Losses - A part of life

Anitha 17/F

Jahnavi 1 1/2 y/F

Anitha had Congenital Heart Disease - Single Dysplastic Ventricle
Considered inoperable
Diagnosed in July 2011
Patient passed away on 23 Oct 2011










Jahnavi was optd 02 Aug 2011 with a Bidirectional Glenn Procedure on CPB
However post op course was stormy and baby had recurrent cardiac failures, finally passing away on 03 Oct 2011








All of us at the RHC have been affected by these two deaths, brings home the fact that there is always a higher power than us mere mortals 

October 2011

Finally a sense of relaxation. The RHC closes for 2 weeks for Diwali, reopening on 07 Nov 2011

A much needed break for all of us!!

Total Outpatient: 1430

 

Below 15 years: Male - 89; Female - 88
Above 65 years: Male: 101; Female - 94
15 - 65 years: Male - 483; Female - 575

Income (per month)
INR less than 1000: 989
1000 - 2000: 388
2000 - 3000: 26
3000 - 4000: 21
More than 4000: 06

Eye Care

Total patients: 54
Glasses: 15
Medicines: 26
Surgeries: 13

Antenatal Programme
New registrations: 01
Domiciliary Delivery: 0

Hospital Delivery: 01

Caesarean Section: 00
Abortion: NIL

Still Birth: 0

September 2011

We have almost given up about the rains this year. The lack of work is telling on all. The patient load has gone up and we are flooded with Diabetics who come from all over.

Total Outpatient: 2025

 

Below 15 years: Male - 113; Female - 100
Above 65 years: Male: 188; Female - 131
15 - 65 years: Male - 688; Female - 805

Income (per month)
INR less than 1000: 1385
1000 - 2000: 571
2000 - 3000: 42
3000 - 4000: 21
More than 4000: 06

Eye Care

Total patients: 103
Glasses: 42
Medicines: 50
Surgeries: 11

Antenatal Programme
New registrations: 04
Domiciliary Delivery: 0

Hospital Delivery: 01

Caesarean Section: 00
Abortion: NIL

Still Birth: 0

Aug 2011

The rains continue to be poor affecting the sowing. The goundnuts have all been planted and seem to have sprouted fairly well. All of use here are praying for good rains just as news about floods in Orissa come in.

The RHC continues to be busy and the stats are given below:

Total Outpatient: 1696

 

Below 15 years: Male - 104; Female - 80
Above 65 years: Male: 112; Female - 115
15 - 65 years: Male - 609; Female - 676

Income (per month)
INR less than 1000: 1151
1000 - 2000: 500
2000 - 3000: 28
3000 - 4000: 09
More than 4000: 08

Eye Care

Total patients: 125
Glasses: 61
Medicines: 78
Surgeries: 08

Antenatal Programme
New registrations: 02
Domiciliary Delivery: 0

Hospital Delivery: 01

Caesarean Section: 00
Abortion: NIL

Still Birth: 0 

Stories

Jahnavi 1.5 years F

Jahnavi - Post Op: GLEN Surgery done

Jahnvi was brought to the RHC with h/o bluish discolouration of fingers and incessant crying. Clinically Dr Ramesh suspected a Congenital Heart Disease. She was referred to STAR Hospitals, Hyderabad, under Arogyasri Scheme. There she was diagnosed as Situs Inversus, Inlet VSD, Pulm Stenosis and Bilat SVC. A Bilateral Bidirectional Glenn Surgery on CPB was done on 02 Aug 2011 by Dr Anil Kumar and team.
Post op was stormy in part due to a misunderstanding about drug schedules. The baby had a cardiac failure which was revived and is now doing well. 

 Vyshnavi  was not so lucky. All of 02 months old, she was brought to us with bluish discoulouration of the nails and cough.
An echo showed a single dysplastic ventricle, single atrium and transposition of vessels. The baby had a Cardiac Failure which was treated at Narayana Hrudyalaya. She was deemed inoperable and is now only on medical management. The parents were quite shattered and still hope that the baby would be well.



Both Jahnavi and Vyshnavi were initially managed thansk to support from Heart and Hand for the Handicapped USA and Sishukunj International, England

July 2011

July sees a large number of patients, primarily since the sowing season has not started as yet. The rains have been deficient and we are hoping for a a good spell. The forecast is however not encouraging.

The stats are given below:

Total Outpatient: 1779

 

Below 15 years: Male - 106; Female - 89
Above 65 years: Male: 142; Female - 115
15 - 65 years: Male - 606; Female - 721

Income (per month)
INR less than 1000: 1226
1000 - 2000: 522
2000 - 3000: 25
3000 - 4000: 04
More than 4000: 02 

 

Eye Care

Total patients: 147
Glasses: 61
Medicines: 78
Surgeries: 08

Antenatal Programme
New registrations: 02
Domiciliary Delivery: 0

Hospital Delivery: 01

Caesarean Section: 00
Abortion: NIL

Still Birth: 0 

 

Stories

The two old people pictured below, have multiple disabilities. As with many such people, they are dependant on the old age pension of Rs 200 pm. Their children are away in cities working for a living.

They are being supported by the Vayovriddhi Scheme of VDC London 

Venkataramana 75/M: HTN, CVA Non Healing Ulcer

Venkataramana 75/M: HTN, CVA, Non Healing Ulcer

Gangulamma, 72/F: HTN, CVA (w/o Venkataramana)

 

June 2011

The new rates came into effect this month. Most patients did not have a problem with paying between Rs 5 and 10 more. For those who did, we stuck to the older rates.
The stats are given below:

Total Outpatient: 1593

 

Below 15 years: Male - 74; Female - 72
Above 65 years: Male: 109; Female - 103
15 - 65 years: Male - 590; Female - 645

Income (per month)
INR less than 1000: 1174
1000 - 2000: 383
2000 - 3000: 24
3000 - 4000: 07
More than 4000: 05

Eye Care
Total patients: 223
Glasses: 54
Medicines: 167
Surgeries: 10

Antenatal Programme
New registrations: 04
Domiciliary Delivery: 0

Hospital Delivery: 02

Caesarean Section: 01
Abortion: NIL

Stories

Hemlata, 09/F, ASD Operated

Hemlatha was detected with a Atrial Septal Defect. She was oprated at STAR Hospital, Hyderabad under the Arogyasri Scheme. She is doing well. 

Sambhavi 1.5 /F

 Sambhavi had a Necrotising Dermatitis. What you see is excessive scarring after the wounds have healed. She is on regular physiotherapy and emollients

Her treatment was supported by Heart and Hand for the Handicapped, USA

Report of Activities 2010 - 11

Rural Health Centre - Report

2010 - 2011

1. The new Outpatient block inaugurated in June 2010 has helped in reducing the overcrowding, thereby ensuring a greater efficiency in patient management.
2. More than 19000 patients have accessed the RHC this year.
3. The rates for consultation and laboratory investigations have been upwardly revised by about 10 – 15% from June 2011.
4. The diagnostic centre continues to be as busy as ever doing more than 23000 tests this year.
5. Dental Centre: Dental chair and other dental equipment donated by Dr Ms Meena Desai was commissioned in November 2010. After initial teething troubles, the room was ready for use and from January, Dr Kalpana, Dental Surgeon from Madanapalle, visits once a week providing dental cover.
6. Ultrasound Machine: A new Colour Doppler (Sonoscape SSI 5000) was purchased from donations received at a cost of approximately Rs 10,00,000/-. About 5 scans are done daily. Dr Vishnu Reddy, a sonologist, visits once a fortnight to do more complex scans.
7. Conference: Dr Kartik presented a paper “Tensions in Livelihoods – A Rural Perspective” at the IAEVG (International Association for Educational and Vocational Guidance) – JIVA Conference in Bengaluru in October 2010
   This paper has been selected for publication as a chapter for the forthcoming book " Handbook of Career Development – International Perspectives” to be published by Wiley International.
   Dr Radha Gopal and Dr Kamakshi Kartik have agreed to be co authors for this chapter. Dr Radha will be adding a unit on Livelihoods, how to make it more attractive for youth to stay back in the villages and build a model for sustainability, incorporating common use of common resources, traditional wisdom etc. Dr Kamakshi will be adding a unit on adolescent girls and young women, their choices and tensions.
8. Distance Fellowship in Diabetology from CMC Vellore: Dr Kartik is presently doing the course and is scheduled for completion in July 2011.
9. America India Foundation: Ms Lindsey Adkisson, a Masters in Community Development from the USA, has been working on documenting Pesticide and Health issues at the RHC. She also works with RVSDA (Dr Radha Gopal) documenting farming practices in the valley. Her contribution to understanding the issues related to pesticides has been tremendous. The RHC and RVSDA have applied for a fellow for the coming year, to take this project forward. We intend looking at environment, health, sanitation, food security, resource management as an integrated whole and attempt to make suitable educational material for the same.
10. The Pharmacy is being run by Usha Medicals, Madanpalle, wef Jan 2011. Only medicines from LOCOST and Generic medicines are being dispensed. The outsourcing was done to reduce administrative load on the RHC. This arrangement is working well.
11. Vascular Diseases Project: Monash University, Melbourne, Australia (Drs Amanda Thrisft, Dr Roger Evans and Dr Srikanth as Principal Investigators from Monash and Drs Kartik and Kamakshi as PIs from RHC) has received a grant for a long term case control study on Hypertension in a rural population. The study envisages an in depth study of 400 hypertensives and and age and sex matched control group. We hope that the results will help in bettering our understanding of the cause factors in Hypertension and then suggest different interventions. The study is scheduled to commence in Sep 2011 running till September 2013.
    An existing building near the RHC will be used as an office and a new team consisting of one coordinator, one nurse and one lab technician will be recruited for the project.
    CMC, Vellore has expressed a keen interest in being part of this project. A formal application to the Institutional Review Board of CMC, Vellore is scheduled for July 2011. It is envisaged that this project will continue to run for 10 – 15 years to follow up both hypertensives as well as non hypertensives to understand the life course and natural history of the two groups.

April 2011

The month of April is always welcome, since the vacations are just around the corner. The RHC will be closed for 4 weeks in May so that we could all enjoy a much needed break

 Total Outpatient: 1838

 

Below 15 years: Male - 86; Female - 69
Above 65 years: Male: 97; Female - 90
15 - 65 years: Male - 697; Female - 799

Income (per month)
INR less than 1000: 1381
1000 - 2000: 420
2000 - 3000: 27
3000 - 4000: 09
More than 4000: 01

Eye Care
Total patients: 58
Glasses: 17
Medicines: 32
Surgeries: 09

Antenatal Programme
New registrations: 04
Delivery: 0
Abortion: NIL

March 2011

The last month of the financial year and as usual it has been really busy. We crossed 2000 patients in a month after a long time and you can imagine how tiring it was. Dr Ramesh coming back on duty after a prolonged absence due to a broken leg was welcome to say the least.

 

 Total Outpatient: 2074

 

Below 15 years: Male - 128; Female - 95
Above 65 years: Male: 136; Female - 146
15 - 65 years: Male - 724; Female - 845

Income (per month)
INR less than 1000: 1474
1000 - 2000: 552
2000 - 3000: 35
3000 - 4000: 10
More than 4000: 03

Eye Care
Total patients: 106
Glasses: 38
Medicines: 62
Surgeries: 06

Antenatal Programme
New registrations: 02
Delivery: 01 (hospital)
Abortion: NIL

February 2011L

February zipped past as usual. How much difference three days makes!!!

 

 Total Outpatient: 1788

 

Below 15 years: Male - 135; Female - 121
Above 65 years: Male: 125; Female - 122
15 - 65 years: Male - 583; Female - 702

Income (per month)
INR less than 1000: 1281
1000 - 2000: 469
2000 - 3000: 27
3000 - 4000: 11
More than 4000: NIL

Eye Care
Total patients: 104
Glasses: 20
Medicines: 72
Surgeries: 12

Antenatal Programme
New registrations: 03
Delivery: 01 (hospital)
Abortion: NIL

January 2011

The new year dawns and one hopes that the year ahead will prove beneficial to the farmers and daily wage workers

Total Outpatient: 1641
Below 15 years: Male - 122; Female - 101
Above 65 years: Male: 129; Female - 121
15 - 65 years: Male - 503; Female - 665

Income (per month)
INR less than 1000: 1103
1000 - 2000: 493
2000 - 3000: 30
3000 - 4000: 11
More than 4000: 08

Eye Care
Total patients: 88
Glasses: 21
Medicines: 61
Surgeries: 06

Antenatal Programme
New registrations: 06
Delivery: NIL
Abortion: NIL

Venkat - CHD VSD and Kypho Scoliosis

 Venkat is a 14 yr old boy. He has a large Ventricular Septal Defect and a Kypho Scoliosis
We are hoping to get him operated under the Arogyasri scheme. Till then his treatment is being supported by Heart and Hand for the Handicapped, USA

Geetha - Malnutrition

Geetha, 14 years, came to us because of excessive fatigue. When I was talking to her found that she was bit dull and her hair quite coarse. Suspected a hypothyroid state and the investigations proved it. She is now on Eltroxin and Nutritional supplements. Hope that she does well.
Her treatment is supported by Heart and Hand for the Handicapped USA.

December 2010

The last month of the year and the patient continue puring in. We have had to put restrictions on the number of patients being seen as we are unable to cope with the demands.

Total Outpatient: 1780
Below 15 years: Male - 128; Female - 122
Above 65 years: Male: 156; Female - 121
15 - 65 years: Male - 520; Female - 733

Income (per month)
INR less than 1000: 1172
1000 - 2000: 534
2000 - 3000: 55
3000 - 4000: 13
More than 4000: 06

Eye Care
Total patients: 93
Glasses: 20
Medicines: 71
Surgeries: 02

Antenatal Programme
New registrations: 04
Delivery: 01 (LSCS)
Abortion: NIL

Mohd Sameer - Inguinal Hernia

Post op With mother

Mohd Sameer - Post op

 Mohd Sameer all of 04 months of age - was operated at St Johns Medical College for a Congenital Hernia. he is doing well and the smile on his and his mothers face is worth it. By the way the mother is just 18!







 
Erappa came to us with a rapidly growing mass on the right side of the neck. An FNAC and subsequent Biopsy showed it be a Cancer, but the primary was not clear. Immunohistochemistry studies showed  that the Cancer was a melanoma. This led us for a search of the Primary and it is possible that it was in the floor of the mouth.
He is under treatment at SVIMS, Tirupati, under Arogyasri programme
All his investigations costs were supported by Village Development Council, London, under the Old Age Scheme

Erappa ? Melanoma floor of mouth

Erappa - Secondaries in the neck

November 2010

Back from a vacation and a good diwali, the RHC started off slowly.

Rishi Valley it self was busy hosting the annual Krishnamurti Gathering from 22 to 25 November. The children came back after their winter vacations on 26th and the valley was agog once again with all the noise and energy children bring.

Total Outpatient: 1323
Below 15 years: Male - 108; Female - 90
Above 65 years: Male: 117; Female - 89
15 - 65 years: Male - 418; Female - 501

Income (per month)
INR less than 1000: 867
1000 - 2000: 383
2000 - 3000: 57
3000 - 4000: 09
More than 4000: 08

Eye Care
Total patients: 68
Glasses: 16
Medicines: 47
Surgeries: 08

Antenatal Programme
New registrations: 02
Delivery: 02 (both LSCS)
Abortion: NIL

Keerthi - Nephrotic Syndrome

 

Anjamma - Pesticide Dermatitis

 Anjamma has typical dermatitis brought on by spraying / using pesticides (Endosulfan in particular) without safety precautions

Keerthi had come to us with facial swelling and a diagnosis of Nephrotic Syndrome was made. She was treated by Paediatric Nephrologist at St Johns Medical College and is now doing well.

Her treatment was supported by Sishukunj International,London

October 2010

With October the Valley starts cooling off. This is also the time for the festive vacation. The RHC was closed for 2 weeks from the end of October till the 1st week of November, and  reopened after Diwali.
It was a much needed break for all of us.


Total Outpatient: 1327
Below 15 years: Male - 85; Female - 75
Above 65 years: Male: 97; Female - 85
15 - 65 years: Male - 466; Female - 519

Income (per month)
INR less than 1000: 834
1000 - 2000: 460
2000 - 3000: 18
3000 - 4000: 11
More than 4000: 04

Eye Care
Total patients: 102
Glasses: 19
Medicines: 79
Surgeries: 04

Antenatal Programme
New registrations: 03
Delivery: NIL
Abortion: NIL

Nandini was brought to us because of failure to thrive. We found a Mental Retardation, probably due to consanguinity. She is under investigation and assessment at St Johns Medical College

Nandini Mental Retardation and Bronchial Asthma

September 2010

The rains have stopped. This year though there has been a better rainfall, the tanks are not full and hence the problem of summer looms large.
Lindsey Adkisson, who has done her Masters in Rural Development, is a William J Clinton Fellow. She has been sponsored by the America India Foundation to work at the RHC for 10 months. She will be working on documenting Health Issues related to Pesticide use as well as doing a survey on land use, cropping patterns, economics of farming.
Its a pleasure to welcome her to this field.


Total Outpatient: 1971
Below 15 years: Male - 181; Female - 167
Above 65 years: Male: 143; Female - 111
15 - 65 years: Male - 556; Female - 813

Income (per month)
INR less than 1000: 1384
1000 - 2000: 542
2000 - 3000: 24
3000 - 4000: 18
More than 4000: 03

Eye Care
Total patients: 99
Glasses: 19
Medicines: 78
Surgeries: 02

Antenatal Programme
New registrations: 03
Delivery: 01 (Hospital)
Abortion: NIL

Narasamma and Child

 Narasamma had Pesticide (Endosulfan) induced dermatitis and infertility.
Following complete cessation of pesticide use, she conceived and delivered a healthy female baby.
Mom and kiddo are really happy.