The Mungeli Christian Hospital has entered into a process of consolidation and is now embarking upon changes that are significant and reach out to many more in the surrounding community. One point of significant progress is Mungeli being the first mission hospital in its part of India to own a CT scanner. This unit is not a refurbished one or bought secondhand; it is a brand-new General Electric unit. CT scanning is a common diagnostic procedure for patients with strokes or head injuries. Previously, such patients arriving to Mungeli had to go to a larger city to receive these tests.
Inpatient services are the backbone of the hospital’s operations. The operating room has been as busy as ever. This is an exciting part of the hospital. Because of the surgeries that occur there, volunteers or students are immersed in new experiences of sight and touch as babies are born, large masses are removed from abdomens, or people are put back together after being hurt in traffic accidents. Dr. Deeptiman James joined the staff in orthopedics.
The birth of new babies occurs each day. In a country like India, the number of births does not decrease at all. The sad part is that many patients use the hospital as a tertiary care center after first attempting delivery in the home and then going to a government hospital if they have difficulties. It is not until problems arise that they come to Mungeli Hospital. Because of the delay, a lot of complications occur during delivery, and a number of intra-uterine, neonatal, and maternal deaths are recorded. The hope is that, through education, changes can be made. Achieving change will be a challenge, however, because in the Indian culture it is the mother-in-law that typically makes such decisions. Even though the government subsidizes hospital births, many still prefer to deliver at home and come to the hospital only if there is trouble. Lisa Roberts joined the Mungeli staff for a three-month period to interview mothers and study the behavioral patterns of women whose hospital deliveries ended in intra-uterine deaths. The results will be analyzed to see how changes can be made to help alleviate these problem births.
The lab continued to be busy. Even with staff turnover, four lab technicians remain to continue the work. Microbiology services are being expanded to do further work with cultures. A partnership with Christian Medical College (CMC) Vellore and the Department of Infectious Diseases has been instituted to study acute undifferentiated febrile illnesses.
The x-ray department was redone during this period. A new 500mA x-ray machine has been obtained as well as a CR system to take digital x-rays. Eventually, all x-ray images will be saved and stored on a central computer server. These will be able to be viewed anywhere in the wards, as well as online, making services cheaper for the hospital since no hard copies will be generated unless the patient requests one. Two new machines have been purchased to help with the ECG services.
The hospital’s dental services were administered by Dr. Josie. New equipment has been bought and Dr. Josie has been able to collaborate with a dental lab in Bilaspur in order to do crown work. Many cases of oral cavities and head and neck carcinomas were treated.
The physiotherapy department continued to be busy and is expected to get even busier as the orthopedic department is expanded.
The hospital participated in a government health insurance program for low-income families called RSBY. Through this program, 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 approximately $665 in a year. The benefit is applied only to inpatient services, and there are packages by which the hospital is supposed to receive reimbursement. The number of patients with RSBY cards has greatly multiplied since the program was introduced last year; however, much-needed aid is still not reaching the poor. Unfortunately, some abuse is happening, with some of the middle class people having access to the card while the poorest of the poor fall through the cracks. Mungeli Hospital has been the main hospital in the area for the RSBY program, rendering services to many patients. Unfortunately, the hospital has not been reimbursed for its services, leaving huge amounts in balance. This trend has been disturbing, but there still is hope that these balances will be paid. Even though accepting these cards was a difficult decision for the hospital to make, it is the government that would like these facilities for its people, and so the hospital continues to work hard to provide the best care it can in spite of the program’s flaws.
The addition of another room for cooking was added to the canteen. The offering of low-cost meals for sale was a hit with 80 to 90 people eating there each day. The gas company continued to subsidize connections so that patients could cook their own food using clean natural gas rather than firewood. The dharamshala, the place where relatives stay, was a boon for those who have to bring patients from distant villages and need a place to rest. Here the patient’s family could stay on the hospital grounds, have a picnic, and be an active part of the care of the patient, as is the culture in this part of the world.
History will be made in the coming year when the first batch of nursing students will be welcomed in September 2011. Permission to start the school was given by the Mid India Board of Examiners, followed by an inspection and clearance from the State Nursing Council, and, lastly, the Indian Nursing Council clearance for the school. There are four university-trained nurses leading the program, including Mrs. Alka Prasad, who is the Principal. Mrs. Prasad will be joined by the Vice Principal, Mrs. Sweta Titus, who was in Mungeli for about nine years before being sent on for her Bachelors in Science in Nursing. They are joined by Mariamma Baby from Vellore and Avinash Sundas, who also completed his studies at CMC Vellore this year. The next thing that needs to be done is the provision of a nursing hostel where the students can live. Right now, two floors on top of the old guest house will be used which will be sufficient for two groups of students. After that the nursing school will need a new hostel.
Recently a nursery school for children of working women was started at the hospital. The children play and learn songs, the alphabet, and numbers. The program presently has four children enrolled, but the numbers are increasing. It is surely a different culture for people in India to think of sending their children to a nursery school, but people are becoming open to the idea. Children who have attended the nursery school will be given first chance to begin their studies at the English Medium School.
RAMBO MEMORIAL ENGLISH SCHOOL
The Rambo Memorial English School was a great project of vision for this community, one that attempts to provide low-cost, affordable English medium education to children from Mungeli and neighboring villages. Four school buses have been obtained which go out and travel about 60 miles a day bringing children to school and returning them home. Enrollment numbers during the 2010 – 2011 year were over 500. The new school building will be finished soon and will accommodate over 1,000 children. Because the current facility lacks space, many children have been refused admission. The school was also a way of reaching out to the community to show them what kind of future Mungeli can have. Friends and volunteers came from other places to encourage and teach the children so that they could learn and enhance their skills in English.
Because the outpatient department was always so busy, hospital management software has been secured. The software will allow the hospital to go paperless, starting at patient registration where a plastic ID card will be given with a bar code on it and the patient’s picture. This the patient will keep. This system was also linked to a new server in the X-ray department so that it will be possible to view reports and pictures on any of the computer screens in the hospital. Ultrasound and gastro-scope images can also be viewed. It is hoped that this software will both be able to further accuracy in storing and retrieving data as well as make the work of the hospital more streamlined and easy. The doctors will now have to enter data into the computer and will have to know the software. Other staff members have been trained to use the software, but not the doctors.
The following equipment was purchased for use by the hospital: more air conditioners, an electroconvulsive therapy machine, a video gastro-scope and video trachea-bronchoscope, a laminar air flow chamber for microbiology, a mortuary chamber refrigerator for two bodies, a solar heater for water for the staff homes, a new school bus, a 500mA x-ray machine, a Digital CR system for x-rays, new picture archiving and communication system, a CT scanner, two water coolers, a cement mixture machine, a cancer therapy machine, and new hospital management software.
The hospital has completed the following projects during the past year: a conference room and library, a new x-ray room and CT scanner room (x-ray department), a burn unit with four private rooms, two apartments above existing staff houses, two floors and extension of the old guest house, a cancer machine and infrastructure placed in the cancer treatment center, renovation and building of the boys’ hostel/old nursing superintendent’s house, building and furnishing of classrooms for the School of Nursing, and foundation for the new Rambo Memorial School building -- the foundation of the whole building has been laid and prepared for putting in the first six classrooms within the next few months.
This next year, the projects that are proposed include:
1. Cancer treatment services. A 1.3-meter-thick roof needs to be installed over the part of the bunker that houses the machine which is already there.
2. The new school building. CBSE board recognition will be obtained as soon as the building is done.
3. A nurses’ hostel.
4. A new water tank. At the present time only two 2000-litre tanks on top of the ward are being used. Additional ones are needed.
5. More staff housing.
6. Begin a survey and community health project.
Global Ministries missionary Dr. Anil Henry writes: As I come to the end of this report, I realize that nothing would be possible without the Guiding Hand of God. We really do dream and visions come, but we also realize that these visions were planted from above, and God gives us the strength to make them happen. The hospital and school is a growing community which brings hope to thousands around us. We see this happening every day as babies are born, children come to school and get educated, people come for healing in their pain and suffering—and yes, there are a few who do not make it. However, at each step along this path, we attempt to touch each individual with the love and hope that Christ has promised in our lives.
Dr. Anil Henry and wife Dr. Teresa Henry, are Global Ministries Mission Personnel supportd by One Great Hour of Sharing.