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St. Lukes Hospital. Hiranpur. Pakur. Jharkhand
First newsletter from Shubhro and Elisabeth at St Lukes Hospital Hiranpur.
On 9th August we left Scotland for a new venture here in India to revive medical and nursing services in a small village in the state of Jharkhand (formerly Bihar).
The village is Hiranpur, and St Lukes Hospital lies in a lovely situation surrounded by hills. The Church Missionary Society (Church of England) established St Lukes Hospital here in 1929.
First a little bit of history
Dr. H. C. Edmunds St Lukes original Medical Superintendent served here from 1929 to 1959 and was greatly loved and highly respected by everyone.
He handed over the reigns to Drs. Bryan and Helen Thompson in 1955, and they like Dr. Edmunds were hugely admired and loved and gave their entire working lives to serving the people of this area. Drs. Bryan and Helen Thompson retired from St Lukes in 1989 but a quarter century later, not a day passes without a patient mentioning Thompson Sahib with pride and gratitude.
Both the Edmunds and Thompson families made a big sacrifice having to be separated from their children for education, but those children still follow what is happening here in St Lukes Hospital with prayerful and practical support.
In February this year, Dr. Elizabeth Edmunds ( Dr. Edmunds daughter also a medical doctor, now in her 80s travelled up from her home in the south of England to Glasgow to discuss with a small group of us the possibility of reviving St Lukes.
Dr. Barnabas Murmu, the present Medical Superintendent had served here faithfully, working alongside the Thompsons as a young man, and taking over the leadership when they left in 1989. But, in recent years, as is the case in so many of the old mission hospitals, it had become impossible to recruit either nursing or medical staff, and the hospital gradually ground to a halt, closing its doors even to outpatients on 5th March 2014.
The meeting in February was held in the home of Dr. Kirsteen Dutton (nee Thompson their youngest daughter.) Kirsteen is also a doctor, an ophthalmologist, born in St Lukes, and having spent her formative years here in India, considers St Lukes her second home. Kirsteen and Elisabeth renewed contact and friendship in 1994, when Kirsteen was working In Purulyia Leprosy Mission, and Elisabeth in KSN Hospital Sarenga.
St Lukes has 170 beds, but with the potential for 250, and the predominant need is for maternal, child and eye services. But to run the hospital, we need resources, both human and financial. Initially, to get services up and running Shubhro budgeted for around 3000 per month, so we set about fundraising, in the hope we could get 300 people to agree to donate 10 per month.
Eventually, with funding, St Lukes will be able to function fully again on a no profit, no loss basis.
But, to do this effectively, there needs to be proper governance, with a Governing Body, and Hospital Service Rules, so that discipline and accountability be maintained. St Lukes has financial liabilities, which need to be dealt with prior to re-opening the hospital and running it under a transparent constitution.
For all this to even get off the ground, we need to build up a team - not just medical and nursing, but administrative, legal, and financial.
Our first priority is to the patients we serve, and at present our small team can only offer outpatient services. It may take years to establish a full team around us, and the same time to rebuild the infrastructure to deal with patients, but we have a strong sense of Gods leading and desire that this old hospital should once again become the thriving institution it once was.
We are very privileged to be working alongside, two retired Auxiliary Nurse Midwives Sister Susanna Tudu and Sister Jyoti Baha between them they have given over one hundred years of service here, and nursed not just the parents, but the grandparents of the patients we see in the clinic from day to day.
The present hospital staff consist of Dr. Barnabas Murmu, Shubhro and Elisabeth, Sister Susanna and Sister Jyoti, and James Hembrom a radiographer also retired. Then we have a younger Nursing Aid Kamalini, Kalidasi, our cleaner, and two maintenance/multipurpose workers Bhairon and Lal Mohammed. We also have two night guards Michael and Biswanath who patrol the entire hospital campus in the night. Peter Paul helps with patient registration and is an all-rounder acting as the teams eyes and ears and generally being aware of whats going on.
In our first three months we have seen over 1450 new patients and around 700 returns the clinic runs 6 days a week. We try to have a half day on Saturday, but often we are still there at 3pm. Sunday the clinic remains closed. Initially we saw patients on the verandah, but now we have moved into a ward, with more privacy, and shelter from the elements. There is still no water or electricity connection for the hospital, so we see patients by torchlight for the last 1-2 hours each day.
A story which illustrates the dire poverty of people here, and their helplessness in tragic circumstances..a teenage girl Sarala (name changed) was brought from her home a mile away in a rope bed carried on poles to the St Lukes OPD - she was clearly very sick, rousable but not fully conscious, deathly pale with a soaring fever, and pus pouring out of her. She had delivered her first baby at home under the care of a village dai (untrained local midwife). At delivery her baby son did not cry, and seemed to have breathing difficulty, was never able to suck and after a few hours started having convulsions which carried on until he died three days later. Sarala lost a lot of blood at delivery (according to her Mum) and from her third postnatal day she was running a high fever. It was not
until she became sleepy and not easily rousable that her family decided to bring her to St Lukes Hospital (SLH) - the closest to her home.
With this story and a very brief examination it was clear Sarala was in septic shock and needed hospitalisation, intravenous antibiotics and a blood transfusion. Explaining the seriousness of the situation to the family, and the fact that Sarala could die without the correct treatment, they got money together and organised an auto (three wheeler vehicle) to take Sarala to the nearest government hospital about 15 miles away. The most tragic part of this story is that Sarala was booked to deliver her baby in this same government hospital. Because the family fall below the poverty line they are given free treatment in the government hospital, and free transport to and from the hospital. But the free ambulance transport can only happen twice, and during her pregnancy at 7 months and then again at eight months Sarala had episodes of false labour pain, so she had used up her two free ambulance transports to the hospital, and when it came to her true labour the family had no financial means to get her to the government hospital 15 miles away. Had she been delivered there, she would most likely be now at home with her baby son.
This elderly gentleman could only manage to come to St Lukes OPD, because his slightly less elderly friend offered to take him on his bicycle. It was during the rainy season you can see the umbrella hooked over the handlebars, but neither of these men had shoes. It was painfully difficult for the old man to walk down the steps with the aid of his stick, and having got to the bottom of the steps and handed his stick to his friend, you can see in his face his anxious determination to get himself seated. Once on, he is contemplating the long painful journey home with the possibility of further heavy rain en route.
And ..finally they are off.
We can vouch for just how difficult it is to balance seated on the back of the bike it is almost easier for the person in front pushing the bike, though this is also a challenge with somebody sitting behind.
And the little 8 year old girl below also managed to get to the OPD with her parents on a bicycle. When I saw them arriving, I wondered why they needed so many blankets on the back of the bike, until I saw the blankets moving and noticed a little foot underneath. This little girl is in acute kidney failure, but we do not know why. The most likely cause is a preceding infection, since she had been apparently well until a few weeks previously. You can see her eyelids and tummy are swollen up with fluid, and if you look carefully you can also see
some brown marks on her tummy. These are healing burn marks burning the skin on the outside is a traditional treatment for any ailment which is going on in the inside, so this little one has been subjected to the burning treatment. Apart from all the fluid that swells her tummy and cause discomfort, being in kidney failure is exhausting, and having to contemplate travelling by bicycle only
increases her suffering but she and her parents were desperate for a cure.
Here she is with her Dad, preparing to go home she will put her arms around her Mum, who will be sitting on the saddle, and her Dad will peddle them both - a really difficult balancing act for all three.
When we worked in Sarenga KSN Hospital in the early 1990s occasionally patients were brought in on rope beds. But as the roads improved, and the peoples means improved it became a rare sight, and has not been seen in Sarenga for the past decade. But in SLH there are still many families who have no form of transport.and this is their only option. Here, the majority come to OPD walking, but occasionally by bicycle motorcycle or rarely by car.
In early October, a surgeon, Dr. R K Chadhuri - from Pakur Government Hospital phoned Shubhro to offer his services at SLH