to be was most relieved when only one bawling baby emerged! Well wishers or wishers in the well?