good governance' cmji 29.3 july - september 2014

goodGOVERNANCE

A Quarterly Journal of the Christian Medical Association of India

VOLUME 29 NUMBER 3JULY - SEPTEMBER 2014

CHRISTIAN MEDICAL JOURNAL OF INDIA

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CMJI Communicating HealthSince 1895

CHRISTIAN MEDICAL JOURNAL OF INDIAA Quarterly Journal of the Christian Medical Association of India

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VOLUME 29 NUMBER 3 JULY - SEPTEMBER 2014

Letters to the Editor 2

EDITORIAL 3

BIBLICAL REFLECTIONS Marked LeadersRev Sharath C David 4

FEATURE Good Governance in Christian OrganisationsRev Dr Tomi Thomas 7

FEATURE Financial Accountability in Healthcare OrganisationsDr M Mariappan 10

FEATURE Legal Aspects of Good Governance in Christian OrganisationsAdv. Ms Tanuja M Kolhatkar 14

FEATURE Leadership: The Anchor for Progress of Nursing Profession Mrs Sheetal Samson C Pottety 17

SPECIAL FEATURE EBOLA, The Deadly ChallengeEbola Virus Disease (EVD)Dr Nayana Harrison 20

CMAI ANNOUNCEMENT 22

FROM OUR ARCHIVES 23

HUMAN RESOURCE 23, 27, 28

INSTITUTIONAL FEATURE 100 Years of Jorhat Christian Medical Centre also known as ‘The Mission Hospital’ Dr Esther Liani 25

HUMOUR 28

SPECIAL FEATURE Christian Response to Health and Development Dr Ronald Lalthanmawia 29

SPECIAL FEATURE Summary of Roundtable for EBOLA Preparedness Dr Priya John 33

BOOK REVIEW Business as MissionDr Nitin Theodore Joseph 36

OFFICE BEARERSPRESIDENT: Dr Sudhir Joseph, Director,St Stephen’s Hospital, Delhi

VICE PRESIDENT: Mrs Punitha Ezhilarasu, Prof. & Head, Dept of Medical Surgical Nursing Dept. and Dept of Continuing Nursing Education & Research, CMC, Vellore

TREASURER: Ms Vijaya Kumari Mure Memorial Hospital, Nagpur

EDITOR: Dr Nitin Joseph, Medical Superintendent, NM Wadia Hospital, Pune

GENERAL SECRETARY: Dr Bimal Charles

COMMUNICATION ADVISORY COMMITTEE:

Dr Sudhir Joseph, Dr Nitin Joseph Dr Bimal Charles, Dr Shobhana Bhattacharji, Dr Nittin Parkhe, Ms Latika Singha, Mr Jacob C Varghese, Mr Prince David, Rev Sweety Helen, Mrs Shirley Jacob, Ms Sushma Ramaswamy Ms Anuvinda Varkey, Ms Jancy Johnson Mr S Jacob Bernard, Dr Ronald Lalthanmawia, Dr Abhijeet Sangma Mr S Paul Raj, Rev Sharath C David

EDITORIAL WORKING GROUP: Dr Nitin Joseph, Dr Bimal Charles, Ms Jancy Johnson, Mr S Jacob Bernard, Dr Ronald Lalthanmawia, Dr Abhijeet Sangma, Mr S Paul Raj, Rev Sharath C David

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Rev Sharath C David

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Good

LETTERSTO THEEDITOR

LETTERS / ARTICLES FOR CMJI

We invite your views and opinions to make the CMJI interactive and vibrant. As you go through this and each issue of CMJI, we would like to know what comes to your mind. Is it provoking your thoughts? The next issue is on the subject “ Information on Communication Technology”. Share it with us all. This may help someone else in the network and would definitely guide us in the Editorial team. E-mail your responses to: [email protected] Articles of humour, cartoons etc. are welcome.

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submitted in soft copy format. The soft copy can be sent by e-mail; alternatively it can be sent on a CD by post. Authors may please mention the source of all references: for e.g. in case of journals: Binswanger, Hans and Shaidur Khandker (1995), ‘The Impact of Formal Finance on the Rural Economy in India’, Journal of Development Studies, 32(2), December. pp 234-62 and in case of Books; Rutherford, Stuart (1997): ‘Informal FinancialServices in Dhaka’s Slums’Jeoffrey Wood and Ifftah Sharif(eds), Who Needs Credit? Poverty and Finance in Bangladesh, Dhaka University Press, Dhaka.

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ADDRESS FOR COMMUNICATIONHead – Communication Dept.CMAIPlot No 2, A-3 Local Shopping CentreJanakpuri, New Delhi 110 058Tel: 011 2559 9991/2/3Email: [email protected]

Dear Sir,

Greeting from Asha Kiran Hospital, Lamtaput,Odisha. Sir I am Somini working as a counsellor cum chaplain. I have read about your articles in the CMJI journal about the topic of Adolescence. Do you conduct any trainings or conference about this topic. I have been dealing with this age group quiet often. I would like to get some skills about

this topic. could you please give us some information.

If you have any materials on this topic kindly share with us also.

Thanks

Somini.

Dear Sir

Thank you CMAI for bringing an issue on Adolescent Health. Since this was informative and helpful to deal with my two young sons, friends and nephews who are facing adolescence.

The article - ‘Everything comes not from the father…Adolescents low risk perception’ was excellent and also the ‘Youth Flair’ was very thought provoking topic which takes us to the biblical time and characters.

This is definitely useful for me with young people in the Church, hospital, young women who need lot of guidance during this stage in their life.

Please produce more thought provoking CMJIs like this.

Thanking you

Dr Jayem Juliet

EDITORIAL

Dr Nitin Theodore Joseph

Dr Nitin Theodore Joseph

Good Governance and Achche Din were the catch words used by our Prime Minister during the recent Lok Sabha election campaign. Although they now seem to be replaced by Swach Bharat, the link between Good Governance and Good days cannot be overemphasized. The PM has proposed that Mr Vajpayee’s birthday should be observed as “Good Governance Day”, and by a divine coincidence his birthday is on December 25th! Good Governance is the key to establishing and maintaining a healthy working environment in the work place.

A study titled “Sustainability of Church Health Care in India” was done by Dr V Aruldas, P Zachariah and S Awale on behalf of CMAI in 1997, in which 6 hospitals (2 each from the northern, central and eastern regions) were evaluated in great detail. Based on this study the determinants of sustainability were concluded to be - Constructive Governance by a capable Governing board without undue interference, good quality of administration, proactive management, a clear definition of the institutions’ vision, and practices which help to nurture this vision. A large number of mission hospitals have shut down in the last 60 years and those which have survived thus far are facing increasing challenges on a daily basis. If the reasons for this downhill trend are carefully analysed I am sure Governance would be a major factor in most cases.

The Bible emphasizes Good Governance literally from its first page! After being satisfied with His Creation God, having created Man in His own image and likeness set him as a steward of all the Creation, “Be fruitful and multiply; fill the earth and subdue it; have dominion…..” (Gen.1:28). Man was placed as the CEO of God’s creation but sadly Man did not comply with the mandate given by his “Appointing Authority” and so had to pay the heavy price for his disobedience. Moses got a

wonderful lesson on delegation and empowering the people from his father-in-law Jethro. Several Biblical characters like Joseph, Nehemiah, Daniel and Esther demonstrated great courage and gumption when they were required to take a difficult stand in adverse situations. Jesus trained 12 people who were illiterate, with diverse and questionable backgrounds, were impulsive, ambitious, radical and also cowardly! He used them to “turn the world upside down!” Jesus the CEO also pioneered the concept of Servant Leadership and Good Stewardship.

This issue is dedicated to address what we face daily in running a nonprofit, faith based enterprise, in addition to the ever growing competition from the corporates. We have to also comply with stringent government regulations and have to often walk a tight rope. The articles on Finance & Legal issues are very practical and relevant to the contemporary times. EBOLA has emerged as the latest threat to us and though still largely confined to West Africa, it has entered the USA and also the shores of India. I have reviewed a book titled Business As Mission that I strongly recommend. Let us all become BAMers, using Kingdom values coupled with professional excellence to steward our professions and institutions in a way that God expects of us.

As we draw to the close of yet another year it is a good time to reflect on the challenges and blessings of 2014 and look ahead to 2015 with the hope that God will continue to steer and guide us with His grace and love. I wish you all a very Blessed Christmas and a Christ-centered New Year! The centre verse of the Bible is, It is better to trust in the Lord than to put confidence in man (Psalm 118:8)

“GOOD GOVERNANCE”“GOOD GOVERNANCE”

4:: VOLUME 29 NUMBER 3 :: CMJI

Taking responsibility and making decisions and owning decisions are critical to any leadership which will result in good governance. The Bible says a country becomes fortunate when its leader is able to govern it well which results in a smooth functioning of a state where the quality of life becomes better enhanced in the midst of challenges and difficulties. This result in peace, prosperity, comfort and life become pleasing and worthy of what God intends for his people.

At times to give good governance initially the road can be rough as it needs to be dug and paved but ultimately it results in good infrastructure for smooth functioning of a nation, state, organisations, communities, and family.

The Bible talks about good governance that is realized, when leaders make good decision

understanding the context. Such are leaders who are experienced, wise, strategic, controls and considerate in taking decisions. The leader who is in the lime light, who is in control and willing to take risks in deciding, can make a difference in governance. The highlight of the verse is, the leader must make own decisions, eat at proper time, control himself, and avoid getting drunk.

Make own decisionsA benevolent leader uses the intelligence gathered, makes own evaluation and then takes decisions.

“A country is fortunate to have a king who makes his own decisions and leaders who eat at proper time, who control themselves and don’t get drunk.” Eccl 10:11 (TEV)

Marked Leaders

The leader who is in the lime light, who is in control and willing to take risks in deciding, can make a difference in governance. The highlight of the verse is, the leader must make own decisions, eat at proper time, control himself, and avoid getting drunk.

BIBLICAL REFLECTIONS

Rev Sharath C David

CMJI :: VOLUME 29 NUMBER 3 :: 5

It is not from borrowed ideas, pre-conceived notions or prejudices but more original from an objective platform and on the spot analysis considering others as human beings created in the image of God. The leader also studies the issue quickly and makes objective evaluation of issues, self-evaluation using the grace of God in every situation while implementing decisions and thus enables God to give His wisdom. When the leader takes a decision, he owns and he takes responsibility for it.

When at times leaders don’t take own decisions it may be because of fear of backfire, facing criticisms from others. The onus of responsibility stays with the leader and decision making must not be outsourced. A true leader will not allow this to happen and will always lead from the front taking responsibility for the decisions.

The wise man Solomon knew the importance of God in decision making, to give good governance. It is the wisdom God endows one with, to take the right decisions and have courage to stand by them even if it backfires.

The leader can be proud of his decision making power which God has gifted him because God who is with him gives His counsel and advises to take the right decisions and to take the right route in traversing through problems and issues. The implication is to own decisions and know that leader needs God’s counsel and guidance to give good governance.

Eat at proper timeAll this converges to say that, a leader who is a man/woman of God who is disciplined, systematic, organized, scientific, and pragmatic and maintains time. When decisions are made in the right time one will have an extra bit of time to manage and do things well.

Eating at proper time is one such observation of others, doing things rightly at the right time, this is the litmus test for leaders offering good governance. It is an art of managing affairs within the time frame. This includes the affairs of the public and personal life. “The proof of the pudding is in the eating”.

When do we do justice in managing affairs, issues of life both in public and private, official and personal? The fine balance in those areas is to prioritize, have clarity in affairs to justify the time spent and on those that make a difference. It is a delicate balance of personal and public life. It also tell the world how the leader is organized and thorough a person can be distinctly manage many things yet does not get influenced or succumbed to issues, situations and personal interests.

A leader who delegates work to others and learned to share work and responsibility can do much more above all and have extra time to go an extra mile.

The secret is to have food on time every time and is to practice the knack of delegation and then getting maximum work done by others. This does not mean that, one must relax and evade tasks. The art of delegation is to allow others to contribute and complete the work, instead of carrying the whole load by oneself.

A confused leader can bring more confusion and can create chaos and disinterest and stray away from focus. Clarity in issues will bring in strengths that others could contribute to do good governance. Even when one team member pulls in different direction and does not understand

their role it can lead to unsatisfactory results. The worst is when there is corruption and lack of integrity which can cause much damage and destruction. The sin of Achan caused the whole army of Israel to lose a battle for Ai and made the people to fear and retreat thus lose courage complete tasks. (Joshua 7:5, 20) Selfishness and ego are a big stumbling blocks in a democratic setup for good governance. In dictatorial form of governance subordinates plot and make opportunity take power by force or make the situation vulnerable due to uncertainty in the governance.

Eating in time can relax and make the leader feel at ease and feel better organized that he can accommodate and enjoy even a small event of a day like having meals on time. This is a sign of a well-organized leader with good governance capabilities.

Relax at all times so you feel hungry at right times and eat your meal peacefully. This is what Solomon the wise manager says about good governance, time and event management.

Control themselvesReceipe for good governance is all decisions made with objectivity, subjectivity and control over situations and problems. All three are like gears in a moving car that moves the object go forward as it functions



smoothly. In normal governance the leader provides dynamics from the all sides leading people into a bright future.

An objective bound leader doesn’t take sides or have personal biases. When objectivity is realized in management you will have more and better control. Non-interference from others even relatives and resorting to more goal oriented activities the prime aim.

An important aspect in the life of leaders is not to forget that they live for others. They make decisions for the good of others. It is also a reminder that leaders are selected, chosen and called by God to serve the people of God.

The main control rests and comes from God, though God shared and delegated His power and control with leaders and the people. He is the ultimate source of control of distribution of good governance of the whole universe.

They are appointed by God to maintain quality of life and wellbeing of individuals.

At no time they can lose control over what they are made in charge of. God who has called and chosen the leader will preserve their territory and area of influence.

A leader need not be an ideal person but he should be conscious of his weakness and shortcomings. An ideal leader must follow the principles and values of Christ and His kingdom practices and fears of God. Such people will have control over situations, people and events.

Do not get drunk:A leader should not get influenced by some external force and use substances to feel good and lose control over oneself and make a mess in governance. Good governance is the outcome of a person’s power and strength to ward of situations and the ability to avoid people, situations and substance

that are addictive which would give false judgment, courage, and strength. A leader who does not yield to alcohol and its effect is paramount for making significant governance.

A leader who takes refuge in alcohol to evade problems and issues will lead to a predictable end. Dependence on alcohol leads to a temporary relief and a grandiose behavior, thus being anesthetized to understand the real situation and context.

Such a leader believes in falsely fabricated stories and makes decisions which can be grossly wrong and misleading.

Alcohol also disconnects a person from God and makes him vulnerable to other forces of power leading to disaster, decay and destruction. Then he is handed over to the vultures to be devoured and decimated. Alcohol disconnects a person from reality and makes him selfish that he becomes self-centered leading to self-destruction

Alcohol can make one bury their talents consciously and cause one to be helplessly hopeless. It gives a capsuled environment and blinded to see issues in its enormity and wholeness.The cause and effect of an alcoholic in leadership can be disastrous and may end prematurely such a leader will be remembered for the worst governance ever provided.

In conclusion the wise man Solomon reiterates that there are certain qualities and characters that are necessary to become a marked leader. All he sees is the vision of nation that is blooming with good things due to good governance. A good leader is there to take a nation, state, family, organisation go forward with the help of God. The vision is to let nations prosper and bear good fruit to have life that is blessed. God is remembered, worshiped and glorified in all this.


Alcohol can make one bury their talents consciously and cause one to be helplessly hopeless. It gives a capsuled environment and blinded to see issues in its enormity and wholeness.

Rev Sharath C David is the Secretary of Chaplains Section

It is also a reminder that leaders are selected, chosen and called by God to serve the people of God.


The Collins Dictionary defines `govern’ as “to direct and control the action, affairs, policies, functions etc. (of an organisation, nation etc)”.

What is governance?

“Good governance is perhaps the single most important factor in eradicating poverty and promoting development (UN 1998). So the outcome of governance is the welfare of all citizens,” observes Kofi Annan, former Secretary-General of the United Nations.

‘Governance’ refers to the manner a country’s affairs at all levels are managed through the exercise of economic, political and administrative authority. The governance set-up consists of various processes and institutions through which citizens and groups, exercise their legal rights, meet their obligations and resolve their differences. The term governance was first used by World Bank in 1989 in the context of Sub-Saharan Africa to ensure change and reform while receiving aid. The World Bank defines governance as “the manner in which power is exercised in the management of a country’s economic and social resources for development”. (Governance for

Sustainable Development, 1997, UNDP)

When the people of a country become the centre of development, and when the values of ‘inclusiveness’ and ‘accountability’ are fulfilled for them, then the country can be credited with having ‘efficient’ or ‘good’ governance.

The United Nations Development Programme (UNDP) has classified the essential characteristics of good governance which include Participation, Rule of Law, Transparency, Consensus orientation, Equity, Efficiency, Accountability and Strategic vision respectively.

Everyone - men and women - must have a voice in decision-making, either directly or through legitimate intermediate institutions that represent their interests. Everyone should have easy access to Rule of Law which should be fair and enforced impartially, particularly the laws on human rights.

The concept of transparency is built on the free flow of information. Processes, institutions and information should be directly accessible. Good governance

Good Governance in Christian Organisations

‘Governance’ refers to the manner a country’s affairs at all levels are managed through the exercise of economic, political and administrative authority.

Everyone - men and women - must have a voice in decision-making, either directly or through legitimate intermediate institutions that represent their interests.

FEATURE

Rev Dr Tomi Thomas


should mediate differing interests in order to reach a broad consensus on the best interests of the group and, where possible, on policies and procedures.

People should have equal opportunity for growth and to maintain or improve their well-being. Processes and institutions should produce results that meet the needs while making the best use of resources.

Decision-making in government, the private sector and civil society organisations should be accountable to the public as well as institutional stakeholders. Leaders and the public should have broad and long-term perspectives on good governance and human development together with a vision for action. The vision should in due course translate into reality. (Source: Good Governance: An overview, International Fund for Agricultural Development)

The above-mentioned factors that can make or break governance are absolutely essential. It is quite natural that governments may face various limitations and compulsions and may fail to comply with the above-mentioned aspects. The effect of such a state will be evident in the many scams and scandals that may be exposed or the absence of rule of law or the violent happenings like crimes or riots a country witnesses.

People and governance

Healthy relationship between governance and people is crucial for building a strong nation. The two held in fine tension would be key both for its people in particular and the country in general. The availability of a progressive Constitution and well-organized legal framework help to ensure that good governance becomes a reality contributing to the welfare of people.

Recently, when our honourable Prime Minister asked the public to clean up their surroundings to make `Swachh Bharat’ (Clean India), he was tasking the citizens with responsibilities in governance. “The citizens, too, should have a sense of responsibility in good governance”, said an officer in the government.

A concrete activityGovernance is a concrete activity carried out by a formal or informal organisation. If the organisation is a formal one, governance is primarily about what the relevant ‘governing body’ does. If it is informal, such as a market, governance is primarily about the rules and norms that guide the relevant activity. Whether the organisation is a geopolitical entity (nation-state) a corporate entity (business entity) a socio-political entity (tribe, family) or an informed one, its governance is the way rules

FEATURE


and actions are produced, sustained and regulated.

Politics differs from governance. Politics involves processes by which a group of people (having divergent views and interests) arrive at collective decisions binding on the group, and enforced as common policy. Governance conveys the administrative and process-oriented elements of governing.

Governance in the BibleJesus acknowledged the structures of power as valid. He told his disciples, “The scribes and the Pharisees sit in Moses’ seat. Therefore whatever they tell you to observe, observe it and do it. (Matt 23:2,3), and again he said “Give to Caesar what is Caesar’s” (Matt 22:21) on the other hand, he also set limits. “But do not do what they (Pharisees) do, for they do not practice what they preach’ and ‘Give to God what belongs to God”. It is clear that Caesar does not have a say over that which belongs to God. The general assumption in the Earliest Church is that “the government rewards those who do right and punishes those who do wrong.” (Rom 13: 1-5).

Jesus’ use of phrases like the “Kingdom of God” and “the Church” were powerful reminders that his people were called to demonstrate alternative style of governance. So he said to them “the kings of the Gentiles lord it over them, and those who exercise authority over them call themselves ‘Benefactors’. But you must not to be like that. Instead, the greatest among you must be like the youngest, and the one who rules

Rev Dr Tomi Thomas, IMS, Director-General, The Catholic Health Association of India, Gunrock Enclave, Secunderabad

like the one who serves” (Luke 22-25). ‘You are not like that’ – both the structure and the style of governance in the community of God is different.

Most of the references in the Bible on governance are limited to its practice in the Church. Peter reminds the elders ‘to shepherd the flock of God’ and encourages them that “when the Chief Shepherd appears, you will receive the crown of glory, that will never fade away”. (1 Pet 5:4) The principles remain the same. Governance is entrusted by and therefore accountable to God. Good governance means ensuring a just and compassionate society. (Courtesy: Drishtikone, Issue 3 2013, page 9)

Advantages of good governance

Whether it is the state, public office, or private Institution, or organisation, delivery of good governance should be the ultimate goal. Transparency and accountability are the twin concepts which help to provide efficient governance. Both are mutually reinforcing. Without good governance development of any sort is impossible. Corruption which has become a universal phenomenon can be checked through participation, transparency, accountability and probity in administration. All the citizens of a country or the members or constituents of an organisation or institution have the right to good governance. Addressing concerns of the members is an important part of good governance.

Efficient or good governance provides better service to people once people

are satisfied with the service their commitment to the organisation increases. Financial sustainability, an offshoot of good governance, is crucial to any organisation without which it may fail to function. Better service and financial sustainability together help to win people’s trust which is indispensable for running an institution successfully. These days there is e-governance, an effective tool that helps in making governance visible, corruption free and effective.

Religious and other non-profit organisations have a responsibility to their various constituents to be fiscally responsible and transparent in carrying out their mission. Financial support is received by non-profits in the form of tithes, pledges and donations. So they need to be prudent in their activities and efficient in their administration. Through documenting their policies and procedures and they can make their governance transparent. Good governance is indispensable to Church Ministries whose organisations are related to the work of Jesus Christ. It is the name of Christ that is at stake as regards governance. (http://www.freepatentsonline.com/article/Academy-Accounting-Financial-Studies-Journal/182468626.html)

Financial sustainability, an offshoot of good governance, is crucial to any organisation without which it may fail to function. Better

service and financial sustainability together help to win people’s trust which is indispensable for running an institution successfully.

[ ]FEATURE


Introduction

When we are living together every one is expected to follow a set of rules and regulations which are governed to ensure harmony, happiness, satisfaction, safety and security. Is it all being achieved? The answer is very simple, we desire to live together to take more than what deserve. It is because they are not accountable to their actions and not ready to take the accountability. This paper tries to bring some understanding about accountability particularly in financial aspects of the organisation.

Accountability an overview

Accountability is defined as “being called to account for one’s actions”. The word accountability derived from Latin – computare, which is also the root of the verb “to compute”. Computare is the compound of com, which means together, and putare, which means to count, reckon, consider, as well as to settle (an account).

The words ‘accountability’, ‘accountable’, ‘account’ and ‘accounting’ have the basic root of financial accounting. It is nothing but accounting of accounting

records. However the concept of accountability has been spread across all disciplines with broader meaning with strong emphasis on truthful action. Accountability shall exist with only good governance and implementing rules, ethics and moral values with right practices.

Accountability is a generic term which can be suffixed with different contexts, for example political, social, environmental, administrative, financial, educational, legal, judicial, etc.

Further accountability can be explained as the obligation of an individual or organisation to account for its activities, accept responsibility for them, and to disclose the results in a transparent manner.

It also includes the responsibility for money or other entrusted property (David J. Hunter, 1992). Oxford dictionary defines “accountable” as one required or expected to justify actions or decisions; explicable or understandable.

Therefore accountability has two sides one is being accountable or answerable (accountee) and the other is seeking accountable or asking questions (accountor).

Financial Accountabilityin Healthcare Organisations

Accountability is a generic term which can be suffixed with different contexts. For example political, social, environmental, administrative, financial, educational, legal, judicial, etc.

Dr M Mariappan

FEATURE


Financial accountability in healthcare organisationsIt is understood that accountability was primarily emerged from financial transactions which brings out four key questions such as “of whom”, “for what” “to whom” and “how”. In healthcare organisation the accountors are owners, patients, donors, funding agencies, etc. The accountees are the managerial staff, healthcare providers, and other staff who involved in running the hospital or healthcare organisations.

The major responsibility of hospital is to answer the questions of public or the various stakeholders. Here the major challenges are healthcare organisation is complex whereas different kind of people operate in the systems. How do we understand the accountability and who will be the primary target for accountability measures? Therefore accountability lies with organisation’s rules and procedures, which provide an accountability framework at the highest level. This calls for financial accountability system, which consists of different mutually related elements/mechanisms of financial accountability.

Financial Accountability System

The elements of financial accountability are:

i. ensuring honesty in dealing with money including appropriate records and documents and at most care is taken to avoid mistakes and fraud;

ii. good governance and sound policies;

iii. establishing right mission and strict to the mission; and

iv. demonstrating purpose of the organisation incase charitable

institution it should show charity’ effectiveness, or incase of profit oriented organisation should show value for money (service worthiness).

Financial accountability systems should be very strong and sound so that it can provide better effectiveness of financial accountability. Good financial accountability systems demonstrates certain traits such as

1. Effective control mechanism: Evidence and Auditing

Accountability cannot be treated isolated trait without having any formal mechanism of verification. Therefore it becomes essential for the ‘accountor’ to maintain appropriate evidence (verifiable) for the action being carried out and the same is verified by appropriate agency. Here the evidence can be voucher, bills, receipts, correspondence, cheque and bank transactions, books of account, financial statements, etc. In this case auditing becomes one of the most important components to ensure the presence of accountability in an organisation. Auditing can be internal as well as external. It is better to have both in the organisation so that at every level accountability can be ensured.

How do we understand the accountability and who will be the primary target for accountability measures? Therefore accountability lies with organisation’s rules and procedures, which provide an accountability framework at the highest level.

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It is seen majority of the organisation try to maintain such mechanism, but it is not enough to prove due to inadequate practice of accountability. It means that accountability goes beyond certain formal financial systems. It is important to bring the concepts such as internal and external accountability, compliance and performance accountability, managerial, financial process and program accountability, individuals or groups that are in a position where they are held accountable for their behavior as accountors and individuals or groups that are receiving this information and judging the appropriateness of actions as accountees. Transparency is understood here as “a mechanism of accountability; to cast light upon what would otherwise remain obscure or invisible” “All key economic assumptions should be disclosed explicitly.” (DoratheaGreiling and Katharina Spraul, 2010)

2. Good Governance practices: self-regulations and adherence to performance evaluation

Good Governance means organisation develops its own ethical and moral values in which it brings out self-referential with trust. Also the organisation should treat distrust of stakeholders with regard to financial affairs of the organisation as one of very important indicators to measure its performance. It is observed many Indian Healthcare organisations have significant potential to establish appropriate

governance, accountability and performance monitoring systems. Further one of the main components of good governance is gap between regulation and practices. It is very much evident that we have so many laws in the country; these are neither implemented nor ignored. As a result there is culture of over ruling laws and ignoring good practices. Majority of the people do not even recognize the moral and ethical values.

3. Professional accountability

The present financial accounting standards which are part of the Generally Accepted Accounting Principles have been augmented by managerial and professional accountability requirements in India and other countries. These standards are very much in force with all private and charitable hospitals in the country. But it is not enough to achieve good governance practices. The accountability and governance mechanism linked with the cultural values of the respective organisation is most important. Further the organisational practices such as legality, integrity, efficiency, effectiveness, involvement, transparency and fairness, is an important factor are part of good governance. Also an organisation should ensure better performance management in relation with organisation goals and objectives and in the context of financial accountability (DortheaGreiling and ArieHalachmi, 2010).

4. Quality of output to stakeholders: quality and responsiveness

One of main focus of financial accountability systems is to ensure that accountability linked with quality improvement in the hospital. It means all efforts are directly connected with cost therefore it is important quality efforts bring better benefit to stakeholders (Eugene Bardach and Cara Lesser, 1996). The other important notion is that in terms of responsiveness of providers and opportunities extended to patients to voice their problems. It is very important to note that financial accountability to make sure quick decisions in terms solving the problems of patients which may cost to the organisation (Paolo Novak, 2007).

Discussion

Many times we may feel that accountability and other concepts like responsibility, liability, and control are one and the same. But actually accountability is much different from all these concepts. Also it is necessary to differentiate these concepts from accountability as much as possible. It is because each concept brings specific meaning in it. For example, the word responsibility is backed with authority, power, autonomy in decision making, etc. under legitimacy but accountability is “to behave rationally and reliably and with consistency and trustworthiness in exercising internal judgment”. On

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Financial Accountability Framework

Ownership forevery financialtransactions

Actions results out of financial transactions as productive and judicious

use of resources

Accepting consequences or outcome out of transactions under not only verifiable conditions but also conditons claims to prove

moral and ethical values


the other hand the word liability is an obligation to fulfill certain prerequisite also ensures the organisational practices are free from malpractice or misconduct. Although the concept of accountability shares some of the features of liability, it ensures answers to what was done, offer justifications and provide assurance of doing work appropriately. Further the word control very much relevant to financial management, it provides an opportunity to measures the performance and offers ways for intervention. However accountability does not go with very rigid like control. In fact accountability denotes the complex and stable relationship which exists between two actors (based on delegation of duties), while control denotes a process which aims to ensure that things are done in the way it was required and that expected standards have been met.

Financial accountability is about responsible stewardship for the use of money. It is to ensure the money is

REFERENCES1. David J. Hunter, 1992, “Accountability and the NHS”, British Medical Journal, Vol. 304, No. 6824, pp. 436-4382. DoratheaGreiling and Katharina Spraul, 2010,Accountability and the challenges of information disclosure, Public Administration

Quarterly, vol. 34, no. 3 (fall 2010), pp. 338-3773. DortheaGreiling and ArieHalachmi, 2010 “Accountability and Governance Issues: Introduction to Country Studies” Public

Administration Quarterly, Vol. 34, No. 4 pp. 442-4484. Eugene Bardach and Cara Lesser, 1996 “Accountability in Human Services Collaboratives: For What? And to Whom?” Journal

of Public Administration Research and Theory: J-PART, Vol. 6, No. 2, Symposium on the Hollow State: Capacity, Control, and Performance in Interorganisational Settings, pp. 197-224

5. Paolo Novak, 2007“Accountability to Whom?” Economic and Political Weekly, Vol. 42, No. 30, pp. 3172-3177Published6. Elizabeth K. Keating and Peter Frumkin2003, “Reengineering Nonprofit Financial Accountability: Toward a More Reliable

Foundation for Regulation”, Public Administration Review, Vol. 63, No. 1, pp. 3-15

being used in a responsible manner only for the said purpose which makes beneficial to the organisation. It is also part of adherence of legal, regulatory and verifiable mechanism. Further financial accountability has very important role to ensure value for money which has been placed as input to any action or the resources being employed. It is clear that financial accountability brings honest, sincere and dedicated practices in dealing with money. Further it makes sure that there is no opportunity for fraud, cheating and mishandling of money for personal and wrongful purposes.

ConclusionThe concept of financial accountability is very complex in nature. It can be brought into the practices by inculcating right culture, appropriate accounting process, accounting systems and procedures and auditing systems. There is a need for strong network of internal and external financial accountability

mechanisms, including adequate accounting records, reporting and internal and external auditing. Apart from this it is necessary to create sense of feeling among those who deal with finance to use the resources, and money with carefulness for appropriate actions. There are two very important things such use of money for right purposes and ensuring value for the money. Financial accountability means not only very honest but also very efficient to ensure organisational success, sustainability and long term growth and development.

[ ] It is clear financial accountability brings honest, sincere and dedicated practices in dealing with money. Further it makes sure that there is no opportunity for fraud, cheating and mishandling of money

for personal and wrongful purposes.

Dr M Mariappan is the Chairperson of Centre for Hospital Management, School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai

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I. Christian organisations should be models for good governance

The meaning of good governance is about the process for making and implementing decisions. It is not about making correct decisions but about the best possible process for making those decisions.

All have a positive effect on various aspects of management, practices, procedure, service quality conduct and good working relationship.

In any given Christian organisation it is observed that they are established in the pre-independence era and follow the age old pattern of running the organisation. With the development of law, post independence period the organisations do not necessarily subscribe to those laws and there is a total ignorance about them.

The Judgments of the Apex Courts as well as one High Court spells out that through certain organisations outside the purview of different acts still most of the laws are applicable to all the organisations.

Indian labour laws date back to the beginning of the 20th century where the Social Security legislations like

the workmen’s Compensation act 1923, the Trade unions act 1926 the Payment of wages act and then followed by the welfare provisions under the Factories act, the Minimum Wages act and the Industrial Employment standing Orders act, The Payment of Gratuity Act, The Employees Provident Fund, the Maternity Benefits act , the Payment of bonus Act , The Industrial Disputes act whose immense protection is given to the workmen (employees)

As we would find in any other organisation the Christian organisation should

1. Punctuality- It should not be IST (Indian Stretchable time). Reporting on time, maintaining of leave record and formulating service rules suitable to the organisation. Service Rules should be informed to the employees.

2. Equality in the management of the organisation. Fair chance to both the sexes than it being a male dominate affair.

3. Effectiveness and efficiency needs to be looked into as it is observed that one denomination, one language, one individual

Legal Aspects of Good Governance in Christian Organisations

Adv. Ms Tanuja M Kolhatkar

The Judgments of the Apex Courts as well as one High Court spells out that through certain organisations outside the purview of different acts still most of the laws are applicable to all the organisations.

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and his descendents are looking after the organisation despite his capability.

4. Effective planning and non wastage of resources therefore leading the organisation from a mediocre working organisation to a standardized establishment.

5. Subscribe to sustainable and targeted development, timely qualitative interventions in various development activities through partnership with like-minded institutions and government agencies.

II. The organisation has to comply with all statutory procedures required by law during appointment of the employers.

If there is a clear vacancy on application for employment should be sought from the candidate prior to the interview and then an appointment either as a Probationer

or a temporary or permanency be given. The duty list of the expected responsibility should also be given.

At the time of appointment the original birth date and birth certificate duly attested should be obtained. As

the Apex Court is very clear about the change of birth at the time of retirement of any employee.

If an organisation has offices or sub offices situated at different place within one state or in the country the application for appointment should spell out the clause of transfer and that the service conditions would not change and the financial aspect of his service would stand protected.

Usually it is expected in establishments with a large strength an agreement needs to be signed with the employees by protecting their services conditions however, it has to be done with the financial capacity and the paying capacity of the employer.

In case of a project employee or appointment for a particular duration the period needs to be specified.

The availability of residential quarters if provided should be specifically granted only during the period of service with automatic

vacation of quarters after retirement or termination of service.

The employer should be given intimation about his superannuation/Retirement with a specific clause of vacation of quarter immediately.

The Scale or salary with all the facilities like Basic +DA+HRA other allowances need to be informed to the employee.

Overstaying of leave, unauthorized leave, and misconduct under the standing orders call for strict disciplinary action by issuance of a show cause notice, charge sheet conducting domestic enquiry during which employee could be suspended with 50% subsistence allowance in the first 3 months, 75% in the next month and 100% after 6 months. Payments of subsistence allowance is mandatory as it is the survival allowance for the employee during that suspended period.

Sick leave has to be applied for with a Certificate of the doctor in certain organisation a panel doctor and upon the fitness certificate given. Then only employee should resume duties.

In most of the case it is observed that the employees’ personal data or the maintenance of record is the last on the priority list. This leads to immense complications when any legal issue comes up for consideration.

Time and again legal expertise be sought for though the issue grow up into a huge monster. In case of PF the matching contribution of the employer-employee@ the rate of……% be deposited in the PF Account of the organisation. In case the organisation does not have code it is expected to have one by applying

for it and make regular payments.

Incase of the payment of gratuity the employee becomes entitled to Gratuity after completion of 4.5 years of continuous serious and it is calculated year service.

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Gratuity cannot be withheld for any reason whatsoever unless the employee has committed a fraud or there are exemptions under the act.

The organisations have to subscribe to safe working in the premises’. Any accident during the course of employment is covered under the Employees Compensation Act (earlier workmen’s compensation act)

The death of an employee results in payment of compensation of as per the Schedule provided in the act. In case of partial and total disablement also the organisation is required to deposit payment as provided in the Act and the loss of earning capacity (%).

The payment in case of death or disability has to be made before the commission for employees’ compensation act where the incident has occurred. Any payment made outside the court is not taken into account.

In case of hospitals which are running in shifts, overtime allowance at the doubt rate of salary should be paid. No employee should work for more than 48 hours in a week. In case of emergency when the employee has worked or working on public nowadays compensatory off should be granted.

In organisation where women employees are employed the Sexual harassment of Women at Workplace (prevention and prohibition and redressal act 2013) come to the rescue of women. An internal

committee with a presiding officer who is a senior lady at workplace and two other members from employees or social work or legal knowledge should constitute the Committee. It is expected that the management should provide with awareness of the consequence of harassment as Sexual Harassment is a misconduct.

In addition to these, the organisations should subscribe to healthy relations with its employees to avoid unionization and invite unnecessary litigation. It is essential to channelize different departments; plant heads of different departments conduct meetings at regular intervals and delegate responsibility and control.

Upgradation of the overall data of the establishment, computerization department wise, strict action with the employees in case of default,

avoiding favoritism and partiality to a few employees, planning of the organisation but avoid wastage of expenses on meetings without timely implementation of the decision.

Adv.Tanuja Kolhatkar, BSL, LLB, is a practicing advocate and labour law consultant in the Labour & Industrial Court in all major cities of Maharashtra. She is a panel member on the Ethics Committees of many hospitals.

Effective implementation and result oriented programmes be chalked out for better services to be rendered to the society collaboration with government organisation with different facilities available with government for minorities and non-profit organisation.

Encouraging and employing out of community employees to accept the challenge to sustain the high competitive would especially our educational and medical institutions. Under qualified staff should be discouraged thereby leading to the downfall of the standard of the organisation.

The organisation should plan their limited resources wisely and should plan their extremely calculative to ensure satisfaction amongst in the staff and additional facilities should be produced in the pay packet which would attract the employees to continue working in the organisation and work efficiently.

Welfare facilities though not being a factory could be provided like crèche, lunch, Relaxation lawns for moment transport, residential quarters or rent houses to discourage discontent.

Heads of the Institutions should be ably qualified with rich experience in management to control the organisation effectively.

Encouraging and employing out of community employees to accept the challenge to sustain the high competitive would especially our educational and medical institutions. Under qualified staff should be discouraged thereby leading to the downfall of the standard of the organisation.

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In case of hospitals which are running in shifts, overtime allowance at the doubt rate of salary should be paid. No employee should work for more than 48 hours in a week.


Introduction

Today, leaders who influence, guide, opine relevantly and take timely action are most sought after. The very fundamental role of a leader in standing ahead of a situation or issue, moving forward defying the blocks on the way, taking risks for the benefit of a group and challenging the status –quo makes even a novice leader a wanted person! However the ultimate criterion is Christ-like leadership which is the most honouring to God and benefits all mankind. If nurses, the key players in the health care team, envision progress, they ought to pay serious attention to the imperative role of a Nurse –leader and sincerely consider their calling to serve as well as to lead. Dignified nurse- professionals, it’s time to peep within.....but deep within!!

Need to prevent a drift

Nursing in India, when seen from a standpoint of professional dignity, continues to face the social disparity and a discriminating comparison in face of its other health-care related counterparts viz; Medicine, Dentistry, Physiotherapy etc. Despite the subtly expected or demanded ‘followership,’ from nurses, nursing stands on the brink of another spurt of advancement and progress when taken into consideration, the nature of majority of

health concerns related to life style, increase in need of compassionate, palliative care and essential health information on disease prevention and health promotion and above all quality time given to consumers of health care without which there is immense dissatisfaction as well as incidences of medical negligence. In light of this scenario, its right time for nursing to repossess its autonomy within the practice of nursing, and replenish its role as an equal collaborator with other health professionals in the planning, delivery and evaluation of health care.

Essentials to prevent a drift“Every kingdom divided against itself will be ruined and every city or household divided against itself will not stand” [Matthew 12:25]. Irrespective of the cadres,

Leadership: The Anchor For Progress Of Nursing Profession“Leadership is a heart-warming privilege but also a painstaking responsibility..”

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Mrs Sheetal Samson C Pottety


hierarchy, expertise in nursing, it’s worth comprehending that because all parts of the nursing system affect each other, the profession will reach its highest potential only when its members relate to one another in a cohesive, united manner. Thus to prevent a drift from the path of advancement we require nurse-leaders with the following attributes:

Upward and onward vision: Motives of growth need to be directed towards growth for all. As history records, nurse - leaders with upward and onward vision to care, serve and lead have pioneered much progress and served as role models throughout. A consistently zealous heart and inquisitive mind that echoes with thoughts of ‘I am called to be at my best, what more can I do?’, like that of Florence Nightingale who continued working restlessly saying, ‘I have far much to do’ would open our eyes to the sight of pathways that would lead to self-growth as well as growth of others thus leading to undeniable progress in quality of care, excellence in standards of practice, evidence - based practice, competent administration and effective delivery of nursing education.

Nurses, from bed-side to boardroom need to ponder and work on ‘innovation’. It’s time to give up being opponents

of change and become champions of change. Upward yet onward would seem a stretch, but surely not so, when we are committed to Christ-like leadership, being a person who God can use and see our potential as God sees it.

Attitude of servant Leadership: The term servant leadership seems a very paradoxical combination of words but is, infact, the essence of the centrality of leadership quality. Servant leaders put serving others, including employees, customers and the community as their first priority. Greenleaf (1977), through his keen observation that most successful leaders lead in a different way from traditional leaders, coined the term servant leadership which is a interwoven fine fabric of precious strands of values, leadership and trust in work relationships that impact work productivity and organisational climate. He said, “It begins with the natural feeling that one wants to serve, to serve first. Then conscious choice brings one to aspire to lead. That person is sharply different from one who is leader first. The leader - first and servant - first are two extreme types. Between them there are shadings and blend that are part of the infinite variety of human nature”. In exercising servant leadership it is important to note that humility gives tensile strength to leadership and

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that it is unconscious of itself. The person who is humble doesn’t know he is humble and therefore does not boast of himself, creating another paradox of ‘proud-to-be –humble’. Let’s be cautious not to be leaders with false humility like ‘a Head’ but with no connection with ‘The Head’ having only a appearance of wisdom. [Colossians 2:18-23]. The most effective leaders are those who have experienced and understand the struggles of those under their charge.

Practice of appreciation: Leaders are called to help their followers grow through inspiration and encouragement. As aptly written in Proverbs 3:27 ‘Do not withhold good from those who deserve it when it is in your power to act’. People want to experience and feel the bliss of the relationship between contribution and compensation. Burnout, dealing with absenteeism and reducing staff tension takes careful skill. Refrain from sweeping the toil of nurse professionals under the carpet

of ‘dedication’. This phenomenon implies to all aspiring as well as practising nurse-leaders who would contemplate flaunting a banner of ‘Service through dedication’ while actually inflicting mere exploitation on those who work with all sincerity and integrity to give their best. A leader maintains a keen awareness and sensitivity to the needs of followers, subordinates and beneficiaries. When it is in your power to act, express appreciation and reward openly.

Goals of beneficial permanence: It surely must have costed Paul much courage and confidence to say, “ Imitate me as I imitate Christ.” But the ministry of Paul displays the permanence of sound doctrinal truthful pathways he himself treaded on and laid for others to follow to grow in Christ-likeness. It’s time to set trends carefully so that they produce lasting benefits. It’s just not the fulfillment of requirements to oblige to regulatory bodies, or competition for better advancement in

comparison to others, it’s about sustenance and creating building blocks..... It’s working with a sense of destiny, an unshakable conviction that we are instruments in God’s hand for a time such as this, in the arena of health care !

We, as nurse professionals, have no much time to lose in demolishing and rebuilding again and again. We have much to progress to match actual dignity we deserve, the actual quality of care expected by the consumers , our patients, and the actual standing & say we got to have at bed-side as well as in the board room.

Conclusion‘Willing followership’ is for the purpose of learning but ‘diligent leadership’ is the anchor for progress. We have adopted and submitted to followership for long. It’s time to soar and raise leadership!

“So I sought for a man among them who would make a wall and stand in the gap before Me on behalf of the land, that I should not destroy it; but I found no one” [ Ezekiel 22:30] . There is a dearth of able, exemplary leadership....Worthy nurse-professionals; would you choose to be that ONE?

BIBLIOGRAPHY: • Grohar-Murray ME, DiCroce HR. Leadership and Management in Nursing. 3rd ed. New Jersey: Prentice Hall Publication;2003• Haggai JE.Leadership that endures in a changing world. Singapore:Haggai Institute ;2006• Marquis B,Huston C. Leadership roles and management functions in Nursing.Philadelphia:Lippincott Williams and Wilkins;2006• The Leadership Bible, New International Version.Michigan : Zondervan Publishing House;1998

Mrs Sheetal Samson C Pottety, MSc(N) is Associate Professor, Ob&Gynaec Nursing at Krishna Institute of Nursing, Karad, Maharashtra. She worked as a medical missionary and was the founder Principal of the GEMS School of Nursing in the Naxal infested district of Rohtas in Bihar.

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IntroductionEbola Virus disease or Ebola Hemorrhagic Disease is a severe and often fatal disease in humans. It is caused by the Ebola virus which was first discovered in 1976 in the Democratic Republic of the Congo near the Ebola River from where it received its name. The first outbreak of the disease infected 318 people and caused 280 deaths with a high mortality of 88%. Since then sporadic outbreaks occurred, with no cases reported between 1979 and 1994.

The latest ongoing Ebola Virus Disease outbreak in West Africa was reported in March 2014. It is the largest epidemic in history. Outbreaks are occurring mainly in the villages of Central and West Africa with a mortality rate of upto 90%. The latest mortality figures according to WHO as on Nov 2014 are:

• 2413 deaths from 6535 cases in Liberia

• 1510 deaths from 5338 cases in Sierra Leone

• 1018 deaths from 1667 cases in Guinea

Virus was also spotted outside Africa – USA, Spain, Germany and France.

CauseEVD is caused by an infection with Ebola virus a member of the Filiviridae family. It is found in monkeys and Chimpanzees. Researchers believe that the virus is Zoonotic (animal borne) with bats being the most likely reservoir.

5 species have been identified-

• Zaire Ebola Virus.• Sudan Ebola Virus• Tai Forest Ebola Virus• Bundibugyo Ebola Virus.

• Reston Ebola virus (has not caused illness in humans.)

Risk Those highest at risk are-• Health workers and family of the infected person.

EBOLA, The Deadly ChallengeEbola Virus Disease (EVD) Dr Nayana Harrison

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• Laboratory personnel working with body fluids of the infected persons.

• Animal researchers directly handling bats and rodents where EVD has occurred.

EVD transmissionA person is contagious after developing symptoms of EVD. People become exposed to the virus through direct contact with an infected person’s blood or body fluids like urine, saliva, faeces, vomitus and semen.

It can spread through contaminated needles and syringes too.

During outbreaks the virus spreads rapidly in the hospitals specially if health workers are not wearing protective equipment like gloves, gowns and masks.

Signs and symptomsUsually appear from 2 to 21 days after exposure, average is 8-10 days. Typical signs are fever, headache, joint and muscle pains, weakness, and loss of appetite. Usually followed by vomiting, diarrhea, stomach pain.

Some patients have skin rash, red eyes, hiccups, cough, difficulty in breathing and chest pain. Bleeding from inside and outside the body (ear, eyes, nose) is a late sign.

ComplicationsThe survival rate in EVD is 10-50%

As the disease progresses it leads to multiple organ failure (such as lungs, liver and kidneys), severe bleeding inside and outside the body, jaundice, seizures, coma and shock due to low blood pressure.

Recovery is slow. It has been found by researchers that those who die from this disease are not able to develop adequate immune response to the virus.

DiagnosisThe disease presents with signs and symptoms similar to

Timeline of Infection Diagnostic tests available

Within a few days after symptoms begin

• Antigen capture enzyme linked Immuno sorbent Assay ( ELISA) test

• Ig M ELISA • Polymerase Chain Reaction

(PCR)• Virus Isolation.

Later in disease courseor after recovery

• Ig M and Ig G Antibodies

Retrospectively indeceased patient

• Immunohistochemistry test• PCR• Virus Isolation

source: http://www.ctcumc.org/news/detail/401


common illnesses. If Ebola virus infection is suspected, samples can be collected to confirm diagnosis.

Treatment Supportive treatment is standard which includes-

• IV fluids and electrolytes to treat dehydration.• Maintaining Blood Pressure.• Providing Oxygen.• Blood transfusion• Treating other infections that may develop.

EVD medicationAt present there is no vaccine or cure for EVD.

Few drugs like ZMapp and TKM-Ebola are being developed, but are still under trial and may serve as potential cure.

EVD prevention.• Isolate patient suspected to have EVD.• Protective masks, gloves, gowns, goggles should be

worn by medical personnel to prevent direct contact with blood and other body fluids.

• Proper cleaning and disposal of instruments such as syringes and needles.

• It is important to avoid contact with patients who have died of the disease.

• Avoid travel to areas where outbreak has occurred.

EVD prognosisPrognosis of EVD is poor with high mortality upto 90% with the exception of Reston strain.

The most deadliest species is Zaire Ebola Virus.

ConclusionIndia is one of the top 5 contributors to the fund being collected by UN to be used in the fight against Ebola. India has contributed USD 12.65 million for the 3 West African countries directly which is Liberia, Sierra Leone and Guinea through the UN Ebola Fund and WHO. Clinical trials for a vaccine for Ebola are being carried out on human volunteers in Switzerland.

Let us pray that God would bless all our efforts to find a cure for this deadly infection.

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XXVIII Workshop

on

HOSPITAL AND HEALTH SERVICES MANAGEMENT

Date: 9 - 20 March 2015Venue: CMAI, New Delhi

Who can participate:The workshop is for those (doctors, nurses, administrators and allied health professionals) holding senior or middle management positions in hospitals or health care services

1 - Day Workshop onHOW TO FACE LITIGATION IN HOSPITAL SCENARIOCivil, Criminal, Consumer & Labour

Who can participate:CEOs, Medical Directors/Superintendents, Nursing Director/Superintendents, Administrators/Managers, HODs/Faculty, HR Managers/Supervisors, Healthcare Management students.

ADMINISTRATORS SECTION of

CHRISTIAN MEDICAL ASSOCIATION OF INDIA

Announces

For further details please contact Mr S Jacob Bernard at [email protected]

Date: 24 January 2015Venue: Hotel Shelter, Chennai, TN

Dr Nayana Harrison, MBBS, MD is a Clinical Pathologist in the Christian Hospital (CNI), Jagadhri, Haryana.


Christian Medical Centre Pithapuram

Wanted Doctors

CMC, Pithapuram urgently in need of

Pediatrician, M.D. Pediatrics or DCH

To work in well established Mission hospital

Salary Negotiable, Accommodation provided

Contact: Medical Director

Christian Medical CentrePithapuram 533 450, East Godavari A.P

Mobile: 09959459586 Land Line: 08869 252625

FROM OUR ARCHIVES

The Journal of the Christian Medical Association of India, Burma and CeylonVol XIV No. 2 - 1939

The Distinctive Contribution of the Ministry of Health and Healing

Medical work of high standard, done in the spirit of Christ, is distinctive, in as much as it is an expression of His redeeming powers. Nowhere is such service more urgently needed than in rural areas. It finds special expression in caring for conditions where patience, perseverance and hope are called for, such as leprosy, tuberculosis and mental disease; and in nursing, for, in the entire range of medical work, no one comes nearer to the need of the patient than nurses. Their life should be a daily Christian witness, spent in the service of others.

For all these forms of service the thorough training of workers is fundamental. All who take part in the Ministry of Health and Healing should have the best possible professional qualifications for the work they are called upon to do, and their life and character should express the spirit of Christ. In addition, their training for religious work should also be adequate. The ideal of fellowship must be kept constantly in mind in their selection and training. Churches and missions recognize their obligation to train preachers and teachers. An obligation also rests upon them to secure the adequate training of medical personnel, imbued with that inner equipment of spirit that springs from a living faith in a living Christ, which secular institutions of themselves do nothing to provide, and which needs to be constantly replenished. To this, Christian medical and nursing education has made a contribution of lasting value in many lands. The standard, number, and location of Christian medical institutions in each area should be determined after consultation among Christian forces working in that area. In addition, it may be necessary to use, in certain areas, teachers and others who have been given training in first aid.

ARCHIVES

St. Stephen’s Hospital Tis Hazari, Delhi-54

Medical Records Officer: Degree/Diploma in Medical Records Technology with minimum 10 years managerial experience in the Medical Records of a large Hospital. Candidate with teaching experience, Medical Record Tutor Qualification and Medical Record Officer qualification will be given preference. Salary and other benefits will be commensurate with qualification and experience. Recently retired candidates can also apply.

Chief Security Officer: Retired Ex-Serviceman rank Captain or above with Knowledge of Fire Fighting. Minimum age is 45 years.

Assistant Stores Officer: Graduate with Diploma in Store Keeping/Materials Management with 8 years experience.

Kindly apply to:The Director

St. Stephen’s Hospital through post or e-mail: [email protected]

Write the post applied for in the subject column


FACTORS TO BE CONSIDERED IN THE EVALUATIONOF CHRISTIAN MEDICAL WORKREV. JAMES C. MCGILVRAYCommission on Ecumenical Mission and Relations-The UnitedPresbyterian Church in U.S.A.

That there is a need to clarify our thinking concerning Christian medical

institution goes without saying. …

In any evaluating of Christian Medical work our first question must be ‘Is it an integral part of the Church’s witness?’ If it is not, we must examine the reasons why it is not, and seek to correct this relationship.

Secondly, we must ask whether the hospital staff is committed to the concept and practice of making men whole. Does the ratio of doctors and nurses to patients allow time for this intimate dialogue, which is so necessary.

The third factor in evaluating Christian hospitals will be their ability to train personnel in some or all categories of hospital and medical service. If this training is an end in itself, and not intimately related to the concept of a healing Church, and the practice of making men whole, then it has no special significance.

A consideration of the three factors enumerated above leads to the obvious conclusion that a Christian institution can only be judged by the quality of its leadership, performance and commitment to these purposes. After all, an institution is only a channel through which people function. They either function peculiarly as Christians or they do not. This points up the tremendous importance we must attach to the selection of personnel, whether they be missionaries and fraternal workers, or national workers at every level of service.

Here, inevitably, we face the problem of the non-Christian worker or the nominal Christian, who might be an even greater liability. How far can we compromise? How far can we afford to dilute the witness so that it loses its potency? This is a very real problem in many of our hospitals today. In dealing with it, it is necessary to understand what our purpose is and what it is not. It is not our purpose primarily or even necessarily to meet need in terms of quantitative suffering. It is not our purpose to save face or supply prestige or jobs to a local or national church. It is our purpose to be a part of the Body of Christ, leading men and women to salvation through reconciliation. We cannot afford to compromise with that. If we have to employ those who are not fully committed to this task, it should be only as a temporary measure. If we have to do it in order to meet some government requirements or to measure up to some high clinical standards of our own, that hospital should immediately be put on the doubtful list and its ‘discontinuance seriously considered.

If the above conditions are met, we can look to those standards of professional excellence which make our performance worthy of our Christian name. God deserves and requires the best we have to offer, whether it be in professional training, original and continuing, as well as in modern equipment and diagnostic aids; for these too are the gifts of His grace. This paper is not concerned with enumerating these standards, for they are already available elsewhere. Suffice it to add that they demand resources which we must make available to any hospital which measures up to the conditions we have set. It’s redundant to argue that such resources are beyond the capabilities of a national church, when we as a Commission are already committed to a partnership in obedience and mission.

As a specific medical function, we would immediately investigate our obligations to reach out into preventive medicine in conjunction with our curative hospitals and clinics. Our task is to minister to man in his totality; not only in his specific physical need, which brought him to us, but in his environment and his relationships. Many patients come back repeatedly with worm infestations and other conditions resulting from an environment which is in need of healing. Our obligation here is no less than it is with the individual patient and it is in such an environmental and community approach that we can enlist the co-operation of every church member in the healing task.

FROM OUR ARCHIVES

The Journal of the Christian Medical Association of IndiaVol XXXIX No 5 August 1964

ARCHIVES


I feel humbled to write an article on one of the oldest mission hospital in Assam and also feel privileged to be a part of this great institution. Jorhat Christian Medical Centre also popularly known here as ‘The Mission Hospital’ had its humble beginning in the year 1924 when the American Baptist Foreign Mission Society sent Dr Herbert William Kirby, a medical missionary to Sadia, Upper Assam. Dr H W Kirby was a qualified homeopath, a graduate of the Hahnemann Homeopathic Medical College, Pennsylvania, USA and began his ministry of serving the people of Jorhat and surrounding region in the early 1906.

During those days, leprosy was very common and many patients with leprosy came to him for treatment and Dr Kirby not only gave them medicines but also gave them shelter by constructing houses from a grant of US dollar 10,000 received from a church in Philadelphia. With the increasing number of patients suffering not only from leprosy but various other diseases, Dr Kirby greatly felt the need of opening a dispensary and a hospital. Mrs Clark offered to build the dispensary which was named ‘Clark Memorial

Dispensary’ in 1924 in the area where the present Hospital lies. Soon after, Mr Miles Clinton Treat, another fellow American from California donated a gift of 25,000 US dollar for construction of a hospital and so a sixteen bedded hospital was built near the dispensary and was named ‘Treat Memorial Hospital’. This was the beginning of Jorhat Christian Medical Centre (JCMC) which is now a 100 bedded multispecialty hospital under the Council of Baptist Churches in North East India (CBCNEI).

JCMC is situated in Borbheta, Jorhat which is now a fast developing city in upper Assam. The hospital has a beautiful campus with trees and greeneries and has a calming effect to everyone who enters the campus. Though the hospital building is old and built in Assam type (horizontal expansion), continuous renovation and up gradation has made it strong and appealing. Jorhat is well connected by train, road and air and the hospital is only 10 minutes drive from the airport.

All major specialities like Medicine, Surgery, Obstetrics & Gynaecology, Orthopaedics, Paediatrics, ENT, Psychiatry and Cardiology services and a well equipped 14

100 Years of Jorhat Christian Medical Centre also known as ‘The Mission Hospital’

‘The Mission Hospital’ had its humble beginning in the year 1924 when the American Baptist Foreign Mission Society sent Dr Herbert William Kirby, a medical missionary to Sadia, Upper Assam.

Dr Esther Liani

INSTITUTIONAL FEATURE


bedded Intensive Care Unit, two Operation Theatres including Laparoscopy, C-ARM facilities, well equipped laboratory, digital X-Ray, Ultrasonography and Pharmacy services are available at present. The hospital chaplain’s visits to the patients in the wards, counseling and prayer for their family members all contribute to the holistic healing of the patients.

JCMC also has a School of Nursing for GNM courses which was first started by Miss Elna Gustille Forsell a Registered nurse from the United States in 1934 and under her able leadership produced the first batch of trained nurses in 1938.The School which is recognized by the Indian

Nursing Council is well known for training nurses in the true Christian spirit of love and compassion since its inception and have produced many dedicated and competent nurses since then.

Another wing of the hospital is the Dr Mary Kirby Berry Memorial Leprosy Clinic where Leprosy affected patients are given proper care and treatment and also helps in the rehabilitation process. A Project has been started with the help of Asian Rural Life Development Foundation in the campus to help these patients and their families become self reliant.

An important part of our ministry is Community Outreach programme

through which we organize several Free Health Camps and distribute medicines in the nearby villages and also impart health education. We also run a Community Sub Centre at Tengajan which is about 27 kms from Jorhat where one nurse and an assistant are posted. The centre is also regularly visited by our resident doctors and GNM students.

Another thing I would like to highlight is about the homely environment that we as staffs of this hospital share within the campus. Doctors’ quarters, nurses’ and other staffs quarters, students’ hostel all within the huge campus gives a feeling of unity and strength as we come from various ethnic background to

We also run a Community Sub Centre at Tengajan which is about 27 kms from Jorhat where one nurse and an assistant are posted. The centre is also regularly visited by our resident doctors and GNM students.

[ ]



serve the Lord together in this far fetched land of Assam. Regular Bible studies are conducted by our Chaplain and yearly retreats are arranged for all staff and students for spiritual nourishment.

In the midst of tough competitions from private nursing homes and Government Medical College nearby, we strive for excellence in all our services thereby witnessing the love of Jesus Christ in and through our institution. This is possible only by the grace and blessings from our

Heavenly Father and the commitment of our staff and prayers of our well wishers. May our God be glorified always!

Dr Esther R D Liani, MD(Obst.&Gyn.Worked in Mission Hospitals in Tura, Kangpokpi & and is currently Medical Superintendent, Jorhat Christian Medical Centre, Assam.

[ ]Regular Bible studies are conducted by our Chaplain and yearly retreats are arranged for all staff and students for spiritual nourishment.

BETHESDA (LEPROSY) HOSPITALNARSAPUR – 534 275

Bethesda (Leprosy) Hospital is a 90 year old Mission Hospital working for Leprosy, HIV/AIDS & General Care. The hospital requires a committed Medical Doctor preferably a Christian to provide Medical care

Qualification: MBBS, Salary: Negotiable

Interested candidates may please apply to the General Superintendent with a copy of CV and certificates at the below mentioned address or email.

BETHESDA LEPROSY HOSPITALRUSTUMBADA, NARSAPUR 534275, W.G. DISTRICT, ANDHRA PRADESH

Phone/mobile: 08814-274618, 278179, 9440984979, Email: [email protected]



S. No. Post S.No Post

1. Res. Junior Surgical Consultant - M.S / DNB 4. Res. Junior Orthopaedic Surgeon - M.S / DNB

2. Junior Physician - M.D., (Gen. Med) / DNB 5. Radiographer with CT experience

3. Res. Junior Anaesthetist - M.D / DNB

Apply with Bio-data to the Medical DirectorCSI Kalyani Multi Speciality Hospital

# 15, Dr. Radhakrishnan Salai, Mylapore, CHENNAI – 4Ph. No.: 044 – 28475101/0642/3306/4141 / email:[email protected]

HUMOUR

Corporate GovernanceA crow was sitting on a tree, doing nothing all day. A small rabbit saw the crow and asked him: “Can I also sit like you and do nothing all day long?” The crow answered: “Sure, why not.” So, the rabbit sat on the ground below the crow, and rested. All of a sudden, a fox appeared, jumped on the rabbit and ate it.

Q: What can we learn from this?

A: To be sitting and doing nothing, you must be sitting very high up.

The brains of a four-year-oldThe following short quiz consists of 4 questions and establishes whether you are qualified to be a “professional”.

Go down for the answer. The questions are not that difficult.

1. How do you put a giraffe into a refrigerator? . . The correct answer is: Open the refrigerator put in the giraffe and close the door.

This question tests whether you tend to do simple things in an overly complicated way.

2. How do you put an elephant into a refrigerator ? . . Wrong Answer : Open the refrigerator, put in the elephant and close the door.

Correct Answer : Open the refrigerator, take out the giraffe, put in the elephant and close the door.

This tests your ability to think through the repercussions of your actions.

Humour

3. The Lion King is hosting an animal conference; all the animals attend except one. Which animal does not attend? . . Correct Answer : The Elephant. The Elephant is in the refrigerator.

This tests your memory.

OK, even if you did not answer the first three questions, correctly, you still have one more chance to show your abilities.

4. There is a river you must cross. But it is inhabited by crocodiles. How do you manage it? .

. Correct Answer: You swim across. All the Crocodiles are attending the Animal Meeting!

This tests whether you learn quickly from your mistakes. According to Andersen Consulting Worldwide, around 90% of the professionals they tested got all questions wrong. But many preschoolers got several correct answers. Andersen Consulting says this conclusively disproves the theory that most professionals have the brains of a four year old.

CSI Kalyani Multi Speciality HospitalMylapore, Chennai, Tamil Nadu

Last date for sending the application: 15 January 2015


SPECIAL FEATURE

Christian Response to Health and DevelopmentThe symposium was convened in commemoration of the 50th anniversary of a conference on Christian health work in Tübingen (Tübingen I).

At the international symposium on “Christian Responses to Health and Development” in Tübingen, Germany in June 2014, 60 health professionals and representatives of churches, mission societies, church-based and secular organisations, academics in medicine, health economics and theology came together. The symposium was convened in commemoration of the 50th anniversary of a conference on Christian health work in Tübingen (Tübingen I). In the spirit of Tübingen I and Tübingen

II (1967), participants remembered the achievements of the conference and, more importantly, discussed ways forward for Christians and churches in health. The participants represented a considerable number of networks and initiatives active in health.

Christian Healthcare network in India was represented by Dr Bimal Charles (CMAI), Dr John C Oomen (Christian Hospital, Bissamcuttack), Dr Sujith Chandy (CMC Vellore


SPECIAL FEATURE

& EPN), Rev Dr Mathew Abraham (CBCI) and Dr Ronald Lalthanmawia (CMAI). They made various presentations including CMAI, MITRA, Ecumenical Pharmaceutical Network. Dr John C Oomen presented “What makes our health services Christian? Christian values under the challenge of increasing demand, brain drain and economic pressures” and Dr Bimal Charles presented “Christian health care contributing to equity and protection from financial hardship”

Based on the policy paper, 5 groups were formed to discuss various aspects like• Justice in health care – how can we reach the

marginalized and poor?

• Advocacy in health

• Human resources in health and financing health services

• The contribution of Christian churches and communities to Primary Health Care

• Christian responses in middle and high income countries.

As a result of the meeting, “A call to health and healing – Declaration Tübingen III” was developed and published.

There was also formation of a Christian Health Services Platform to foster policy formation in health, advocacy, and implementation of health strategies. A concept has been developed and circulated for comments. The purpose is to strengthen Christian Healthcare work and advocacy at national and international levels.

REFERENCES1. Genesis 1:27 2. John 10:10; 2 Peter 3:9, 3. E.g. Deuteronomy 6,

4. Philippians 2:5-11 5. E.g. Revelation 22:1-5 6. WHO Constitution, www.who.int


A call to health and healing - Declaration Tübingen III (2014)We, the participants of the Symposium “Christian Responses to Health and Development” held at the German Institute for Medical Mission (DIFAEM), Tübingen, Germany, from 26 – 28 June 2014, are Christians in Health from Africa, India, Korea, Europe and the USA, from different denominational and professional backgrounds, different cultures, yet part of the Body of Christ, His Church in the world.

We affirm that

1. The Christian Church continues to have a unique, relevant and specific role to play in Health, Health Care, Healing and Wholeness, in changing contexts and in all regions of the world.

2. Every human being is made in the image of God1, created with dignity in diversity irrespective of any personal circumstances, and this is equally true in suffering, disability or when living with chronic disease.

3. God wishes that all may have life; and life in all its fullness2; through living relationships with God, each other, themselves and the world3.

4. Part of God’s call to the Church is a ministry of healing and transformation, with compassion and unconditional love, in the spirit of Jesus Christ4, the servant healer and author of peace, justice and reconciliation5.

5. The WHO Constitution states that “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being”6 – This calls for participation of all in prevention, promotion, treatment, care and rehabilitation, as well as the engagement for justice, peace and reconciliation, taking responsibility individually and collectively.

We want to see

• A world where everyone is participating in the health and healing experience and no neighbourhood is left behind based on the Primary Health Care approach that puts communities at the centre. It is a cornerstone for any health system and can strengthen the key determinants of health.

• Reconciling and healing communities and congregations participating in social transformation.

• Universal health coverage and the protection of individuals and families from falling into poverty through unaffordable health care.

• New financing mechanisms creating equity in health care.

• Health Systems strengthened with equitable access to care taking into account local patterns of disease and evidence-based treatment and care irrespective of whether a person is poor or rich and irrespective of religion, ethnicity, gender or political standing.

• Churches, Christian organisations and networks working together with civil society including people affected by disability or disease to mobilise governments, international agencies and the corporate world for more justice in health and access to medicines and quality health care.

• Opportunities used to develop health care to its highest possible standards in the local context, creating access for those who are poor, marginalised and vulnerable.

• Christian health care that reflects Christ’s love, at all levels, for all people in all parts of the world.

We call on Churches to

• Create healing and reconciling communities and congregations that are open for those who are marginalised, poor and vulnerable, restoring their dignity, protecting their rights and nurturing their agency through active participation.

• Accept God’s given calling to be hospitable communities of health and healing.

• Support all Christian health professionals and those working within church health systems through training, support, the creation of conducive working environments and the development of career paths, thus enabling a motivated and committed workforce.

• Lift their voice with those who are poor, marginalised and vulnerable for justice, reconciliation and access to quality health care.

SPECIAL FEATURE


Dr Ronald Lalthanmawia is the Head of the Community Health Department, CMAI

• Help in the setting of standards for compassionate and competent care.

• Contribute to the elimination of financial barriers to health care for those who are poor and marginalised.

• Play an active part in developing and maintaining national health systems with the Ministry of Health in collaboration with all stakeholders.

• Participate in the development of local answers to health challenges and share these through their global networks.

• Equip church leaders with sufficient knowledge of health that allows them to be involved in partnership in helping to provide adequate pastoral care and support health workers and communities.

Governments to

• Ensure that adequate resources are allocated to health to allow everyone access to health care.

• Affirm the local responses as critical foundation for effective Primary Health Care.

• Protect all persons from stigma and discrimination irrespective of ethnicity, disease, religion, gender, sexual orientation or economic status.

• Respect faith based health services as an important part of the public health system and actively engages them as part of civil society to contribute to policy making and accessing respective resources.

• Ensure legislation that fully supports access to quality medicines at affordable prices irrespective of international trade laws.

• Ensure that adequate resources are allocated to fund research into proving better healthcare for those who are poor, marginalised or otherwise disadvantaged.

• Further promote new drug development for diseases affecting those with Neglected Tropical Diseases and other illnesses especially impacting those in the developing world through the use of regulatory incentives and other active measures.

International Corporations, global donors and the private sector to

• Invest in research and development addressing global health needs.

• Provide affordable access to essential medicine and other supplies, especially for those who are poor and marginalised.

We commit ourselves to

• A healing and reconciling ministry that puts people at the centre and allows for a wholistic approach in health care.

• The pursuit of professional excellence and relevance in our health care service and our willingness to learn and share.

• Ethical health care specifically in view of those at the beginning and the end of life or otherwise vulnerable to exploitation and abuse.

• Work with people who are marginalized and to advocate for their health.

• Flexible and adoptive responses to the dynamics of global and local health situations.

• Contribute to research and development in health that is locally relevant, evidence-based, ethically sound and globally accepted.

• Network and support each other in mutual respect, demonstrated by an approach of love, justice and compassion willing to learn, share and being a caring, appreciative global Christian community.

SPECIAL FEATURE


The Roundtable for Ebola Preparedness was organized by CMAI in response to the Ebola epidemic in Africa and the status of India’s preparedness for a possible pandemic. The roundtable discussion was conducted on the 12 November 2014 in the New Delhi, YMCA premises.

Resource personsDr Jacob John - Dr T Jacob John is a Pediatrician and a PhD in Laboratory Virology, Epidemiology and Public Health. He retired from CMC Vellore as Emeritus Scientist in 2000. He is the recipient of the Dr B R Ambedkar Centenary Award for Excellence in Biomedical research in 2001 for excellence in any field of biomedical research, as evidenced by scientific publications in internationally recognized journals and significant contribution to advancement of knowledge & improvements in medical practices and health programmes.

Dr Manoj Jain - An infectious Diseases Physician in Memphis USA is a consultant for 17 Baptist hospitals and writes about Medical issues in the newspapers including Washington Post and Huffington Post.

Introduction by Dr Jacob JohnWhy is the probability of Ebola pandemic low?

The virus is named after the river Ebola in Zaire in 1976. The incubation period of the virus is up to 21 days. Two third of the people who get infected do not get the disease, thus discontinuing the

SUMMARY of ROUNDTABLE FOR

EBOLA PREPAREDNESS

SPECIAL FEATURE


chain of transmission. The remaining one / third can transmit the disease. Ebola also is infectious only after the disease process starts/symptoms are manifested.

When the person begins to get symptomatic, every body fluid is heavily loaded with the Ebola virus and is infectious. The reproduction number or the average number of new cases that arise when an infected person enters an uninfected population, for the Ebola virus is 1.7.( 1.81 for Guinea, 1.51 for Liberia, and 1.38 for Sierra Leone.) That is the one/third (30%) of those who are infected can transmit the virus to 1.7 more people during the time they are symptomatic. The serial interval is 15-17days. This means that if the virus from a symptomatic person does not infect another person in this time, then the infection will die. The curve will be climbing very fast if not for the 70% who are not infective.

The probability of Ebola in India is quite small. But IF it came to India the impact is fairly high in health care settings.

The area for concern is that any infectious virus mutates. For measles there are 20 different viruses. Basic measles reproductive number is 20; therefore the pandemic probability is high.

The curve would be climbing very fast if not for the 70 percent who are not infective. 30 percent alone are infective.

The chain of transmission can grow. The virus can create small fires in different communities. The challenge is to stamp out the spark before the fires catches on.

How can this be controlled?

1. Creating systems

2. Creating protocols for detecting probable cases.

3. Assigning diagnostic centres. There are 2 in India: a. Clinical Diagnostic Centre in Karkardooma, Delhi b. The National Institute of Virology, Pune 4. Improve surveillance especially Quarantine surveillance

5. Proper systems for transportation of specimens

SPECIAL FEATURE


Dr Manoj Jain

Important steps to be followed

1. Take a good and complete medical history. Give importance to the following:

a. Travel history b. Where (Liberia, Sierra Leonne, Guinea) and high risk countries c. History of symptoms

2. Identification of a symptomatic

3. Isolation

a. Risk of infection is directly proportional to the time spent with the patient. Therefore minimum contact is strongly advised for 48 hours. b. Healthcare worker protection is crucial. c. Separate the relatives from the patient. Isolate both.

4. Contact numbers of the Government designated facility for care of Ebola patients to be given to Casualty.

5. Send blood sample – Result will come in 24-48 hours.

6. Use time to spread awareness on how Ebola is transmitted.

7. Psychological preparedness has to be communicated.

8. Get the list of Nodal Centres and the contact details of the Nodal officers – Notification to be done.

9. Get contact details of suppliers of Personal Protection Equipment(PPE).

10. Once patient is transferred then the government responsibility is triage, care and tracking.

What a hospital can do?• Every hospital must identify an Ebola specialist team who is adequately trained among their staff

• Standard protocol for Healthcare workers to be developed

• Design a mock drill in case of a symptomatic in the hospital

SPECIAL FEATURE

Dr Priya John is the Sr Programme Coordinator of Community Health Department, CMAI


BOOK REVIEW

When I was presented the book Business as Mission by its author Michael Baer at a seminar last year I

was taken aback since the title sounded like an oxymoron. To the purist business and mission are like water and oil. However I quickly remembered the seemingly brusque response by the boy Jesus to His worried parents, “Did you not know that I must be about My Father’s business?” (Luke 2:49).

The author was in the pastoral ministry for fifteen years after being trained at the Dallas Theological Seminary. He then moved on to organisational and leadership development. He has also initiated several micro enterprises in seventeen countries over the last twenty five years. He begins with a perhaps utopian proposition, Imagine what could happen if every Christian businessperson recognised that God had a purpose for his or her company that was greater than profit, employment and customer satisfaction. Imagine if the vast number of believing business owners or operators were to turn their companies over to God to use for His glory. Imagine the power and joy of integrating business and faith for God’s kingdom.

With this he presents in five parts how indeed we can integrate business and mission. He begins with putting to rest the negative connotations that so often come when we talk about business. He says that ‘Business is a Good Thing from God’ and that business is derived from “busy-ness”, meaning that which keeps us occupied. God entrusted to Adam and Eve the mandate to be stewards of His creation. There are many examples of successful business people in the Bible from Abraham, Amos, Luke, James and John, Peter and Andrew, Paul and Lydia. Jesus too helped his daddy in their business of carpentry. Business therefore is a high calling from God and should be considered as a vocation.

He encourages the reader to discover our Kingdom purpose in our vocation. We read the disciple must, “Deny himself and take up his cross daily and follow Him”

(Luke 9:23). We must therefore displace our own plans and purposes, accept the full will of God, whatever the implications, and wholeheartedly pursue that will. We can discover God’s will by prayer, meditating on His word, fellowship with other believers, be informed of the changes around and by writing our own “Kingdom impact statement” that will help keep us on course.

The author reiterates that we would be successful if we build lasting relationships with our clients and suppliers and demonstrate good ethical practices. Using the Kingdom Values we must develop excellence in what we do by being teachable and be ready to change whenever required. Ethical living in a corrupt society can be challenging. The author quotes Phil.2:14-16 where Paul commands us to be “blameless and pure, children of God without fault in a crooked and depraved generation.” He concludes by stating how we should integrate with the world. Some people like to separate the sacred from the secular, others allow the sacred and secular to invade into one another, while still others try to enforce and overlay their faith on their employees and clients. He suggests that we should instead have a “seamless integration”. There is no dichotomy between sacred and secular. That is how kingdom professionals view and approach business. Every aspect of their lives- home, church, leisure and business- is under the rule of God.

This is an extremely well written book and is highly recommended for personal reflection and group study. In fact we have recently started a Business as Mission group in Pune and by regular meetings and seminars we are trying to propagate this concept of seamless integration and using Kingdom principles among Christian business persons and professionals.

BUSINESS AS MISSIONAuthor: Michal R Baer Publisher: Authentic Headlines Year: 2006

Reviewed by Dr Nitin Joseph, MS, MCh, BCS, PGDHHM, is Medical Superintendent, N M Wadia Hospital in Pune & Editor of CMAI

CMAI URGENTLY NEEDSTechnical Manager and Lab Quality Consultants

(LABS FOR LIFE PROJECT)

Christian Medical Association of India (CMAI), in partnership with the US Centres of Disease Control and Prevention (CDC) is providing technical support to improve Lab Quality systems including Regional Laboratories under the Ministry of Health and Family Welfare.

Laboratory testing plays a cross-cutting role in managing the health and disease spectrum, extending to both communicable and non-communicable diseases (prevention, care and treatment). The Labs for Life (L4L) Project seeks to identify innovative practices to support integrated laboratory services that can be leveraged across co-morbidities of persons living with HIV/AIDS.

The L4L Project will work in five regions in six states namely Rajasthan, Gujarat, Maharashtra, Karnataka, Andhra Pradesh, West Bengal and Assam.

POSITION 1: Technical Manager (One position based in New Delhi)The Technical Manager (L4L) will be based in Delhi supervising the regions providing technical assistance, monitoring Quality Consultants (L4L) and strengthening referrals and linkages. The position requires extensive travel coordinating with other labs, stakeholders and L4L Lab Quality Consultants in various regions. The Technical Manager (L4L) will report to the Deputy Director General (Lab Service Division), National AIDS Control Organization. Qualifications: MD / Diploma Clinical Pathology / Microbiology or Ph.D in Microbiology.

Experience: He/ She must have worked in lab quality improvement with extensive experience in mentoring lab personnel. Preference will be given to candidates with public health experience at the na-tional level.

POSITION 2: Laboratory Quality Consultants (5 regional positions)

The Lab Quality Consultant (L4L) will be based in one of the five regions (Rajasthan, Gujarat, Maharashtra, West Bengal, Andhra Pradesh and Assam) providing technical assistance in gap analysis, capacity building and implementation of quality systems essentials; strengthening referrals and linkages; training lab workforce in good lab practices; and implementing reporting systems. The position requires extensive travel coordinating with other labs and stakeholders in the regions. The Lab Quality Consultants (L4L) will report to the National Technical Manager – L4L, based in Delhi.Qualifications: MD/ Diploma in Clinical Pathology or Ph.D in laboratory medicine.Experience: He/ She must have worked in lab quality improvement with minimum five years’ experience with public health lab experience.

Apply to the Project Director (CDC-CMAI Project), by email with soft copies of current CV addressed to the

Administrative Manager, [email protected] with a copy to [email protected] with the name of the position applied for.

Last date of Application: 15 January 2015

LOCATION: 1. Located in Pratap Nagar, opposite to Harinagar DTC Bus

Depot and Tihar Jail,New Delhi2. Connectivity: Situated close to the Tilak Nagar Metro

station (1.5 kms) and New Delhi International airport (10 km). It is well connected by bus/ taxi/ auto, etc services.

3. Neighbourhood: The place is close to shopping malls, markets, good hotels, hospitals, etc. The area has parks and gardens which offer a pleasant & peaceful environment to stay.

• Provision of 14 beds accommodation

• 5 rooms with 2 beds each and one with 4 beds

• Additional folding cots can be provided if required

OTHER FACILITIES• 24 - hr security and services of a care taker• 24 - hr power supply• Coffee/Tea can be self made• TV with cable network• Huge drawing and dining room with sofa• AC Rooms • 24 - hr running water

CMAI Guest Rooms are available to its members, member institutions, staff, official visitors, sister agencies and friends of CMAI for temporary stay.

WHO CAN STAY?

For further details Please contact CMAI Administration

Tel: 011-2559 9991/2/3, Fax: 011-2559 8150, Email: [email protected], [email protected] Elizabeth Mathew, Mobile: 9868142622

Rev Sharath David, Mobile: 7503489312

CMAI NEW GUEST HOUSE FACILITIES IN DELHI

Enquire and book your accommodation through telephone or email

good governance' cmji 29.3 july - september 2014

Documents

year diploma

year advanced diploma

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