Saturday, December 31, 2011

Remembering 2011 . . . .

Its a tradition as we pass on to a new year to remember the major events of our lives and be thankful that we are blessed to see yet another year.

2011  - the major points of thanksgiving . . .

1. For me and my family, we thank the Lord that we were able to be there for the whole year which witnessed quite a lot of happenings at NJH. A violent society around us has been the biggest challenge. Life has not been smooth with quite a number of bandhs around. We thank the Lord that he kept us and all the staff and their families safe and healthy in 2011. 

2. Obstetric care at NJH has been quite busy. We had patients like KB, PD and SD who survived in very adverse situations in spite of losing their babies. Then we had quite miraculous escapes for babies, AB, SD, KD and SB - all of them were blessed with live babies.Unfortunately, we witnessed quite a number of maternal deaths, the last of them being RD. In fact, I started off this blog to a certain extent to highlight the poor obstetric care in the region. The post on the stories about LD, SD and MD is the most read post of my blog. We are thankful for the mothers and babies we saved. We look forward to the day, when pregnant women in this region would get basic antenatal care without much hiccups and there are facilities in place for complicated cases. We are thankful that government health authorities along with UNICEF has already started to take steps in the right direction.

3. We've had a 100% survival rates with regard to tetanus patient care. Starting off with MS who in fact made it into the 2012 NJH calendar to LO and SK - all of them did well. We thank the Lord for all of them as well as for the superb nursing care.

4. We are thankful for Dr Nandamani who has been giving great leadership in surgical care at NJH. We've had few open prostatectomies. All of them did well. The first cholecystectomy which Nandu did was quite a complicated one. Subsequent to that, he did few more. All the patients have done well. We've had quite a number of burns patients - many of them have been healed. VM, MI and LD were few of our successfully managed patients. We thank the Lord for each of them.

5. In addition to routine surgical work, Dr Nandamani also initiated the burns unit construction. - which has progressed well. The presence of Dinesh with his sound experience of engineering has been a blessing. We are thankful for Dr Ron Hiles, Dr Colin Binks and Ms RuthAnn, who have been steadfastly working towards this dream for quite a long time. There have been amazing developments over the last month which has encouraged us quite a lot. We thank the Lord that we are part of this amazing process.

6. The Golden Jubilee celebrations was something we looked forward. We thank the Lord that the celebrations went on quite smoothly. We were quite privileged to have had Mark Kniss for the celebrations. We are thankful that the Lord gave him the health to fly all the way from the US to be part of us.

7. The purchase of a new ventilator, couple of multipara monitors, a Nycocard reader for HbA1C along with the necessary electrical back-up and a non-contact tonometer is a major thanksgiving point for the year 2011.

8. During the second half of 2011, we had quite a lot of patients with severe malaria. We thank the Lord for patients like MS and Jithen's grand-daughters whom we could save.

9. We had a very bad epidemic of viral encephalitis in our region in 2011. We had few patients who were too poor to go to a higher centre. We thank the Lord that we could manage these patients especially because of the availability of one more ventilator.

10. The last weeks of 2011 brought about more good tidings - I've had initial reports of a Pediatrician willing to join us soon. We pray for this person as a decision is taken - we pray that the Lord will lead. There appears to be solutions appearing for water security for NJH as well as surrounding regions. Many of our friends and wellwishers have started to respond positively towards our future requirements. We are so thankful for this.

We've a very popular Gospel song in Malayalam (Tamil translation) the translation of which goes something like -

- To thank Thee counting each blessing
- For the countless blessing You've bestowed
- You've kept us safe in your palms so far
- You've carried me, O Lord . . . 

(All those with better literary skills, kindly excuse)

Similiar to the song, for us at NJH, the blessings have been countless...We've tried to count them.... But they are endless and we acknowledge that... I shall put in a seperate points on our dreams for 2012.  I wish to share with you the Kingdom Bible Reading Plan which I plan to follow next year . . .  Wish each one of you a blessed 2012.

Sunday, December 25, 2011

Thoughts on Christmas Day . . .

Couple of days back, I happened to go to the Christmas carol service of my home parish, the Immanuel Mar Thoma Church, Paruthippara, Trivandrum. As I sat listening to the songs, my thoughts raced back to the days when my brother and me were active members of the church choir and the Youth Group. It was quite encouraging to see quite a lot of new young faces in the choir as well the Youth Group.

The church choir has been a major place where I learnt the basics of Christian discipline and practice. The songs we sang over and over made quite an imprint on my mind. I remember someone telling us to chew over the words of the songs we sang over and over again. As I look back, I cannot deny that the singing did quite a lot of good to us.

The choir had always been quite an influence in our childhood and youth days.

I remember the story told by one of our choirmasters about a practice somewhere on Handel's I know that my Redeemer lives where the choirmaster stopped the practice and stepped upto to the soloist if she believed what she was singing. The story goes on that the singer burst into tears and wished that she could make Christ a reality in her life.

As I saw on the pews, I was very much encouraged by our vicar's presidential address where he commented that in the olden days, there was quite a lot of emphasis given on spiritual renewal during Christmas time which has diminished over time. In it's place, arose the tremendous amount of spending on decorations, fun and frolick.

The first song I remember singing in the choir was a song called 'Manger Boy'. It was a sweet song which I sang around for quite a long time. However, it was quite a long time later that I found out the meaning of 'manger'. But, when we first sang it, the term 'manger' seemed very romantic. The corresponding word used in Greek denotes a feeding trough used in cattlesheds. I got this picture from a blog when I searched the net. No, it hardly resembles the pictures we see on Christmas cards and Nativity Plays.

I do not think that one can go any more lower than this. The king of kings to be laid in a manger after he's born. And something more - nowhere in the Bible is it told that he was born in the cowshed/stable/manger. I remember someone suggesting that Jesus may have been born on the wayside, some kind heart had suggested that they rest in the cowshed before proceeding further and Mary improvising the manger into a comfortable crib for baby Jesus. Not improbable. 

What a contrast from the celebrations we see today? 

We've thoroughly missed the message of Christmas. 

There are already quite a movement within believers, on the pagan origins of Christmas and why we should be moving away from many of the outward signs of Christmas like Santa Claus, Christmas Tree etc. You can read about them here. And a bit more stronger message here. 

I'm not sure what the cause is. Of recent, many of the things which we associate with Christmas, even the carol singing pales in camparison to the events associated with the Christ birth. Maybe, I'm becoming old. 

However, I've to convince myself to be part of all the festivities because I've realised that even my present beliefs and affirmations about the lordship of Jesus Christ in my life evolved and were firmed through participation in many of these celebrations especially the choir. I cannot deny that there is a voice deep down somewhere in me urging me to get into some four part singing. Oh...How I used to love those sessions. It was affirmed as we drove back when my sweetheart also expressed a desire to sing in a choir next Christmas...

As for my choristers in my parish, they did a fantastic job. However, do remember that the ultimate aim for the believer in Christ is to know Christ Jesus as Lord of each of our lives Philippians 3:8). Well, do not feel much disturbed about whether to celebrate or not to celebrate Christmas. I've found this article quite useful.

Hope you had a blessed time of Christmas celebrations with friends and family. We pray that you will have a Christ filled 2012...      

Friday, December 23, 2011

Thanking you . . .

This post is quite special to us at NJH.

The blog is to thank the support we received from 4 churches in the United Kingdom through Dr. Colin Binks, our former surgeon who is now back in the UK.

The 4 churches who sent the generous donations are
St. Francis’ Church, Westborough, Guildford, UK;
St Clare’s Church, Park Barn, Guildford, UK;
Castle Square United Reformed Church, Treforest, UK;
St Mary’s Church, Ash Vale, UK

So, what have we brought?

1.   Ventilator: Costing about 150,000 Indian Rupees (INR), the machine has already been a life saver for quite a number of patients, prominent of them being SeeD and SDe both of whom were near maternal misses, and SK, who was bitten by a Bengal monitor. We’ve had some more donations from couple of our friends which would help us to buy on more of this type of ventilator soon. We praise God for this machine.

The ventilator and the multipara monitor in the theatre

2.   Multipara monitors: A basic need for management of a sick patient, we could buy 2 of these machines recently – thanks to this donation. Since it automatically monitors pulse rate, blood pressure and saturation – it decreases the work load of the Acute Care Unit and theatre nurses. The 2 machines together cost 130,000 INR. We require couple of more these machines for the theatre and the Acute Care Unit.

The ventilator (same one as the snap above) and the multipara monitor being used on SDe.

3.   HbA1C machine (Nycocard reader): We’ve been having quite a lot of diabetic patients. HbA1C being one of the latest parameter we use to monitor blood sugar control in diabetes patients – we took a decision to get a machine. It has proved to be a big boon for our clinical work for 2 reasons. The costs at Daltonganj for the same test vary from 700 to 1200 INR. We’re able to do the same for a cost of 350 INR. The costs of the machine which is also able to do Urine Microalbumin, C-Reactive Protein and D-dimer is about 45,000 INR.

Mr Anil Nand, our senior lab technician with the HbA1C machine

4.   Electrical Back-Up: One of the major challenges we face at NJH is the poor electricity supply in terms of both quantity and more importantly quality. There is quite a lot of fluctuation and there is a time gap when we switch on the generators when there is a cut in government electricity supply. So, after much discussions, we decided to install power back up in the form of invertors and stabilizers in the Acute Care Unit and the Theatre. In addition, there has been a long standing request from Nursing School Hostel for an inverter for round the clock electricity supply in the corridors and washrooms especially during the night. The total cost of the electrical back up was about 70,000 INR

Invertor and stabiliser in the acute care unit

Invertor in the theatre. There is a stabiliser too which was out of the frame

Invertor in the nursing school
The donation has made quite a lot of difference in the patient care at NJH and the comfort of the boarding facilities of our nursing students. We praise and thank God for each of the donors who made a contribution as well as Dr Colin Binks who facilitated the same. We pray that the Lord will bless them for their generosity.

Thursday, December 22, 2011

Relaxing . . .

Many of my friends told me that they are too petrified after reading my blogs. It seems as if we don’t do anything else other than deal with sick patients and the hospital.

Well, this blog is for to assure them that we get the opportunity to lead quite normal lives and rather enjoy time doing things we like.

Below are snaps of us doing things as a family. Both of us reach home and we do not realise how fast time flies.

And as you can see the kids helping to scrap the cake batter vessel clean, baking is a major past-time. Our son, Shalom likes to watch us and help to prepare the cake and our daughter, Charis (helped by me and Shalom) ensures that it does not last more than 24 hours.

Below is the recipe for one of the cakes which enjoys tremendous patronage from both our kids. It is a combination of 3 recipes which I found in the internet for dates cake.

So, if anyone is interested. For a 9 inch pan cake –

Refined flour (maida): 11/4 cup
Milk: 3/4 cup
Sugar: 3/4 cup
Powdered cinnamon: 1/2 teaspoon
Egg: 1
Dates: 18 nos.
Butter: 3/4 cup
Baking powder: 1 teaspoon
Vanilla essence: 1 teaspoon

Preparation Time: 30 minutes
Baking Time: 40-50 minutes


1.   Separate the yolk and white of the egg. Keep the yolk aside. Fluff up the white of the egg with an egg beater.
2.   Sieve the flour and add baking powder to the same.
3.   After removing the seeds from the dates, put it in milk and bring it to boil. You would need to do it quite early as the mixture needs to cool to room temperature before being mixed with the cake batter. Most of the dates have coarse fibre which needs to be removed. After boiling, we use a sieve to pass the milk-dates paste through.
4.   Mix the sugar and the butter well. We usually powder the sugar before mixing.
5.   Add the yolk of the egg to the sugar-butter batter.
6.   Add the milk-date paste to the batter.
7.   Incorporate the flour gradually into the batter. The batter may look a bit thick, but that is how it should be. Once, I had added a bit more milk to the batter to make it thin, but the resulting cake was a disaster. I have realised that the trick of getting a good cake is to ensure that you don’t mix the batter too long – you just need to ensure that the flour is incorporated into the batter.
8.   At last, fold the fluffed up egg whites to the batter. Do not use a cake mixer for it. Take a spoon and just fold it into the cake batter.
9.   Don’t keep the batter outside for long. Bake as soon as possible at 175 degree Celsius (about 300 degree Fahrenheit) for about 40 to 50 minutes. Ensure that the cake is well cooled before you attempt to cut.

Instead of dates if you use bananas – about 2 medium sized ones for one 9 inch pan cake, you have the banana cake. Similar to dates, the banana paste also needs to be sieved through to remove the fibre. We’ve done both cakes couple of times without the sieving part and the result was not that great – the cake did not rise on baking.

Hope that I've something refreshingly different for a post this time.

Visit to the zoo . . .

Both of my kids give high regards for a visit to the zoo whenever we visit any town. Over the last 5 days, we visited 2 zoos in the country. Well, the first one we visited was the Alipur zoo (Kolkota) - it was one of the worst days to visit and therefore I would not comment much on it. We were warned well in advance about the possibility of a heavy rush. We got the entrance tickets quite luckily.

When we reached the zoo, the queue for the tickets was almost half a mile long and we had almost made up our minds to postpone the visit to another time. So, we came to the entrance and was about to go ahead to catch a taxi back to where we stayed. Out of blue came a zoo employee and started announcing that 2 new ticket counters were being started. My knowledge of a bit of Bengali served us well.

I found myself standing in a new counter with not many people. The people in the main queue were mostly sleepy waiting for their turn and it took some time for most of the crowd to realise that there were 2 more new queues.

However, on going inside, I realised that it was going to be tough. Visitors had occupied almost every inch of space inside. And moving was quite tough. However, we were quite impressed with the giraffes which made up for the disappointment we had about not being able to see the entire zoo.

And one snap to give you an imagination of how large the crowd was - I felt quite sad for the animals who were being heckled in almost all enclosures.

And yesterday night, Shalom remembered about the zoo at Trivandrum, my home town. It was not easy to deny the request. And so, we were off late morning.

And wow, it was a delight. The zoo has been spruced up quite a lot after we had visited last June. The rules about plastic usage had become very strict. The ticket collectors at the gate were very adamant they would not allow any amount of plastic to get into the zoo. I really appreciate the plastic free policy in the Trivandrum zoo.

Angel, Shalom and Charis trying to pose with the Vulture.

Cannon Ball Tree Flower

The owl who thought I was trying to steal his lunch.

One of Shalom's favorite birds - stork.

Probably the croc waiting for the birds to make the wrong move

The last time I visited, this paved area used to be quite muddy

Bats roosting. Wish I had a high end camera with lens to zoom

One of the ponds filled with water hyacinth. Quite a beautiful sight.

Both the langurs we saw were quite shy. Maybe, they got the message that we come from langur land.
(NJH has quite a large langur population)

The emu who gave us quite a hard and long stare.

Shalom's favorite animal - the zebra.

Appointment with the tiger. The most sought after. Shalom and Charis insisted that they see the tigers, leopards and the lions twice. Charis even waved goodbye to most of them.

Snap of the day.

The ostriches... By the time we reached here, we were dead tired. Then, there is quite a good collection of parakeets and macaws of amazing colours. I could not get snaps of them as they were quite deep inside their enclosures.

Then, there is a good collection of snakes. And outside the zoo, there is a pretty acquarium with a good collection.

Well, we had a great time. Watch out for photographs from the beach which we plan to visit sometime during the next 5 days here at Trivandrum.

Little rats, rather mice . . .Need help

One of the stories that used to really stir our imaginations during my childhood was that of the Pied Piper of Hamelyn. I used to really think about myself as the Pied Piper who would lead all sorts of animals with different tunes from my imaginary flute.

Well, of late, I really wish I had the powers of the Pied Piper. Because, we have been facing a real challenge with a sudden spurt in the population of rats and mice in the hospital as well as in our residences. Dealing with rats is not that difficult – they are quite large and eat poisoned baits as well as are easily trapped.

The problem is with the small mice. I never thought we had a major problem till last week, when our maid told me that a lot of clothes were being damaged. I was quite busy with work, till she kept 3 killed mice for me to see.

The next day, my fur-phobic better half was after me to clean up couple of old boxes in which we had kept a water hose and some footwear. Well, it was a revelation. In fact, we realized that we were a breeding station for mice.

After that we had a major discussion about how to control these pests. Nobody had much of a clue. I tried to put powdered poison – but these mice did not eat any of those. Suggestions are invited from our well-wishers on how to control these little pests.

Tuesday, December 20, 2011

Praise and Prayer Bulletin - 20 Dec 2011

1. We praise the Lord for LO and SK, both children with tetanus who made remarkable recoveries and have been discharged.

2. There has been a situation of unrest in the region over the last month. There were about 12 days of total shutdown which affected hospital work to quite an extent. In addition, there were patients like RD who died because of inability to go ahead after referral. Please pray that there would be everlasting peace in the region.

3. Tuberculosis continues to ravage the country, especially our region. As a Tuberculosis Unit, we are looking at new strategies to address this terrible scourge. We praise for the team led by Dr Johnson as well as requests prayers for the future.

4. We have seen a spurt of patients with alleged history of poisoning. Most of them could be successfully saved but there were few of them like CD who did not make it. We are not able to do full justice to most of these patients as the part related to counselling them does not happen many a time. Please pray that we would be able to respond to such cases more positively.

5. We praise the Lord for the 3 very sick pregnant patients whom we were able to save over the last 2 weeks. SDe, who had come in with a very bad eclampsia with pulmonary edema was a miracle. She was in the ventilator for 5 days. She is doing well and would be discharged tomorrow. SeeD also has improved although she has a bad vesicovaginal fistula. She has run up a bill of about 40,000 which I'm definite that her family would not be able to pay. SeeD was also in the ventilator for 3 days. SakD, the patient with the rupture uterus had a very uneventful recovery.

6. Please pray for the families of ND, who died unexpectedly after malaria complicating pregnancy and RD, who had severe eclampsia. There needs to be quite a lot to be done in public healthcare in this region before we can think about preventing such unnecessary deaths.

7. We've been seeing quite a number of sick malaria patients over the last 1 month. It is quite unusual to see such patients during this winter. Please pray for protection for our staff. As well as ability to treat such patients when they come to NJH.

8. We organised a Christmas get-together for our neighbours around the hospital campus, which was well attended. Initially, there was quite a lot of apprehensions about hosting such a programme. We praise God for the response from the local community. We request special prayers as we plan for a more closer interaction with the community we serve.

9. Along with the rest of India, Jharkhand has also been severe affected by severe cold. According to the press, about 50 people have lost their lives in Jharkhand. But, our friends in the villages tell us that it is only the tip of the iceberg. The poor are really hit by the cold. Kindly pray that the cold wave will subside and that there would not be any deaths.

10. The hospital celebrates Christmas on the 22nd December with a dinner and on 27th December with the staging of the Christmas play. Kindly pray for all the arrangements. Quite a lot of staff and families are away during Christmas. Please pray for all their travel. In addition, the hospital functions with skeleton staff. Kindly remember Drs Nandamani and Ango who have been shouldering clinical work since the 17th. Dr Johnson would join work from 23rd December.

11. Last week, we were able to install 2 Multipara Monitors, thanks to a kind donation from churches in the United Kingdom through Dr. Colin Binks. We thank the Lord as well as all the donors. We have already used it well.

12. In response to our wish list for 2012, we've started to recieve quite a few donations. We thank the Lord for all the donations and well as pray that more gifts will follow soon.

Monday, December 19, 2011

The 2nd Maternal Death. . . Many lessons to learn

Carefully read this report of the maternal death, the second one of the previous post on ND. There are a lot of lessons to be learnt especially something which I've been emphasizing in my blog.

RD, a 25 year pregnant lady almost at term had multiple episodes of seizures since Friday night. She went to the nearest health centre which was not a government run health centre - a mission hospital about 135 kms away from our place. I'm not sure of the circumstances of her going straightaway to this mission hospital where there is not much facility for any secondary care - but similiar to us do a lot of secondary care especially in obstetric and malaria treatment.

RD was unconscious by the time she reached the above mentioned mission hospital. And it was Saturday morning.

I recieved a call from one of the main nurses of this place saying that they have referred RD. I was quite busy and told her not to refer as we were having a tough time and I was leaving on vacation. But, it seems that RD had already left. I informed the labour room that such a patient is coming and I should be informed as soon as the patient comes.

I was doing all the last minute clearing up of office work and I totally forgot that this patient would be coming in. I was on leave and it seems that Dr Nandamani had told that he be told of every patient who comes in.

After I entrained, I happened to call up Nandu who told me that a very sick eclampsia patient had come in sometime in the afternoon and he had referred her. I told him that was fine and told him that I had asked the nurses to call me as the patient came in. But, then, they saw me rushing to and fro finishing my work before rushing to catch the train.

Next day, as I called up Nandu, he seemed quite disraught. After he had the shock of having lost ND, he had to deal with RD too. It seems that he was quite busy with other patients and RD did not leave NJH for quite some time. By the time her family arranged everything to take her to Ranchi it was late afternoon.

As they travelled to Ranchi, they were stopped by policemen on the way saying that the route was quite dangerous and they would not allow travel. With quite a lot of social unrest going on, this was a common occurance in this part of India. Many a time, travel before 5 in the morning and after 6 in the evening is not without risk.

RD came back to NJH. She was still unconscious and was putting out frothy pink sputum from the mouth. Similiar to SDe on whom we spent quite a lot of our energies, RD was also quite sick. Nandu hooked her onto the ventilator, but she was too sick for attempt of any sort of intervention. RD died by midnight.

Recently, there was some bit of discussion on one of the social networks about the cause of maternal mortality. I've always maintained that health education and social changes are only possible once we have a robust system of healthcare put in place.

Most of the places where the MMR is high has a very poor public healthcare system. 3rd world regions like Sri Lanka and few states within our own country boasts of high standards of maternal and child health indices only after they've had basic necessities of primary and secondary healthcare and to some extent tertiary healthcare put into place before all the other social engineering measures including changes of health seeking behaviour was attempted. (In some places, it was done alongside)

In the region (block level) where we serve, we had run a 3 year programme on reducing maternal and infant mortality. One of the major emphasis that we had given was on taking the patient to the nearest healthcare centre on earliest signs of complications. But, if you had noticed - in most of the maternal deaths and the maternal near misses which I've documented in this blog, almost 70% of them had taken the expectant mother to a government health centre - subcentres, primary health centres and even district hospitals. And there were glaring deficiencies.

Before I finish this post, I need to tell about ED. The story is pathetic. I did a Cesarian on ED on Friday afternoon (16th Dec) for the indication of hand prolapse and obstructed labour. The baby was alive on delivery but died soon after.

ED's pains had started sometime on Thursday morning. It was her 4th pregnancy - the family had 3 girls and social norm demanded that she has a boy. The traditional birth attendant who saw ED had diagnosed the complication as soon as she had done a pervaginal examination. And she had told the family to take her very soon to a hospital . . . Which they did . . . The nearest Primary Health Centre . . . who also diagnosed her complication and had referred her to the District Hospital.

ED remained in the district hospital from Thursday evening till Friday morning when she was told that nothing more can be done there and to take her NJH. Which also they did . . .

But it was too late. The baby was moribund . . .with only the heart beating. The lungs were all clogged with thick meconium. We intubated the baby and tried to suck it out. But, it was too late. . .

ED's family and RD's family did the right things, took decisions at the right moment. But, the healthcare system failedt them. For RD it was more than that.


I'm not out on a blame game. What I want to emphasize is that we would not make much progress on all our umpteen health related goals without giving utmost priority to our healthcare system. No amount of health education or attempts at changing social beliefs are going to change health more than serious attempts at ensuring that the three tiers of public healthcare are in place to at least some extent.

Per operatively, it was a difficult case. She narrowly missed a uterine rupture. The bladder was all edematous and there were multiple hemorrhages on the lower segment which was dangerously thinned out. Some part of the lower segment had dehisced out and was like mincemeat. The baby was very badly impacted in the inlet.

After all that had happened with ED, the biggest disappointment for ED's family was that the dead baby was a boy. They wished they had brought her straightaway to NJH. But, they have not realised that it could have been worser. ED still runs the chance of developing a vesico-vaginal fistula.

Sunday, December 18, 2011

2 Maternal Deaths . . . The first one . . .

We had 2 maternal deaths on Saturday (17th Dec), the day I left NJH for my vacation.

One of them was quite expected and the other was quite unbelievably shocking. One happened in NJH and the other occured at Medical College, Ranchi.

I had written about ND in my previous post. Clinically, ND was improving. However, I was not confident of continuing to treat her at NJH as Nandamani was going to be alone from 18th December. We had been talking to her relatives about having her treated at a higher centre from the very beginning.

The plan was ultimately to do an Ultrasound of the fetus on the early morning of 17th December and then to refer her to Ranchi. I was on call on the 16th and sometime during midnight, her relatives requested that they be allowed to take her early morning of the 17th without waiting till daybreak for the ultrasound.

The next thing we know is that her dead body was brought sometime in the evening to NJH emergency. It was unbelievable. The story was that she reached Medical College, Ranchi at around 8:00 am. Ultrasound revealed that her 28 week fetus was dead. The doctors started treatment. She was feeling fine. She had her lunch at around 12:30 pm. But, she was found dead on her bed at around 1:30 pm. There was no explanation given.

But the reason for which the dead body was brought to NJH emergency was different. After the relatives reached back to her home at Satbarwa, one of the local quacks gave an opinion that she does not seem to be fully dead and that her heart is still going on. So, they rushed with the body to NJH.

The story is quite a sad one. But, that is how life goes on this region of our country.