Reminiscing and praising God

It was one of those chilly nights in 2004. Just around Puja time . . . I don't remember if it was before Puja or after. One of us on duty was called for a late night call . . . it was not yet midnight. We were just a group of 4 junior doctors in the hospital for that week. No one senior enough to give us solid guidance . . . 

The patient in question was a young lady, 16 years old . . . with a history which could only be one diagnosis . . . an enteric perforation. With a history of fever of around 10 days followed by severe abdominal pain, vomiting and abdominal guarding, it was point blank . . .

Now, what were we supposed to do? Of course, refer . . . The person on duty called another of us . . . to try to convince the family to take the patient to Ranchi. It did not work . . . the next doctor was stirred up from his sleep . . . we still had no luck . .. ... the fourth one also came. The father was adamant - 'we've spent enough on her treatment. If you don't do anything, we're taking her home'. 

We had to operate. Drs. Nandamani and Vikram were going to operate. . . One medical student who had come to visit, Atul also volunteered to assist. Johnson and myself were to be on floor . .. ... We decided to document so that if there is a medicolegal issue at a later stage, it could be of some help. Nobody really knew what to do or why we were doing it. 

Nandamani suggested that we call up Dr. Bala, the surgeon who had recently left us after completing his service obligation. With few pearls of surgical knowledge transmitted over the telephone and some quick reading, we were ready to take the plunge. The surgery was uneventful .. .. ..

Snaps from the documentation . . . do remember, the snaps are dated 4th October, 2004. 

Praying before the start of surgery

Everybody interested in what is going to show up

There was faeces in the peritoneal cavity

The rent in the intestine

The tension was quite palpable . . .

But, post-operatively the wound had become infested and we found out that we were in a soup. A fistula had developed. 

A long period of admission of about 2 months followed. Nandamani would only think about this patient for almost 2 months. You can very well see from his discharge summary on how relieved he was when she was ready to go home. There was so much of prayer which went into this girl. 

Whenever we talked about miracles we witnessed in 2003-04, we regularly used to remember this case. 

Fast forward to 16th February, 2014 . . . One of our doctors was seeing a antenatal patient who had a very peculiar request. She wanted details of a surgery done about 10 years back. The concerned doctor came to me and told about the request. The patient was having her antenatal care at our sister hospital - Jiwan Jyothi Hospital, Robertsganj. 

I could not believe my eyes when I looked at the outpatient card . . . the lady in front of me was the same Sarita Kumari on whom we had done the surgery 9 years back. Married about a year back, she was just into the second trimester of her pregnancy. 

I could only praise God that we novices were involved in saving the life of this lady 10 years back . . . whereas she would have died if her father took her home if we had refused to intervene. 

We broke lot of rules 10 years back . . . quite a complicated surgery without any surgeon, anesthetist or any sort of consultant, two pints of blood by UDBT (Unbanked direct blood transfusion). 

10 years later, I wonder if we would have taken up this lady for surgery. Times have changed with regard to medical practice. Really . . . for the poor . . . no . . . not much has changed. 

The other day, when Dr. Nandamani was here, I told about 6 patients with acute abdomen who needed surgery and we did not take them up for surgery since he was away . . . 

People in developing regions die more because of easily treatable conditions . . . Of course, we also have rare conditions . . . but the idea about people dying of easily treatable/preventable conditions is really troubling . . . The question is about more people like Drs. Roshine, Nandamani etc. who are ready to venture into areas where a simple intervention could save more lives than a complicated intervention . . . 

And when people venture to such difficult situations, we've always seen miracles in the lives of our patients as well as ours . . . and reasons to praise God when we become a blessing to countless lives and families . . . 

Post-burn contracture - Hand

About a week back, Dr. Nandamani was here for his bimonthly visit. Although it was a shorter visit than usual, we had quite a many surgeries. 

Of note, was a young man who was from one of the target villages of the Community Based Rehabilitation for the Disabled. This young man had approached our staff with a post burn contracture of his fingers which were quite expensive for him to get operated. 

Unfortunately, he did not have a RSBY card . . . however, we operated him for a cost of about 5000 INR although the actual cost was approximately 13,000 INR. 

Snaps of his hand before the surgery . . .

And the surgery in progress .. .. ..

Dr. Nandamani would be coming next on March 31st. He would be continuing his bimonthly visits till March 2015 when he would join the hospital back for good. 

There was one more young lady who also had a burn contracture of the finger following a neglected burn injury. A surgery has been done on her too. 

Please pray that both these young people would be able to use their hands well after the surgery. 

Both these surgeries may be quite simple ones for experienced hand surgeons. However, the fact remains that there are quite a many patients with such conditions who would never think about visiting a specialty centre where such surgeries are attempted - the first reason being the logistics of such a travel and the second being the cost . . . 

Surgeons such as Nandamani who chose to serve in underserved areas like ours are a blessing to countless people like these young people . . . 

I would also like to invite surgeons and other consultants who would like to come to us on a short-term period and do similar surgeries . . . Of course, the best time to visit would be from September to March .. .. .. well, December and January only if you can adjust to the severe cold. 

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 . . .

Thankful

The last Friday of every month, the staff at the hospital meets together for a whole day of prayer where we remember the blessings we had over the past month and put forward specific prayer requests. On 29th November we met, and had a wonderful time of sharing the blessing we enjoyed over 2013 and thanking the Lord for each of them. 

Apologies for the delay in sharing these with you all . . .

Please join us in thanking the Lord for each of the blessings. 

1. The hospital has been done well in 2013 in spite of major challenges. The absence of a surgeon was a major challenge as traditionally we are known as a surgical centre. We thank the Lord that the requirements in terms of finances and other requirements have been met so far especially in the light of a salary revision this year. 

2. Sampoorn Development India, one like-minded organisation has facilitated the construction of a water-tank in the campus. The Lord willing, the construction should be over very soon. 

3. The hospital has got an exclusive electricity connection to the campus and the electricity supply to the region has improved tremendously with us getting an average of 20-22 hours of electricity every day. 

4. There was a portion of land which was donated to us by one of our staff about 2 decades back. Unfortunately, few of the locals had been preventing us from taking occupation of the land. The Lord worked in the minds of these locals and has enabled us to take possession of the land. We could construct a boundary for this land and last week, the Maintenance Department started to cultivate on this land. 

5. Our Community Health Projects have been doing well so far. The impact made by the Climate Change Project, Community Based Rehabilitation Project is being slowly seen in the community. 

6. Our engagement with the government has increased over the last year. In the sphere of Tuberculosis Control, the Tuberculosis Unit caters to a population of over 750,000 population and the Global Fund Project increases awareness about the disease in the district. The UNICEF had requested us to oversee the mentoring of Labour Room facilities in Palamu and Latehar districts, thereby influencing Reproductive and Child Health in the region. Today, we were informed that we have been once more been authorized to disburse funds under the Janani Suraksha Yojana. This scheme was discontinued about 2 years back saying that we did not qualify as we did not have the requisite facilities in terms of personnel. 

7. We live in a region with tremendous amount of social unrest. We estimate that our hospital vehicles travels an average of 300 kilometers every day. We thank the Lord for safety and protection from accidents. 

8. We had some amazing stories of miraculous healing over the last year. We thank the Lord for each of these patients. Many of these patients had come to us as a last resort. 

9. There have been few constructions in the hospital. We thank the Lord for the funds that has enabled us to do these constructions. Please remember the burns unit, critical care unit, the sarai etc.  for which we need more funds. 

10. We thank the Lord for the new staff who joined in 2013. Dr. Roshine Mary Koshy (Medicine Consultant), Dr. Grace Mary George (Medical Officer), Dr. Aroma Tirkey (Dentist), Ms. Meghala Ramasamy, Mr. Jonathan Hongsha (IT Manager), Ms. Sheron Mathew (Physiotherapist), Mr. Asherush (Pharmacist) and Mrs. Tavitha, Ms. Priyanka, Ms. Premadini (Staff Nurses). 

These are the first ten items of thanks and praise which came. There were many more . . . 

Wish we had a surgeon

The below X-Ray is that of a middle aged lady to came to us today in outpatient. She had been having severe abdominal pain since yesterday. As is quite typical of the region, she had been taken to one of the witch doctors as well as a quack. The witch doctor had nicely smeared lime around her umblicus. The quack had given her Ranitidine tablets and Syrup Gelusil. 

I told our predicament to the relatives. They wanted that she be operated only by a surgeon. I referred her. 

Now, this is the third intestinal obstruction we got over the last 48 hours. 

And it is quite difficult to see them off as couple of us are quite well versed in doing this sort of surgeries, although we are not surgeons. People are quite aware now of how important it is to have a specialist see them. 

All the three patients with intestinal obstruction were not that rich. In fact, one of them was very very poor. 

This very poor patient, I offered to operate. They told that they would rather take the patient home rather be operated. 

Yes, they took the patient home. 

Please do look out for surgeons who would be willing to come and help us out. And please pray that we would get a surgeon till Jan 2015 when Dr. Nandamani would rejoin NJH for good. 

Surgery at NJH

During my short vacation, it was quite a blessing to have Dr. Nandamani and Dr. Ango to be with us. 

And I believe that it was a big relief for quite a few of our patients, especially to 2 young men who came with acute abdomen. 

The first one was VK, a 16 year old who came in with acute abdominal pain and distension. Of course, it was intestinal obstruction. 

On opening the abdomen, this is what we found . . .  

In addition, there was an area of constriction caused by tuberculosis which caused the obstruction. 

Then, there was one more young man who is still recuperating from the surgery for a duodenal perforation. 

After quite a long time, we had quite a large renal stone (staghorn calculus) removed. 

It does not need much research to conclude that a surgeon is a very much essential component in the scheme of things in a mission hospital. I wish we had a surgeon who was always around. Our surgical load is immense. Dr. Nandamani did about 70 surgeries in a space of around 2 weeks. 

Dr. Nandamani coming on a bimonthly basis is a major relief for us. We praise and thank the Lord for his bigheartedness. 

Could I request prayers for a regular surgeon to be at NJH? 

VK just before discharge . . . 

Opportunities at NJH

We have few more openings at NJH. We request people with a commitment to serve underserved and marginalised communities to apply. We prefer those with a personal call to such a vocation because of the Lordship of Jesus Christ in their lives.

1. Consultants in Surgery, Pediatrics, Obstetrics  and Orthopaedics. They should be willing to rough it out in a bit of a hostile environment.

2. Masters in Social Work/Develoment graduates with experience in Community Based Rehabilitation/Disability for 2 posts of Project Assistant in Community BasedRehabilitation of the Disabled.

3. Masters in Social Work/Rural Development graduates with experience for 2 posts of Project Officers in Community Based Adaptation to Climate Change.

4. Masters in Social Work/ Rural Development graduates for 2 posts of Project Assistant in Community Based Rehabilitation of the Disabled.

5. Accountant cum Data Entry Operator for the Community Health Projects.

6. 2 Pharmacists with registration in Jharkhand or willing to get registered in Jharkhand.

7. X-Ray technician.

8. Warden for Nursing School hostel. 

9. Occupational Therapist for the Disability Project. 

10. Electrical Engineer for the Hospital and the Community College. 

Please note that this is a updated post and all previous opportunity announcements stand cancelled. 

Update on opportunities at NJH

The following are opportunities available at NJH . . . Please pass the message along and pray that the Lord will send the right people . . .

1.  Pharmacist (2 nos): Our present pharmacist has requested for a transfer to his home state. We need one more pharmacist for our store. The candidates should at least have a diploma in pharmacy and should be willing to be registered in Jharkhand state.

2.  Information Technology Manager: With about 20 computers/Laptops in the unit and further expansion being planned, we need a full time IT manager. A MCA or Diploma in Computer Hardware would be ideal. She/he would also be involved in training of staff in computers.

3.  Electrical Engineer for Maintenance Supervisor: Being a 100 bedded hospital in a 25 acre campus, we need a full time electrical engineer.  

4.  Project Officer: This is for the Community Health Department. The present projects in the department are in the themes of Community Based Adaptation, Disability and Rashtriya Swasthya Bima Yojana. We would prefer a fresh graduate. 

5. Occupational Therapist: We’ve started to do some major work in disability in this region.

6.   Physiotherapist: This is again to help us out with the work among the disabled.

7.   X-Ray technician: Somebody with couple of years of experience would be preferred.  

8.   General Surgeon: We would like someone who is committed to work in needy areas among the very poor. Opportunities for developing minimal access surgery would be offered if they can commit for long term. There is a upcoming burns unit also in the hospital. 

9.   Orthopedician: The same qualities which we need for the surgeon. We would give opportunities for developing further in terms of technology and techniques if the candidate can commit long-term. Considering that the nearest orthopaedic facilities are few and expensive, there is a great opportunity. 

10.Paediatrician: There is already a fairly well equipped neonatal unit (which is the only one for a radius of around 100 kilometers).

Please forward/refer this post to whoever would be interested to be part of the little things we do to make this part of the country a better place to live. If you are genuinely interested for any of the above positions, please contact me at jeevan@eha-health.org. You can also directly apply to our Central Office in New Delhi.