Odisha and Christian hospital Bissamcuttack
I was stuck in my own mind on what do to with my life as everything seemed to have reached a road block. Should I join the rat race and attend a bunch of coaching classes that would help me get a post graduate degree or stay at home and think or just find a place to work?
Well obviously the sensible thing to do was to join a centre and prepare for the all India medical pg exams, since this was the only exam at that point of time that's I could appear for with a chance of getting a clinical subject for my career in medicine. Now since I am far from the sensible I started looking up organisations like MSF where I could get the adrenalin rush I crave for, I found some place in north India in Bihar where MSF had an opening and so was seriously giving thought to it, the only thing that halted me dead in my track was the fact that I knew absolutely nothing about medicine in rural areas. That's when a family friend Ashish Koshy told me about this place in Odisha where his brother in law was working at and how they were always on the lookout for doctors,no job interview just straight up join and get cracking, thus started a short correspondence with John Cherian Oomen, so this guy is an expert on malaria and is on a number national and international committees, thought he would be a bit difficult to correspond too, but he was very approachable and a gentleman. So I took the decision to go to Odisha in the tiny rural town called bissamcuttack.
Now the only things I ever heard of Odisha were about cyclones, real poor people, tribal area, and naxals and communal riots. Nothing good about this place ever. The pace picked up and within a week I was packed and ready to go, turned out Dr Johnny was coming to my place in Pune to visit his
94 year old dad Rev A C. Oommen a freedom fighter and Gandhian,and a wise man ,one of the best men I've ever had the opportunity of getting to know. So the three of us would travel together to
Christian hospital Bissamcuttack.
I don't really need to validate my thoughts but want to tell you that the education system in India and the globe. The education system is tailored for industrialism and capitalism, it creates an illusion of need where in fact there is no need. It speaks of progress, but at what cost, it has lost the humanity. There is no doubt that the system has been effective in bringing change, the only problem I see here is that the system itself has not evolved for the new needs of the 21st century where information is available at your fingertips, the system is supposed to aid a person to becoming the best he can, but resources are not equal, opportunities are not equal, and the system imposes itself on you. So all in all the system created a system, a bunch of robots, original thinking and creativity is taking a back seat. I went through this system as has everyone else I know. So this step that I took, a leap of faith, something off the beaten track, some would associate with my character but I thought of it as a stroke of luck because this decision changed the way I saw medicine. I hope you find 'your stroke of luck' early on in your days.
March 19 2015, yes that date is stuck in my mind forever, we reached Bissamcuttack on that night
after a full day of travel. It was a dark path that lead to the door of our house dimly lit by a yellow
bulb, three guys came out in loud voices greeting Dr John they, they took out the bags into the house a spooky looking house at night but I didn't mind that. Work would start at 730am the next day. Those voices I mentioned earlier would later become those of dear friends.
The morning of the 20th I was asked which department I would like to join, traditionally the choice was medicine and that's what I wanted to pursue, but all chairs were filled in medicine so I sort of reluctantly joined the surgery department.
Work in Bissamcuttack is like wine, you just can't seem to get enough. There are no fixed hours you just work till you finish, and then catch some sleep and get cracking the next day whether you had night shift or not. Even the senior doctors would do night shifts so no excuses here. Also you must realise the name of the hospital has no bias against other religions the employees are from all faiths, as are the patients and care is given equally irrespective of caste or creed.
The hospital serves the people from three districts a radius of 200km there is no other hospital that
provides the quality of secondary care that you experience at CHB. The government hospitals are run
shabbily, and so people prefer to get treatment from CHB. The hospital provides care in general medicine, general surgery, obstetrics and gynaecology, paediatrics, orthopaedics, dental and
ophthalmology and has a community health department which takes care of 50 villages called
MITRA. The capacity of the hospital is at 250 beds,with a daily average of about 300 out patients and 95% bed occupancy. The number of doctors has been fluctuating between 7 and 14, with some interns from the Martin Luther Christian university from Shillong who have done their Bsc in community health, the opd runs from 8am to the last patient in the evening. There are no units in any of the departments, the surgery department has no fixed operating days or opd days, both are done simultaneously everyday, averaging around 15 general surgery cases and 10 gynaecology and obstetric cases per day.
The real highlight of the hospital is the nursing school and the care that they are trained to give to the patients. They set some real high standards, the nursing school gives degrees in ANM and GNM for the candidate.
The hospital began as a tiny clinic on the verandah of a church by Dr Lis Madsen a Danish doctor with a vision and the commitment to serve the poor in India. What made a highly educated white woman want to come to India and work in this jungle where tigers and leopards roamed the country and where there was absolutely no connection to the outside world, I don't know, how she found out
of this place? Most likely through the Danish missoinaries who had been here before, what urged her to stay despite the great adversity? Must have been a real crazy woman with a great heart.
The main hospital that we see today was founded in 1954 with funding from the Danish and German missions, the hospital has grown steadily under the leadership of Dr Madsen who then in 1975 handed it over to Dr V K Henry and his wife Mrs Nancy Henry who took over the hospital in a real difficult time as fund money from the missions at Denmark and Germany run dry. They slowly but steadily raised funds from America and got he hospital back on track. Dr Henry was by all means a great surgeon from all the stories I've heard of him he was a kind man with real love for his work he was a maverick. Together they started the school of nursing here at CHB in 1979 mainly
for the local girls and provided a free education to them. They were in charge of the hospital till 1998
when they handed over the hospitals responsibilities to Dr Padmashree Sahu who is the obstetrician
and gynaecologist at present, when she retired she handed over to Dr Hemaprabha Mohanty who is
the present medical superintendent and the ophthalmologist. Today the hospital is a non for profit organisation that is self sufficient.
I started working with Dr Sunil Jiwanmall who is the chief surgeon and Dr Anupam Dey in the department of surgery, the first day I had was like the longest day of my life but I enjoyed I thoroughly, and I asked myself ' what have I got myself into'. The first two weeks I had been kept in the surgery opd to beta feel of things, it was quite boring but then once the theatre doors were opened I couldn't have asked for more. I was given hands on experience and taught at a brisk pace that I absolutely enjoyed, now all those days of standing aimlessly in the medical college theatre finally made sense when I was in the thick of action. The adrenaline keeps pumping you don't feel the tiredness of running 4 theatres simulataneously you feel good about yourself and ask for more work. With the limited resources that you have you learn to manage things precisely, make rational decisions and take calculated risks. The pay is less here but the feel good and satisfied factor is priceless.
After 8 whirlwind months in surgery I had decided to leave and join the department of general medicine, the decision was also made partly because I had crashed my motorbike into a bunch of cows at night and suffered a concussion with amnesia, also note that in India at this,juncture of time the cow is more protected than women and children...... what a world we live in.. So I took 3 days off and then started my medicine rotation at the end of October. The head of general medicine at the time of my rotation was and still is Dr Pragya Jiwanmall, also the orthopaedic surgeon Dr Suranjan Bhatacharji sits in the medicine opd and attends to the ortho patients as well as the medicine patients. Dr SB is a wonderful human being, and very approachable like all the senior doctors out here in Bissamcuttack, he used to be the director of CMC vellore, but doesn't show an inkling of pride that
you would normally associate with someone who ran an institute as prestigious as CMC vellore. I
learnt how to be gentle, understanding and the fact that how much ever a patient is ignorant about his
illness that we are dealing mostly with adults, mature people who may have unforeseen difficulty in
their lives and are looking for someone to give them some tender loving care than to just see a doctor, just be a good human being to them.
This paragraph is about the difficulties of working in such a demanding place. Yes I enjoyed the work
but sometimes things get out of hand, tempers can flare, friends betrayed, daggers drawn. I am not
known for a calm demeanour at times when I feel things could have been done better and more efficiently than what actually took place. Certain staff members, colleagues can become hostile to you if you behave in such a manner, especially in places like this where everyone is related to everyone else, the repercussions of such behaviour are quite annoying, to say the least, unprofessional. This does not mean that I am always right but I'm trying to convey the fact that I too can be wrong
but will accept my mistakes learn from them and move on, but there will always be some false accusations that cannot be forgotten, let me tell you frankly that all is not rosy in CHB and for the matter at any work place. But time can change people and time can heal but healing can leave some pretty nasty scars, ugly hypertrophied scars if you may. One example would be that of fallouts between the great leaders of this hospital like Dr Madsen and Dr Kai Pederson. Dr Kai Pederson was the brilliant doctor a great doctor but not much of a social person, Dr Madsen a pioneer a stubborn lady and someone with strong views. Egos clashed and it was one or the other, in the end Dr Pederson was literally banished from the hospital and his name was erased from any historical literature written about the hospital.so now with the lessons learnt from the past the lessons learnt from the present the younger doctors will need to work for a future that is conducive to attend well to the needs of the people at the same time being courteous to your colleague and especially the one whom you have authority over to bring in the uncertain future and to be prepared to face it with courage. With hindsight and foresight the future of this place looks good.The most important and most significant part of this line of work is with the people, the people of Odisha. Most of my interactions on a day to day basis are limited within the boundaries of the hospital,and a once in awhile interaction with the locals in the marketplace and some tribal children in the MRSK school in kachapaju, so my views may not be accurate.
What I have experienced from my interactions with the patients is that they are a very hardworking class with very little or no formal education, they live life in the present, deal with the difficulties as they occur, and are very accepting and tolerant to adverse events in their lives.
From the medical point of view, they have almost no concept of disease, they do not fear death they do not understand why they fall sick attributing disease to bad water or air. They live more or less peaceful lives, many of them have never seen a toilet, many of them have never seen a building with more than one floor. They fear the modern world and modern methods of man, considering most things modern to be taboo, they distrust people wearing western clothing, they fear being cheated and tricked and taken advantage of,they have not seen the world beyond their villages and are also very very poor.Let me give you an account of my interaction with the type of patient that I generally see in the OPD. There is no dress code in the OPD for doctors so to seem more approachable and look friendlier I wear casuals like a t-shirt and cargos, they will open up better if you dress simple, a bit of shabbiness helps too😜
I call the name on the OPD card through the mic and in comes a patient who looks totally lost, searching for someone who called his or her name heard over the speakers in a room where I am the only person sitting, I then ask him in Odisha ' thumoro naam koounthu' which means tell me your name please,the patient looking stunned and again staring around the room with all his belongings in a cloth bag and keeping silent, I repeat my question two more times and then I get a response 'Hoi agayan moro naam' which means yes sir that's my name. Then I ask him to come and sit and ask him what's your problem ' assontu bassontu, ebe koowo kauno asuvdha occhi?' So here I am sitting and wondering why he could not figure out who was calling him from a room with just one person sitting in it, after a few months of being baffled by this I realised that a lot these people have had ear infections repeatedly during their lives and now have hearing loss, and definitely there are some who are just too keenly observing the room that they don't realise that I have got work to do and a long day ahead. Now the history taking occurs with the patient saying ' Moro deha re soor soor karuchi, hatho godo sab bothaochi, mundo sabbubelle buuluchi aur bothaochi' I have got soor soor sensation all over my body and my hands and feet hurt, my head is dizzy and aches all the time. All this being described by him or her by pointing to all parts described and running his hands down his arms and feet, all this mostly because I don't know to speak odiya very well and also to get me to give my undivided attention to his or her problem. At the end of all I am asked ' agayan moro kompooter karibarochi' , I want to do the computer test, this is their description for ultrasonography, pretty accurate but they think it is a form of treatment and since Amitabh Bacchan says on his show kaun banega crorepati that the computer has all the answers. Patients trust the machine but do not realise that the doctor interprets the images and it is just a tool to reach a diagnosis, they also want the USG for all disease whether it's a dermatology problem or an obvious limb fracture. I write the history on the card and send him on his way for investigations after scolding him for asking me for the USG, reluctantly he walks away, saying that he has come from a far off place and came just for the USG, I then scold him some more and tell him it's an unnecessary test and that I have done a thorough clinical examination and deemed it unnecessary. The point here is that he has more faith in the machine than in me, the only way I can reverse this is by getting him properly examined, diagnosed and treated. I have to be firm and confident in my approach since the USG is an expensive test and how much money can a man in rags afford to spend, there are many patients who have been to different doctors and have spent thousands of rupees on unnecessary investigations for a disease that could have been diagnosed with clinical skills, they also want to test my competence as well as the competence of the other doctors, so I am in a competition that I am unaware of, that is going on in the patients mind. I have to win the patients trust on as many occasions as possible.
What happens when you cannot treat a certain illness or if the patient is too ill and suffering from a common illness but has developed complications? This is a dicey situation, but again make your decision firm and explain like you would to a five year old about his or her illness, explain the complications and possible outcomes use plenty of metaphors and similes they love that, leave the onus on the patients relatives and patient. A good number will most likely go back to their villages to die at home,the reason we don't admit very sick patients whom we predict will die in hospital is that the bed could be used for someone who can be treated and saved, asking a poor man to go to the big city for treatment is like asking me to go to New York or London if I was suffering something horrible. But always give the patient your time however busy you are.
The hospital has been recognised by the TATA trust which is the charity wing of the TATA group as a place of great need and they have been kind enough to put in several crores of rupees that would help make the hospital provide better care like one would expect at a modern city hospital but also to keep in mind that the main service is to the poor. The project is already underway construction has begun and the scheduled time limit is 2019 March if I'm not wrong.
So this is a summary of my thoughts and experiences after 1year and 4 months of working at CHB, still got many months left, being optimistic at the future and at the same time realistic if the two can be possible at the same time.
Now the only things I ever heard of Odisha were about cyclones, real poor people, tribal area, and naxals and communal riots. Nothing good about this place ever. The pace picked up and within a week I was packed and ready to go, turned out Dr Johnny was coming to my place in Pune to visit his
94 year old dad Rev A C. Oommen a freedom fighter and Gandhian,and a wise man ,one of the best men I've ever had the opportunity of getting to know. So the three of us would travel together to
Christian hospital Bissamcuttack.
I don't really need to validate my thoughts but want to tell you that the education system in India and the globe. The education system is tailored for industrialism and capitalism, it creates an illusion of need where in fact there is no need. It speaks of progress, but at what cost, it has lost the humanity. There is no doubt that the system has been effective in bringing change, the only problem I see here is that the system itself has not evolved for the new needs of the 21st century where information is available at your fingertips, the system is supposed to aid a person to becoming the best he can, but resources are not equal, opportunities are not equal, and the system imposes itself on you. So all in all the system created a system, a bunch of robots, original thinking and creativity is taking a back seat. I went through this system as has everyone else I know. So this step that I took, a leap of faith, something off the beaten track, some would associate with my character but I thought of it as a stroke of luck because this decision changed the way I saw medicine. I hope you find 'your stroke of luck' early on in your days.
March 19 2015, yes that date is stuck in my mind forever, we reached Bissamcuttack on that night
after a full day of travel. It was a dark path that lead to the door of our house dimly lit by a yellow
bulb, three guys came out in loud voices greeting Dr John they, they took out the bags into the house a spooky looking house at night but I didn't mind that. Work would start at 730am the next day. Those voices I mentioned earlier would later become those of dear friends.
The morning of the 20th I was asked which department I would like to join, traditionally the choice was medicine and that's what I wanted to pursue, but all chairs were filled in medicine so I sort of reluctantly joined the surgery department.
Work in Bissamcuttack is like wine, you just can't seem to get enough. There are no fixed hours you just work till you finish, and then catch some sleep and get cracking the next day whether you had night shift or not. Even the senior doctors would do night shifts so no excuses here. Also you must realise the name of the hospital has no bias against other religions the employees are from all faiths, as are the patients and care is given equally irrespective of caste or creed.
The hospital serves the people from three districts a radius of 200km there is no other hospital that
provides the quality of secondary care that you experience at CHB. The government hospitals are run
shabbily, and so people prefer to get treatment from CHB. The hospital provides care in general medicine, general surgery, obstetrics and gynaecology, paediatrics, orthopaedics, dental and
ophthalmology and has a community health department which takes care of 50 villages called
MITRA. The capacity of the hospital is at 250 beds,with a daily average of about 300 out patients and 95% bed occupancy. The number of doctors has been fluctuating between 7 and 14, with some interns from the Martin Luther Christian university from Shillong who have done their Bsc in community health, the opd runs from 8am to the last patient in the evening. There are no units in any of the departments, the surgery department has no fixed operating days or opd days, both are done simultaneously everyday, averaging around 15 general surgery cases and 10 gynaecology and obstetric cases per day.
The real highlight of the hospital is the nursing school and the care that they are trained to give to the patients. They set some real high standards, the nursing school gives degrees in ANM and GNM for the candidate.
The hospital began as a tiny clinic on the verandah of a church by Dr Lis Madsen a Danish doctor with a vision and the commitment to serve the poor in India. What made a highly educated white woman want to come to India and work in this jungle where tigers and leopards roamed the country and where there was absolutely no connection to the outside world, I don't know, how she found out
of this place? Most likely through the Danish missoinaries who had been here before, what urged her to stay despite the great adversity? Must have been a real crazy woman with a great heart.
The main hospital that we see today was founded in 1954 with funding from the Danish and German missions, the hospital has grown steadily under the leadership of Dr Madsen who then in 1975 handed it over to Dr V K Henry and his wife Mrs Nancy Henry who took over the hospital in a real difficult time as fund money from the missions at Denmark and Germany run dry. They slowly but steadily raised funds from America and got he hospital back on track. Dr Henry was by all means a great surgeon from all the stories I've heard of him he was a kind man with real love for his work he was a maverick. Together they started the school of nursing here at CHB in 1979 mainly
for the local girls and provided a free education to them. They were in charge of the hospital till 1998
when they handed over the hospitals responsibilities to Dr Padmashree Sahu who is the obstetrician
and gynaecologist at present, when she retired she handed over to Dr Hemaprabha Mohanty who is
the present medical superintendent and the ophthalmologist. Today the hospital is a non for profit organisation that is self sufficient.
I started working with Dr Sunil Jiwanmall who is the chief surgeon and Dr Anupam Dey in the department of surgery, the first day I had was like the longest day of my life but I enjoyed I thoroughly, and I asked myself ' what have I got myself into'. The first two weeks I had been kept in the surgery opd to beta feel of things, it was quite boring but then once the theatre doors were opened I couldn't have asked for more. I was given hands on experience and taught at a brisk pace that I absolutely enjoyed, now all those days of standing aimlessly in the medical college theatre finally made sense when I was in the thick of action. The adrenaline keeps pumping you don't feel the tiredness of running 4 theatres simulataneously you feel good about yourself and ask for more work. With the limited resources that you have you learn to manage things precisely, make rational decisions and take calculated risks. The pay is less here but the feel good and satisfied factor is priceless.
After 8 whirlwind months in surgery I had decided to leave and join the department of general medicine, the decision was also made partly because I had crashed my motorbike into a bunch of cows at night and suffered a concussion with amnesia, also note that in India at this,juncture of time the cow is more protected than women and children...... what a world we live in.. So I took 3 days off and then started my medicine rotation at the end of October. The head of general medicine at the time of my rotation was and still is Dr Pragya Jiwanmall, also the orthopaedic surgeon Dr Suranjan Bhatacharji sits in the medicine opd and attends to the ortho patients as well as the medicine patients. Dr SB is a wonderful human being, and very approachable like all the senior doctors out here in Bissamcuttack, he used to be the director of CMC vellore, but doesn't show an inkling of pride that
you would normally associate with someone who ran an institute as prestigious as CMC vellore. I
learnt how to be gentle, understanding and the fact that how much ever a patient is ignorant about his
illness that we are dealing mostly with adults, mature people who may have unforeseen difficulty in
their lives and are looking for someone to give them some tender loving care than to just see a doctor, just be a good human being to them.
This paragraph is about the difficulties of working in such a demanding place. Yes I enjoyed the work
but sometimes things get out of hand, tempers can flare, friends betrayed, daggers drawn. I am not
known for a calm demeanour at times when I feel things could have been done better and more efficiently than what actually took place. Certain staff members, colleagues can become hostile to you if you behave in such a manner, especially in places like this where everyone is related to everyone else, the repercussions of such behaviour are quite annoying, to say the least, unprofessional. This does not mean that I am always right but I'm trying to convey the fact that I too can be wrong
but will accept my mistakes learn from them and move on, but there will always be some false accusations that cannot be forgotten, let me tell you frankly that all is not rosy in CHB and for the matter at any work place. But time can change people and time can heal but healing can leave some pretty nasty scars, ugly hypertrophied scars if you may. One example would be that of fallouts between the great leaders of this hospital like Dr Madsen and Dr Kai Pederson. Dr Kai Pederson was the brilliant doctor a great doctor but not much of a social person, Dr Madsen a pioneer a stubborn lady and someone with strong views. Egos clashed and it was one or the other, in the end Dr Pederson was literally banished from the hospital and his name was erased from any historical literature written about the hospital.so now with the lessons learnt from the past the lessons learnt from the present the younger doctors will need to work for a future that is conducive to attend well to the needs of the people at the same time being courteous to your colleague and especially the one whom you have authority over to bring in the uncertain future and to be prepared to face it with courage. With hindsight and foresight the future of this place looks good.The most important and most significant part of this line of work is with the people, the people of Odisha. Most of my interactions on a day to day basis are limited within the boundaries of the hospital,and a once in awhile interaction with the locals in the marketplace and some tribal children in the MRSK school in kachapaju, so my views may not be accurate.
What I have experienced from my interactions with the patients is that they are a very hardworking class with very little or no formal education, they live life in the present, deal with the difficulties as they occur, and are very accepting and tolerant to adverse events in their lives.
From the medical point of view, they have almost no concept of disease, they do not fear death they do not understand why they fall sick attributing disease to bad water or air. They live more or less peaceful lives, many of them have never seen a toilet, many of them have never seen a building with more than one floor. They fear the modern world and modern methods of man, considering most things modern to be taboo, they distrust people wearing western clothing, they fear being cheated and tricked and taken advantage of,they have not seen the world beyond their villages and are also very very poor.Let me give you an account of my interaction with the type of patient that I generally see in the OPD. There is no dress code in the OPD for doctors so to seem more approachable and look friendlier I wear casuals like a t-shirt and cargos, they will open up better if you dress simple, a bit of shabbiness helps too😜
I call the name on the OPD card through the mic and in comes a patient who looks totally lost, searching for someone who called his or her name heard over the speakers in a room where I am the only person sitting, I then ask him in Odisha ' thumoro naam koounthu' which means tell me your name please,the patient looking stunned and again staring around the room with all his belongings in a cloth bag and keeping silent, I repeat my question two more times and then I get a response 'Hoi agayan moro naam' which means yes sir that's my name. Then I ask him to come and sit and ask him what's your problem ' assontu bassontu, ebe koowo kauno asuvdha occhi?' So here I am sitting and wondering why he could not figure out who was calling him from a room with just one person sitting in it, after a few months of being baffled by this I realised that a lot these people have had ear infections repeatedly during their lives and now have hearing loss, and definitely there are some who are just too keenly observing the room that they don't realise that I have got work to do and a long day ahead. Now the history taking occurs with the patient saying ' Moro deha re soor soor karuchi, hatho godo sab bothaochi, mundo sabbubelle buuluchi aur bothaochi' I have got soor soor sensation all over my body and my hands and feet hurt, my head is dizzy and aches all the time. All this being described by him or her by pointing to all parts described and running his hands down his arms and feet, all this mostly because I don't know to speak odiya very well and also to get me to give my undivided attention to his or her problem. At the end of all I am asked ' agayan moro kompooter karibarochi' , I want to do the computer test, this is their description for ultrasonography, pretty accurate but they think it is a form of treatment and since Amitabh Bacchan says on his show kaun banega crorepati that the computer has all the answers. Patients trust the machine but do not realise that the doctor interprets the images and it is just a tool to reach a diagnosis, they also want the USG for all disease whether it's a dermatology problem or an obvious limb fracture. I write the history on the card and send him on his way for investigations after scolding him for asking me for the USG, reluctantly he walks away, saying that he has come from a far off place and came just for the USG, I then scold him some more and tell him it's an unnecessary test and that I have done a thorough clinical examination and deemed it unnecessary. The point here is that he has more faith in the machine than in me, the only way I can reverse this is by getting him properly examined, diagnosed and treated. I have to be firm and confident in my approach since the USG is an expensive test and how much money can a man in rags afford to spend, there are many patients who have been to different doctors and have spent thousands of rupees on unnecessary investigations for a disease that could have been diagnosed with clinical skills, they also want to test my competence as well as the competence of the other doctors, so I am in a competition that I am unaware of, that is going on in the patients mind. I have to win the patients trust on as many occasions as possible.
What happens when you cannot treat a certain illness or if the patient is too ill and suffering from a common illness but has developed complications? This is a dicey situation, but again make your decision firm and explain like you would to a five year old about his or her illness, explain the complications and possible outcomes use plenty of metaphors and similes they love that, leave the onus on the patients relatives and patient. A good number will most likely go back to their villages to die at home,the reason we don't admit very sick patients whom we predict will die in hospital is that the bed could be used for someone who can be treated and saved, asking a poor man to go to the big city for treatment is like asking me to go to New York or London if I was suffering something horrible. But always give the patient your time however busy you are.
The hospital has been recognised by the TATA trust which is the charity wing of the TATA group as a place of great need and they have been kind enough to put in several crores of rupees that would help make the hospital provide better care like one would expect at a modern city hospital but also to keep in mind that the main service is to the poor. The project is already underway construction has begun and the scheduled time limit is 2019 March if I'm not wrong.
So this is a summary of my thoughts and experiences after 1year and 4 months of working at CHB, still got many months left, being optimistic at the future and at the same time realistic if the two can be possible at the same time.
