April to June 2018

A summer break to look forward to in May. April was very pleasant, lots of intermittent showers which kept things cool.

A few days which were really hot. As expected a few heat exhaustion patients, some diarrheal diseases, few viral fevers. 

Patients continue to meet us daily

June started on a subdued not, with workshops at Rishi Valley School on teaching learning, counseling. The need for counseling services seems to be a felt need.

Projects wise

cVEDA - is up and running. Have made measured progress in ticking off the required numbers. The staff also trained now and are able to keep up with the questionnaires.

Having Amritha Gourisankar overseeing the project, is a huge help. She has really taken charge of the project.

Numbers: 

TOTAL: 3631

Males: < 15: 102; 16 - 65: 1117; > 65: 333

Females: < 15: 68; 16 - 64: 1661; > 65: 350

Income Levels: < 48000 pa: 3504, > 48000: 127

70 yr old with a mass lesion. We decided against investigating any further and just treated him symptomatically

40 M, with an Acute Direct Inguinal Hernia

45 M walk in patient - BP recorded on visit
With 2 drugs he is well conrtrolled

Wound debridement of a Diabetic Ulcer
being done by our nurse

Jan to March 2018

Winter stayed on for quite a while, a blessed relief.
A conscious decision was made to try and reduce the numbers of patients accessing the RHC daily. We found that well off patients and patients from far towns and cities were thronging the RHC for treatment of Diabetes as well as Thyroid disorders. The loads were becoming too much to handle. We started sending back patients as well as giving appointments.
However the aged, those with complications were given priority to be seen that day itself.

Most afternoons, I find it increasingly difficult to focus on what the patients are saying, registering their ailments and then try and find appropriate remedies for them. There, would,  possibly be some, not so appropriate treatment as a consequence of fatigue. However what we ensure is that the basic medications are correct. For example dose adjustment for diabetics, diet advise, foot care are not compromised upon. Aches and pains, dyspepsia are possibly given short shrift!

6706 patients accessed the RHC during this period
Children (less than 15) M 242 : F 264
Elderly ( more than 65) M 747 : F 709
Adults: M 2190 : F 2554

Income - less than 48000 pa : 6563 and more than 48000 143

Treatment of Diabetic Foot

Diabetic feet are quite common amongst our patients. Its a leading cause of debility, morbidity resulting in loss of wages, increasing difficulty in finding work etc and a source of stress for the family to look after one with a diabetic foot, particularly those which are infected and smelling like god knows what. 

To be able to treat and provide some sort of quality of life is of paramount importance.

The pictures below show an old lady with a diabetic foot who has been provided with orthotic footwear designed at the RHC. An excellent cobbler who understands what is needed and is able to translate and execute the design that I give him helps us make this footwear.

What was touching was the husband, himself with creaky knees squatting and helping his wife with the footwear

A lady with a Diabetic foot

Footwear designed and made at the RHC

The Husband helping her with the new footwear

Completed Footwear in place

The cobbler at work

Two Sides of a Coin

Couldn't resist posting these photos. Small children and an elderly gentleman. Both patients at the RHC. 

Children carrying a water can probably as heavy as the younger one. What struck me was the ease with which the older girl was carrying the can. How does she do it - watching her mother, or has she been trained?

The dignity of the old man waiting for his medications struck me. At the end of the day - patiently waiting his turn using the tree as a support.

Diabetic foot treatment at RHC

A Diabetic foot with ulcers

Orthotic footwear made at RHC

3 months later - voila healed

Oct to December 2017

The good rains continued through September and October. its such a lovely sight to see the fields green and lush.
Rishi Valley celebrated its 86th year with an alumni meet in November. It was a great time to reconnect with old friends and also get to know the younger generations of RVites.

The RHC kept us busy as usual.
 5275 patients over the 3 month period
460 children (M:F 225:235) and 1082 elderly (M:F 535:547)

A young baby who was operated for Cranial Synostosis in 2016 at St Johns Medical College, passed away due to complications and a general failure to thrive. The parents were heart broken, even though the child had severe brain damage and never completed his milestones.