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Surgical camp in Pangi

Posted by: Philip Alex | Posted on: October 6th, 2018 | 0 Comments


Killad in Pangi, Chamba district is one of the most remote regions in Himachal. Hidden behind formidable mountain ranges, accessible only by one hazardous road carved into rock face four hundred feet above a precipitous gorge cut by the  Chandrabagha river, it is a full day journey from Manali. Our team was to leave for Pangi on the morning of the 15thSeptember. The entire team of doctors slowly assembled on 14thSeptember. Dr. Joel, anesthetist from Baptist hospital Bangalore, Dr. Hansdak, eye surgeon from Pondicherry, Dr. Anand Prajapati, radiologist from CMC Vellore, Dr. Annie Prasanti, Obstetrician from CMC Vellore, with her husband Dr. Anand, also an anesthetist. Dr. Annie brought along Joshua her 17 month son, and her father in law. The eye team members were old hands from CMC Ludhiana, Dr. Amrit, Santhokh Singh and Anil, participants of prior camps. Roads into Manali were a challenge, four laning work delaying arrivals as heavy equipment and machinery clawed and tore up the hillsides, carving the ambition of a highway through an already perilous path.

Consequently, our team this time was a large one. 29 people all told, were packed into two travelers, one bolero and a pick up groaning with all our equipment. Anesthesia machine, operating microscope, slit lamp, generator, lights, cautery, suction machines and all medicines that we needed to conduct safe surgery in a wilderness had to be transported. This journey normally takes two days but this time we pushed through in one, a tribute to the border roads organization. We settled into accommodations and had all of Sunday to set up our workspace in the civil hospital Killad.

The old hospital, our earlier venue,  is an ancient dungeon like wood and stone structure that has succumbed to the ravages of time. This year we were presented with a spanking new hospital with tiled floors, large spacious well lit wards and new furniture which was a rare treat. The operation theatre area however, was uncomfortably near the entrance, and had no provison for scrubbing or cleaning and preparation of instruments! Finding a space for eye surgery was a challenge. It is a travesty to realise that so much public money would go into a spanking new building, only to omit essential functional aspects that compromise patient care. The labor room, for example was an oversight, and has been entirely omitted from the building!

Our camp started with a prayer on the morning of the 17th. Huge numbers of patients had to be herded into lines that snaked through the doctors rooms, laboratory and the ultrasound room, and then back to the doctors rooms. The ultrasound machine is always a fascination, people coming with a core belief that this box  held the answers to all their problems. Patients with headaches and joint pains remained convinced that a wave of the probe would fix their ailments, or yield clues to the causes of their disease. We saw over one thousand one hundred patients in five days, performed four hundred ultrasounds, and were able to get routine lab tests and xrays done.

This camp was refreshingly different from past experience. Earlier patients viewed us with suspicion and those who needed surgery subjected themselves to the procedures with a sense of impending doom. This time they had come well prepared for surgery, bringing with them bedding, old reports and were admitted most willingly, an index of the trust our team has now gained with the populace. Surgeries started up on the morning of the 18th. Over the next four days, we performed thirty major surgeries, nine minors, 21 eye surgeries, which averages to about ten surgeries a day. Most of these were done under spinal anesthesia but there was also need to administer general anesthesia. Our surgical teams functioned like smoothly oiled machines, safe, efficient and fast, making sure every patient received a high standard of safety and care. All of us felt and experienced the presence of Jesus, in the operating room. There were no complications or untoward incidents, and all the patients were cared for in the new wards by our super nurses.

The people of Pangi by nature are reticent and suspicious of good outcomes. Neglect, ill treatment, and death a frequent companion of disease, has caused them to expect the worst. Post operative days were primarily spent encouraging them to resume normal activities and convincing them to return home healed and well! Their smiles as they finally turned to go home were unforgettable as we reassured them that God had healed them!

Our camp finished on the 23rdSunday.  That was when all hell broke loose in Himachal. An intense high pressure zone camouflaged the entire lesser Himalayas and unleashed unceasing rain for the next three days. In Pangi, it snowed, much to the delight of the South Indians. We were ill prepared for snow as our thin shoes and jackets soaked. We lost electricity, connectivity and for the next three days, were unable to move out of our accommodations other than to make rounds and visit our patients in a similar predicament. All approach roads were cut off with landslides and landslips. Landslides are not an uncommon event in Himachal. Roads that are blocked are usually opened within a day or two by the Border Roads organization. Not this time. Reports of havoc happening in Manali were trickling in, as we heard of roads and bridges swept away by floods. By the third day we realized that we were not about to get out of Killad anytime soon. All roads were essentially impassable and we were trapped.

There followed intense negotiations by Dr. Bishan, our team leader, for helicopter evacuation. In improbable situations, we saw the hand of God organize our evacuation. The Assistant commissioner for all the roads in Himachal happened to be staying in the same guest house we were occupying. He promised safe passage for our visiting doctors via Kishtawar. Fortuitously we found a force traveler, and they left Killad on the 27th. They were to still experience more adventure as that road also closed in on them requiring them to walk across the landslide to resume their journey. The rest of our team however was still sitting pretty in Killad.

We spent the next two days vainly looking up at the sky for the promised helicopters. Finally, our saviours from the sky did descend in the form of two IAF helicopters which ferried our seventeen members out  to Chamba over two days. From Chamba we made our way back to Manali via back ways, since the highway to Manali was washed out.  Our drivers brought the vehicles out via Kishtawar. Eventually by Sunday, all our team members were safely at their homes.

This was a camp to remember for all of us, a tremendous testimony to the lordship of our God, working out every detail for us in the midst of a natural disaster. Everything got done. Everyone returned safe. Every life was impacted, both the served, and those serving.  We are forever grateful.


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