Saturday, June 30, 2012

NJH Annual Report 2011-12



FROM THE SENIOR ADMINISTRATIVE OFFICER

2011-12 was the Golden Jubilee year of the hospital. After a 3 year long drought we were blessed with heavy rains. And towards the fag end of the year, we were blessed to be empanelled under the Rashtriya Swasthya Bima Yojana of the Government of India, which we expect to go a long way in furthering our core value of focus on the poor and marginalized.
Although, we continue to lack a stable unit of doctors especially specialists, there has been a steady rise in the number of patients accessing our facilities.

The highlight of the year was the Golden Jubilee celebrations which extended for almost a week. We were blessed by the presence of Dr Mark Kniss, the founder of the unit as well as Rev. Paul Kniss, the pioneer missionary to this region.

The Burns Unit construction was started and is expected to be completed by October 2012.

In addition to the RSBY, the co-operation with the government continues through the Tuberculosis Unit under the Revised National Tuberculosis Program. The hospital continues to remain committed to implement the Mukhya Mantri Janani Suraksha Yojana as well to be an Integrated Counselling and Testing Centre facility under the Jharkhand Aids Control Society. The Global Fund Programme for Tuberculosis continues to do yeoman service to Tuberculosis Control in the district. Since August 2011, we are actively participating in the Institutional Maternal Death Review facilitated through UNICEF.

The networking with various mission organizations and churches including Catholic Church dispensaries, Gospel Echoing Missionary Society and the Calvary Gospel Mission.

As we look ahead, consultants, especially in the specialties of Medicine and Paediatrics is a dire need. The poverty, remoteness and lack of basic infrastructure like electricity and transport begs for external funding to sustain our smooth functioning. A fully fledged blood bank is a dire need of the region.

We continue to value and cherish the support received from the functionaries of the government especially the Civil Surgeons of Palamu and Latehar, Dr Gopal Srivastava and Dr Aaron Tigga respectively, members of the Unit Management Committee, and the Central Office of EHA

All glory, honor and praises to Jesus Christ, the King of kings and the Lord of lords.




 CLINICAL SERVICES

The reporting year has been very busy in spite of almost 2 months lost to general strikes and non-availability of a specialist team. In addition to patients from the districts of Palamu, Latehar and Garhwa, we also recieved patients from other districts of Jharkhand as well as Bihar, Madhya Pradesh, Chattisgarh and Uttar Pradesh. The followng are compilation of statistics over the last 3 months. 

Departments
Year
2009-10
2010-11
2011-12





General
New Patients
5598
5482
6188

Repeat Patients
5757
6896
8134
Eye
New Patients
2628
2479
2617

Repeat Patients
3054
2724
2681
ANC
New Patient
665
1068
1282

Repeat Patient
739
822
1347
Dental
New Patients
186
286
437

Repeat Patients
336
322
443
Others
New Patients
0
547
638

Repeat Patients
0
547
606
Inpatients
Admissions
4812
5037
4510
General Surgeries
Gen Major
91
72
101

Gen Minor
270
326
375

Tubectomy
368
242
152
Eye surgeries
Ophthalmic Major
703
605
543

Ophthalmic Minor
55
78
58
Laboratory
Clinical Pathology
40491
32357
35702

Biochemistry
5805
4813
5818

Micro Biology
1406
20
155

Serology
6909
6508
4275

Others
936
1422
1660
Radiodiagnosis
X-ray
1702
1698
2215

Ultrasound
1517
1274
1446

ECG
278
59
241
Obstetrics
Deliveries
1040
1294
1374

LSCS
313
363
429


OPHTHALMOLOGICAL SERVICES

CBM SARO (N) and CBM Germany continued their generous support and encouragement which enabled us to maintain regular eye services. Major challenges in the form of bandhs (general strikes), poor communication facilities including poor road-conditions brought about a fall in the statistics of eye OPD as well surgeries. One major development which looks to be encouraging for ophthalmic services is the enrollment of the hospital under RSBY. We have been able to maintain 100% IOL surgeries and SICS for all cataract surgeries.

Dr. Pradhan`s absence on leave from the hospital  as a family for  48 days in the season for his only  daughter`s wedding affectd the eye work to a certain extent.

Ophthalmic services – Overview 2009-2012

2009-10
2010-11
2011-12
Eye OPD patients
5682
5203
5298
Total refraction done
927
952
971
Cataract patients seen
2905
1861
1892
Glaucoma
114
173
176
Vitamin A deficiency
126
106
109
Others
2443
2111
2150
Ophthalmic Surgery
Major surgery (All IOLs)
720
605
543
Minor surgery
52
78
58
Total surgery
772
683
601

THE FUTURE – 
1.  800 cataract surgeries and 6000 outpatients in the next reporting year. 
2.  Open a spectacle shop within the hospital. 
3.  Network with the government to enable Sahiyas to screen causes of visual disability and refer for appropriate treatment/surgery.
4.  Further training for Dr Srijit Pradhan in Phacoemulsification. 
5.  Multipurpose training of all the staff. 
6.  Ophthalmic technician training course in the unit.

I would like to place on record the Officers from CBM SARO (N) for their kind help and understanding. We are also very grateful to the families of Mrs. Betty Goodwin and Mrs. Ivy Kerr, Cambray Baptist Church, Cheltenham, UK for facilitating the purchase of the Non-Contact Tonometer. We are also grateful to Dr. Santosh Mathew, Executive Director, EHA . Certainly I would also like to thank Dr. Sydney Thyle (Ophthalmic coordinator EHA) for his patience, tolerance and guidance.  

GENERAL SURGERY AND BURNS UNIT

- Emergency surgeries including complicated obstetrics comprise the major chunk of work.
- Initiation of the construction of the Burns Unit has been a major development the last year.
- Need to bring in laparoscopic surgery into the unit at some point of time.
- We expect the surgical services to become busier after the full fledged functioning of the Burns Unit. In addition to 2 nurse anesthetists, we’ve sent a third nurse for the Nurse Anesthetist course. We seriously explore the possibility of having one more Surgeon.


MATERNAL AND CHILD HEALTH


The maternal and health care of the unit continues to progress well in spite of the absence of consultants in obstetrics and pediatrics. The highlight of the year has been the operationalisation of the Newborn Intensive Care Unit under the leadership of Sr. Wendy Cowles along with Dr Johnson. 6 nurses were specially identified and trained. 2 of the nurses completed RCH training at Herbertpur.

The empanellment of the hospital under the RSBY program will bring more patients. We explore the possibility of expanding our labour room facilities to accomodate at least 5 delivery cots. Unfortunately, the de-empanellment of the hospital from the Mukhya Mantri Janani Suraksha Yojana has been a discouragement. 


Obstetric Data
2010-11
2011-12
 Total deliveries
1293
1374
Normal Vaginal Deliveries
810
789
LSCS
363
 429
Breech
36
 41
Vacuum
28
 32
Forceps
9
 30
Craniotomy
15
 6
Rupture Uterus
17
 19
Twins
15
 24

LABORATORY SERVICES 


The major development of the year are as follows –
-          Introduction of HbA1C and CRP
-          Analysis of CSF
-          Mr. Immanuel Rathod attended workshop for technicians at Raxual

Future plans would be
-          Facilities for Coomb’s test, in view of the increase in Ante-Natal Care statistics
-          Blood bank facilities are a crying need for this region.
 

RADIODIAGNOSIS SERVICES


The Ultrasound diagnosis services are being ably handled by Dr Shishir Jojo and we sent him for a certificate course. We plan to send one more doctor for the certificate course next year. Mr John Jeyachandran continues as X-Ray technician. Digital imaging of X-Rays is something we are exploring as we develop.  


TUBERCULOSIS UNIT

The Tuberculosis Unit which is one of the first of its kind under the Public Private Partnership of the Revised National Tuberculosis Control Programme continues to provide credible services to the region. We acknowledge the inputs provided by the District Tuberculosis Officer, Dr Anand Kumar and his staff.

NJH has played a pivotal role in the control and treatment of tuberculosis in the region of Palamu district since the year 2000. Initially the hospital provided DOTS facilities with external financial support (T.B ALERT U.K) and later was recognized as a Designated microscopy center(DMC) under Revised National Tuberculosis Control Programme (RNTCP) in 2003. Later the DMC was upgraded into a Tuberculosis Unit (T.U) under RNTCP in 2006 catering to a population of five lakhs and supervises the functioning of microscopic centers (DMC) in Panki, Patan, Lesliganj , Manatu and Satbarwa blocks. The present target population of the TU is almost 650,000.
The statistics over the last three years are given below – 


2009
2010
2011
No. of patient suspected to have T.B.
2734
2785
3062
Total Sputum Positive Patients
489
428
472
Registered patients
822
771
813
Success rate of new smear positive patient
95.2%
94.5%
91%

All the staff of the TU was trained for implementation of DOTS Plus during the year. We look forward for the empanelment of the hospital for Integrated Counseling and Testing Centre under the Jharkhand State Aids Control Society. The GF TB R 9 project continues to provide synergistic support for the Tuberculosis Unit.
  
DENTAL SERVICES

The dental services which were started by Dr Mimi were restarted after Dr Aji Mathew was posted to NJH. With a vision to provide services in the neglected area of mouth care to the poorest of the poor in the region – we have been able to provide wide range of service and quality care in affordable prices. The following ranges of services are available –

  1. Preventive and Conservative Services
    1. GIC, MIRM, Light Cure Restorations
    2. Root Canal Treatment for Anteriors and Posteriors
    3. Apicoectomy, episectomy
    4. Scaling
  1. Cosmetic and Prosthetic Services
    1.  Veneering of anterior teeth, crowns and bridges
    2. Complete denture and removable partial denture
    3. Denture rebasing and relining
  2. Oral Surgical Procedures
    1. Tooth extraction
    2. Surgical extraction
    3. Flap surgeries for periodontal instrumentation
ADMINISTRATION

The following staff joined the institution during the reporting period (April 2011-March 2012). We sincerely hope that their period of service through NJH would bring glory to the Lord. 

First Name
Designation
Mrs. Pramila Devi 
General Worker
Mr. Suresh Rajak 
General Worker
Mrs. J Chandrakala 
Staff Nurse
Mrs. Sushma Lakra 
General Worker
Mr. Malaya Kumar Deep
RSBY Coordinator
Mrs. Deepti Jose 
Staff Nurse
Ms. Shazia Parween 
Project Officer
Dr. Angeline M  Zachariah
Medical Officer
Ms. Birsi Orain
ANM
Ms. Kusumlata Ekka
ANM
Dr. Titus Raju
Jr Medical Officer
Mr. Selvin N
Staff Nurse
Mr. Mohendra
General Worker
Ms. Poonam Tigga
ANM
Ms. Anjlina Minz
ANM
Ms. Vibha Rani Lakra
ANM
Mr. Pratap Ekka
Jr. Manager

We are thankful to the staff who have moved on from NJH as part of their job description as well as to places where the Lord has called them.  
 
Name
Designation
Mr. Paresh Gaikwad
Clerk
Mrs. Shabnam Barjo
ANM
Dr. Nelen Ranjana Aind
Medical Officer
Mr. Susovit Sagar
Project Officer
Mr. Satyaprakash Mishra
Community coordinator
Ms. Jissa Sara Jose
Staff Nurse
Mrs. Nean Ekka
ANM
Mrs. Martha Tigga
ANM
Dr. Mitali Soren
Jr Medical Officer
Mr. Anup Prakash Minz
Multipurpose Worker
Mr. Samuel Dhiraj
Community coordinator
Mr. Sunil Minz
Multipurpose Worker
Ms. Vanlalmuani
Administrator
Ms. Kresencia Ekka
ANM
Ms. Anita Tirkey
ANM
Mrs. Rumul Kerketta
GNM

 Special mention of gratitude to Sr. Martha Tigga and Sr. Nean Ekka who retired last year. 

Sr. Martha Tigga

Sr. Nean Ekka
 
The following staff underwent various courses aimed at skill and spiritual development - 

Name
Details of T/D
Mr. Anil Nand
Mission
Update
Conference,
Dehradun
Sr. Kresencia
Sr. Namyani
Dr. Chongtham Nandamani
Secondary Hospital Training, Vellore

National Burns Conference (NABICON 2012
Dr. Titus Raju
Medicine CME Training, Herbertpur
Dr. Shishir K O Jojo
Ultrasound Training, Delhi
Dr. Jeevan Kuruvilla
Burns Training, Bangladesh
Dr. Immanuel Rathod
Laboratory Update Training, Raxaul
Dr. Rita Pradhan
Nursing workshop,Tezpur
Sr. Bharati Mohapatra
Sr. Vanlalmuani
Costing workshop,
Chhatarpur
Sr. Mejhras Minz
Sr. Abha Kujur
Reproductive Child Health Training,
Herbertpur
Sr. Pratima Tirkey (Jr)
MsVanlalmuani
Finance workshop, Herbertpur
Mr. Mejhras Minz
Finance workshop, Herbertpur
Dr. Johnson C Bage
Counselling Training(Shalom), Delhi
MO-TC Training, Ranchi
Sr. S. Nand
Effective Teaching and Student Learning, Indore
Sr. Alice Kaschap
Mr. Arvind Tirkey
Sustainable Agriculture, Allahabad
Mr. Prabodh Kujur
Community Health themes
-          Disaster Risk Reduction
-          Advocacy


Rev. Ramji Mehta
Anurag Bhengra
Arvind Tirkey
Shazia Parween
Dr. Titus Raju
CME in Internal Medicine
Sr. Silwanti
Emergency Obstetric Care, Herbertpur

Sr. Pratima Tirkey

Other major requirements are–
  1. Separate office space for administration.
  2. The attendance marking system is manual at the point and so many a times we observe manipulation in marking attendance which also affects the leave compensation of the employees. Therefore we also need a better system for attendance marking and leave management, like a biometric attendance marking unit.
  3. Unique identification system has been put into place. However, we need a human resource management system (HRMS) to streamline the details and data.

NURSING SCHOOL


The school of nursing runs one and half years (18 months) ANM course. Prior to the new intake, a pre Nursing Course is held for 10 days. This introduces the students to an over view of nursing including a three day Spiritual retreat. MIBE has its internship for six months. 
 
During the reporting year, there was 100% pass percentage in both first year and second year.

The following were the highlights of the year –
-      1. After quite a long duration, Jharkhand State Nurses Council Inspection was done inspectors were from Ranchi RIMS and health ministry personnel .
-       2. The external and internal evaluation of the Nursing School was done.
-       3. 3 day Spiritual Retreat led Rev. Prakash George
-       4. World Aid’s Day was celebrated in the hospital on December 5, 2011
     5. Sr. Alice went as external examiner to Holy Family Hospital, Patna and Sr. Rita Pradhan went for inspection at Nuagaon and St. Thomas Hospital, Balasore, Orissa
-     6. 37th Graduation and 39th Capping &lamp lighting ceremony was held on 10th Feb `12’ the chief guest was Mrs. Elisaba Dhan from Ranchi.
o    The following students were honored during this occasion.
§  MIBE Topper in NJH in first year  Ms. Madhu Kujur (2010-2011)
§  MIBE Topper in NJH in second  year  Ms. Roshan Gidh (2011-2012)
§  PTS Topper Ms. Reema Tigga (2012)
Requirements –
·         Inproved space and facilities in the students hostel.
·         School bus for the nursing school.
·         Explore the possibility of starting GNM programme.

We acknowledge the financial sponsorship given to one student each from Duncan Hospital, Raxaul; Compassion Institute from Gangopada  and Mennonite Church Chandawa.                                                                           

We are very thankful to our Executive Director, Dr Santosh Mathew; previous regional director Mrs. Margaret Kurian and present Regional director Mr. P Jayakumar, Nursing Co-ordinator – Eastern Regon, Sr. Manjula Deenam; Registrar, Jharkhand Nursing Council, Lakhiya Lakra; SAO/MS of NJH, Faculty for their hard work , Nursing Superintendent NJH, staffs , well wishers from far and near  who had supported us with your helpful hands ,prayer and guidance .

Last but not the least we thank our God Almighty who has led us throughout the last year.

Sr. Rita Pradhan, Principal



COMMUNITY HEALTH AND DEVELOPMENT


The Community Health and Development initiative was supported till September 2011 by Simavi, Netherlands and March 2012 by Tearfund UK. We acknowledge the support provided by Sampurn Development India in facilitating bore-wells and hand-pumps in the surrounding villages.
Main Goals:
A. Improve the health status of women and children in Satbarwa block of Palamau district, Jharkhand.
B. Major disease burden of the communities are reduced equitably, through their participation and at a cost that they can afford.
C. Communities prosper economically, demonstrating good stewardship of their available resources, living in a safe and healthy environment, constantly learning, demonstrating mutual trust, co-operation and caring attitudes towards other communities.

 Major Activities done:
·         Capacity building of the Community Based Organisationss, Panchayat Raj Institutions, Accredited Social Health Activist (ASHA/Sahiya), School Students, health volunteers.
·         Training for the Auxiliary Nurses and Midwives and Anganwadi workers of the Public Health care systems of the government.
·         Promotion of institutional deliveries through street plays. (Nukad Natak)
·         Fixing of posters and display boards on Reproductive and Child Health
·         Installation of bore-wells and hand pumps in the surrounding villages.
·         Promotion of Rashtriya Swasthya Bima Yojna.
·         Identification of disabled in the communities.

Outcomes of the project:
Ø  43% increase in the institutional deliveries in the block.
Ø  28% pregnant women accessed quality antenatal care during the year.
Ø  Infant Mortality Rate has been reduced to 7.5%
Ø  Increased in the number of eligible couples who adopted different family planning methods
Ø  Level of knowledge of the community has been enhanced on malaria, diarrhea, HIV/AIDS & TB
Ø  People taking benefits of govt. schemes e.g. JSY, RSBY, Indra Awas etc.

Major impacts of the project on the communities:
*      PRIs, CBOs and ASHAs have started to take lead roles in development initiatives.
*      Awareness initiatives have helped communities to participate in the welfare schemes
*      The SHGs taking up different IGPs have helped them to improve their financial concerns
*      Net working with government has provided opportunities in development programmes


GFRB R-9 PROJECT (Project Axshaya) - PALAMU DISTRICT


Goal: To decrease morbidity and mortality due to drug resistant TB (DR-TB) in India and improve access to quality TB care and control services through enhanced civil society participation.

Networking

*        Akhil Bhartiya Sarvodaya Mandal- Lesliganj & manatu blocks.
*        Calvary Gospel Mission –Panki block.
*        Gospel Echoing Missionary Society - Patan, Chhatarpur, Husainabad, Mohmmedganj blocks.
*        Samaj Vikas Samithy - Working in Chainpur block.

Activities & Achievements:-

District Level (Palamu District):

·           57 RHCPs(Rural Health Care Providers) have been trained.
·           Soft skill training for - 189 Govt. health staff were trained.
·           20 members from various Community Based Organization were trained as peer educators for create awareness on TB and mobilizing the community.
·           BCC training – 27 members from different community groups were trained to use Inter Personal Communication tool on TB.
·           TB forum has been established at the district level. 
·           Quarterly follow up meeting of RHCP, CBO, ICTC & DMC staffs & TB forum with DTO.
·           Observation of World TB Day at district and block level.

Community Level:
·           307 community meeting (through Gaon kalyan Samittee, CBOs, VHCs, SHGs)  done by the NGOs where 4725 members took active participation.
·           Mid Media Activity – Total 47 awareness programme through skit/film show.
·           Sputum collection of 513 patients (1026 samples collected and transported) for testing. 84 patients of the 513 tested AFB positive and started on DOTS.
·           Retracing defaulter - Total 25 defaulters were retraced by the NGOs and they were again put in the DOTS.


MAINTENANCE


The year 2011-12 was a very busy year for the Maintenance Department. The major projects which were completed or initiated are the following.
1.       Streamlining of power suppy –
a.       Underground wiring
b.      Power distribution panels
c.       Earthing work
d.      Stabilizers and Power back up at various departments in the hospital
2.       Energy conservation initiative –
a.       Change of conventional filament bulbs to energy saving LED bulbs and tubelights
b.      Street-lights installation
c.       Change of wiring of selected buildings
3.       Construction/Maintenance of buildings –
a.       Started burn unit construction
b.      Renovation of outpatient department
c.       Purchase of Fire Fighting Equipment
d.      New toilets constructed.
e.      Purchase of brick machine
4.       Campus maintenance –
a.       Tree planting initiated
b.      Fish cultivation
c.       Pruning of trees in campus
d.      Cleaning of septic tanks

Maintenance of the extensive areas in the campus is a major challenge. Most of the residential areas are quite old and in a dilapidated state. The major requirements for the new year will be funds for
a.       Boundary wall construction
b.      New residences
 -    Water harvesting
c.       Shrub removal machines


VISITORS

We would like to thank the following organizations/individuals who helped us to facilitate services to the poor

  1. Tearfund UK
  2. Simavi Netherlands
  3. Christoffel Blinden Mission
  4. EHA, USA
  5. EMMS International
  6. Families of Mrs. Betty Goodwin and Mrs. Ivy Kerr, Cambray Baptist Church, Cheltenham, UK
  7. Dr Colin Binks, Cheltenham, UK
  8. Dr Roy Kuruvilla, Consultant Orthopedician, Saudi Arabia
  9. Dr Heinrich Stolbrick, Consultant Physician, Germany
  10. Dr Mark Kniss, US
  11. Sr. Wendy and Mr. Jerry, Maine, US
  12. Mrs. Juliet, UK
  13. Dr Elizabeth George, US
  14. Varghese Mathew, Pullad, Tiruvalla, Kerala
  15. James Kuruvilla, Singapore
  16. Mrs. Margaret Oliver, Cambray Baptist Church, Bristol
  17. St. Francis Church, Westborough, Guildford, UK
  18. St. Clare’s Church, Park Barn, Guildford, UK
  19. Castle Square United Reformed Church, Treforest, UK
  20. St. Mary’s Church, Ash Vale, UK
  21. Putson Baptist Church, Hereford, UK
  22. Fishponds Baptist Church, Bristol, UK
  23. State Bank of India, Daltonganj
  24. St. Thomas Marthoma Church, Kolkota
 CAPITAL REQUIREMENTS


S. Nos
Category of Capital Item
Total Amount
1
Building – Residences 27000 square feet
27000000 (54%)
2
Building – Renovation of residences 15000 square feet
7500000 (15%)
3
Building – New OPD Building – 6700 square feet
6700000 (13%)
4
Office Equipment – new computers and new HIS
1000000 (2%)
5
Water Supply – change of supply conduits
200000 (<1%)
6
School bus
1200000 (2%)
7
Four wheeler
700000 (1%)
8
Generators (100 KV & 30 KV)
1000000 (2%)
9
Nursing School Upgradation including Hostel
5000000 (10%)

Total
50300000 (100%)

 VISITORS

We are quite grateful to the following visitors to NJH who encouraged us as well as gave valuable input into our work here.

  1. Mr Hari Krishna, Honorable Member of Legislative Assembly, Manika Assembly Constituency
  2. Dr. Gopal Shrivastava, Civil Surgeon, Palamu District
  3. Dr Awadesh Singh, MCH Officer, Palamu District
  4. Dr Anand Kumar, District TB Officer, Palamu District
  5. Dr Barwar, MOHFW, Jharkhand State
  6. Mrs Ullasi Lakra, Comptroller of Examinations, Jharkhand Nursing Council
  7. Mrs Prabha Dey, College of Nursing, RIMS
  8. Dr Mark Kniss
  9. Rev Paul Kniss
  10. Dr Vikram Tirkey, EMFI
  11. Fr. Christu Das, SIGN, Ranchi
  12. Fr. Regi Cyriac, Samaj Vikas Sanstha,  Chandwa
  13. Sr. Augustina, Co-ordinator, Catholic Health Centres, Daltonganj Diocese
  14. Dr Ronald Hiles, FRCS, OBE, Plastic Surgeon, UK
  15. Wendy and Gerald Cowles, Grace Babies, USA
  16. Mr. Victor Immanuel, Central Office, EHA
  17. Ms Esther Ghosh, GFTB, Central Office, EHA
  18. Dr Ashok Chacko, Regional Director, Central Office, EHA
  19. Mrs. Margaret Kurian, Regional Director, Central Office, EHA
  20. Mr. P Jayakumar, Regional Director, Central Office, EHA
  21. Dr Uttam Mohapatra,  Regional Director, Central Office, EHA
  22. Dr Santosh Mathew, Exective Director, EHA 
  23. Dr Anil Cherian, Central Office, EHA
  24. Dr Sunil Gokavi, Regional Director, Central Office, EHA
  25. Me. E Vijayabhaskar, Central Office, EHA
  26. Dr Sam David, Central Office, EHA – Chennai Office
  27. Dr Philip Fenny, Duncan Hospital, Raxual
  28. Dr Sam Thomas and Sr. Shashi Thomas, Dehra Dun
  29. Dr Kenny David, Christian Medical College, Vellore
  30. Mr. Vinay John, Director, Nursing Education, Chattarpur
  31. Mr. Shailendra Ghosh, Principal, Nursing School, Herbertpur
  32. Dr Jeff Mathias, Consultant, Climate Change and Disaster Risk Reduction, EHA
  33. Mr. Thomas John, Program Manager, Climate Change and Disaster Risk Reduction, EHA
  34. Ms. Doerthe Stolbrink and Ms Manuela Loux, Germany
  35. Ms RuthAnn Fastone, Interburns
  36. Mrs. Juliet Herd, UK
  37. Dr Mathew George, Duncan Hospital, Raxaul
  38. Mr. Ravee, Duncan Hospital, Raxaul
  39. Dr Vijila Isac, Premjyothi Hospital, Barharwa
  40. Dr Singson, Utraula





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