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Oct
9
Mon
12:30 am Surgical camp in Kaaza
Surgical camp in Kaaza
Oct 9 @ 12:30 am – Oct 15 @ 1:30 am
The Lady Willingdon Hospital hopes to conduct a surgical camp in Kaaza, Spiti. This is a huge excercise since we take the entire operative team and equipment in and provide surgical services for a people[...]
Oct
30
Mon
12:26 am Surgical camp in Killar, Pangi
Surgical camp in Killar, Pangi
Oct 30 @ 12:26 am – 1:26 am
The Lady Willingdon Hospital hopes to conduct a surgical camp in Killar, Pangi. This is a huge excercise since we take the entire operative team and equipment in and provide surgical services for a people[...]

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Tribute to a doctor

Even now as the ENT camp is in full swing in Manali, with hordes of patients waiting to be seen and operated in Lady Willingdon Hospital Manali, we pay tribute to Dr. George Ani, the surgeon who pioneered this and made it possible. 

Dr. George finished his MBBS from Christian Medical College Ludhiana, and then specialised in ENT from Christian Medical College Vellore. He stayed on at Vellore to be come faculty and specialised in voice and hearing disorders. 

His heart always went out to those who did not have. In an attempt to make a difference, he spent his own leave travelling to far flung and remote areas of India to provide ENT services, operate on people and help needy locations. 

He started providing this service in Manali biannually since 2009. Every year, he used to come twice and see about 500 patients and operate through the night to give those who were deaf, the miracle of hearing again. For the people in this region, this is nothing short of a miracle, since the only other option for them is to travel to Chandigarh for similar facilities, at an exorbitant and often unaffordable cost. He also used to bring surgeons from other parts of India to help him here. 

In late February 2016, while cycling from Vellore to Bangalore, he was hit by a speeding vehicle and died in a tragic accident. He leaves a huge lacuna, not only in his family and his institution, but in all our hearts,  here and in various hospitals scattered all over India, who remember the kindly doctor and his ministrations. 

Here he is seen with his wife, Dr. Annie. 

We know you are with Jesus, George but  we miss you! 

 

When air becomes breath

 

Oxygen is essential for all hospitals. Ours is no different. The logistics of procuring oxgygen in Manali are overwhelming, and procuring it regularly is a formidable challenge. Our hospital has fifty five beds, of which four are intensive care beds with three ventilators. Ventilators are a sluice gate for oxygen, rapidly exhausting cylinders. The nearest filling station for oxygen is in Mandi, three hours away by road. In early 2004 we required  two cylinders a day. We are presently using twenty cylinders every three days. The logistics of transporting empty cylinders down by truck, filling  them and having them on hand for all emergencies is an onerous task. At first we used to send our cylinders inside a Sumo with the back seats removed to make space. That was not safe, since the driver is in the same cab with the jostling cylinders. So we bought a pick up truck. The truck marked “medical oxygen” used to make its pilgrimage every third day down the mountain roads to the filling station. This was not without danger. Once the truck had a narrow escape, collided en route with another vehicle and spewed the oxygen cylinders all over the mountainside. Thankfully the cylinders were empty and no one was injured.

One of our employees, Mr. Ramdev,  who had come to our hospital as a destitute patient over fifteen years ago has been the chief co ordinator of this exercise. Originally from Nepal, without any known support or family, he wandered into our hospital as a patient. While admitted, he was instrumental in catching a thief and was thereby inducted into the staff as a watchman. The income he earned did not slake his search for a reason to exist, and he turned to alcohol, which became a trap. He wandered down the road to complete inebriation and faced the day when we had to confront him with termination of service. Desperate, and with no human help at hand or family to turn to, he asked us for help. We arranged to send him to a Christian rehabilitation centre in Lucknow for six months.

He returned a changed man. Returning to his job, he assumed complete responsibility for the supply of oxygen, keeping tabs on the number of cylinders that were available and ensuring that we always had filled cylinders at hand. We have never run out of oxygen, thanks to his faithfulness. He established contact with one of his close relatives in Nepal, and visited them immediately after the earthquake there. He has become a support to his close ones in Nepal by taking them blankets and money. He is now always nattily turned out, and has never looked at alcohol again. He is acutely aware of the transformation God has brought about in his life, not only by saving him from alcohol, but being instrumental in providing help to his family.

Installing an oxygen plant in Manali has been a year long project. This last week, the plant is finally up and running. The plant produces oxygen by extracting all other components from air. The pick up truck does not have to run that mountain road much anymore, and will only need to go  occasionally for back up cylinders. Later, we can install our own filling station. This plant is now hissing and humming happily in campus. It sends messages of its well-being periodically to the phones of  concerned personnel informing them of any errors or blips in its function. Prominent among the list of those who get messages is – you guessed it,   Ramdev, our living testimony that air does become breath.

We obtained permission from Mr. Ramdev to share his story on the website to serve as a source of encouragement to others.

Treadmill stress testing starts in LWH Manali

Saju was a thirty seven year old patient who came to us with crushing chest pain which started when he was shovelling snow. In hospital he was diagnosed with a myocardial infarction (heart attack). Quick and timely thrombolysis (to dissolve the clot in his heart) saved his life. He was discharged safely in three days time and advised further follow up with a cardiologist in Chandigarh.

The health of the inhabitants of this valley has changed over the years. Heart disease was unheard of earlier. Now we are seeing more diabetes, hypertension and heart disease. Whether this is due to less physical activity or a change in the diet of the people is unclear. It a pattern noticed all over India. 

In LWH Manali we are able to thrombolyse and take care of the acutely ill cardiac patient. However till now we did not have stress testing or the ability to uncover latent or hidden ischaemia. Failure to do so could result in a calamitous heart attack for those predisposed to cardiac illness. We initiated the treadmill test here in LWH manali yesterday (12th May 2017).

Dr. Chuck Thompson is a cardiologist from the United States who returns every year to help Dr. Anna Alexander and conduct a cardiac camp here for the many patients seen all year round and for new patients who need help. This has been a boon for so many patients who have received timely and appropriate advice and have been guided to take steps to obtain relevant treatment. Dr. Chuck and Dr. Anna started treadmill testing here since we have procured a very good machine which will now enable them to guide patients in time and allow them to rest assured that they are safe with their current medication or be advised to go to a higher centre for further investigations. This will be a boon for Manali and for the people here. 

The treadmill test is a moving platform that makes the patient walk, at first slowly then at increasing speeds and inclination. All the while the patients are being monitored and their ECG is continuously recorded. This uncovers any potential area of ischaemia or blockage where the blood supply to the heart is not what it should be, and shows up on the changes in the ECG which are detected and recorded. This permits the doctors to know if these patients need further tests or not. If they pass the treadmill test, it is unlikely that the patients will have any heart attacks in the near future. 

We are grateful to Drs. Chris and Taehee Shin who had approached  Interserve through whom this machine has been  donated  for the people of Manali. 

Encounter with God

Dr. Sam Thomas and Ms. Sashi Thomas took a three day seminar on “Encounter with God” for the school and hospital staff. This is the first of three sessions over the year. We thank you both!

Updates 2017

It has been a while since we were active on the internet. In cold climates, bears regularly hibernate to tide over the winter, and the website thought it was a bear. 

But with the thaw of spring, we stretch our limbs and yawn, and look around to a new year. The snows have gone, and a sense of spring is in the air. This sense has not touched the trees as yet, which are as skeletal as ever but hope of budding and greening trills with the warbles of the ashy drongo which has come to Manali. 

We still have pending projects from last year. One operating theatre has been completed and we have started surgery in it. It is SUCH a wonderful thing to have climate controlled conditions. Our patients won’t become hypothermic anymore and surgeons too are most grateful for this change. Laminar flow establishes 25 air changes a minute through the theatre via hepa filters situated above the operative field. A fluid warmer provides warmed iv fluids so we don’t need to give cold saline infusions any more! Now we need to start work on the other ot to bring that also unto this standard, and I suspect this process will take two more months at the least. 

Our oxygen plant is still incomplete but we have hope of getting it done now that snow has left the ground permitting workers to complete it. 

There are a lot of projects and plans on the anvil for this year. 

Watch this space for updates !

Thank you for your support and interest. 

We are very thankful to God for another year to look forward to and work here in Manali. 

Merry Christmas and Blessed New Year

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Christmas is in the air. A bite of cold wind, portent of a long awaited winter. The trees have shed their leaves and seem ready, as every one is, for the first snow. It is difficult to believe that one year has sped by.

This year has seen the hospital continue to grow. New team members, Dr. Dennis Martin, Orthopedic Surgeon, and his wife Ms. Sharel, who finished her M.Ph. both from Christian Medical College Vellore, joined us earlier in the year. Dr. Josy Thomas, General Surgeon and his wife Dr. Amy and little boy Mark, also from Vellore, joined us mid year. Dr. Ranjit Christopher, our previous administrator and Ms. Pushpa, Social worker, moved to Thane after a decade with us. Dr. Christopher handed over to two administrators Ms. Christina Dhas Sankhro and Mr. Thomas Mathai. Our junior doctors from last year left to pursue post- graduation. Drs. Shefali William, Dr. Shireen Chacko and Dr. Neerav Aruldas, have since joined to take their place. Dr. Ajit Albert continues with us, having been with us for two years. Dr. Chris Shin (Medicine) and Dr. Taehee Shin (Dental) continue to partner with us from Interserve. Dr. Riya has been our dentist now for the fourth consecutive year. Ms. Anuradha Garg has established a medical records section, and Ashish Giri has joined as an Occupational therapist both trained from Vellore,. Ms. Usha joined us as social worker and Ms. Pinki as Office assistant. Professionally, we have continued to move toward our goals of providing an appropriate standard of care at an affordable cost in the spirit of Jesus. The provision of orthopedic surgery has been a great asset to the people. With advancement come advancing needs for equipment, and we testify to God’s faithfulness in providing all our needs. Besides new lab equipment, operating lights and a new ventilator kindly provided by Interserve, we are in the process of introducing laminar flow in our operating rooms, and installing an oxygen plant on campus. A wonderful Christmas gift will be a new ambulance to replace

our older one, which has done so many miles the odometer is tired of recording them.

Our forays into the community under Dr. Bishan Shasni have been very well received and people from far-flung areas of Lahaul Spiti and Pangi have started travelling all the way to reach our hospital as a result of the surgical and medical camps we conducted in those areas, reaching around 2600 people, for the third consecutive year. They have now come to trust us and look forward to these camps, compared to three years ago when we first encountered fear and suspicion.

Being the salt and light is not difficult when we are keenly aware that all that we are and do is a direct consequence of obedience to our Heavenly Father. It removes the compulsion to seek to “perform” or “accomplish” and replaces it with a need to “obey” and “be”. We would like this knowledge to permeate all that we do and plan for the next year. We have seen the growth of the institution, of people, the church, and of each other over the years and are keenly aware that all of us are still a “work in progress”. To continue to be changed into His image is a wonderful aspiration for the New Year.

We have so many encouraging stories of families and individuals whose lives have been touched. Stories of healing, of restoration, and of renewal. These stories permit us to press on and persevere in what we clearly have come to recognize, as the work of God in Manali.

From all of us in Manali, we wish you a Merry Christmas, and a Blessed New Year.

Annual day 2016

The Annual day was a resounding success in all respects. Great fun, great music, dancing, skits, and bonhomie. The food was astounding, and the post dinner dancing addictive. All the staff came together to put up a fantastic program in record time. The theme was love, with exhortation to above all love each other deeply…. taken from 1 Peter 4:8

All the presentations underscored this theme, and came together to produce a seamless two hours of fun and entertainment.

We are grateful to the Daystar school staff and the DUF home also who helped us with this program.

A wonderful time was had by all.

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Hospital Photo

We present our hospital staff photo, long overdue. From 60 employees in 2004, we have swelled to 112, nearly double, though our bed strength has risen by only five. We are therefore comfortably placed for employment. We are reluctant to raise the bed strength or expand too rapidly. We believe we can provide the best care with our existing framework in the circumstances we are currently in. We are grateful for each and every one of our employees.

2016

Surgical camp in Pangi

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The Chandrabhagha river slices a gorge through gargantuan granite cliffs that make the Pangi valley simultaneously inaccessible and breathtakingly beautiful. An unprotected road blasted three hundred feet high above the river along the side of granite and shale provides the only access into the valley. The journey is a bone rattling, nail biting, dust coated ordeal from anywhere between thirteen to sixteen hours. One has to wonder, while negotiating the precipitous curves, what would have led people to journey so far into wild inhospitable terrain to live? Myth and folklore have it that the Pangwalis, as they are known, were runaway criminals, or slaves fleeing from an irate king. The twenty thousand people here are evidently ethnically different, with peaked features, sharp eyes and aquiline noses.

 

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Our team of twenty seven packed into two tempo travellers one pick up truck and one SUV bounced and jiggled their way to the sub divisional headquarters in Pangi called Killar, the location of government offices and the only hospital in the entire region. The hospital itself is a ramshackle wood and stone structure, dark, dingy, much like a subterranean cavern complete with rocks that serve for steps at the entrance. Our staff formed a human chain and unloaded our equipment, including our operating microscope, operating light, cautery machine, ultrasound machine, autoclave, and the entire stock of medicines and consumables which we needed. Every item had to be brought in, down to the sticking plaster. Having unloaded all this, we retired to our guest houses to wash off the grime and dust.

Just before dinner, our team leader, Dr. Bishan Shasni received a distress call from the government doctors at the hospital. They had a young lady who was in shock, whom they thought probably had an ectopic pregnancy that had burst inside her abdomen and was bleeding. Another short statured teenage mother had been in labor for two days and was probably having obstructed labor. The doctors there could not help, and these patients would not make it out to another hospital alive. Our operative and anesthetic staff piled into our vehicles and raced to the hospital.

Over there we found that the lady with the probable ectopic had been in shock for the past three hours. Her blood pressure was not recordable, she was pale, and her abdomen was extremely tender to touch. The pregnant mother was fully dilated (which means that the mouth of her uterus had opened completely) but the baby was stuck. Apparently she was in this state for the past six hours.

We really did not have a choice. The operating theatre in the civil hospital is generally unused, utilized only when teams like ours come in to operate. It was not fumigated by us or cleaned by our staff, who have a time tested ritual to sterilize the operating environment. They usually spend one day doing just this. We had just arrived, and had planned to sterilize the theatre the next day. But this situation required a solution that could not be postponed. Our team swung into action.thumb_dsc07656_1024

Within half an hour they had the basic equipment ready and a functional operational table ready to go. We used this time to resuscitate both patients with iv fluids and prepare them for surgery. Our radiologist Dr. Uma Shankar confirmed our suspicions of a ruptured ectopic with the portable ultrasound machine we had brought with us. With a hurried prayer, we rushed the lady with the burst ectopic pregnancy onto the operating table. Our anesthetist Dr. Prashant Varghese quickly intubated the patient and had her ready for the knife. There was two litres of blood in the belly, and indeed the right tube had an ectopic pregnancy which was bleeding. The bleeding was controlled, the ectopic removed safely and within the hour the patient was extubated and returned safely to the ward, now with a recordable blood pressure. The table was immediately readied for the lady with the obstructed labor. By now, our gynaecologist Dr. Priya had arrived, after a harrowing journey when her vehicle went off the road and nearly over the precipice after having reached Killar town. She had left from Manali after us and was travelling alone. Unfazed despite this ,she rolled her sleeves up and operated on the lady, delivering a healthy baby in a matter of minutes, a baby who to our great reassurance protested loudly at his extrication,. The baby was breech (upside down in the mothers tummy, with its hindquarters presenting first).

The next day, both patients were doing well, the lady with the ectopic sitting up and smiling, wan and pale, but well. The young Nepali couple were thrilled with their little one, who was sleeping peacefully next to his mother who herself looked like a school girl. With a huge sigh of relief, our team resumed the normal pattern of our camps, setting up rooms for ultrasound, eye examinations, a pharmacy and consultations, and the theatre staff started their magical transformation of the theatre into a sterile haven for surgeries.

Patients poured in, clamouring and jockeying with each other for precedence to be seen. Our staff had worked out a numbering system by which they would be seen, but they did not want to follow it. Eventually, the melee subsided, and some semblance of orderly consultations commenced. Patients were examined by the doctors, tested in the laboratory, x rayed or sent for ultrasound examinations. The ultrasound machine was the rage. Every one wanted an ultrasound, even those with headache foot pain, shoulder pain and knee pain. They were very hard to dissuade or be convinced that the magical black screen would not help them. We even heard the patients leaving the consultation whisper to those waiting to be seen “Say you have abdominal pain, not knee pain” so that they could justify the use of the box with the wand that uncovers all secrets of the body. Dr. Uma bravely soldiered on doing about seventy ultrasound examinations every day.

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Rounds were conducted twice a day, and we came face to face with the fear and trepidation that the people live with. The lack of any viable health services for emergencies have filled the people with fear which is written large on their faces. It took a lot of convincing, cajoling and humourous reassurance to get them to relax and believe that their wounds were not going to burst or explode, or some other drastic complication happen to them. Those who were well enough to go home were unwilling to leave, wanting to stay till all the sutures were removed. However beds were limited and every day there was a new wave of surgeries to be done.

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All the operations went well. There were no complications, and even our two emergent cases did not develop any wound infection, which was truly the grace of God. The eye team of Dr. Satish and Naveen were overwhelmed by the need of surgeries to be performed. We were very aware of the overshadowing grace and presence of God through all the days we were there. It was with great joy and a sense of accomplishment that we loaded up our vehicles again on the last day for our return to Manali. A brief visit to a mountain lake nearby provided a welcome break on the last day, an opportunity for all to experience the joy of walking mountain trails and revel in the beauty all around.

We are very grateful that we could do this camp again this year. We are grateful to all those who came, and worked hard to provide hope and healing to a people deprived of the chance for safe surgery. We are also humbled that God would so prepare us and providentially plan for us to be there to save those three lives that first night, an testimony to His great love for the people of Pangi.

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