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”.
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.
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?
Posted by: Philip Alex | Posted on: January 1st, 2013 | 0 Comments
A lady H had come to us with awareness of a mass in the abdomen and pain. Examination revealed a large mass arising from the pelvis. Ultrasound had showed a cystic mass filling the pelvis adjacent to the uterus. On surgery a large ovariancyst was found adherent and torted. It is amazing how much discomfort and pain the local people can tolerate prior to seeking help!
Photograph shows Dr. Sarah Funai our gynaecologist removing this cyst.
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Posted by: Philip Alex | Posted on: December 31st, 2012 | 2 Comments
Baby K is the son of a Nepali labourer family. The child started crying suddenly at four pm and then started vomiting followed by the passage of currant jelly stools. The young yet astute mother noticed a mass in the abdomen. The child was brought to us in the night. A working diagnosis of intussusception was made, confirmed by the “Sign de dance” on the plain x ray ( empty right iliac fossa).
Hydroreduction was attempted but was not successful, hence the infant taken up for surgery, where ileocecal intussusception was found which had approached the sigmoid colon in its extent. Thankfully, on reduction the bowel was viable. A type 1 malrotation had predisposed to this. A cecopexy was performed. ( The bowel was returned to the proper place it was supposed to be in, which was why this happened in the first place).
The baby is now doing well.
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Posted by: Philip Alex | Posted on: December 27th, 2012 | 0 Comments
Mr. R had come to us from Chamba, over two days journey away. He had sustained a fall and a straddle injury which destroyed one testes and ruptured his urethra three months ago for which he had a suprapubic cystostomy to drain his urine. He had already been to PGI Chandigarh and IGMC Simla, but for one reason or the other, was not able to get anyone to fix his problem, which would require a surgical refashioning of his ruptured urethra.
He arrived here last week and was most adamant that he stay till we were able to operate on him. He underwent a successful urethroplasty, which cuts away the damaged portion of the urethra and refashions it to create a passage for urine. He is now doing well and should be able to be discharged soon.
We thank God that we were able to do this for him.
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Posted by: Philip Alex | Posted on: December 23rd, 2012 | 0 Comments
For a number of years, we have been working towards obtaining a ct scanner in manali. The nearest CT scanner is in Kullu, one hour away by road. This journey can be a life threatening one for a patient who is seriously injured. As a result, we have often had to perform exploratory burr holes in patients who had sustained severe head injuries to establish the site of the collection of blood. Further, we have not been able to send our critically injured patients for a ct scan. On an elective basis too, we have always had to refer outpatients for a ct scan to Kullu.
We need a sum of fifty lacs (Ninety four thousand three hundred US $) to allow us to purchase a refurbished ct scan with a digital cr system. Obtaining these together is advantageous since the machines use similar imaging cameras.
We have collected a sum of thirty five lacs so far, with the help of donors and by saving money.
We hope to install this machine by April of 2013.
We invite any further help to allow us to make this dream a reality.
Please contact Dr. Philip Alexander on firstname.lastname@example.org if you would like to help with this project.
Donations can be made to us directly or through charities in the United States or the United Kingdom which are registered in the respective countries.
Posted by: Philip Alex | Posted on: December 23rd, 2012 | 0 Comments
Two tourists from Punjab had come with the history of assault with a sharp edged weapon. One had all his nerves, arteries and tendons divided in his forearm, and his hand was lifeless. The other had all the tendons that cause flexion divided. All night surgery managed to restore function and blood supply to the hands of both. They are now safely discharged back to their home town.
Posted by: Philip Alex | Posted on: December 21st, 2012 | 1 Comments
Baby of Amy – a Christmas message of hope
Baby of Amy (name changed) was born to a mother who had previously had a stillborn child here in Manali. The husband is a tailor here and is basically from another state. The child was born by a Caesarean section and developed severe respiratory distress after birth. An x ray revealed that both lungs had fluid, probably from the baby aspirating fluid inside the mothers womb. The gestational age of the baby was at 36 weeks, the mother not being absolutely sure of her dates and some discrepancy with the ultrasound estimation of the dates. The family was not able to transport the baby to a higher centre. The child was first given oxygen through a special apparatus engineered here in Manali, but then developed a pneumothorax ( a small hole in the lungs) which needed a chest tube. The child went on to need intubation and ventilation. For the first time in the history of Manali a child this small was ventilated with our ventilators, with the able assistance and supervision of pediatrician Dr. Feico, who just happened to be here at the time. If he was not here, we may not have had the guts to ventilate this small baby. Night and day vigils at the baby’s bedside with our doctors and staff in constant attendance eventually bore fruit and the baby stabilized, was gradually taken off the ventilator and was handed over to the beaming parents. The child was discharged last week, a true Christmas baby and a testament to God’s faithfulness in answering our prayers.
This family would truly rejoice as this baby lights up their world just as the world rejoices remembering Christ’s arrival to light up its darkness.
Posted by: Philip Alex | Posted on: November 30th, 2012 | 0 Comments
We were blessed to have Drs. Feico and Madeline with us for the last four months. Drs Feico and Madeline had visited Manali when they were young doctors and since have visited us again together and separately. In fact, Manali was a common interest for them which drew them together, and now they return to us with their three lovely children, Reuben, Mathias and Elske.
Dr. Feico was a great help, and had a lot of patients waiting to see him since he was the only pediatrician, and in his tenure here it so happened that we got a series of very sick neonates, all of whom have survived and done well under his care.
Dr. Madeline helped out in the opd and also in arranging the transfer of a sick Dutch national back to his homeland. (see the article on “Beyond the call of duty”).
While here they were also able to attend clinics in Spiti and Madgram.
It was lovely having them here with us, and as they leave us today, we send them with our blessings and thanks, knowing how much it would have cost them to take time away from their practice at home to be with us.
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