October 2008

Outpatient Total: 1566

Children < 15 years
Male: 127 ; Female: 108
Old Age > 65
Males: 80; Females: 80
Adults
Male: 449; Females: 772

Income Levels of Patients (INR per month)

< 1000 pm: 802
1000 - 1500 pm: 555
1500 - 3000 pm: 209

Eye Programme:
Number Examined: 99
Glasses Prescribed: 26
Medications: 58
Surgeries: 15

Ante Natal Programme:
New registrations: 02
Deliveries: Nil
Abortion: 01

September 2008

Outpatient Total: 1721
Children < 15 years
Male: 171; Female: 126
Old Age > 65 years
Male: 117; Female: 97
Adults
Male: 487; Female 723

Income Levels of Patients (INR per month)

< 1000 pm: 771
1000 - 1500: 431
1500 - 3000: 505

Eye Programme
Number Examined: 95
Glasses Prescribed: 22
Medications: 63
Surgery: 10

Ante Natal Programme
New Registrations: 2
Deliveries: 02 (Hospital 02, LSCS 01)
Abortions: 01

August 2008

Outpatient Total: 1550
Children <>Male: 142; Female: 77
Old Age (> 65 years)
Male: 99 ; Female 174
Adults
Male: 465 ; Female 593

Eye Programme
Number examined: 74
Glasses prescribed: 26
Medications: 34
Surgery: 09

Ante Natal Programme
New registration: 3
Deliveries: 02 (LSCS 01)
Abortions: Nil

Reddi Babu had a severe Viral Keratitis. Malnutrition and local practices like putting milk in the yes aggravated the infection. Fortunately we were able to save the eye with minimal corneal damage.

July 2008

As expected the pace of work picked up in July.

Outpatient Total: 1686
Children < 15
Male: 167, Female: 107
Old Age (> 65 years)
Male: 120; Female: 104
Adults
Male: 405; Female: 782

Eye Programme
Number examined: 103
Glasses Prescribed: 34
Medications: 56
Surgeries: 13

Antenatal Programme
New Registered: 05

Bavaji is a 17 year old boy, who came to us with massive loss of weight. As is apparent from the photograph, he is emaciated and the swelling on the neck is apparent.
He has THROTOXOCOSIS.
Clinically he also had Aortic and Mitral Regurgitation
His laboratory Investigations done here proved this diagnosis and an Echo done at St John's Medical College proved the presence of valvular heart disease.
He is now under treatment at the Health Centre.
His Investigations and hospitalisation was supported by SISHUKUNJ INTERNATIONAL
His medications are being supported by HEART and HAND FOR THE HANDICAPPED.


Kadirappa, is a 65 year old man who came to the Health Centre with a chronic pain in the neck and difficulty in walking.
Clinically his gait was spastic, with brisk lower limb reflexes. Bowel and bladder control were maintained. This suggested a cord compression in the cervical (neck) region.
An X Ray done at the Health Centre, proved this diagnosis.
He has been put on a Cervical Collar and NSAIDs for the pain.
He will require graded physiotherapy and cervical muscle strengthening excercises.
The cost of his collar and investigation were supported by the Village Development Council.

The health centre restarted work on 02 June, a Monday, and sure enough the word of mouth express ensured that the patients were there in full. We have decided to showcase our statistics in a different way which we hope will be clearer.

Outpatient: Total 1382
Children (<15)
Male: 132 Female: 132
Old Age (> 65 years)
Male: 120 Female: 102
Adults
Male: 389 Female: 559
Eye Programme
Total Patients: 66
Glasses: 16
Medications: 37
Cataract Surgeries: 13
Antenatal Programme
New Patients: 01


Every day one encounters a slew of stories, some to do with hard luck, some just defeated by the world, but in all this the very spirit of humanity shines through....
A few of the stories are given below:

Shivaiah, who is 70 years is a Rural Artisan. What that means is that he depends upon traditional art work for his living. He has an only son who is mentally retarded. Shivaiah takes care of him with his meagre earnings and old age pension of Rs 200 pm. Shivaiah himself is a Diabetic and Hypertensive. The health centre provides free treatment to both Shivaiah and his son.
Shivaiah's treatment is possible thanks to a grant from Village Development Council, London, who have funded us for Old Age support.
His son's medicines for Fits comes from a grant from Heart and Hand for the Handicapped, New York

Deena has no parents, both of them succumbing to some illness - possibly AIDS. She is looked after by her grandmother. Deena stays in the Rural Education Centre, through the week. At the REC she gets to eat three meals a day and also gets a few clothes. Weekends she is back with her grandmother.
Subbamma, was hit by her son, because she was too old and was a drain on her family. As youcan see in the photograph, her right shoulder is swollen and distorted from the blow. This is domestic violence aimed at the old. Rising prices and runaway inflation is making life all the more difficult for the rural poor.

A Death

Shanaz Bee was only 30 years old when she died leaving behind five children, the youngest being twins aged 08 months.
Why did she have to die at this young age - its is a story of neglect, poverty and probably mismanagement.
She had not been well for over two months, going to some village doctors, who treated her with Injections etc - the usual stuff. Her mother kept insisting that she come to the Health Centre, but she would not or could not - putting off the visit with some excuse or the other - "Who will look after the kids?" "Who will cook food?" and so on and so forth.
Finally her parents convinced her to come and stay with them. By then she was apparently in a pretty bad shape. She went to a private practitioner in Madanapalle, who again treated her with some antibiotics.
She finally came to the health centre on a Friday morning, reaching early to beat the rush. When the staff came in an hour later, they found her quite breathless. They were in the process of shifting her to the Emergency Room, when she collapsed. We tried resuscitating her but to no avail.
Why did she die - no one knows - a post mortem may have helped, but then who has the money to pay the police, the civil surgeons? After all it is one more death in an overpopulated land.
But a death is a death and what of the kids?

April 2008

Well the new year has started without a let up. Patients continue streaming in, more numbers than usual as they know that it is time for our annual vacation!! This much needed break will give us all a breather to recharge batteries, exhausted minds to ensure that we continue to give our best to our patients. The health centre closed on 26 April and will reopen on 25th May. Exactly a month's break.
The numbers for April:

Patients
Children: 46
Adults: 1851

Antenatal
Registered: 02
Spontaneous Abortion: 01. She had an abortion at 10 weeks of pregnancy

Eye Care
Patients 38
Cataract Surgeries: 07

March 2008

As the Financial Year closes, it is time to take stock of what happened the previous year and look forward to plans for the coming year, not that it makes a difference to the patients as any year, day is the same when it comes to illnesses.
March was like any other month, probably busier than others. The review of work is as follows:
Patients:
Children: 104
Adults: 1861


Antenatal
Number Registered: 05
Deliveries: Nil

Eye Care
Patients: 85
Children: 01
Cataract Surgeries: 04

Gowthami - ? Lymphoproliferative disorder

Gowthami, a 6 year old girl, from a village about 15 km from here, was brough to the RHC with a h/o poor apetite and increasing lassitude.
Clinically she was undernourished (as the photo shows), there was pallor and she was very hesitant in answering questions. Her parents had followed the usual route of going to RMPs, Doctors who all have given her injections and IV fluids. Not one of them had done a blood test or examined her.
There was Cervical lymphadenopathy and diminshed air entry on the left side of the chest
Investigations:
Hb: 12 gm%, TC 30000/cumm, P 18%, Lymphocytes 79%, E 02% and M 01%
Peripheral smear showed normocytic, normochromic RBCs with moderate Leucocytosis and atypical lymphocytes. Immunohistochemistry was suggested

The X Ray of the chest showed a fullness of the Pulmonary Bay, suggestive of a mediastinal mass, probably a lymph node.
This made us think of a LYMPHOPROLIFERATIVE DISORDER, ? Hodgkins or NHL.
We have sent her for CT Scan to find out the spread of the disease. We are awiting this report.

February 2008

As usual another busy month:
Outpatient:
Children: 165
Adults:
Total: 1888
Eye Care:
Children: 01
Adults:93
Cataracts Operated: 05
Ante Natal:
New registrations: 05
Deliveries: 02 - Birth Weight (3.2 kg and 0.750 kg)
Still Birth: 01 (0.750 gm - Mother contracted chicken pox in her 2nd trimester and had a still birth)

Our New Generator

As you can see we have a new generator, which has been installed, tested and is now fully functional. This hopefully will help us tide over the ever present problems of power cuts, which, as summer approaches is only bound to get worse.
This Generator was thanks to the kind generosity of Mr Shyamal Purushottam, a prent of Rishi Valley School. We all thank him for his generosity.

Paediatric Camp 16 Feb 2008

16th February is always a date that hangs heavily over us. Dr Ramamurthy, PhD passed away on this date. This year, thanks to his brothers, we were able to organise a Paediatric and Dental Camp for about 100 children of the Rishi Valley Rural Education Centre. These photos are from the camp. Ofcourse analysis of data will take some time.

A New Ambulance for the School

The pictures you see are that of a new ambulance. This has been made possible thanks to class of 1982 of RVS. After buying the ambulance we found a builder in Bangalore who modifies Ambulances. We got it modified to suit our needs with roll on/off stretcher, airconditioning doctors seat, electricalpoints etc, including a placement for an Oxygen Concentrator. We now need to get a Defibrillator and a Transport Ventilator to make the ambulance fully and effcetively functional.

THANKS CLASS OF 82 FOR YOUR GENEROUS CONTRIBUTION

Tha

Congenital Heart Disease - Operated - Thanks to AROGYASRI

The Andhra Pradesh Government had recently launched the Arogyasri programme in which, the poor get access to high end medical care which otherwise would not have been accessible to them because of the costs involved.
Mallika, was diagnosed in the health centre to have a Congenital Heart Disease - most likely a Patent Ductus Arteriosus in early February this year. She was referred to SVIMS, Tirupati, under this schme. The the ECHO Cardiography confirmed the diagnosis and by the 20th of Feb she was operated and discharged by the end of the month - ALL DONE FREE OF CHARGE.
Mallika is now doing well and is quite health post operatively.
Such programmes, if they function well can do a lot of good for the poor,who are as it is hamstrung by the lackof financial resources. May the Arogyasri continue doing good work.

December 2007 and January 2008

A usual the days go by with the constant flow of patients.

December 2007

OUTPATIENT
Children: 150
Adults: 1634
Total: 1784

EYE CARE
Children: 02
Adults: 71
Cataracts: 04

ANTENATAL:
Registered: 07


January 2008

OUTPATIENTS
Children: 90
Adults: 1444
Total: 1534

EYE CARE
Children: 01
Adults: 71
Cataracts: 05

ANTENATAL
Registered: 04

We have a new Doctor

Dr Ramesh, a paediatrician, joined us from the 01st of January. His presence has made adefinite and positive impact on the quality of health care for children. His wife, Jyothi teaches English at the Rishi Valley School and we hope that he will be with us for a long period of time.

Venkataramana - A wizened baby - UPDATE

An update.
Venkataramana barely survived a week in St Johns Medical College, succumbing to his various illnesses.
Loosing a life is always a hard one to take. In this case the mother is also ill with a Congestive Heart Failure due to Rheumatic Heart Disease. We have been counselling the family to avoid further pregnancies as it could prove dangerous to the mother.