The Best Christmas Gift

This year, we at NJH had a special gift on Christmas day. Many a time, quite a lot of us ponder over whether we are at the right place or doing the right thing for ourselves and our families.

On Christmas morning, we had a Cesarian section. The indication was that the lady had a previous Cesarian section and there was a scar tenderness. We decided to operate as soon as the family arranged blood.

All of us took it as a routine case of Previous Cesarian section. It was only when I started to open the abdomen, I felt that something was amiss. The whole of the subcutaneous tissue was badly fibrosed and was full of adhesions. I asked the patient about what had happened during the previous surgery.

I could not believe my ears when I heard that this was a patient we operated sometime in September 2010 who came in unconscious with severe eclampsia and was on the old ventilator for few days. She was severely anemic and we had done the surgery only for the sake of getting the live baby. Her GCS was 3 and we had no hope. She had received a total of 7 pints of blood.

Later she had wound infection, but at the end she made it.

She went on to have her second baby for which she never thought about having any ante-natal care, but ended up having an uneventful delivery. 

One of the best Christmas gifts we could get . . . an affirmation about how NJH has been a beacon of hope for such families.

Ending 2013

We had amazing last few hours in the labour room on December 31, 2013.

3 patients . . . and they made our day.

All of them very very high risk patients who should have gone on to a tertiary centre. All of them poor and . . . coming here just because they could not afford a trip to Ranchi. They trusted us . . . wrote the high risk papers . . . we could only pray . . . and the Lord gave them deliverance and healthy live babies.

The first one, JB, who had come around noon-time. She was one of our regular ante-natal care patients. We had told the family that it would be good to have her delivery in Ranchi. The reason – she had lost her first baby. But, the family could just not afford to go ahead. To make matters difficult during admission she had couple of high blood pressure readings. Thankfully, the BP stayed normal after admission. She responded well to induction and delivered a girl baby just before the clock chimed 12 midnight.

The second one, SD had all of us in tenterhooks for quite some time. SD had lost both her babies the previous time and the family did not seem it worth to get her a regular antenatal care when she was pregnant a third time. And both the previous pregnancies had delivered by Cesarian section elsewhere. A G3P2D2L0 with both previous Cesarians. The only saving grace was that her haemoglobin was 11 gms%. After the customary high risk papers were signed, we sent off the relatives for one pint of blood. I took a decision to operate only if I’ve a pint of blood. We’ve had previous experiences of patients bleeding heavily when they’ve had a Cesarian elsewhere.

To our horror, SD went into full fledged labour pains. She had terrible lower segment tenderness. We decided to take her for Cesarian without the blood having arrived. We were afraid that she would rupture. To our surprise, we found that she had dilated fully by the time we took her to theatre and to cut the story short, she delivered normally. The baby and the mother are doing fine.

The third one, TB came from another centre after she was referred for pre-term labour. We found out that she was in fact term. But, there were issues. Her haemoglobin was only 7 gm% and she was in sepsis. She had been leaking for almost 48 hours which the family had ignored. She also progressed so fast that the baby was delivered normally and the mother has done well so far.

It was so satisfying to finish the year having been part of the management of these three ladies all of whom had come to us expecting a miracle.

We thank the Lord for using us to be a blessing to these families. 

Educated Communities

Yesterday, in the local newspaper there was the shocking news of the very high drop-out rate of children from schools as well as the non-attendance of enrolled students in the state. The given numbers are so high and should be a major cause of concern to one and all.

Recently, I happened to attend a convergence meeting between the Department of Education and the Department of Health in one of the districts of the state. It was shocking to hear the District Education Officer mention that of the 1500 vacancies for teachers in the district, only 300 teachers are on the rolls. He was not sure if it was because of the lack of qualified people for the job or the lack of government commitment to fill the remaining vacancies.

When we go to visit our local communities, it is quite common to see students of different classes being taught by a single teacher. Many a time, we find these teachers arriving so late for work.

Couple of weeks back, I had a discussion with our staff on what ails the community and the reasons behind the poor socio-economic situation. I was quite surprised to hear one of the staff from a near village say, ‘Many of our problems will be solved if the schools in our villages are run well. Hardly any one of them are run well. Teachers hardly come. Even when they come, they stay for about an hour and return.’ He mentioned about one gentleman who stays quite near our hospital and works as a teacher in the nearby school. This teacher would come for about one hour to school. Then, he goes back home and takes tuition at home for well to do families in the village.

I asked him why nobody took a stand against this teacher. Of course, he was from a dominant caste and nobody dared question him.

I’m sure that this is the situation in most of the villages.

We have quite a lot of our friends who run schools on non-profit and profit basis in various parts of the state. The voice I hear from them is so uniform. Each of them struggle to select students from the number of applicants. There is so much of a demand even for schools being run for profit in the rural areas of the state.

The government appears to be hardly bothered. I wonder if there would be like-minded people who would be interested in this venture. 

Diarrhoea

We were one of centers who were requested to be part of the Rotavirus Vaccine study,of which initial research answers have started to appear. Unfortunately, we do not get many cases of children with acute diarrhoeal disease. It's not that there are not much cases in the community.

The reason is that quite a lot of the community knows that we do not give much medicines.

ORS . . . that's the only thing you get when you go to NJH.

Now, if you go to a quack . . . I've had pictures of what they end up getting.

I got a one year old child with diarrhoea about a week back. The medicines which the quack had already prescribed.

The family expected me to prescribe more drugs.

When I told them that all these drugs are not needed, they left in a huff claiming that they know better doctors elsewhere. Of course, I've had worse cases before . . . And also similar cases who had gone to qualified doctors who got same type of treatment.

So, who's going to come to us ? ? ?

So much for our participation in the study . . . 

Looking forward

It’s going to be 4 years since we have been serving at NJH. When I first saw this place in 2003, I was fascinated by the possibilities in this place. And I’m thankful that the Lord has used us as a family to bring hope and smiles to the lives of quite a lot of people.

Over the last year, we were in the middle of a decision making process about Angel going ahead for a Master’s qualification. We had requested quite a lot of our friends to pray over it. 

We did not want that to happen just for the heck of it. We were quite sure that we are going ahead with it only if it was within the Lord’s will.

Couple of weeks back, we were led to believe that the Lord wanted us to continue here over the next year.

From the world's view, this was the best time for Angel to do her masters. However, we are convinced now that it does not fall into God’s plan for us for the time-being.

Now that we’re sure that we’re staying on, I thought I should jot down my dreams for this place. When there are dreams, there needs to be things put in place if they need to become reality. People . . . infrastructure . . . the major things.

It was couple of hours back that Dr. Roshine, our Medicine Consultant, Mr. Dinesh, our engineer and myself were in the ward looking at temperatures in the different areas. It’s been too cold over the last couple of days. And we had to do some checking to see if patients were comfortable. As we went into the Neonatal Intensive Care Unit, we could not stop wondering aloud on how much we need to have a paediatrician at NJH.

Of course, if you ask any mission hospital doctor, the first need anybody will blurt out is the need for more doctors, especially specialists.

As we continue our stint in NJH, we look at the prospect of more co-labourers . . .

It is now 52 years since the founding of the hospital. Most of the buildings are more than 30-40 years old. This means that we need quite a lot of new buildings. Hospital area including new outpatient areas, theatre complexes, intensive care units etc and residential spaces for staff are a crying need.

We have a nursing school which needs to be upgraded to a GNM/BSc nursing training facility. Qualified and committed staff along with more buildings is needed.

Could I request you to pray specifically for us as we continue at NJH? The dreams are quite huge. But, I think they are quite possible. But, more important is that we stay within the Will of the Lord for our lives . . .

To start off, we look forward to few specific things we would like to see in 2014. Permit me to put them down here.

1. Tuberculosis is a major challenge in the region. We want to do more in this area. Having a Tuberculosis Unit in NJH gives us quite a lot of leverage. Kindly pray that we will be able to do more for controlling tuberculosis in the region and the country. There are couple of things we are looking at. The first is research and the second thing is starting off Drug Sensitivity and Culture.

2. Starting a specific facility for non-communicable diseases in a rural set-up like ours is something I look forward in 2014. Kindly pray as Dr. Roshine sets it up at NJH.

3. Dr. Nandamani returns to NJH in January 2015. I would like to complete the Burns Unit by then. Please pray for resources including committed staff.

4. We have seen quite a few patients dying of Carcinoma Cervix in the region. Angel has been quite pressing to start off PAP Smear or VIA for Ca Cervix screening. Please pray as we plan.

5. New residential complexes are a pressing need.

6. Kindly pray as we consolidate the impacts we have made through the Community Health projects.

7. Consultant leaders in the specialities of Surgery, Obstetrics, Orthopaedics and Pediatrics with a belief in the saving grace and healing of Jesus Christ are something we should benefit from.

8. We’ve got a team of young and enthusiastic staff. Kindly pray that they’ll continue to grow in the Lordship of Jesus Christ. 

9. Complete ground work to start a blood bank.

10. Develop the specialty of Neonatology with emphasis on training. 

We value support and prayers . . . again, more prayers to remain in His Will. 

Wish all of you a blessed 2014 . . .