Praise and Prayer Bulletin, March 2014

It's been quite a long time since I've put out a Praise and Prayer Bulletin. Do pass this around and encourage friends and relatives to be part of our work. 

The praise and prayer points . . . 

1. We had a blessed time of retreat couple of weeks back with Rev. Maxwell David and his wife, Mrs. Snehalatha David. We thank the Lord for all those who have dedicated/rededicate their lives to the Lord. Please pray for the ministry of Rev. Maxwell and his wife. We pray that they will continue to be a blessing to many.

2. There have been quite a lot of sick patients who got well over the last 2 months. We thank the Lord for each of them. Special praises for Munia Kumari and the umpteen high risk obstetric patients.

3. The CH team has been working overtime over the last 2 weeks. There has been couple of mass awareness programs for finger millet cultivation and usage in diet. We received invitation to be part of Agrotech, the state level agriculture fair organised by the State University for Agriculture and Veterinary Sciences. In addition, we’ve been acknowledged for our work in the field of care for the disabled.

4. We’ve received some generous gifts from our friends and well-wishers for upgrading the acute care unit. Plans have been made for the purchase of a full-fledged ventilator, few multipara monitors and syringe pumps. Please pray that we would make the right choices. We thank all those who helped. We need much more funds (only 25% of our plans can be met by the funds we have now) to make changes that we dream of.

5. The water tank construction is complete. The pipes are been now laid for the supply of water to the residences now. Supply to the hospital is partially complete. We thank the Lord and the Indian wing of Living Waters, Sampoorn Development India who were instrumental in constructing this tank in the campus. We had the dedication of the tank last week. Mr. Howard Searle, the first director of EHA visited us last month and it was such a joy to know about how Living Waters came to be associated with EHA. 

6. We thank the Lord for Dr Titus who served as Medical Officer with us for the last 2 years. Dr Titus has got selected for Diploma in ENT in the Christian Medical College, Vellore. We request prayer for Dr. Titus and his wife, Dr. Grace that they would stay in the will of God and the Lordship of Christ would be the priority in their lives. Titus' parents and brother visited us as Titus and Grace left NJH. 

In the foreground, from left to right - Dr. Grace, Dr. Titus, Titus' parents - Dr. Raju Jacob (Professor and Head of the Department of Anatomy, Medical College, Kottayam), Dr. Jaimol Zachariah (Professor, Department of Physiology, Medical College, Kottayam), Titus' brother - John Raju (Engineer with Bharat Gas, Mumbai). Also in the snap - Mr. Tapeswar (driver) on the left and Annoos, daughter of Sr. Dipti (staff nurse) and Mr. Benoy Jose. 

7. We thank the Lord for Sr. Wendy and Mr. Gerry of the Grace Babies Foundation who has visited us again this year. I'm sure that the number of babies who're going to live well because of their contribution to our hospital is quite a good number. Kindly pray for this wonderful couple as the Lord leads them for greater things. Please also pray that we would be able to get a Paediatrician who will be able to do much more. Especially training for the government, for which UNICEF has been asking us for some time. 

8. There are quite a few staff who have gone on training. Few of them are away on long periods of training. We thank the Lord that their travel and stay went off fine. Kindly pray for staff who are away on long term training. Especially, pray for their families.

9. We request specific prayers for Sr. Sushma Kujur who has a very bad Inter-Vertebral Disc Prolapse. She has been on bed rest for the last 6 weeks. Please pray for complete cure.

10. We’ve a new trainee Human Resources Manager who has joined us. Mr. Amit William. Kindly pray as he adjusts to life at NJH.

11. We thank the Lord for Sr. Bharati (Nursing Services), Mr. Sapan (Maintanence Department) and Mr. Alex (Administration - Billing Department) who has moved on after serving NJH. We request prayers for their further professional work.

12. There is quite a lot of money pending to be given from RNTCP and also from RSBY. The total amount is so high (about 1,200,000 – your read it right – more than a million Indian Rupees) that the financial situation of the hospital has taken a major hit. Please pray that the officials who are responsible would make arrangements to disburse the amounts at the earliest.

13. We had a break down of the X-Ray machine. The x-ray tube has run off steam - it had served us for almost 30 years. We need to purchase a new one. The total costs would be around 160,000. We request prayers as well as generous gifts from well-wishers to get the X-Ray back on track. 

14. General elections have been declared for the country. In Jharkhand we already had a political murder. Please pray for peace in the region and for peaceful elections. 

15. Please remember the Sarai construction in your prayers. We've almost completed it using our own funds. However, it would be extremely helpful if we could have someone to bear the costs of construction. 

Praise and Prayer Bulletin, November 2013

1. We thank the Lord for the 24 hours electricity supply we have since the last week. 

2. Almost all of our high risk patients survived and went home well. We thank the Lord that that we've been used to be a blessing in the lives of these patients. We specially thank the Lord for the baby whom we could save after a rupture uterus. However, we're very well also aware that we would do better with specialists in the areas of obstetrics and pediatrics. Please pray. 

3. We thank the Lord for the success we've had with the Finger Millet cultivation and the SRI Method of Rice Cultivation which we did as part of the project on Community Based Adaptation towards Climate Change. Please pray for the efforts we take to promote millet (rather, reintroduce) in the community. 

4. We thank the Lord for the Mr. Ashurosh (Pharmacist) and his wife Mrs. Tabitha (Staff Nurse) who joined us since last week. Please pray that the Lord will bless them and they would be a blessing to the hospital and the community. 

5. Duncan Hospital, Raxual has been kind enough to depute Mr. Shivnath, laboratory technician as we have a shortage of lab technicians. We thank the Lord for the Mr. Shivnath's life as well as pray that the Lord will bless him. 

6. We thank for the Lord for Dr. Titus and his wife, Dr. Grace. Kindly pray for them as they plan for the future, especially post-graduate studies. 

7. We thank the Lord for the smooth construction of the water tank. The contractors plan to complete the construction by the end of this year. 

8. There were 2 of our staff families who were blessed with babies over the last couple of weeks. Mrs. Sudha (staff nurse) was blessed with a baby boy. Mr. Rajeev (laboratory technician) was blessed with a baby girl. We thank the Lord that both the deliveries were uneventful. 

9. Please pray for the financial needs of the hospital. The new transformer and the high tension electricity connection has been a major financial burden for the hospital. In addition, we need to upgrade the Acute Care Unit, put in place a new Hospital Information System, construct the Sarai and at least couple of new residential apartments for our staff. 

10. We look forward for new consultants in the specialties of General Surgery, Obstetrics and Pediatrics to join us. Please pray and pass the message along. 

11. We appear to be heading into a very harsh winter. We already temperatures dipping to as low as 5 degree Celsius. Please pray for the health and protection of the staff.

12. Please pray for couple of our staff who are sick. 

Praise and Prayer Bulletin . . . October 2013

It’s quite a long time since we’ve put in a praise and prayer bulletin. Apologies . . .  Below is the latest list . . .

1. We had an amazing time with YWAM team who ministered to us about a week back. The thank the Lord for each of the members. Kindly pray that the Lord will use them mightily in the coming days.

2. Over the last few weeks, we’ve had some amazing patients who made it in spite of challenges. We thank the Lord for healing each one of them.

3. The water tank construction is in smooth progress. We thank the Lord. Please pray that we would also be able to raise some funds for laying new pipelines.

4. We thank the Lord for Dr. Roshine and the amazing work she’s been doing. She has completed about 4 months of service at NJH. We look forward for a junior medical officer to help her work. And also, the acute care unit is in dire need of more facilities and space. Please pray and spread the message.

5. We thank the Lord for the kind donation of the bilevel CPAPmachine. Kindly pray for the family who made this donation.

6. Maternal and child health continues to be of a major challenge. Kindly pray for the Lord’s guidance.

7. The surgery load in this region is quite high. Dr. Nandamani has been kind enough to come and help us once in 2-3 months. However, we pray for a permanent surgeon at NJH. Please pray and pass the message along.

8. Kindly pray that we would able to get electricity connection to the campus as soon as possible. 

9. We start work on the Sarai today. This is the place where patients who need long term care but not hospital admission, can stay on without getting admitted. It will also provide space for the umpteen number of relatives that accompany patients.

10. Considering the huge increase volume of work over the last few years, we’ve come under Income Tax scrutiny this year. Please pray for wisdom to our administrative and finance team that necessary precautions be taken in their work.

11. Kindly pray for the Lord’s leading as we plan for outreach work during Christmas season. We look back with gratitude when we remember the last year's program we had for our surrounding villages. 

12. Kindly pray for our staff and their immediate relatives who are sick.

13. Our calendar 2014 has gone into print. Kindly pray for all logistics involved. Also thank the Lord for everybody who put their lot behind the effort. 

14. Few organisations including EHA has been advocating to the government to legalize Unbanked Direct Blood Transfusion. Kindly pray for the efforts going on. Hospitals like NJH would be able to serve the poor more effectively if UDBT is allowed. 

15. We're pained to hear stories of families who do not value their girl child. Please pray for the communities around us that they would value boys and girls in the same measure. (By the way, our hunch regarding the patient mentioned towards the end of this post was correct. It was a girl)

Prayer Bulletin – June 1-15, 2013

We thank all those who've been regularly following us. Below are the items for praise and prayer . . .

1. Thank the Lord for the healing of RD and BDD who were real miracles for us.

2. Thank the Lord for the weddings of Dr. Titus with Dr. Grace and Mr. Dinesh with Sr. Priscilla which went on well. Titus joins back work on June 10^th and Dinesh on June 13^th.

3. Kindly pray for electricity issues in the campus. Last week we did not have electricity for about 6 days continuously. Our generators worked overtime. We understand that we would need a replacement for the 63 KVA generator soon.

4. We thank the Lord for the amazing harvest of fish from our pond over the last 3 weeks. We estimate that there should be another 200 kilograms left in the pond.

5. We are thankful for the Sacred Heart School which has once again showed that quality education can be provided in remote areas such as ours. Quite a few of our students go to this school. Kindly pray for the management and the staff.

6. We’ve had a very severe summer over the last 2 weeks. However, there has been some showers of late. Kindly pray that the Lord will bless us with a good monsoon this year too.

7. We thank the Lord that we could manage a very bad case of injury to the eye. Kindly pray for complete healing.

8. Maternaland child healthcare remains one of the major challenges. Considering the increase in patient statistics, we are certain that we would do better with an obstetrician and a pediatrician.

9. Over the last 2 weeks and the next 2 weeks, we’ve quite a lot of our staff travelling. Kindly pray for each of them. Thank the Lord for journey mercies so far.

10. The Community Based Adaptation on Climate Change is at a crucial juncture where the team is in the process of facilitating farmers in the target communities to do Systematic Rice Intensification method to cultivate rice and also to re-introduce millet farming. In addition, they are into facilitating communities towards afforestation. 

11. One of my dreams is to start off a Cervical Cancer screening program in the hospital. Please pray.  

12. We are in the process of getting few of the mandatory licenses for the hospital for the year. Kindly pray for the application processes. The legislation of Clinical Establishment Act in the state has put quite a lot of pressure on us. 

Praise and Prayer Bulletin, May 2013

Below are our praise and prayer points for the month. 

1. Dr. Roshine Mary Koshy, our new Internal Medicine consultant has passed her MD exams. We praise the Lord. And we request prayers as she makes the transition to NJH.

2. I was away for about 2 weeks. I thank Lord for the leadership given by Ms. Meghala and Dr. Shishir in my absence.

3. Please pray for Dr. Titus and Dr. Grace who’ll be getting married on May 20^th and Mr. Dinesh and Sr. Priscilla who gets married on May 30^th.

4. We are in the process of consolidating the achievements of the previous years. We thank the Lord that the auditing went about without much hitches.

5. We continue to remain empanelled under RSBY. However, there are major issues with compensations which is a major deterrant for the smooth functioning of the program. Please pray that all problems will be ironed out.

6. Drs. Nandamani and Ango plan to be with us at NJH from the 22^nd June to 2^nd July. Please pray for their travel and other arrangements.

7. There is a small window period in the first 2 weeks of June, when we are going to be really short of doctors. Kindly pray for this time. Please encourage doctors who can help out to contact us.

8. At EHA, we’ve making an effort to remind ourselves that we are primarily here as spiritual leaders. At NJH too, we are well aware of the need for us to lean more on the Lordship of Jesus Christ. We request you for prayers that we will grow in the Lord, our fellowship will be an offering of sweet fragrance to the Lord and we will be a blessing to each person whom we deal with, staff and patient.

9. Quite  a lot of our staff are on summer holidays. Kindly pray that they would have a good time of rest and refreshment. Do uphold the team who’s taking the extra burden in the absence of the staff.

10. There is need for more staff in the Community Health Projects. Kindly pray for the need.

11. We continue to dream about the presence of a Pediatrician, Surgeon, Orthopaedician and an Anesthetist in our team. Please pray. Specialists become all the more necessary because of laws like the Clinical Establishment Act and the continuing danger of litigations in this era.

12. We’re into a major phase of investing into our Hospital Information System. Kindly pray for Mr. Jonathan who’s giving the leadership. There is a need for quite a lot of funds. 

Praise and Prayers . . .18 Nov . . .

I always hope that friends of NJH who keep us in prayers would benefit from my postings and would uphold us in their regular prayers.

Recently, one of my very close friends requested that I be very specific and put in the praise and prayer points regularly.

So, here is it. I hope to put it on once a week.

Praise Points . . .

1. Today morning, we had a sort of surprise inspection from the Income Tax Department. They were paying such a visit after quite a long time because of which there was a bit of anxiety at the administration level. But, the inspection went off quite smoothly and the officers were quite happy with our papers. They were so happy that they insisted on having a group photograph with all the doctors and office staff.

2. We have got one of my friends getting interested in further helping us with the construction of the burns unit. There is quite a lot of homework for us to do before it can be taken forward. We thank the Lord for this friend of mine who has shown interest in our work among burns patients.

3. The Daltonganj State Bank of India has promised to look into donating us medical equipment worth about 250,000 Indian Rupees. We thank the Lord for this initiative from the SBI authorities. The quotations have already been given to them. Kindly pray that the Lord will give us success.

4. We had some very sick patients come to us especially over the last week. KB, who had been in obstructed labour with a dead baby for about a week has done well and has been discharged. SD, who was quite a complicated case is slowly making a recovery although she has a long way to go. PD, whose baby had hydrocephalus in a breech presentation has also gone home well.

5. The baby born to KD is gaining weight quite well. The family is quite delighted to have a live baby after 2 intrauterine deaths. Please continue to remember this family who is quite poor.

Prayer points -

1. Dr. Srijit Pradhan, our ophthalmologist has left today for his daughter's wedding. Kindly pray for the family as they travel to Cuttack today, preparations for the wedding and the ceremony including the reception arranged at Nagercoil.

2. Sr. Rita Pradhan, our Nursing School Principal is on travel to various nursing schools as part of MIBE inspection. Kindly pray as she travels.

3. One of the social activitist nuns from the Catholic church, Sr. Valsa John who had been working for the upliftment of the tribal community has been murdered. in our state of Jharkhand. The funeral was yesterday at Dumka. Please pray that we would not be discouraged by incidents such as this.

4. Please pray for PD who had come to us about 4 days back with severe post-partum eclampsia. Her blood pressure is yet to be fully control. Kindly pray for her complete recovery.

5. We have a very preterm baby born to a mother with severe eclampsia. The mother died after couple of days of the delivery of  pulmonary edema and cardiac failure.

6. LO is a young boy with tetanus. He has done well so far. Kindly pray for his completely recovery.  

Please do share this post with friends who will spent one minute of prayer for us. I hope I shall be able to post 'Praise and Prayer' posts on a regular basis.

Monday diary

We start Mondays in NJH with much anticipation and preparedness. Usually, they are very busy and it would be very difficult to find any of us sitting doing nothing. I knew that today was going to be tougher than usual as Dr Nandamani who was on duty on Sunday was running a very high fever with body pain and Dr Johnson was on leave.

As soon I finished the rounds in the Maternity Ward and before I started rounds in the Male ward, I managed to peep into the OPD and was surprised to find it quite empty for a Monday morning. I took things a bit lightly and did a very relaxed round in the Acute Care Unit and the Male Ward.

Well, silly me. It was just the calm before the storm. As soon as I finished Male ward rounds, I got a call from Dr. Nandamani requesting me to review a patient in OPD. KD who had a LSCS about a month back had come with pus pouring out of her vagina and pieces of catgut too. The patient was otherwise doing fine. She had come quite sick for her delivery. She was unconscious and having continuous seizures following which we had do an emergency cesarian section. She was in the ventilator for 4 days. The relatives had given up hope. Somehow, she had lived. I asked for an ultrasound. She was quite pale. I’m yet to follow up on the investigations.

As I came out, there was a call from Labour Room. There was CD, a 27 year old G3P2L2 with leaking since early morning. The duty nurse requested me to come fast as the abdomen looked abnormal. One look was enough to suggest that it was either a transverse lie or a Bandl’s ring had formed, the former more likelier than the latter. There was more in store. I did a per vaginal examination and to my horror, a good 2 inches of the umblical cord was hanging out of the cervix and it was pulsating well. The patient had started to contract and there were no membranes. I was not sure if the baby was alive. The nurse was sure she heard the fetal heart.

I took CD for an ultrasound abdomen. Thankfully, the baby was alive. The question was how much longer she would hold on. The only saving grace was that the baby being in a transverse lie, there was nothing putting pressure on the cord.

I rolled her straight from the ultrasound room to the theatre where a call from the laboratory put me in trouble. Her hemoglobin was only 6 gm%. I had no other choice but to operate immediately if I wanted a live baby. With a prayer that the Lord will protect the mother and the baby and very high risk consent from the bystanders, we went on with the surgery. The mother and the baby are doing fine. By evening, the bystanders had arranged couple of pints of blood.

There was more happenings going on elsewhere. Shazia, our community health staff was helping us take the delivery of a Nycocard reader in EHA Central Office in Delhi. The person from the company had called me just before the surgery on CD and had told me that they did get any intimation of the NEFT transfer of the required funds for the purchase of the machine. I explained that the transfer has been made and requested that the machine be handed over. I’m glad that the machine was given although the confirmation of the transaction of funds is yet to happen.

As soon as CD’s surgery was over, I went over and scanned a copy of the NEFT transfer slip and send it over. Later, there was a problem in the pharmacy as it turned out a batch of Ranitidine tablets were becoming semisolid like - almost  liquid-like. So, I had to officially intimate the suppliers as our requirements are quite voluminous.

I made my way to the OPD, where Angel was having trouble with a patient with hallucinations and delusions. The patient was quite poor. From the history, it was obvious that the patient was going into Schizophrenia. I told them of the option of going to Ranchi, but it was quite obvious that it was going to be difficult. So, I had to call up my friend, Dr Raja at Burrows Memorial Christian Hospital, Alipur and soon I had put in a plan of action for the patient and they were quite relieved. That’s telemedicine for us.

Soon, we had our next obstetric emergency. EE, a 34 year old G3P2L2 who had been in labour elsewhere had turned up in the OPD. She had an abdomen like a pear. We had a similiar patient couple of months back. It was obvious obstruction. The only question that remained was whether she had started to rupture. Once again, I was not sure about the baby’s status. The ultrasound showed a fine baby. I had to operate her.

She looked sure anemic. My only prayer was that she would be at least 8 or 9 gm%. She was 7 gm%. But the severity of obstruction she had made me to take a decision to go ahead with the surgery as soon as possible. After sending the relatives to somehow get hold of 2 pints of blood I took the baby in. Once I opened the uterus, I wished I had put in a midline vertical incision rather than a Joel Cohen Incision. The bladder had been pulled quite high up. I had to reflect the upper flap of the abdominal wall quite high to reflect the peritoneum down.

My prayers were answered when we delivered a live girl baby. She had a poor Apgar initially, but was well resuscitated by the theatre team. When I went in the evening to review her, she was bawling out. And oh my, the only time you feel so happy to see a child cry out.

I had staff from the hospital where EE was admitted for the last 3 days. It seemed that she was asked to go to a higher centre on Saturday night as the doctor had felt that the baby had not rotated properly and she could need a Cesarian Section – but the family had not taken it seriously. And having waited for quite long – they had taken a very high risk.

As soon as I finished surgery, Sr. Bharati, the Nursing Superintendent had news for me. Dr. Nandamani could hardly sit, leave alone work. He had told me that he was feeling quite sick in the morning and I had told him to take sick leave if he finds things difficult. Dr Nandamani had left OPD and there was quite a large crowd.

As usual, there was a bunch of tuberculosis patients, couple of patients with bronchial asthma, two patients with long duration of fever with typical features of dengue and a low platelet count whom I ultimately admitted.

However, I need to tell you about a patient who I felt so bad about. She was SD, a 65 year old lady with a swelling over her right cheek. It was obvious oral malignancy which was spread locally. There was nothing much I could do. As soon as I told the husband that he needed to take his wife to the Medical College under Banaras Hindu University, both of them started to cry. I asked them about their children. More tears rolled down their cheeks – there was so much of hopelessness in their eyes.

I told them that I’ll help them to obtain help in going. They sat down and talked for a long time. It seemed that their children were doing well. But, they had no time for the parents. I gave letters for them to give to the local government authorities so that they could request help.

Like the many malignancies which we have been seeing of late, most of these poor people have nowhere to go.

In between, we had a elderly lady with electrical burns. There was only about 10% of burns and most of it was quite deep. Since electrical burns could be quite deep such that it could involve even the bones, the patient was quite elderly and the family looked quite well off, I gave them the option of taking her to Ranchi which they promptly did.

By the time, we finished OPD it was 5:30 pm. As with each day, we had learnt quite a lot. There are concerns which I would share in my later posts especially about the prevalence of anemia which is responsible for quite a lot of morbidity and mortality in this part of the country.

I also realized that Dr Shishir, Dr Nandamani, Dr Angel and I had dealt with quite a number of sick patients whose management could have resulted in quite a number of complications and I acknowledge the grace of God in whatever we did during the day. My prayer is that our patients also realize the same in their lives.