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November 10th, 2015

Surgical camp in Banjaar

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A 3.9 km tunnel drilled through the mountain provides access to the in the Tirthan valley in Banjaar block of Kullu district. The block has seventy thousand people. The river here narrows, tamed by a dam at its head. Roads are narrow and winding. This can cause a precarious stand off between two opposing vehicles on the mountainside. Drivers have to be adept at reversing down winding roads to permit passage. The road leads up to the Jalori pass, beyond which is Anni, and for all these the nearest health facility is the Banjaar civil hospital.

The civil hospital is situated in a peculiar bottle neck in the road, spread eagled over six separate buildings built over a slope. The hospital is old, decrepit, poorly lit and poorly maintained. Facilities are frugal, and the staff are beleaguered with a goodly attendance of patients clamoring for treatment which the hospital is not equipped or staffed to be able to provide. This makes for a fractious relationship. The gate of the hospital faces the corporation waste dump, faithfully tended daily by two black cows who after their breakfast at the dumpster would make it a point to do rounds in hospital and leave testimony of their passage by sharing their droppings through the corridors. Some buildings are old, in desperate need of demolition, way beyond the stage of repair. A space has been salvaged to permit inpatients, and a basic lab, dental, x ray pharmacy and ecg facility are functional. There was no space available for an operating theatre, which is a huge roadblock to the conduct of what we were about to jus do.. a surgical camp!

So we did what we could. We commandeered the only tiled and clean complex in the hospital, the out patient clinic, and had it gutted of all furniture. Our ace team working like a smoothly oiled machine, converted this space over two days into a relatively sterile space which could permit safe surgery. The team has got this down pat, scrubbing swabbing and washing the whole area, sealing off all windows and doors, fumigating the space over and over again till there could be no germ there capable of survival. Then the equipement was brought in. This time, we needed to bring in everything. Ot table, ot lights, anesthesia machine, suction machine, all monitoring, all oxygen, in short, we needed to bring in everything. Manali was only three hours away and our Jibhi centre was half an hour away so we were able to achieve this. Our team had a tough time transporting the heavy operating table across the narrow metal bridge in Jibhi. Finally, on the second day, it was all done, and we were ready.

We were deluged with patients. Our screening camp conducted two days prior here had already seen six hundred patients, and the very first day were were deluged with two hundred and forty patients. Our operating lists filled up for three days. The eye surgeon Dr. Jai and the gynaecologist Dr. Sukanya from Baptist hospital were inundated with patients. The next day our operating lists started in the morning and proceeded late into the night till three thirty am. Over the next three days we performed forty major surgeries, six minor surgeries and twenty seven eye surgeries. There were an abundance of galls tones. We performed twenty two cholecystectomies. One supposedly seventy year old patient for a cholecystectomy had given us anxious moments in the operating theatre when Dr. Wesley, our anesthetist from St. Stephens hospital noticed her spinal anesthesia was resulting in some respiratory difficulty. Simultaneously she started bleeding from her liver. Thankfully both situations came under control and she was shifted out after surgery safely, only to learn later that daughter was sixty years old, so she had to be over eighty five years at the least! I made a mental note to modify my history taking by never ask a woman her age directly.

The night staff ran around taking care of the patients overflowing the wards, bedded in corridors. The eye surgery patients were bedded on mattresses in buildings commandeered and cleared for the purpose. All the patients did well, testament to the grace and hand of God with us.

Punchock, our mascot chef too had a tougher time this time, huddled in a little space converted into a kitchen, from where he still dished out impeccable meals that gladdened our hearts after hard labour.

Dr. Bishan, our team leader and the brains behind the whole operation was kept harried and hassled on every front. The water was irregular. The electricity department decided to shut power for one morning. The wiring in the block we were working needed some emergent repairs, and he had to pitch tents in the lawn of the pwd guest house to finally house all our staff. All our camps have been possible because of his intense efforts and I pay tribute to him.

But finally, it all paid off. All the patients did well, our staff were able to bid adieu to all of them prior to our departure from here back to Manali on the day of Diwali, the festival of lights. For those few days, we were able to shine a light in a dark space, and bring a message of hope and healing to a desperate people.

It is a with a huge sense of thankfulness and achievement I wind up this report, because for this year, we have finished all our surgical camps successfully. And we wont be opening this chapter again till next year. I am very grateful to all those who supported and sent people to participate, to all our staff who worked seamlessly together, and to God who made it all come to pass and watched over us with His presence.

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October 22nd, 2015

Surgical camp in Keylong

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The camp in Keylong from the 12th to the 18th October was a welcome break from the breakneck pace that normally dictates these camps. On arrival, it was fortuitous for a patient brought in just as our vehicles pulled in to the hospital for the first day. A middle aged man was brought in unconscious, having collapsed on his way to work. A quick examination revealed he had a stroke probably in the midbrain region or the brainstem. As his condition was deteriorating rapidly our team quickly intubated him, stabilized him and had him transferred to Manali via the 108 ambulance. We later heard he was subsequently transferred to PGI via our Manali ventilated ambulance. We have no further news of him.

 

The subsequent days were quite orderly, with a handful of surgeries, and out patient clinics that were not overly busy. The people of Keylong have money and access to medical care, quite of few of them arriving at destinations like Fortiss or Simla or PGI according to their paying capacity. Further, in preparation for winter, quite a few of the families had embarked on their winter migration to lower altitudes in Kullu or Manali. Nevertheless, we saw 870 patients and performed 25 surgeries and 18 eye surgeries.

 

Our team this time was constituted by the ever faithful Dr. Jai Xavier, eye surgeon from CMC Ludhiana, Dr. Nalini (obstetrician) and her husband Dr. Arun (medicine). Dr. Rao had stepped in from St. Stephens at the last minute to salvage the camp since we did not have an anesthetist to come, and Dr. Jasleen from CMC Ludhiana did all the ultrasound examinations.

 

Since the load was not heavy, the operating theatre staff did get a break and were able to relax a bit, as did the whole team. All our postoperative patients did well, and we were able to discharge all of them prior to our departure from Keylong.

 

The highlights of the camp was trek to a nearby Gompa, which appeared deceptively close, but demanded a stiff work out from all the campers to visit. On the last day, Dr. Bishan, our team leader organized dinner round a campfire, accompanied by music playing from our force traveller, and of course, dancing, lots of dancing.

 

In terms of health needs, though we finished the camp successfully and well this year, I do not sense a great necessity to repeat the camp here next year. So for us from the mission hospital, it will be for now, adieu, Keylong, since we do not think the needs of the people warrant a repetition of the camp here next year.

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October 10th, 2015

Picnic in Kothi

The hospital was split into two groups which went for a picnic to Kothi. A fun time was had by all at the  site provided by Himalayan climbers. Rock climbing, games, just chilling out and yes, lots and lots of dancing. Quite a few of our staff turned out to be avid rock climbers!

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October 8th, 2015

Surgical camp in Spiti, 2015

SURGICAL CAMP IN SPITI 2015

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Hard on the heels of the camp from Killar, even as the dust from Pangi had hardly been brushed off from grimy sleeping bags and backpacks, the vehicles needed to be reloaded to embark on the surgical camp to Kaaza, two hundred and fifty kilometers in the opposite direction. Much like a travelling caravan, the convoy was loaded up again and the team players assembled on the morning of the 22nd September to undertake the formidable journey eastwards over the Rohtang and Kunzum pass. Every trip we had made to Kaaza in the years prior had punished men and machines. Every vehicle had broken down en route, and many team members had suffered from altitude sickness.

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This time however, our trip was uneventful and we arrived safely in Kaaza over the punishing terrain at four thirty pm. The team unloaded all the equipment at the Kaaza government hospital and then dispersed to the respective guest houses to wash off the pervasive Kaaza dust. There was no electricity or hope of it appearing. We had been repeatedly reassured that the spanking new generator installed at the hospital was capable of running the whole hospital for a week if necessary. We rested well that night. It rained all night.

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The sun burned the snow on the mountains the next morning. Snow had decorated them like frost icing on a layer cake. Large crowds turned up, and our operating schedules filled up rapidly. This was in marked contrast to our camp conducted here the last year, where we had sensed an all pervasive fear of surgery, as people related horror stories of surgeries that had gone wrong from teams operating in the years prior. The last year we did not find many patients coming forward for major surgery. This year our lists were mainly major surgeries and minor surgeries were few and far between. People seemed quite willing to be admitted and undergo surgery, for which we were glad.

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Dr. Jai Xavier and his team set up his eye theatre and our gynaecologists Dr. Ravi and Rekha posted their cases on the morning of the first operating day on the 13th. That was when we found that the spanking new generator actually did not run the operating theatre! The portable generator we had with us would not run the autoclave! Somehow, a heavy duty generator was arranged, and these machines subsequently ran all day every day for the next four days as the surgeries progressed. We performed thirty nine general and gynaecology procedures combined, and Dr. Jai performed eye surgery on twenty six patients. Dr. Narjeet Osaha, administered spinal anesthesia for most patients and her skills came to the fore as quite of few of the patients were older and administering spinal anesthesia to them was not easy. Stones in Spiti litter the roads and the insides of people, as gallstones seemed to be the most common general surgical malady. Quite a few of the patients who underwent eye surgery had hypermature cataracts. In other areas in India they would have been operated upon long ago. Over here, they just had to wait for our camp to provide them sight. Quite a few were blind in both eyes. If we had not operated upon them this year, they would have been blind forever since delay for a year would have caused them to lose their sight permanently. Our team has now gelled into a smoothly functioning unit and we were able to operate upto ten major cases a day, besides see a total of one thousand two hundred patients in the outpatient clinic.

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Our radiologist Dr. Sahith, had some anxious moments as his bride had embarked on the journey a day later and was brought to Kaaza by one of our friends. He was the most popular doctor on the team, because EVERYONE in spiti wanted an ultrasound. We had patients with headaches, and nose bleeds because of the dry air, and leg pains and back pains all demanding the magic procedure, which seems to occupy in their minds a position of a Delphic oracle, providing answers to every ache and pain. Some did not even want to see the doctor, but go directly for an ultrasound.

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The wards overflowed with patients who spilled over onto mattresses placed in the corridors. Our nurses flitted from patient to patient, ministering to their needs untiringly and uncomplainingly, which was a marvel to the nursing staff of the government hospital, for whom this became a topic of discussion in their tea room as they warmed themselves over constant cups of tea.

 

Dr. Bishan, our team leader has given twenty years of his service in this region, and he was very happy with the outcome of the camp as all the procedures went off uneventfully and all patients made a good recovery. His pleased smile met with broader smiles on our faces as we congregated every evening around a dinner table that always had special gourmet surprises dished up by our team cook, Phunchok, whose reputation has been established as the MIP or “Most important person” on the team.

 

It was with tired but grateful hearts that we packed up after seven days and bid a final “jule” to the lovely folk of Spiti, and returned to Manali on the 29th September. We carried with us the memories of smiles, hands to foreheads with their traditional greeting and an adieu. Each of us felt so privileged to have been able to reach out, and touch lives. More so, each of us had been touched, in ways that we can never forget. Jule Spiti, until next year.

 

 

 

 

September 20th, 2015

Pangi Surgical camp 2015

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Twenty six people. Two tempo travellers (11 seaters). One Bolero (five seater). One pickup loaded with medical supplies. That’s what it takes to get safe surgery to Pangi, at the edge of the border of Himachal Pradesh with China. The entire cavalcade was poised and ready to leave by eleven am, to embark on the two hundred and sixty kilometer journey that would span two days. A particular concern for me was one and a half year old Lucas, son of the radiologist, whose parents seemed most confident would stand the journey well. I did not share their confidence. Getting a team together like this was a huge effort. The gynaecologist Dr. Vaneeta, from New Delhi, had stepped in at the last minute to substitute for someone who could not come. The radiologist Dr. Joshua was from CMC Ludhiana, placid and calm despite having spent the last twelve hours in a public bus with his wife and child. The eye surgeon was an old hand at surgery in rural places, Dr. Jai Xavier, and his technician, Mr. Sandeep, was also from C.M.C. Ludhiana. Our new eye technician, Mr. Shivdayal completed his outfit. We had an anesthetist from St. Stephens hospital, Dr. Rao, together with his resident in anesthesia, Dr. Aditya. Our anesthetic technician, Mr. Rewat Ram completed that section of the team. In addition there were nurses, lab technician, pharmacist, surgical resident, operating theatre staff, two drivers, a cook and his assistant.

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Much like a travelling circus, or a posse setting off on a distant pursuit, the cavalcade left the gates of Lady Willingdon Hospital, in high spirits and with great anticipation. The grueling road beyond the Rohtang pass, the dust that entered every crevice and cranny, and the constant bone jolting bumping over the next one hundred and sixty kilometers did much to dampen that enthusiasm as a tired convoy pulled into our centre in Madgram, and collapsed on blankets, mattresses and sleeping bags in the night. We were very quiet and downcast that night, because we received the horrendous news of the death of the child of one of the drivers whose vehicle we had hired. The child had been in Udaipur, and had slipped to her death from the bridge earlier in the day. The driver was sent back to Manali to his family that night and another took his place.

Early the next morning, shutterbugs were out early, attempting to capture on their cameras the first fingers of dawn creeping over the snow clad peaks in the distance. Bleary eyed, the others fell in line for a hurried breakfast, before clambering on to the same vehicles again.

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We finally arrived in Killar in Pangi in the evening. There was intense altercation between guest house keepers and our team leader Dr. Bishan, who was trying to fit the posse into shelters for the night. The cooks busied themselves providing food for all, and finally all were fed, and found a place to sleep. The team unloaded all the supplies at the ancient district hospital, established in 1987, a wooden structure with crumbling stone steps down which a leaking pipe constantly discharged effluent as if in an attempt to wash off the ubiquitous grime and dust. The one operating theatre was spacious, but unused after the surgical camp from the year prior, conducted by a team that had come in from Delhi. As we entered, sleeves rolled, with buckets, brooms, gloves and masks, we were horrified to find caked and congealed blood under one of the operating table mattresses, a bloody testament to the conditions that we were now called upon to sanitize. Our team stepped up to the task, and after much labour, transformed the space into a sterile and functional operating theatre which inspired confidence to work in. Fumigation machines were employed double time, but to our dismay we found that the shiny new autoclaves were faulty. Earlier we were assured that one worked perfectly. So a scramble again to fix them, and commandeer smaller autoclaves to sterilize the necessary supplies. The room that we were directed to for eye surgeries had mould on the ceilings and walls, and dust everywhere, and we could not bring ourselves to consider operating there, despite assurances from all the staff that in the years gone by, all the eye surgeries had been conducted uneventfully in it. So we made a decision to give the eye surgeon a fresh theatre in the morning, to be followed by the general surgery list.

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We began screening patients early the next morning, on the 11th of September, and long lines of patients waiting patiently for their turn to be seen was indication of the pressing health needs prevalent in the area.(I have written about this in my previous blog after our screening camp held here in June this year). Our operating lists began to rapidly fill up over the next days. Eye surgery would finish by two pm, and a brief lunch break would precede the general surgery team taking over the precincts. General surgery the first day continued till one thirty in the morning. The next days the lists moved quicker and finished at more civilized times. We performed twenty five eye surgeries and forty five surgical cases over four days. Every day would start with a short devotion in our rest house, a sumptuous breakfast then rounds, followed by outpatient clinic while the eye surgeons went directly into the theatre. They would emerge at lunch time to see patients in the afternoon as the general surgical crew traded places with them. The day ended with rounds of all the postoperative patients who were left in the care of one of our staff nurses who stayed with them through the night. All surgeries went well, without any complications. There were brief periods when the electricity would go off, and all sorts of devices providing illumination were pressed into service, torches, mobile phones, until the generator we had brought with us was yanked to life. Most surgeries were done under either local or regional block or spinal anesthesia, except tonsillectomies for which we used general anesthesia. A tired troup would return to the rest houses, and the morale always received a fillip from the amazing meals that our cook would conjure up for us from that rustic kitchen.

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All the team members gelled very well together as a team, and were welded by the second day into a very efficient group. Lucas did admirably, as his parents had predicted, and quickly became the camp mascot. Some skills he learnt in Pangi, to the chagrin of his parents, but the delight of some of our team were to throw stones when directed, chase boys, and wave to girls.

 

 

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Days and nights ran into each other, and soon it was time to pack up again, fit the entire outfit into assorted cardboard boxes, load up the wagons, and hit the trail again. We were all tired, but very grateful and satisfied as we all piled into the vehicles for the long ride to Manali. As our convoy negotiated the turns in the boulder strewn path that served as a road blasted from the sheer cliff face above a five hundred feet gorge, we returned knowing that something changed, forever, inside each of us from this expedition. Images are frozen in our minds, varied snapshots that have burnt into memory. Of sunlight rippling on the foaming distant river, a mountain goat poised for a leap on the edge of the precipice on three legs, the smile and wave of children watching us drive by. Much much, more than we have given, have we received. Adieu, for now, till next year.

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June 21st, 2015

Medical camp team leaves today for Lahaul

The team is assembled. We will be heading across the pass to Lahaul, all the way to Killar and Sach this time. Back on 1st. We will be having camps following this schedule: Thanks everyone for making this possible. Watch this space for a report later!

21st June

 

Manali to Keylong Journey

 

 

22nd & 23rd June

 

Camp at Keylong
24th June

 

camp at Udaipur
25th June

 

Udaipur to killer travel
26th & 27th  June

 

Camp at Killer
28th June Camp at Saach
29th June Camp at Purthi
30th June Back to Udaipur
1st July back to Manali

May 3rd, 2015

Visiting surgeons

Dr. Sampath Karl, Pediatric surgeon from CMC Vellore will be visiting from the 4th to the 8th of May. He will see patients and also operate during his time here.

Dr. Anupam Philip and his wife Dr. Rachel are also visiting Manali for a week.

We welcome them.

April 29th, 2015

New autoanalyser

The lab staff are happy. The increased work load on the previous semi automatic analyser had work backed up, and was causing them to have patients wait. A new fully automatic analyser was installed yesterday (29th April 2015), which will now permit them not only to work faster, but also increase the range of tests that are done.

In the group are seen from L to R, Mini, Merci, Bhagwati and Neelma.

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April 22nd, 2015

Protest against the land mafia

The Lady Willingdon hospital belongs to the Church of North India, Amritsar Diocese, which had inherited all lands and properties from the church of England at the time of Indepedence. The hospital has 9 bighas of  land in Katrain. This property has been under dispute for years, since fraudulent impostors had impersonated the real Bishop of Amritsar, and sold the land twice over in the past with forged documents. These cases are subjudice.

Recently another party, following the same fraudulent means, has sold it again, and this despite our personal respresentations and letters from the D.C. to all the concerned authorities not to entertain any transactions about this land. This time, we have come to know that the registration has also been permitted, despite our personal representation to the concerned authority a month prior!

We plead for justice and condemn all those involved in these fraudulent deals concerning church property, and also protest against officials involved.

The fraudulent party who “sold” the land is Mr. Sunil Masih, and the parties who bought the land are Mr.  Mr.Surenderpal Singh, s/o Shri. Ishar Singh,   and Mr.Rajesh Kumar, s/o Smt. Krishana Devi.

God is a god of Justice. We are confident of this. We will continue to pursue this in the courts of law and in the hallways of the government.

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April 11th, 2015

Retirement function Sister Mariamma Thampy

A function was held today (11th April 2015) to mark the retirement of Sister Mariamma Thampy, who has served faithfully here in our hospital for the last twenty seven years. All the staff felicitated her and had a thanksgiving lunch with dancing and music ( of course ).

We thank God for her long years of faithful service and wish her well in the years to come.
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