reaching out to the poor - wordpress.com...hospital in thottapalayam. i was upset to hear that and...

VELLORENEWSLETTERISSUE No. 148 · SPRING 2018

REG. CHARITY No. 209168FRIENDS OF

Where did your Donations go? - See page 4

SUPPORTING CHRIST IAN MEDICAL COLLEGE , VELLORE , SOUTH INDIA

asked the lady why she did not come toLCECU before. She replied that she was notaware of this place. She lives close to the mainhospital in Thottapalayam. I was upset to hearthat and convinced of the need to go outmore to where the poor live. That's what theLord did for us.”Friends of Vellore are funding three

community health workers: Alfred, Ambigaand Beryl, who are working in five slums ofVellore building trust with the localcommunities, running clinics and referringthose who need further care to LCECU. Theyhave mapped all those living in the five slums,creating registries of those with chronicdiseases who need regular follow-up. Initially,this was recorded in books but theinformation has now been transferred toelectronic files so it is more accessible. A software engineer has built a database for

storing the information and is developing atablet based app to enable the communityhealth workers to quickly access theinformation by geographical area or clinic andrecord clinic appointments. The app will havealerts for follow-up appointments for

CECU provides low-cost healthcareto the poor living in Vellore town.Doctors from different specialties

give some of their time to provide services forfree so patients are asked just to pay for drugsand investigations. Social workers make homevisits to check financial need and genericdrugs are used to keep costs down. Waitingperiods from referral are kept to a minimumto encourage higher attendance. The systemis truly amazing. Dr Sunil Abraham, head of LCECU, writes

about one couple he saw recently: “Thehusband has hypertension and had a strokelast year. He was seen in the main hospital,had investigations, and put on multiple drugsfor his blood pressure. The wife is ahousemaid who can only buy the medicineswhen she has money. He has not been onregular medications. Her relative who is apatient of mine, brought him to ShalomFamily Medicine Centre. His blood pressurewas very high. I realised that they are poor andcannot afford the treatment there. He wasregistered in LCECU today and the medicineswere changed to affordable generic drugs. I

REACHING OUTTO THE POORAt Christian Medical College’s Low Cost Effective Care Unit (LCECU),the staff are passionate about reaching out to the poor to meet theirhealth needs and bring glory to God. Those who live locally in theslums of Vellore may not seek medical help, as they do not have themeans to pay for it. Sadly some do not realise affordable care isavailable for those in need.

L

One of the clinics in the slums

Boys from the slums

Richard, LCECU nurse, speaking with local residents

I S S U E 1 4 8 • S P R I N G 2 0 1 8 • V E L L O R E N E W S L E T T E R2..........

together, wemake it easier.

particular groups such as those with diabetesor hypertension and the under-fives. There isalso the potential to send text reminders. Theefficiencies gained by this new system shouldmean fewer patients slip through the net andwill enable the community health workers towork more effectively.Improving the health of a population is

more than just providing medicine. Otherneeds of those living in the slums, such assanitation, garbage disposal and vocationaltraining, desperately need to be met. Pleasepray for wisdom for LCECU in how they canhelp to address these needs.

• 9:30am to 10:30am: Sunday Chapel Service• 10:30am to 11:00am: Tea/Coffee• 11:00am to 12:30pm: FOV Annual Meeting• 12:30pm: Indian Lunch (sponsored by FOV but donations welcome)Those attending on the day are welcome to join us in time for the

service or to arrive in the coffee break in time for the meeting itself. Wewould love to see many of you there. If you are able to attend, pleaselet Ruth know so we have an idea of numbers. (Contact details are onthe back cover.)

are holding our annual meeting for all supporters ofFriends of Vellore (FOV) on Sunday 7 October 2018 atthe Holiday Inn, Coventry, CV2 2HP (just off Junction 2

of the M6). This is on the final day of the CMC Alumni Weekend, enabling Alumni

to stay on and others to join us on the day. The purpose of the meetingis to update the friends of Vellore about CMC and FOV as well asproviding an opportunity for fellowship with each other and Alumni.The timetable for the morning is as follows:

January, I was inspired by their desire to show compassion in thename of Jesus.We have updates on several of our projects and some patient

stories to tell, each demonstrating just how much your gifts areblessing the lives of people in Tamil Nadu and beyond. We alsohave a moving article on lessons learnt in Palliative Care written byDr Reena George, first published in the Journal of Clinical Oncology.There is news from CMC more generally and an article showing thebenefits CMC doctors have gained from placements here in the UK.Enclosed with our newsletter is a copy of the December 2017

edition of Pulse, CMC’s annual newsletter. We are also including aconsent form to enable those of you who haven’t yet completedthis, to tell us how you would like us to keep in touch. We hope you enjoy reading the newsletters and are encouraged

by the wonderful work going on at CMC.

THANK YOU for your generous donations and prayers for the workof Christian Medical College (CMC), Vellore. We are so grateful foreach one of you and thank God for your partnership in this work.We would love to see you at our annual supporters’ meeting onSunday 7 October (more details below).I had the privilege of visiting CMC again in January this year. I was

able to meet with the project leads of all our current projects andhad a day visiting the Jawadhi Hills to review possible new projectsthere. My trip also provided a valuable opportunity to meet withrepresentatives from Friends of Vellore organisations in othercountries and to visit the new campuses CMC are building atChittoor and Kannigapuram. This issue starts with a focus on the work of the Low Cost

Effective Care Unit. They are bringing light and hope to those in themargins of society. Joining their weekly departmental bible study in

Ruth [email protected]

STORY CONTINUED FROM PAGE 1

DEAR FRIENDS OF VELLORE

ANNUAL SUPPORTERS’ MEETING: SUNDAY 7 OCTOBER

We

Beryl showing me the electronic registries Ambiga using the new tablet

V E L L O R E N E W S L E T T E R • S P R I N G 2 0 1 8 • I S S U E 1 4 8 3 .........


EXECUTIVE CHAIRMAN’S REPORTSPRING 2018

Jullie Ravi is 38 years old with twosons aged 22 and 18 and a 20-year-olddaughter. All three children havestudied up to high school level butare all unemployed. They live in theirown hut in Shenpakkam which is 5km from the hospital.

JULLIE RAVI

Jullie Ravi works in an orphanage as a helperand her husband works in a welding shop.Together they manage to earn £65 per month.The family gets 20 kg of free rice provided bythe Tamil Nadu government. They manage tohave two simple meals a day; cooking in themorning, they eat the same food for lunchand dinner. Three weeks ago Jullie Ravi had a fall at

home and subsequently developed swellingand pain in her right foot which spread tomid-thigh. She went to a local hospital fortreatment. Still she could only walk withsupport, so her daily activities were affected.Eventually she came to Christian MedicalCollege for more help. She was diagnosedwith cellulitis, a bacterial infection in her rightfoot and leg. The wound in her right foot was

treated under local anaesthesia to remove allthe unhealthy tissue. She was prescribedantibiotics and dressings for the raw area onthe right foot were regularly changed. Hertemperature remained normal while she wason the ward and the wound looked healthy.After ten days she was discharged and advisedto come for regular dressings in theoutpatient department. She was advised touse crutches for walking to keep the weightoff her right foot as it healed. All being well,Jullie Ravi may return for skin grafting later.The cost of hospitalisation for her

treatment came to £386. It was well beyondthe limited means of a poor family like JullieRavi’s. CMC were able to take care of JullieRavi through a donation from the Person toPerson scheme which financed her care.

his family lives in a ‘lean to’ (a ‘leanto’ is a makeshift shelter made ofdried coconut leaves which are

propped up with poles) without any sidewalls. During the rainy season, it is verydifficult for them to stay in this shelter. Thehouse consists of a single room, measuring 8feet by 15 feet, with a floor made of a mixtureof mud and cement. Cooking is done outsidethe house in an open area. During the rainyseason, it is very difficult for them to cookoutside. They have electricity (just two bulbs,one inside and another outside, and a tablefan provided by the Tamil Nadu Government)but there are no water or sanitation facilities.There is a municipal tap on the road outside,where twice a week they collect water fortheir various needs.

T

Warm Christian greetings to you all!

Jullie with her husband and children

directly involved in this as it is outside our scope of providing for thepoor and needy.The uncertainty over medical college admissions continues to

dominate the minds of the doctors who, in addition to their busywork schedules, manage the institution.

Let us all uphold CMC in our thoughts and prayers

Yours in Christ

Ajit Butt, Executive Chair, Friends of Vellore UK

THANK YOU for your continued interest in the work of the ChristianMedical College, Vellore, through this organisation. The past year hasbeen quite busy for Ruth, our administrator; she has done aremarkable job of organising virtually everything digitally so therequirement for office storage is minimal.It was indeed a pleasure to meet so many of you at our annual

supporters’ meeting in Coventry. Please do try to come this year asthe venue remains unchanged; the programme will be notified in duecourse.Like most healthcare providers in India, CMC is changing; with

progressive growth in patient numbers and the need to keep at thecutting edge of care and research, an additional new hospital campusis taking shape requiring a huge amount of investment. We are not



WHERE DID YOURDONATIONS GO?In 2017 Friends of Vellore UK received £118,838 indonations and legacies including gift aid. We receivedan additional £40,277 income from investments. Wesent £119,365 in grants to CMC and £2,500 in grants toindividuals working at CMC.

Restricted Donations£55,954

Unrestricted Donations£19,575

Investment Income - £40,277

Legacies£33,000

Gift Aid - £10,309

enable him to visit and provide support to smaller mission hospitals• Provided £3,000 for mission hospital staff to access distance learning courses• Funded the post of an occupational therapist working in Paediatric Surgerywith burns victims and patients with myelomeningocele (£5,260)

• Bought a fundus camera for the Ophthalmology Department to enabledetection of Diabetic Retinopathy (£5,460)

• Provided financial support for the Palliative Care Department’s Home CareProgramme (£4,340)

• Sent £14,640 of gifts directed Alumni for various batch funds and otherprojects

• Sent a supporter directed gift of £10,000 for Infectious Diseases• Sent £2,460 for the College of Nursing Friendship Chapel• Provided £2,500 for key self-supporting staff at CMC.

hrough staffing changes and efficiency savings we managed to cutour support costs from £26,313 in 2016 to just £17,296 in 2017. Theincome from investment more than covers the support costs and the

cost of raising funds (£12,396 in 2017, similar in 2016), allowing every penny of yourdonations to go directly to funding charitable projects.During 2017 Friends of Vellore has:

• Sent £50,000 to the CMC Person to Person scheme helping about 900patients (see patient stories on page 3 and page 13)

• Continued our support of a five year project enabling three communityhealth workers from the Low Cost Effective Care Unit to work in slum areas

• Given £19,150 in support of projects overseen by the Rural Unit for Health andSocial Affairs (you can read about some of these on page 6)

• Funded the travel expenses of the Missions Network Consultant (£3,790) to

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doctor intensive and so expensive.In 2017, Friends of Vellore gave £5455 to CMC’s

Department of Ophthalmology to enable them tobuy a fundus camera for the detection of diabeticretinopathy. This transportable camera is now in useat CHAD (Community Health and Development),RUHSA (the Rural Unit of Health and Social Affairs),the Jawadhi Hills and the LCECU (Low Cost EffectiveCare Unit) outreach clinics. When I visited inJanuary, I saw it in operation.The purchase of this new camera enables an

optometrist or community health workers toconduct a fundus examination. The pictures of theeye are then sent to an ophthalmologist back at the

base hospital for review. In addition to detectingdiabetic retinopathy, other eye conditions have alsobeen diagnosed. Those requiring treatment andfollow-up due to complications of diabetes arereferred to respective departments in CMC. The early stages of diabetic retinopathy don’t

require treatment; the patient is educated inmanaging their blood sugars to prevent thecondition from worsening. Laser treatment is givenfor the latter stages. Currently 5-10 laser treatmentsare carried out per week at CMC. In the future itmay be possible to invest in a portable lasertreatment machine which can be taken to theoutreach clinics.This camera is enabling a more cost effective

screening method and so allowing more people toreceive screening and benefit from education andtreatment, which will decrease the occurrence ofblindness. This project particularly benefits thepoor and marginalised who are less likely to attendhospital screening sessions. The OphthalmologyDepartment are very grateful for the generosity ofour supporters in funding this.

iabetic retinopathy is a complication ofdiabetes, caused by high blood sugarlevels damaging the back of the eye

(retina). Two thirds of all Type 2 and almost all Type1 diabetics are expected to develop diabeticretinopathy over a period of time. It can causeblindness if left undiagnosed and untreated.However, it usually takes several years for diabeticretinopathy to become sight threatening.Screening and timely intervention is cost-

effective when compared with the disability ofblindness, which can be reduced 10-fold with earlyintervention. Screening for diabetic retinopathy hasalso been shown to be a reliable indicator formonitoring diabetes-related complications.There are a large number of people living in rural

areas outside Vellore who are not routinely seen inthe hospital and are only diagnosed withretinopathy when CMC travels to these areas toconduct screening programmes. The teams go outfour days a week and referral slips are given, so thatpatients screened can be treated at no cost.However, the current method of screening is

D

SAVING SIGHTIn the year 2000, 31.7 million people were affected by Diabetes Mellitus in India. This is

estimated to rise to 79.4 million by the year 2030 and will be the largest number in any nation.

Optometrist using the new Fundus Camera



NEWS FROM CMC

ADMISSIONS UPDATEOne of the main challenges CMC is currentlyfacing is the admission process. CMC is stillwaiting for the Supreme Court verdict ontheir petition to choose their own students.They believe that academic achievementshould not be the only criteria for selection oftheir undergraduate and postgraduatestudents. However, sadly the court case hasbeen a long drawn out process with onepostponement after another and still noresolution. The problems with the Supreme Court case

are leading to significant staff shortagesparticularly amongst the postgraduatedoctors. In some departments, shortage ofstaff has led to senior doctors sleepingovernight in their departments so they canlook after very sick patients themselves. Dr J V Peter, CMC’s Director writes: “In

these times of uncertainty and difficulty, wecan be encouraged that the Lord who has ledus thus far will continue to do so in thecoming year. ‘For I know the plans I have foryou, declares the LORD, plans to prosper youand not to harm you, plans to give you hopeand a future’ (Jeremiah 29:11).”Please continue to uphold CMC in your

prayers.

BUILDING NEW CAPACITYWhen I visited Vellore in January, I was able tovisit CMC’s new campuses in Chittoor, acrossthe state border in Andhra Pradesh, and atKannigapuram, on the main road from Velloretowards Chennai. Space is currently CMC’sbiggest constraint so these new campuses willenable more people to be treated and relievepressure on the main hospital, in addition toproviding a much needed hospital for thelocal people of Chittoor.Services at Chittoor (pictured above and

left) are in operation already with up to 10,000patients being seen a month (compared with

8000 per day at CMC). There is a largeoutpatient department and 130 inpatient bedswith a plan to expand to 900 beds over 10years. We saw for ourselves the state of theart operating theatres which are alreadyrelieving pressure on CMC’s main hospital with75% of the surgeries referred from there.

The site will be split into zones: a hospitalzone, an academic zone (medical college andnursing college), and a residential zone. CMCare working with the developers to encouragebiodiversity and to protect the local wildlife,flora and fauna (see above).

Building work is well underway at CMC’snew campus at Kannigapuram (picturedabove). It is amazing how the site has changedin the last year since I visited for the bricklaying ceremony. There are 1,500 constructionworkers on site and the buildings havereached six storeys. The new multi-specialtyhospital with trauma care centre should beready by mid-2019 and will help relievepressure on the existing campus. TheGovernment of Tamil Nadu is working closelywith CMC and is looking at the centre as amodel to develop for the state.

CELEBRATING 100 YEARS OFMEDICAL EDUCATION

2018 is an important year for Christian MedicalCollege Vellore: it marks one hundred yearssince Dr Ida Scudder opened her medicalcollege for women. It was on August 12, 1918,that the first batch of students was admittedfor the Licensed Medical Practitioner course. CMC’s healthcare service is unique in the

very definition of healing and the delivery andpractice of healthcare - a holistic restoration,the emphasis on reaching out to themarginalised, and a focus on the spiritualdimension, with healing coming from God. CMC is planning various ways to mark this

centenary. They want to celebrate God’sfaithfulness to them as they look back and arereminded how God has blessed and enlargedthe medical mission work in India and to seekHis wisdom and guidance for the years ahead.They will remember those who have becomedoctors, those who have taught them and thegreat contribution they have made tohealthcare in India and beyond. A coffee tablebook entitled ‘Healing for the Nations’ hasbeen commissioned to commemorate thismilestone.“Give thanks to the Lord, for he is good! His

faithful love endures forever” (Psalm 136:1).



A SHORT VISIT TO RUHSAJanuary 2018

Pam and Brian Morris, together with Friends of Vellore (FOV) supporters Lee Morris and Janice Wise have just returned from a most successful visit to CMC’s Rural Unit of Health and

Social Affairs (RUHSA). Pam has written this update for our readers.

elderly and children benefit from sharing theirdays together. A meeting with the parentsconfirmed the high regard in which theplayschool is held by the community and weare very proud of the partnership betweenRUHSA, the Self Help Group Women who runthe centre, FOV and our supporters. During our visit we were very pleased to

meet Mr Paul Jebaraj who is an OccupationalTherapist and Training Officer based inRUHSA. He talked to us enthusiastically abouthis proposed Child Development Initiative, inparticular about the importance of earlyscreening to identify children with anydisability or developmental delay. Hedescribed one or two case studies whereintervention had changed the lives of childrenand helped the local community tounderstand and support the familiesconcerned. Over the years our visits have been both

joyful and at times very sad. We havepersonally known three young people aged 15to 18 years old who have taken their own livesand we have been told that whileapproximately 30% of deaths in the age range10-19 years are due to suicide, adolescent girlsare particularly vulnerable. We were,therefore, very pleased to meet with Dr Rita

and Dr Prashanth for an update on the‘Empowering Adolescent girls through healtheducation and counselling project’, a proposalwhich was supported by FOV last year. Wewere also invited to visit Vidyalakshmi Schoolto observe the first of two sessions on‘Relationships’.Dr Rita Isaac explained to us that due to the

wide range of adolescent concerns and thesensitivity of the subject, the team had takentime to carefully plan this project and haddecided to begin in schools with 13 and 14 yearold girls. Gaining the trust of the youngpeople and ultimately that of parents and thewider community cannot be rushed. There aremany cultural issues and traditions to respectwhilst endeavouring to help young girls tothrive in a modern India. This seems anambitious but very important and worthwhileendeavour and we wish the team success infacing the challenges ahead. Pamela Morris - Vellore Rural Communities

Trust, a subcommittee of FOV

members of Bishopston KuppamFriendship Link, Brian and I havevisited KV Kuppam many times

since 2003 and this was our second visit sincewe merged with FOV in 2015. It was Jan andLee’s first visit and they were most impressedby the work of RUHSA and overwhelmed bythe warmth and welcome extended to themby RUHSA staff and the local people.Our main focus, as always, was the

Pachaikilli Centre for Children and the Elderly.Shortly after our last visit in 2016, one of ourwonderful teachers, Padmini, left to take aposition in a government school and wefeared that she would be difficult to replace.She and her colleague Rani had an amazingrelationship and both were committed todelivering an excellent early years educationas taught to them by Sally Whittingham backin 2009 when the centre was first opened. We need not have worried. Rani and the

new teacher, Priya, are working well together,following an active, play based curriculumwhich also includes special time with theelderly who attend the centre five mornings aweek. It was very moving to observe theinteraction between them. The Pachaikilli Centre continues to gain a

reputation as a Centre of Excellence and the

As

Ball skills with teacher Priya

A special relationship

Spending time with the elderly



INITIATIVES TO REVIVE, RESTORE AND REBUILD MISSION HOSPITALS

India is getting stronger in medical care and even promotes medical tourism from the west.Chennai was once known as 'Temple City'; now it is known as 'City of Health'. But on-the-groundrealities are not encouraging. The poor and marginalised have very few places to go. The policiesencourage private corporate industry driven hospitals where the intentions are tangible profits.

improve the laboratory and community work.There is a high incidence of myocardialinfarction with almost three to four cases aweek and the nearest reliable hospital facility isabout three hours away. Those who are not sowell off cannot afford to travel there.CMC is running medical clinics in two

villages to increase awareness of the hospital.KMF needs staff (full time doctors inparticular), equipment and finances to givethe hospital an initial push.

ERODE CSI MISSION HOSPITALIt is now two years since the Memorandum ofUnderstanding was signed. Two slum clinicshave been started and one CMC graduate isworking there now. The nursing school istraining nurses who are then practising atother hospitals. The immediate need is to getthe building up to standard so it is structuraland safe. CMC has given the hospital sixmonths to do this before any furtherinvolvement.With the CSI Coimbatore Diocese

committing to renovate and rebuild the mainhospital building and structures at Erode, theCMC graduates serving their serviceobligation have taken on themselves to reachout to the urban poor. The obvious outcomeof rapid urbanization is the increase in slumdwellers mostly from the lower margin of thesociety. In order to serve this community, twourban health clinics have been opened,serving around 3000 households, in an areawith a predominant population of beediworkers (who roll thin cigarettes), weavers and

daily wage labourers. The people in boththese areas have been very enthusiastic andreceptive to this new initiative.

REYNOLDS MEMORIALHOSPITAL, WASHIM

On 17 October 2017, a Memorandum ofAgreement was signed between ChristianMedical College Vellore, Emmanuel HospitalAssociation (EHA) and Reynolds MemorialHospital (RMH) Society, Washim, Maharashtra.RMH, a 79-year-old hospital which has beenstruggling to continue its services,approached CMC for assistance.This is the first partnership with a mission

hospital in North India. The vision is torebuild, restore and improve the healthcarefacilities in the region. This is a significantinitiative in expanding medical services tomeet the needs of the unreached regions inthe country.

Please pray for God’s provision of all theneeds mentioned for these three hospitalsand pray that they would be a witness to thehealing ministry of Christ.

MC, seeking to be a witness to thehealing ministry of Christ, want toreach out to those in need. They

want to take healthcare beyond their owncampuses in Vellore to help other missionhospitals through the following frameworks:

1. Owned campuses: for example RUHSA,CHAD (Community Health andDevelopment), Chittoor, Kannigapuram.

2. Partnership Model: CMC is responding tothose hospitals that are willing to hand over the governance and management toCMC’s administration. Currently CMC haspartnered with three hospitals.

3. Associate Hospitals: hospitals that are doingwell and want occasional support or CMC’shelp to upscale some of their services.

4. Affiliate Hospitals: CMC would offersupport in certain areas such as improvingquality of laboratory tests or negotiatingprices for hospital supplies.

In 2017 we sent funds to cover Dr SamDavid’s travel expenses. Dr Sam works asCMC’s mission network consultant, visitingsmaller mission hospitals all over India to seeif CMC can offer support or partner moreformally with them. Three such partnershipshave already been set up:

KOTAGIRI MEDICAL FELLOWSHIPHOSPITAL (KMF)

KMF Hospital in Kotagiri is a 50-beddedhospital catering to a population of almostone million, of which about 60% are from atribal background. This hospital was started in1941 by Dr Pauline Jeffrey (biographer of Dr IdaScudder) and a few other missionaries withencouragement and support from Aunt Idaand CMC.In 2017, this hospital came under the

management of CMC and is in the process ofrenewing the medical work which had declinedover the last 10 years. It has well maintainedinfrastructure and a dedicated eye unit as wellas general services, an operating theatre and ahigh dependency unit. Plans are underway to

C

KMF local clinic

Urban Clinic at Vendipalayam, Erode

Reynolds Memorial Hospital



BRINGING HEALING ANDRESTORATION

For nearly 18 months, Friends of Vellore UK has been funding an occupational therapist working in Paediatricsurgery. This new post was created specifically to help burns victims and children suffering from

myelomeningocele. Dinesh took up the role in November 2016 and is doing a wonderful job. Thedepartment are full of gratitude to Friends of Vellore for making this appointment possible.

better outpatient services in a new dedicated burn care room. The Department of Paediatric Surgery has produced a video to

educate families on safety in the home and burns prevention. It is veryprofessionally done and is being shown in outpatient clinics andinpatient departments on hospital televisions. You can watch it via alink on our website.In January we paid for Dinesh to attend a burns care workshop in

Northern India. Dinesh writes: “It was a great experience I attended theworkshop. I met many experts, specialists in burns. I fully enjoyed theevent with so many interesting seminars, discussion anddemonstrations on various topics. They did a perfect pre-planned firstaid management demonstration. I attended Splinting workshop it was anice experience and I learned new ideas in splinting. And also I won 2ndprize in a quiz. I would like to express my heartfelt thanks to peoplewho have taken effort to send us to the workshop.”

inesh saw 175 patients in his first 14 months in thedepartment. He helps the children with their exercises, usingdiversion strategies where necessary, educates families on

scar management and enables a smooth transition from hospital tohome. He advises on coping strategies and provides valuablepsychological support to his patients. He keeps meticulous records andcan tell you all about each patient he has seen. You can read aboutsome of them in the patient stories below.Paediatric Surgery have been inundated with work as they could not

take in new paediatric surgical trainees on account of the restrictionsplaced on the college by the Indian government. Dinesh has beenextremely useful in filling the gaps arising from the shortage of registrarswith respect to burns care and he has blossomed into a very valuablemember of the team. He and the other burns team members havemanaged to cut down inpatient stay and soon they will be able to offer

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daughter was very badly burnt. Sending the neighbours, who had

congregated outside, to call her husband infrom the fields, they left their son in their careand quickly brought Ramyalekha to CMC.They were admitted to the Paediatric BurnsUnit. Ramyaleka had sustained 42% burns andneeded skin grafting. When she wasdischarged, the family was told to bring herfor weekly occupational therapy in theoutpatient department, in order to preventcontractures and ensure full mobility.

Ten year old Ramyalekha comes from Aarni; atown about 15 miles from Vellore. She isstudying in sixth grade at school. Her father,Sudhakaren, is a farmer. Ramyalekha and her younger brother

were playing in the courtyard with matches, as children do! Suddenly from the kitchenRamyalekha's mother heard screams and theyoung girl rushed in, with her dress aflame.Mrs Sudhakaren did her best to put out the flames as quickly as she could. Nevertheless she could see that her

Dinesh and Sister Sandhia with Ramyalekha

Dancing Girls

RAMYALEKHA

with 20% burns, as a result of running into live electrical wires.Four year old Sanjana Shri, climbing on the

table in the kitchen, had overbalanced andfallen into a pan of hot oil. Fortunately hermother quickly rescued her and speedilybrought her to CMC. As a result she only had13% burns.Both children were seen regularly in the

outpatient clinic by Dinesh.

Each Christmas the Paediatric Burns Unitthrows a Christmas party for patients whohave been seen during the preceding year.This is an enticing way to encourage parentsto bring their children for an annual check-up.Misba Fathima, aged five, on the left, and

Sanjana Shri, aged four, were two of the littlegirls who came to the Christmas Party in 2017.They loved dancing for everyone.Misba Fathima had come to the hospital

MISBA FATHIMA & SANJANA SHRI



burns to his arm and upper right chest. The mother called her husband and they

quickly brought Vinay to CMC. He wasadmitted to the Paediatric Burns Unit for oneweek, during which time the little boy hadskin grafts done. He was discharged home,returning for weekly follow-up andoccupational therapy at the outpatient clinic.

Two year old Vinay comes from Chittoor, atown about 18 miles from Vellore across theState border in Andhra Pradesh. His father,Babu, is a plumber. One day Vinay was playing in the kitchen

while his mother was cooking. She turnedher back for a moment. The toddler reachedup to peer in to see what was cooking in the pot on the stove. He pulled the pot of boiling rice onto himself, sustaining 23%

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Father, Babu, with Vinay, Dinesh and Sister Sandhia

VINAY

NANDITAMala and her husband, an auto rickshaw driver, live in one of the most disadvantaged parts of Vellore, not farfrom CMC’s Low Cost Effective Care Unit (LCECU). The couple are first cousins, living as part of a joint family.

The home is presided over by the mother-in-law, to whom all the working members give their wages andfrom whom the whole family receives such monies as they need. Mala has studied up to the age of sixteen.

to be identified as soon as possible. Remedialhelp given quickly maximises the chance of aninfant being able to develop to live a normallife and be a contributing member of society.Children from poor backgrounds need alltheir wits about them to survive and prosperin a harsh world. Ideally concerns should beraised by the time a baby is one month old. Bythe age of three months a diagnosis can bemade and by six months of age a hearing aid

may be fitted, so that the baby's speech is notseriously compromised.In Nandita's case, she was eleven months

old when Mala brought her to LCECU.Fortunately an audiologist from UK, who hasbeen generously providing high qualityhearing aids for the disadvantaged newbornand youngest school going children in the areaaround LCECU had brought a number ofhearing aids. These are donated throughFriends of Vellore UK. Nandita could be fittedwith a hearing aid, without charge, while anapplication is made to the Chief Minister'sFund which will provide money for a cochlearimplant. A cochlear implant costs about£7600, far beyond anything Mala and herhusband could afford.The Paediatric ENT Unit aims to seek out

and identify newborn babies and theyoungest school-going children with hearingloss, in order to offer remedial rehabilitationto give the most disadvantaged the bestchance to lead as full a normal life as possible.

he couple was delighted with theirfirstborn, a baby girl whom theynamed Mohanapriya. Now aged

four years, she is a bright child, full of chatterand enjoying the Balwadi, (nursery school)which she attends. The contrast betweenMohanapriya and their second baby, anotherdaughter called Nandita, became apparenteven by the time the little one reached elevenmonths. Nandita made no effort to speak anddid not appear to hear even loud noises. Malabecame very anxious and brought her toLCECU to the doctors there in whom she hadcome to have such confidence. Every weekthe Paediatric Ear Nose and Throat (ENT) Unitin CMC conducts a clinic in LCECU.Suspecting that the little one might have ahearing problem, they directed Mala to takethe child to the Main Hospital for furtherinvestigation. This showed that Nandita didindeed have a serious hearing loss, which hadprobably existed from birth. It is vital for hearing loss in newborn babies

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Nandita delighted with her hearing aid

SHOP TILL YOU DROP AND RAISE MONEY FOR FREE!



CMC’S DEPARTMENT OF PULMONARYMEDICINE BENEFIT FROM THE MEDICALTRAINING INITIATIVE OF THE ROYAL

COLLEGE OF PHYSICIANSBTUH are elaborated below.Endobronchial Ultrasound (EBUS): This is anadvanced bronchoscopy skill to access centralthoracic lesions and lymph nodes till thenaccessible only through surgical proceduresunder general anaesthesia. This procedure wasjust being introduced in India and DrThangakunam was in the right place to learnthese skills from Dr Dipak Mukherjee, lead forinterventional bronchoscopy at BTUH. Havinggained good experience, he was able toperform this independently on his return toCMC. Drs James, Gupta and Thomas had someexposure to EBUS through Dr Thangakunamprior to the programme, but their skills andexperience considerably increased duringtheir tenure at BTUH.Sleep medicine was the second

subspecialty area the department benefittedfrom the MTI exchange. Dr Samuel runs afully-fledged sleep service in the regionincluding full multichannel polysomnographyand is very proficient in the interpretation ofsleep tests. Although CMC had a sleep lab, theexperience and skills gained by all four of theCMC faculty has helped to expand andimprove the CMC sleep service followingtheir return.Cardiopulmonary Exercise Tests (CPET):

Although available in CMC, it was sparinglyused at a basic level. The exposure to thevariety and volume of CPET tests andexperience in reporting with Dr Samuel in the

Pulmonary Physiology lab at BTUH hasenabled this to become a comprehensiveclinical service at CMC. This has led tocollaborative training opportunities with thefirst Indian workshop on CPET organised atCMC in March 2018 with Dr Samuel.The faculty from CMC with Dr Samuel and

colleagues at BTUH had 6 publications in peerreviewed journals and 6 presentations ininternational conferences during the MTIprogramme. Dr Samuel facilitated placementsfor the CMC faculty in the Royal BromptonHospital, an internationally renownedrespiratory centre in specialised clinics such asinterstitial lung disease (ILD), ventilation andlung transplantation. This experienceparticularly in ILD directly translated toenhanced care of ILD patients with thedevelopment of the ILD-MDT in CMC. All fourCMC faculty were involved in the regionalteaching symposia organised in BTUH andhave collaborated since in teachingworkshops in India and the UK. Many other aspects of patient care,

education and communication skills havebenefitted the CMC faculty. The feedbackfrom BTUH has been very complimentary andthe exchange proved very beneficial to bothinstitutions and faculty thanks to the MTIprogramme of the RCP London. Dr Barney Thomas Jesudason IsaacAssociate Professor of Pulmonary MedicineCMC Vellore

2008, the Medical Training initiativewas started by the Royal Collegeof Physicians London (RCP), to

enable physicians from all over the world towork and train in the UK. Dr Johnson Samuel,Consultant Respiratory Physician and Directorof Medical Education in Basildon Universityhospital (BTUH), UK, an alumnus (Batch of 83)from Christian Medical College Vellore (CMC),trustee of Friends of Vellore and currentpresident of the CMC UK Alumni Association,proposed this initiative of the RCP and theopportunity to train at BTUH to thedepartment of Pulmonary Medicine in CMCVellore. In 2009, Dr Balamugesh Thangakunam, now

Professor of Pulmonary Medicine in CMC,used his study leave from CMC to avail of theMTI programme and train with Dr Samuel andhis colleagues at BTUH. He spent twomeaningful years in BTUH followed by DrPrince James & Dr Richa Gupta (2012 to 2014)and Dr Barney Thomas (2014 to 2016), allpermanent faculty in the PulmonaryDepartment, CMC. In addition to the facultyfrom the Pulmonary Department, Dr Samuelhas facilitated training posts for faculty fromCMC’s Department of Endocrinology, theCMC Chittoor campus and other CMCaffiliated medical mission organisations suchas the Emmanuel Hospital Association. Thethree main areas Pulmonary Medicine in CMChas benefitted through the MTI programme at

In

From left to right: Dr D J Christopher (Head of Pulmonary Medicine) with Dr Prince James, Dr Richa Gupta,Dr Balamugesh Thankgakunam and Dr Barney Thomas

Dr Balamugesh Thangakunam & Dr JohnsonSamuel at a presentation in Cambridge (2010)



OBITUARY:DR AGNES LESLIE

It is with great sadness that we inform you of the death of one of ourtrustees, Dr Agnes Leslie, who died peacefully after a long and debilitating

illness in the early hours of Saturday 3rd March 2018 aged 85.

and videos to church groups. For many years she served as DeputyChairman on the Board of Friends of Vellore. Agnes was a cornerstone ofFriends of Vellore, generously giving her time to meetings and discussions. Agnes was very involved in the Alumni Association from its inception,

and held various posts of responsibility on the Committee over theyears. She regularly attended alumni events in Vellore and the UK, andwas highly regarded because of her alumnus batch year which is of greatsignificance to those coming from Vellore. We thank God for Agnes and her wisdom, gentleness and untiring

devotion to CMC. She will be remembered for the kindness and concernshe showed, not just for her friends and their families, but also towardsthe needy. Her desire to help the poor and marginalised served by CMCinspired many in her church family, Christ Church Timperley, to join herin raising funds for Friends of Vellore. Please do remember her twochildren: Brian and Jean in your prayers.

gnes was a CMC graduate, of the batch of 1949. She laterworked at the Holdsworth Memorial Hospital, Mysore beforecoming to the UK for her postgraduate studies, becoming a

consultant anaesthetist in January 1966. She was the consultantanaesthetist at the first open heart operation in Britain and wasresponsible for the rostering of doctors in Manchester and thesurrounding areas. During a two year sabbatical at CMC on voluntaryservice, she enabled staff to take a much needed break from theirclinical duties and was greatly appreciated. In her last post beforeretirement, she was the consultant and clinical director of Anaesthesiaand Intensive Care at Manor Hospital, Walsall. Agnes was actively involved with the work of Friends of Vellore UK for

over 40 years. She was chair of the Manchester Branch, and previously ofthe Birmingham Branch, which raised funds through organising concerts,dinners and coffee mornings, making Christmas cards, and showing films

A

CMC UK ALUMNI ASSOCIATIONThe UK Alumni Association aims to promote social and professional

networks amongst CMC alumni in the UK and also with other internationalalumni and CMC Vellore.

In September 2018, the current President ofthe Alumni Association, Dr Johnson Samuel ishanding over to Dr Susan Das. Another recentchange on the committee is the newsecretary: Dr Sunil Zachariah. Below they givea brief introduction to themselves:

DR SUSAN DAS:BATCH OF 1984 MBBSFROM CMC VELLOREI finished MD GeneralMedicine from Vellorein 1995. In 2003, I cameto the UK, trained tobe a GP and obtainedmy MRCGP qualifica-tion. I am currentlyworking as a GP in the

riverside town of Ross-on-Wye inHerefordshire. I’m married to Kaustuv Das,also batch of 1984 MBBS who did MS GeneralSurgery in Vellore and is now working as a

Consultant Breast and Oncoplastic Surgeon inHereford. We have two daughters, one a civilservant in London and the other in LiverpoolMedical school.

DR SUNILZACHARIAH: BATCHOF 1990 MBBS FROMCMC VELLORE I received FRCP (UK)and CCST in Endocrin-ology and Medicine.I’m presently workingas Consultant Endo-crinologist in EastSurrey Hospital, Redhill,

Surrey and also as the Foundation DoctorsProgramme Director. I’m married to InduKoshi, Batch of 1990 who is working asConsultant Physician in Brighton and we haveone son Tarun, who is in Leicester MedicalSchool.

hey hold an annual meeting overthe first weekend of October in acentral location, with both time and

place being chosen to make it as convenientas possible for alumni of all ages to attend.The meeting provides a relaxing break frombusy schedules and is a time to catch up withold friends, make new ones, and reminisceabout the good old days. It is also a quiet timeof fellowship. There are usually talks about ongoing

expansion programmes in Vellore and alsoissues of concern where UK alumni may beable to support CMC. Speakers at the sessionscould be visiting faculty from Vellore, doctorsworking abroad or speakers from other walksof life sharing their experience and expertisewith the alumni.In addition the UK alumni association also

supports the charitable organization Friendsof Vellore, in their fundraising efforts andother endeavours.

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after, that is what really matters. I do not needto ask God for anything else.” I have heard so many different reactions to

bad news: “Are you sure?” “Can it be cured?”“Will alternative treatments work?” “Why didthis happen to me?” and “I don't believe it!”But never this. Where did such a reactioncome from? It was not that she did not knowwhat an untimely death implied; she had seena young husband die. Perhaps unlike most of us who

automatically notice what is wrong or lackingin our lives, letting that existential sore toothdominate our thinking; Kavita homed in onthe essentials: “What is most important inlife? If that is in place, let me focus on beinggrateful for it.” My eyes filled up, hers remained steady. We

were both silent for what seemed a long time,before her elderly mother spoke through herown tears. “I am old. I have been carryingbricks to feed these grandchildren. I don'tknow how much longer I will be there forthem. Please help us.” Thanks to a multinational clinical trial,

Kavita received the best availablechemotherapy. The contrast between theposh suite in which she receivedchemotherapy and the mat on the floor of

her thatched hut, evoked neither jealousy norawe, she took these disparities cheerfully inher stride. Sadly, Kavita did not respond to first-line or

second-line chemotherapy. The imagingfindings showed disease progression. Herincreasing belly and decreasing weight were aconstant reminder that the disease wasgrowing. Admission to the inpatient hospicewas offered, but her last desire was to die athome. Her second daughter joined a hostel run by

the Missionaries of Charity; the other twosisters would join her there after their motherdied. Kavita was very proud when her secondchild topped her class, then went on to say,“My eldest is not doing well in school. Herteachers in the government school complainthat she does not study hard enough.”“Can she really,” I wondered, “When at the

age of twelve she has to miss school in orderto be the cook and the baby sitter every timeher mother is admitted? Her performance as asurrogate mother is surely as praiseworthy asher sister's in school.” It was a sad morning when the slightly built,

undernourished 12-year-old came to theoutpatient clinic, carrying a 6-year-oldhandicapped sister on her waist, accompanied

he was a little woman with a bigsmile, a smile that seemed tosuggest that her life had been

joyously carefree. But this 32-year-old womanwas a widow, desperately poor, and themother of three children (the youngest badlyhandicapped) and was now diagnosed withcolonic cancer necessitating a colostomy. Justone of these many tragedies—widowhood, achild with special needs, severe poverty,cancer, or a colostomy—may have beenenough to shatter joy and faith in many of us,yet here she was smiling in the palliative careclinic. She had been married as a teenager and

had come to the hut in the hamlet in SouthIndia where her husband and his parents lived.They worked hard together to bring up theiryoung family. Her husband had died 3 yearsago, and she and her mother now earned theirliving carrying bricks as constructionlabourers. She spoke of how diffident she had been to

come to CMC when she started havingabdominal bloating and pain. When she heardthat she needed emergency surgery she hadprayed, “Lord I have three children, please takecare of me.” And the operation went well. But it had not gone well, I knew, because

the surgeons had found disseminatedperitoneal disease. The diversion colostomyhad relieved the pain, vomiting, and bloating,and Kavita1 therefore thought all disease hadbeen removed. How did one tell someone,whose brief life already had far more than itsfair share of tragedies, that the cancer was stillthere, that she would not live to see herchildren grow up? I forced myself to share the painful truth,

telling her that the cancer had not beenremoved, that it could be dangerous to herlife, that we would refer her for palliativechemotherapy, but would also need to helpher to find a place where her children couldbe cared for.Her first reaction to the news that she had

terminal cancer was surprising, “If you can finda home for my children, if they will be looked

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THAT IS ALL THATREALLY MATTERS

Dr Reena George,Professor and Head of the

Palliative Care Unit, CMC

Dr Reena George with a patient

1. Name changed2. Clark D. `Total pain', disciplinary power and the body in the work of Cicely Saunders, 1958–1967. Social Science & Medicine. 1999; 49(6):727-36.3. Remen R.N. Helping, Fixing or Serving? Shambhala Sun; 1999.



by their weeping grandmother. “Tell me what happened,” I said. “My mother was very tired last night. She

called my sister and me. She told me to lookafter my sister.” Her voice broke. “She wasable to kiss only the little one, and then hereyes closed.”

URGENT NEEDS AND IMPORTANT NEEDS

We look at a patient through the prism of ourprofessional discipline - be that surgery,nursing, oncology or physiotherapy. CicelySaunders, the founder of modern palliativecare had qualified as a nurse, a social workerand a doctor. She used the term total pain2 toencompass the suffering that is physical andemotional, social and spiritual, a suffering notonly of the patient but also of those who lovethem and need them. So often in so many aspects of life, it is the

urgent that screams for our attention. In ourwork too it is the physical pain, the vomiting,the breathlessness that we urgently have toaddress so that the patient and the family arebetter able to attend to what is important inthe short time that remains. But if we are not careful, the urgent might

become an end in itself. In Kavita’s case thesuffering was so stark that as a mother myself,I could empathize with the important, andmany of us together could help to address it. Yet, serenity does not come primarily from

ourselves or our ability to meet our patient’sneeds. The deepest answer lies within theGod-given strengths3 of the patient. Andmany times we receive as much or more thanwe give.

THE STRENGTH BEYOND THE NEED

Kavita’s grace and luminosity were for me ablessing, a prayer, a meditation. She moved

me to ask myself, “Do my troubles outweighmy blessings? What causes me to dwell on thesore tooth of my life, taking for grantedeverything that goes well? How can I redefinewhat is most essential to my peace of mind?”How can I be grateful for all that goes well, forall who bring blessings into my daily life? Many of our patients have faced far greater

life struggles than we have. The lessons theyhave learned about courage and grief, hopeand gratitude could have much to teach us ifwe but recognized that in the school of life,they are the experts, and we the novices. Our clinics, our wards, our communities are

filled with hidden saints. They wait for us todiscover their identity.Adapted from "Life's Lessons Lost…and

Learned." George R: Journal of ClinicalOncology, 28(10), 2010: 1806–1807. Reprintedwith permission. © 2010 American Society ofClinical Oncology. All rights reserved.

KANNAN

hey live in their own brick housewhich has a damaged asbestos roofand a cement floor. They have

electricity and water facilities but there is nosanitation. The house consists of a singleroom, measuring 10 feet by 15 feet, the cornerof which is used as a kitchen. They have two daughters and a son aged

30, 28 and 26 respectively. All of them aremarried, living separately with their ownfamilies about 300 km away from Salavanpet.Since the children are labourers on dailywages, they are not in a position to help theirparents financially. Kannan gets an old agepension of £10 per month and 20 kg of freerice which is provided by the Tamil NaduGovernment. With these they manage tohave two meals a day. Kannan came to the hospital with a history

of swelling on both sides of his groin for thepast five years. This increased in size onstraining and coughing, and reduced in sizewhen he lay down. Following investigations,he was diagnosed with a bilateral inguinalhernia. Appropriate surgery was carried outunder spinal and epidural anaesthesia. Afterfour days in hospital, he was discharged in a

clinically stable condition. He was advised toeat a normal diet, perform daily activities ashe could tolerate, avoid strenuous work forone month and return to the outpatientdepartment for review. Kannan’s care had to be provided completely

free because they had no resources to raiseany funds at the time of need. CMC and thefamily are very appreciative of Friends ofVellore’s continued support of the Person toPerson programme which funds treatment forpatients like Kannan.

77-year-old Kannan and his wife live at a place called Salavanpet, 7 km away from the Main Hospital.

Kannan with his wife

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The following article is taken from a series entitled Living Our Legacywritten by Mrs Usha Jesudason to mark the Centenary of Medical Educationin CMC, Vellore. Usha Jesudasan is a writer who lives in Vellore and has hada close relationship with CMC for over four decades.

The Scudder Auditorium wherecountless students have begun

following their calling

HOW DO WERECOGNISE A CALLING?

was a tragic night, just before theturn of the 20th century, when threeyoung women whose names we do

not know, died. Young Ida Scudder had comefrom America to be with her missionaryparents for a while before going to college. Shedid not want to be a missionary like herparents. She disliked the poverty, dust andsickness that pervaded India’s villages. Herdesire was to return to America and live thegood life of an educated lady.But during that holiday with her parents,

something happened to change her lifeforever. One night, when her father was awaytending to another very sick patient, threeyoung husbands knocked on her door, oneafter another. They needed help for their wiveswho were struggling through childbirth. Themen wanted a lady doctor only, and Ida notknowing what to do, sent the men away. Thenext morning, she heard that all three womenhad died.This tragedy changed the course of Ida’s life.

Throughout the next day, she experienced thatnagging feeling deep in her heart. The frivolous

life was not for her. She knew she had to goback to America to study medicine and train asa doctor so that she could come back to carefor India’s much neglected poor, sick women.When Dr Scudder returned to India, she did

not come with a vision to start a health carecentre or a medical college. She just saw thegreat need – to care for sick women andchildren - and then just offered herself whollyto meeting that need. Then she saw anotherneed - one for trained women doctors - andshe set out to meet that need. In doing so, sheset an example, for those who followed in herfootsteps – whether it was in caring for thesick, teaching and training future health carespecialists, or striving for new knowledge.Often, through a tragic event in our lives, we

are called to minister to others. Like DrScudder, we may not want to, but are pushedinto doing so. And years later, when we lookback and reflect, we see the Hand of Godleading us and connecting us with others whoeither need our help, or will journey with us.For some, inspiration or ‘calling’ comes fromlooking at someone else’s life. Many doctors

and nurses have come to train at CMC hearingnot only about Dr Scudder, but of the manywho came later, who dedicated themselvesinto living a CMC life – one of personalsacrifice, other centeredness and hard work.In today’s high-tech, fast paced world, is it

still possible to be ‘called’ to be of service toothers? To do the kind of work that no oneelse will? To be the kind of person who stillpractices values that have endured andsustained several generations?Can you still feel ‘called’ if your job is to sit

behind a desk for most of the day? Or to dothe same tests every day? How can you keepfrom doing your job like a robot, and be ofservice to others? That is something to thinkabout!Dr Scudder’s life shows us that a calling is not

a goal to be achieved, but a gift to be received.Receiving the gift graciously and with humilitywill tell us what to do with our lives. Once weidentify what it is, if we work with passion andjoy, even though our work may be boring androutine, ‘our lives will speak.’ Just as Dr Ida’sdoes a hundred years later.

It

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reaching out to the poor - wordpress.com...hospital in thottapalayam. i was upset to hear that and...

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