June 2015

Back after a months break, which was rather busy in itself. Early rains and the valley is looking green. However groundwater is fast depleting. Conflicting reports of the monsoon, skymet saying it  would be normal, while IMD predicting a deficiency. No planting has occurred while some farmers have ploughed their fields.
This slight increase in farming activity means that the number of patients also drops off. Also a large population has migrated out of the villages to cities looking for work.

Total Patients: 1515 

Below 15 years - Male: 94; Female: 97
Above 65 years - Male: 90; Female: 81
Adult: Male: 553; Female: 600

Income (₹) Distribution

Below 12000: 1059
 12001 - 24000: 316
 24001 - 36000: 74
36001 - 48000: 37
Above 48001: 29

April 2015

Its becoming increasingly hot. One has to drink water by the litre to keep hydrated and have some semblance of alertness while dealing with patients.
A couple of showers have helped cool the heat, albeit temporarily. Some relief!!!

Total Patients: 2092 

Below 15 years - Male: 87; Female: 82
Above 65 years - Male: 82; Female: 132
Adult: Male: 740; Female: 926

Income (₹) Distribution

Below 12000: 1231
 12001 - 24000: 618
 24001 - 36000: 127
36001 - 48000: 68
Above 48001: 48

Vignettes of Patients 2014 - 15

Severe Osteoarthritis of  both the knees making him unfit to do any kind of work.
Such patients are disadvantaged both economically as physically

Basal Cell Carcinoma of the cheek
No treatment available in Madanapalle and he is too old to travel

A 10 year old girl. Diagnosed as Hypothyroidism
Now on Eltroxin also investigating for other endocrine anomalies

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Mental Retardation and Hemiplegia
Consanguinous parents

Microcephaly with early fusion of sutures
He also has hypospadias
Another victim of consanguinous marriages

A Diabetic with a large ulcer after debridement
With good control of sugars his foot is healing well

March 2015

Clear skies, warm nights and increasingly hot days. Summer is here and rather quickly. The trees are withered and all the leaves fallen off. Looks like a hot summer ahead. There is already talk of El Nino doing the rounds. Wonder what it augurs for our monsoon? 
The media has stopped reporting H1N1. Maybe the real issues will surface, but one doubts it as malnutrition, Diabetes, Hypertension are not headline grabbing stuff. 
The heat does not seem to affect the inflow of patients however. The crowds seem to have increased. Wonder where they get their money from with crop failures and no work?  

Total Patients: 2293 (Annual Total 2014 - 15: 19650, Annual Total 2013 - 14: 19477)

Below 15 years - Male: 125; Female: 120
Above 65 years - Male: 99; Female: 88
Adult: Male: 877; Female: 984

Income (₹) Distribution

Below 12000: 1364
 12001 - 24000: 737
 24001 - 36000: 108
36001 - 48000: 51
Above 48001: 33

February 2015

Clear skies, cool nights and mornings, a little bit of dew in the early hours, spring is here and a few new leaves. As yet nature has not indicated how the monsoon might be. 
A quite month, but for the H1N1 scare which seems quite misplaced, if one looks at the absolute numbers. More people die of TB, Malaria and other so called common illnesses and yet the media continues to write about this "new" disease!!!! Wonder how long the media interest will last. The response of the Min of Health has been graded and well thought out, No knee jerk reactions.

Total Patients: 1700

Below 15 years - Male: 97; Female: 89
Above 65 years - Male: 74; Female: 76
Adult: Male: 647; Female: 717

Income (₹) Distribution

Below 12000: 1032
 12001 - 24000: 538
 24001 - 36000: 63
36001 - 48000: 36
Above 48001: 31

January 2015

The new year has dawned clear and bright. It was warm over the new year but cooled dramatically after that for a few days. Not a hint of a cloud. 

This is also the time for Sankranti - the harvest festival. Quite subdued this year with the lack of rains. The long wait for the monsoon has begun. One hope that this year at least we get bountiful rainfall

Total Patients: 1714

Below 15 years - Male: 92; Female: 82
Above 65 years - Male: 65; Female: 64
Adult: Male: 700; Female: 711

Income (₹) Distribution

Below 12000: 1238
 12001 - 24000: 361
 24001 - 36000: 63
36001 - 48000: 35
Above 48001: 17

December 2014

Well the North East Monsoon fizzled out. A few drops here and there and that's it. This year we have had just 25 cm of rainfall. Migrations from the villages to the cities has started and of course most bore wells are dry. The South West monsoon is still 5 months away. Wait and see, hope and pray. 
Though we had a fair number of patients, we found that many of them were opting not to do testing or asking to cut down on the number of investigations or drugs prescribed. For example - a Diabetic with myalgia who would benefit from Calcium and D3, but could not afford it, was prescribed only Oral Antidiabetic drugs. Such examples are many. Also patients are postponing doctor visits, simply because of the costs involved.

Total Patients: 2161

Below 15 years - Male: 120; Female: 114
Above 65 years - Male: 89; Female: 104
Adult: Male: 838; Female: 896

Income (₹) Distribution

Below 12000: 1324
 12001 - 24000: 688
 24001 - 36000: 75
36001 - 48000: 42
Above 48001: 32

November 2014

I have been away for almost two months, tied up with various domestic issues. Spent time in Chennai.
The RHC reopened 2nd week of November and a few patients started dropping by.
The constant refrain was the lack of rains and the hardships it has caused
Hoping that the North East Monsoon will at least bring some rains. Its also become quite cold in the nights.Always wonder how the poor survive!

Total Patients: 751

Below 15 years - Male: 64; Female: 63
Above 65 years - Male: 52; Female: 47
Adult: Male: 275; Female: 250

Income (₹) Distribution

Below 12000: 522
 12001 - 24000: 162
 24001 - 36000: 30
36001 - 48000: 21
Above 48001: 16

October 2014

The vacations are due soon, the RHC will close for Deepvalli in the 3rd week of October. The number of patients has come down, possibly due to the lack of rains and also the fact that the RHC closes.
End October is also when the investigators for the Controlling Hypertension in Rural India (CHIRI) a multicentric study meet in Hyderabad to discuss progress and future plans

Total Patients: 1316

Below 15 years - Male: 77; Female: 55
Above 65 years - Male: 69; Female: 68
Adult: Male: 502; Female: 545

Income (₹) Distribution

Below 12000: 805
 12001 - 24000: 416
 24001 - 36000: 51
36001 - 48000: 25
Above 48001: 19

September 2014

A few scattered showers have helped the hardiest millets and ground nuts to grow. Other crops have dried out without water. There seems to be no hope in sight. It is eerie to see people dying in floods and here we suffer with minimal water.
We are hoping against hope for a revival of the monsoon in our area

Total Patients: 2254

Below 15 years - Male: 126; Female: 125
Above 65 years - Male: 116; Female: 107
Adult: Male: 836; Female: 944

Income (₹) Distribution

Below 12000: 1401
 12001 - 24000: 678
 24001 - 36000: 83
36001 - 48000: 60
Above 48001: 32

August 2014

The rains continue to play truant. Cloudy skies promise a shower and that's all. A few drops of rain and its all over. Migration to cities continues, and the water trade booms.
As yet, however, the lack of rains have not made any significant impact on the people accessing the RHC. 

Total Patients: 1734

Below 15 years - Male: 112; Female: 113
Above 65 years - Male: 76; Female: 89
Adult: Male: 649; Female: 695

Income (₹) Distribution

Below 12000: 1030
 12001 - 24000: 573
 24001 - 36000: 56
36001 - 48000: 41
Above 48001: 34