The Christian Hospital of Mugeli IndiaPosted: December 9, 2013
The Christian Hospital of Mungeli India
The Christian Hospital Mungeli has been serving the community for the past 116 years. The hospital, in this past year, has been able to move further in new adventures and strides which has brought recognition and stability. Christian Hospital Mungeli has become known in this region for both sophistication and compassionate medical care for the marginalized at the lowest affordable cost. The addition of the School of Nursing and the addition of the CT scan machine have been major landmarks in this past year. However, these are only some accomplishments among many.
In a year, almost 30,000 patients are seen. This number keeps growing each year. As the population of India increased, the number of infant deliveries also increased this year to 616 and there was a reduction in the number of intra-uterine deaths that often are due to delayed care. It is satisfying to know that patients are coming to the hospital more quickly than before. This is most evident in snake bites and scorpion stings. Originally many patients were brought in too late. Now they are well-aware that the hospital is there and, although some will also try both traditional and hospital care for treatment, in many situations people come directly to the hospital. Sadly there was a shortage of anti-snake venom in the country and it was a challenge to make sure that there was always some on hand.
The surgical department usually experienced an overflow of patients. There was always a flood of students who liked to observe and help in the OR as they came to the hospital for their academic electives. Dr. Deeptiman James has joined the staff, along with Global Ministries staff Dr. Anil Henry, in surgery. He has been able to start off making an impression in the community, as he really cares about the patients that he operates on. It is hoped that his services may be expanded. This might mean that a new OR block would be needed, as joint replacements would be added. Dr. Samuel continues to be one of the pillars of Mungeli but fractured his leg some time ago. He continued hobbling around in a cast with support while the services of the hospital continued on.
There were over 600 deliveries during the past year. There is now some amount of outreach, as the nursing students have been reaching out to the villages as they go on their visits. This will make a difference with the kind of cases coming into the hospital. Dr. Ipsita will be joining the staff as soon as she finishes her studies. The sickest patients that came in were those who came from a long distance and had been rejected in other places, including the government hospital, and thus came for refuge as the last hope of life. Some of these were mothers who came with severe jaundice, anemia, high blood pressure, and convulsions (ecclampsia), a ruptured uterus, or malaria. These cases have a high mortality rate and other hospitals do not want to deal with them. It took much more work and effort to take these patients in the latter stages of sickness and attempt to save some of these mothers.
During the past year, lab services increased and the demand continues to grow. There were over 48,000 lab tests that were done by the four lab technicians that we have. Services in haematology, biochemistry, microbiology, and blood banking have been increased as well. The hospital continues to struggle to find donors willing to give blood. There has been some awareness and young students are sometimes willing to come and give, but there is a lot of work that still needs to be done.
The medical imaging this year made many changes by getting into digital imaging and then acquiring a PACS, a system by which radiological imaging can be examined, compressed, and transferred through the internet. A new 500 mA x-ray unit for higher penetration was acquired as well as the CR system for digitalization. All of this information needed to be stored, and Mungeli became the first hospital in the region to have a PACS that stores all the images on a large server.
The greatest addition to all this was the CT scanner. This is a special spiral CT which can reconstruct images and do all sorts of fancy things to help recreate a lesion in the body to assist in the treatment. This equipment is a first in the region and the scans are cheaper than those done in any city nearby. The CT scans are read by tele-radiology, which means that a radiologist logs into our machine remotely every day and reads and reports the scans of all the patients that were done that day. A second ultrasound machine was also acquired. This ultrasound is a state-of-the-art machine with facilities for color doppler and cardiac echo.
The dental department has been handled by Dr. Nirmal, who has been a great help. He not only works with his own patients, but also helps out with the load of general patients. He assists in cases in the OR which are maxilla-facial and need suturing, as well as being a part of the big cases that we do for oral carcinomas, where major resections and reconstruction are done.
The physiotherapy department continues to grow each year with the variety of patients. With the addition of Dr. Deeptiman, a greater need for physiotherapy has been realized. An occupational therapist from Australia joined the staff and has been able to put a different angle on the kinds of activities that go on in the department.
RSBY Smart Card Insurance Program
Mungeli Hospital participates in a government health insurance program for low-income families called RSBY. Basically, the government pays premiums to an insurance company on behalf of families living below the poverty line. This provides a family of five access to care worth Rs.30,000 (approximately $665) in a year. The benefit applies only to inpatient services, and there are packages by which the hospital is supposed to receive reimbursement. It is now alarmingly true that the number of patients that come with these cards is increasing day by day enabling more patients to be helped. The sad part of it is that there are still the poorest of poor who are not able to get this card, as they are left out. As the program continues the poor are getting awareness, and it is hoped that the program will continue to grow as is the plant by the government. As usual with all insurance companies, there is a very large outstanding amount that the hospital is yet to receive.
Accommodations For Relatives Of Patients
The main activity of the hospital is to take care of the patients; however, when there is a group of 10 – 12 relatives that also comes with each patient, they also are in need of attention. A large hall has been converted for their use, called the Dharamshala, which is free of charge. A kitchen provides subsidized meals and a place where they can cook their meals by gas stoves. It has been difficult for the gas company to keep up with the high load which is required; thus, the hospital has had gas crises at times requiring the relatives to go back to burning wood. Wood, of course, is free to them, but the consequences to the environment are evident and sad.
School Of Nursing
The School of Nursing has now completed its first year of existence with a total of 20 students in 2011 and again in 2012. The hospital could actually handle 30 but there is a shortage of accommodations. Once this gets settled, there will be 30 students each year. The presence of the students on campus has changed the atmosphere of the staff. There is a sense of new life, responsibility and, surely, liveliness which the community has experienced with this growth. A “Capping Celebration” was held in February, and Reverend Landa Simmons was the chief guest, along with Debbie Briese. This was a very special occasion, as it was the first of its kind in the community. At this point, the primary focus for strengthening the School of Nursing is to provide enough space to house the two classes of students on two floors above the guest house. A new nursing hostel needs to be built which will accommodate about 220 students and staff. This is being planned, and ground breaking will take place in about two months.
Automation of the cooking facilities is helping to feed these nurses as the number will grow substantially.
The crèche is a facility that was recently started with a class of six children. This program is geared for children of working women. The children play and learn songs, alphabets, and numbers. The vision with starting the crèche is:
- To bring in children at a younger age to monitor their nutrition and start them on a good road to health.
- To build up their skills in being able to sit, learn, and play with other children.
- Prepare them to be ready to go on to the Rambo Memorial School.
Rambo Memorial English Medium School
The Rambo Memorial School is the hope for tomorrow. This is what will bring true change in Mungeli for the next generation. The school has been increasing in numbers each year and now there are more than 600 children. This growth prompted the purchase of a fourth school bus last year and, beginning the following year, a fifth school route was started. It is something special to be teaching village children using an English medium, and it is felt that this will surely be the way to “get the frogs out of the pond” and into the world. Thanks go out to the friends and volunteers who come and assist with classes and enlightening the children both in speaking English and in teaching them about the world that God has made around us with many amazing things. The main way forward has been to work with the Church to get their agreement that the school will be functioning under the administration of the hospital. This is essential as long as the school needs to grow. Right now, the school is basically in a large bungalow and there is no more space available. It is for that reason that ground was broken and a new building is being constructed. Six classrooms are almost complete and, when it is done, this facility will be able to educate 1,000 children.
This year the hospital has done well, and has been able to do a lot, not only to improve the facilities in the hospital, but also to work with the infrastructure.
Hospital Management Software
A new company was secured, Aavanor, based in Chennai, India, to provide hospital management software. The software has brought about a paperless Outpatient Department, starting with patient registration where a nice hard plastic ID card is given with a bar code on it and the patient’s picture which the patient will keep. This system will also be linked to our new PACS server in the X-ray department so staff will be able to view reports and pictures on any of the computer screens in the hospital. It is hoped that staff can learn and begin the process of storing and viewing images that are saved on the ultrasound and the gastro-scope. This software will be able to give additional accuracy in storing and retrieving data as well as make the work of the hospital more streamlined and easy. There is no doubt that the doctors will have to learn to enter data into the computer and will have to know the software.
Major Equipment Acquisitions
The following equipment was purchased during the past year: more air conditioners, a CT scanner, spiral CT 16 slice machine, a video gastro-scope and video trachea-bronchoscope, a new incinerator, ventilators, a solar water heater for the new nursing hostel and staff homes, a new school bus, a 500mA x-ray machine, a digital CR system for x-rays, new picture archiving and communication system PACS, two water coolers, a cement mixture machine, a cancer therapy machine, new hospital management software, and a new ambulance.
Renovation and building projects at the hospital continued. This year approximately $75,000 was spent toward these renovations and building of new structures. Completed projects include: Conference room and library, new x-ray room and CT scanner room (x-ray department), burn unit with four private rooms, two apartments above existing staff houses, two floors and extension of the old guest house (now the temporary Student Nursing Hostel), cancer machine and infrastructure placed in the cancer treatment center, renovation and building of the boys’ hostel/old nursing superintendent’s house, and building and furnishing of classrooms for the School of Nursing.
Plans For The Future
Over the past nine years, Mungeli has been dreaming and moving along with a vision which has started new endeavors, but it will be necessary to build up the infrastructure for these. Most of all, Mungeli is an exciting place to be. There is always change and there are always surprises that bring staff to the end of the day praising God for guidance as each project gets completed. This next year, one of the anticipated new projects will be the cancer treatment services. This is a dream which is almost realized. The building is completed and the machine is being installed. The prayer is to find the technical hands and the doctor to head this department. God answers prayers, and Dr. Sudeep Marcus has gotten into the radiotherapy course in CMC Ludhiana and will be done in another two years. He is the future of this project. In the meantime, the project will start with current staff and God will guide the way, as always. Also in the planning are:
- The completion of the new school building. This is something which will take some time. Six classrooms are done, and the other six are being completed on the first floor, with two more floors to go.
- The building of a nurses’ hostel. This is becoming urgent, as housing for the nursing students this next year is desperately needed. This project will start very soon and donations are coming in to help get the work started.
- A new water tank will need to be purchased. Construction on this structure has already begun and this project will also have a water recycling system for grey water. Right now the hospital manages with two 2,000-litre tanks on top of the ward.
- More staff housing is needed. This needs to be done if services continue to expand at the rate they are going.
- Begin, in a small way, a survey and community health project.
- There is also interest by the Damien foundation to start an orphanage. This would be a great program to start since the school and the medical facility are already in place and the food will be the only thing that will need to be added.
There is no doubt that nothing could be possible without the support of the hospital staff. They are the backbone of the hospital. The pillars of the medical work are the doctors, of course. Then there is the rest of the staff that put in many extra hours of work in order to produce the excellent results that you see in this report. Staff have been able to attend conferences, including one in Chennai where ten staff members were able to attend the CMAI conference. There have been other conferences and meetings in which staff members have taken part, as well.
The restoration work on the Bishrampur church has been completed. This has been a great accomplishment. This was the first church that was built by Reverend Oscar Lohr in 1868, and it was in shambles. The restoration expenses were defrayed considerably by generous donations of from the Whitcomb family and Sandy Springs Christian Church in Atlanta, Georgia. The rest of the load of was then taken on by the hospital. The opening ceremony was attended by the heads of both the United Church of Christ, Reverend Geoffrey Black, and the Christian Church (Disciples of Christ), Reverend Sharon Watkins. It was a grand celebration with about 4,000 people in attendance. A lunch was enjoyed right after the ceremony.
Every morning, the hospital staff meet in the chapel for morning prayers. It is, however, getting evident that the building needs major help. Therefore, a new chapel will need to be built and plans are being made for this.