Heralding the New Year . . .

We celebrated the New Year a bit differently this year . . .  Snaps from the same . . .

As mentioned in one of my previous posts, there are quite a lot of Catholic dispensaries and mission stations serving remote areas of our region. They do yeoman work in the areas of education and healthcare. For many of the communities, they may be only teachers or healthcare workers they would ever see in their work. Most of these places are in remote areas with very scenic views.

Do enjoy and comment . . .

Shalom and Charis had a great time, watching trains from Barwadih Ashram . . .  

We tried to take a family photograph in a guava grove . . . this is the best we could manage. 

That calf is less than 24 hours old . . . Efforts in animal husbandary by the Ashram inmates . . . 

There was this stream through the Ashram area which we had to cross . . . Quite a trek

Duck farming . . . 

Then there was a sumptuous lunch. Shalom and Charis enjoy the food . . . 

The highlight of the trip was a visit to Morewai health centre which is located quite remote.
For many a people, this is the only access to health . . . 

The Morewai clinic . . . place of refuge for quite a large population . . .

Shalom and Charis cutting the New Year cake . . .
The clinic has been serving the local community since almost 35 years

Everybody having a good time . . . 

The Morewai church . . . construction was overseen by Fr. Barry . . .

A memorial for policemen killed in civil unrest . . . Grim reminder of hard times

More trains . . . 

These are all places which are quite cut off from development. The railway line reminds us that there are better places far away (The Ranchi Rajadhani passes through this route . . . most of the people don't see it go as it is late at night, unless the train is late). And even for the local population, the efforts are all aimed at making their way out of this place.

We wish you all a prosperous New Year. We pray that each of you will be a blessing to the people and communities around you. 

Last maternal death of 2012

The sad part was that she was one of our regular antenatal patients and she had delivered her first baby also with us. Interestingly, her first pregnancy was also complicated. She had enteric fever, later viral hemorrhagic fever and ultimately had a premature birth. 

However, for her second pregnancy, she her her regular check ups elsewhere. However, she came with a very bad urinary tract infection with false labour pains more than 2 weeks back. We had to admit her and manage her aggressively to control the infection and the pain. 

She was well controlled and later took a discharge saying that she can continue her treatment in her town. 

She had an institutional delivery at a Primary Health Centre (PHC) on the morning of 31st December. Within half an hour, she had an episode of seizures which was managed at the PHC. She was at the PHC till around 2:30 pm, when the family was told that she appears to become sick. 

We do not know the details. But, she was brought dead at around 4 pm at NJH . . .

The relatives were in a hurry to take the body home. So, I did not get the details.

I've informed the same to the concerned people. However, I'm not sure if there would be any sort of follow-up on this matter . . . 

It was a like a message for us . . . Maternal and child health continues to be a major concern of the region which we serve. It was a bit unbelievable, but year 2013 also started off with a case of maternal near miss for us which I would narrate later. We have a long way to go. I'm sure that year 2013 is also not going to be any different. We would continue to deal with extreme obstetric care. My biggest wish for 2013 is that we would be able to involve ourselves in child survival a bit more than what we are doing now. 

Wish you all choicest blessings for 2013 .. .. ..

Violence against women . . . the paradox

I had been wanting to share this incident which happened with one of our inpatients about a month back . . . much before the Delhi rape case happened. 

What emerged from this incident was one cruel reality which stalks many a women of our country. Read the incident and decide for yourself. 

It was a busy outpatient day when a young lady, a mother of 2, was brought to the emergency. It seems she suffered burn injuries couple of days back. She was being managed elsewhere. From the injuries, it did not need much knowledge to infer that the burns was not accidental. The history was that the stove burst while she was cooking and her clothes caught fire. 

Since it was quite busy and we were short of hands, we did not go much into arguing with the husband. However, within 2 days, we had found out the truth. The husband had thrown kerosene onto his wife and set her on fire in a fit of rage. But, from the way, he was caring for his wife after the incident, it did not seem so. He was so dedicated to helping his wife to survive. 

With good care, the lady survived and improved. But, it was evident that the hospital admission was taking a toll on the family. Their total bill was around 25000 INR. They had hardly 10000 INR after about 3 weeks in hospital. Obviously, the husband was the only bread-winner in the house. 

Promising that they would come back for the skin graft, they got discharged after we wrote off the rest of the bill. 

Why do I write this? During her admission, as with all cases of burns we had sent a police intimation. The primary report was that it was accidental. However, on coming to know that it was homicidal, I called up one of the policemen and told him of this. He already knew that it was homicidal. 

Then he tried to convince me on the futility of making this case into a murder case. 'The husband was very remorseful. Quite a lot of people depended on him for their daily bread. In addition to the wife and 2 children, he also had his parents to take care of. If I file a case against this man, the family would fall into poverty and would be on the street.' 

Yeah, what the police man told me was true. If the husband went to jail, our system does not have any provision to provide for the rest of the family. 

Later, I happened to meet mother of the wife. I asked her if she knew what had happened. She knew. She told me, 'Please do not betray us to the police. My son-in-law did it in a fit of anger. If he goes to the police, my daughter would have to sell her body to earn a living. Please do not allow that to happen. We've forgiven him.' 

We had another lady with burns injuries caused by her husband more than a year back. Here also, the lady described her husband as a good man. And she refused to testify against her husband. The case was dropped. I presume that in that case too, this must have been the reason for the wife not to proceed with the case against her husband. 

In our country, in very few families is the woman empowered to live a life independently. I do not have any easy answers for this sort of a situation in which the woman would prefer to remain imprisoned in an abusive relationship. 

I would encourage you to put in your thoughts on this matter which I'm sure is a common issue in many families of our country. 

Photo Post . . . 31st December, 2012

Well, few more snaps from 2012 . . . Hope you enjoy them . . .

A class in the CH department going on . . .
One of the few EHA units where you can do a class in the open. 

Another example of indigenous toys . . . Chesed with one of her favourite toys. 

Is this Lupus erythematosis? Initial diagnosis was acne with secondary infection

The cho-mohun chowk (Junction of 6 roads) at Daltonganj

The latest view of the burns unit roof. Curing involves water logging so that concrete sets . . . 

Empyema gall-bladder. Notice the pus in the suction tube . . .

The Third Movement . . .

Over the last year, we've seen 2 major peoples movements on the streets . . . The first one - Anna Hazare's crusade against corruption which seems to died a silent death . . . The second one, the embers of which are still burning - the nation's outrage against the Delhi rape case. We are still not sure of what the outcome of the second movement would be. 

What does one make out of these sort of mass protests. We've seen similar protests taking place in other countries too. But, they made much impact. We're all quite familiar with the White Revolution which started off in Tunisia and went on to engulf Egypt in an unthinkable way and later and continues in Yemen, Bahrain, Syria, Lebanon and Jordan. 

The question is whether we could expect such a result in India. My opinion is that we may not. 

The reasons are many. I shall try to put couple of them in this post . . . 

1. Although a single country, we are divided. Divided in terms of language, culture, cuisine, economic power, caste etc. etc. We've all been actively following the Anna's movement against corruption. We all know that corruption has been entrenched in our veins since quite a long time. When a decision needs to be taken against a corrupt person, all the divisions which are amongst us play a very crucial role. 

2. This is with specific reference to the issue of violence against women. Keeping women in subjugation has been a prevalent practice in almost all of the cultures of the country. If there is any difference, it is the tribal communities of the North East where the woman is empowered to quite an extent. I've put many of the instances where the girl is treated inferior to the boy during our clinical practice here at NJH. 

However, I strongly feel that there is a silver lining to both these mass movements. The very fact that the Indian citizens have responded to both these themes is something which needs to be appreciated. However, responses need to be made at the grass root level too. I repeat the same which I made in my post on the Delhi rape case. 

The change we look for needs to be started in our families and communities . . . 

For corruption . . .  how many of us would resist giving that extra 100 rupees for a berth in our trains, or the extra 100 rupees for chai-pani to the government clerk who has to issue us a certificate or the 500 rupees to speed up the process of obtaining the driving licence. I'm afraid that this is going to take some time . . . but unless this sort of a resistance to corruption builds up the grass root level, we would not go much distance in eradicating the evil of corruption. 

With regard to the violence against women . . . we need to bring up our daughters with the same love and care that we give our sons. As of now, the birth of a daughter brings a pall of gloom in most of the Indian homes. I can tell you instances where the daughter in the family is illiterate whereas the son has gone on to become an engineer. Recently, one of my acquintances was telling me that he was finding it difficult to find a suitable match for himself as none of the prospective brides from his own caste had any education beyond Class X. In fact, it was reported that there were about 25 reported cases of molestation of women while the nation was protesting the Delhi rape. 

As we go on the the New Year 2013, I wonder what are the other issues on which we would need a people's movement . . . another issue which would bring out the crowd into the streets of Delhi . . . 

I strongly feel that the issue of the Caste System is something that is playing havoc in our country. Of course, we've already have had the Mandal commission protests way back in 1990. But, to be very honest, the caste system thoroughly divides our society . . . Villages, communities, colleges .. .. .. it is very sad to see this division causing so much of mistrust and antagonism.

A national integration with respect to language and culture is a distant dream . . . However, there is a crying need for a eradication of the caste based mindset among our communities which is many a time worse than apartheid. 

Wish you all a better India in 2013. I pray that each of us will strive to work together for making our lives enriched and our nation a better place to live in. May each of us be a blessing to our neighbours and communities .. .. ..