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

July 2014

The rains have kept away for the last 06 weeks. The fields lie fallow, no one has planted. Even the few hardy ones who planted millets just sit by and watch the empty fields. A few families have migrated out to the cities looking for jobs and some sort of income. Its a vicious cause and effect. No rains, no planting, no casual work, no income, diminished food production, increase in prices, drinking water scarcity and so on and so forth. How much can one dig for water. Borewells are at around 300 metres in our area, and these are drying up too. All hopes are on some sort of monsoon revival in the coming two months.
However the number of patients continues to be as usual

Total Patients: 2170

Below 15 years - Male: 125; Female: 115
Above 65 years - Male: 107; Female: 106
Adult: Male: 834; Female: 883

Income (₹) Distribution

Below 12000: 1297
 12001 - 24000: 689
 24001 - 36000: 90
36001 - 48000: 58
Above 48001: 36

June 2014

June has come and gone. Reopening after a month's break, makes it that much harder to get back to work. One decent rain in the month with 78 mm coming down in a few hours. But after that it has remained dry. Few clouds but nothing more. Patients are also slowly coming back, some sowing but others ploughing and awaiting the elusive monsoon.

Total Patients: 1595

Below 15 years - Male: 91; Female: 79
Above 65 years - Male: 86; Female: 85
Adult: Male: 612; Female: 642

Income (₹) Distribution

Below 12000: 1039
 12001 - 24000: 451
 24001 - 36000: 52
36001 - 48000: 28
Above 48001: 25

April 2014

Another man made year ending! This time though it feels good with a much needed vacation starting. April was still quite busy though we had started covering our long term patients till June.
The two important festivals in our valley the Gangamma Jatra and Thettu Thirunal have come and gone. Traditionally it is supposed to rain during these periods. However not a drop of rain.Maybe the gods themselves are angry at us human beings for the devastation we have caused? If El Nino acts up and the Indian Ocean Dipole shifts its going to be a bad monsoon. Where do we go for water is the big question?

Total Patients: 1992

Below 15 years - Male: 109; Female: 114
Above 65 years - Male: 125; Female: 120
Adult: Male: 713; Female: 781

Income (₹) Distribution

Below 12000: 1196
 12001 - 24000: 609
 24001 - 36000: 78
36001 - 48000: 47
Above 48001: 32

Dr Bhavya, ISC 2006, worked with us at the RHC for one month. It was a mutually enriching experience for all of us. Photos at the bottom of the blog

These two pretty girls were born after a successful tubal recanalisation

.

Dr Bhavya, Dr Kamakshi, Dr Kartik, Dr Ramesh

March 2014

These man made year endings are quite crazy. Technically this month sees the closing of accounts and a fresh start on 01 April. Does this make any difference to the ebb and flow of life around us?

Total Patients: 2039

Below 15 years - Male: 104; Female: 111
Above 65 years - Male: 78; Female: 86
Adult: Male: 751; Female: 909

Income (₹) Distribution

Below 12000: 1185
 12001 - 24000: 733
 24001 - 36000: 74
36001 - 48000: 30
Above 48001: 18

Vasantha - quietly proud with her 2nd baby. The elder daughter had a sever Congenital Heart Disease. Was operated under Arogyashri but did not survive due to post op complications. The 2nd pregnancy went to term, anomaly scans during pregnancy revealed no congenital anomalies, had a FTND and post natal checks also revealed no abnormality. The mothers smile says its all

A baby with a megacolon - recovered with conservative management

February 2014

It has started warming up, the sun is somewhat fierce, nights still pleasant. Drying up pretty fast

Total Patients: 1790

Below 15 years - Male: 93; Female: 90
Above 65 years - Male: 79; Female: 86
Adult: Male: 704; Female: 738

Income (₹) Distribution

Below 12000: 1088
12001 - 24000: 609
24001 - 36000: 48
36001 - 48000: 29
Above 48001: 16

A typical elderly woman seeking health care - Malnutrition predominates

Years of Bidis and Exposure to the sun - A Basal Cell Carcinoma

January 2014

The cold seems to have abated but it is also very fluctuant. Some days it is down to 10 celsius and other days a balmy 14 celsius
No rains at all and the plans have already started drying. This normally happens in the 2nd week of February - earlier by 2 weeks

Total Patients: 1767

Below 15 years - Male: 78; Female: 70
Above 65 years - Male: 72; Female: 84
Adult: Male: 680; Female: 783

Income (₹) Distribution

Below 12000: 1135
12001 - 24000: 516
24001 - 36000: 69
36001 - 48000: 31
Above 48001: 16

December 2013

The cold has started and its now common for a woolen cap to be worn in the early hours. As one grows older the cold sort of seems to get worse!!!!
Of course no rains - the north east monsoon has been a total let down.

Total Patients: 1954

Below 15 years - Male: 89; Female: 130
Above 65 years - Male: 80; Female: 73
Adult: Male: 790; Female: 792

Income (₹) Distribution

Below 12000: 1169
12001 - 24000: 654
24001 - 36000: 68
36001 - 48000: 36
Above 48001: 28

November 2013

Sorry one and all the posts have sort of got delayed
Back after a much needed 2 week vacation, in time to reopen the RHC and get ready for the The Annual Gathering of the Krishnamurti Foundation India. The gathering itself  went off very well and there was much discussion around the theme of "Living the Teachings in a Secular World". For those interested a summary of the proceedings can be accessed at  http://www.rishivalley.org/features/features.htm
 
About 75 participants visited the RHC and were very happy to see the work which was happening here.
 
The RHC continues to be busy as the numbers show

Total Patients: 1232

Below 15 years - Male: 74; Female: 63
Above 65 years - Male: 44; Female: 49
Adult: Male: 502; Female: 500

Income (₹) Distribution

Below 12000: 741
12001 - 24000: 416
24001 - 36000: 31
36001 - 48000: 20
Above 48001: 24

October 2013

A short two weeks vacation is due at the end of the month and all of us are looking forward to it. Following the vacation, the annual gathering of the Krishnamurti Foundation India will take place at Rishi Valley from 21 November to the 24th. A chance for all to meet and discuss the philosophy and other existential issues. At times one wonders whether such thoughts exercise the poor whom we serve or are their lives only about daily living and making their ends meet.
Of course as far as health seeking goes they continue to throng us

Total Patients: 1751

Below 15 years - Male: 91; Female: 85
Above 65 years - Male: 78; Female 81
Adult: Male: 715; Female: 701

Income (₹) Distribution

Below 12000: 1045
12001 - 24000: 551
24001 - 36000: 92
36001 - 48000: 35
Above 48001: 28

There is a lot of pressure on us to see more patients but this is about the maximum one can handle

A bit of excitement. A huge branch of a Peepul Tree came hurtlin fallingg down in strong winds, falling where patients normally congregate near the dispensary. Fortunately this happened just after the last patients had left!!!!

The photographs below gives you an idea of what happened!!!

Tree Fall on the Dispensary

Tree Fall

September 2013

A welcome break with some rains after long last. Strangely it has been raining all over but over the adjoining 50 km radius. Some tanks actually overflowed in Chinnamandem about 30 km from us. Strange are the vagaries of weather.

Total Patients: 1913

Below 15 years - Male: 99; Female: 108
Above 65 years - Male: 89; Female: 106
Adults - Male: 728; Female: 783

Income (₹) Distribution

Below 12000 pa: 1115
12001 - 24000: 696
24001 - 36000: 35
36001 - 48000: 29
Above 48000: 38

The other programmes continue to be busy. There is a need to support the care of the elderly. Many of them are quite marginalised that they find it difficult to eke out a livelihood

August 2013

The region seems to be in a ferment. From 31 July, the buses have been off the road and there are rolling bandhs everyday. Normal life has been affected as the protests against the division of Andhra Pradesh grow. One cannot see an end in sight as yet. 
The tardy rains add to the woes of the people. For the first time in close to 15 years, I am seeing the hardy groundnut crop drying up. All of us here have become exceedingly conscious about water or rather the lack of it.
The non availability of public transport has affected our patients and one has seen a drop in the numbers coming in. Most affected are the  elderly who are deprived of their regular medications.

Total Outpatient: 1478

 

Below 15 years: Male - 78; Female - 86
Above 65 years: Male: 70; Female - 84
15 - 65 years: Male - 559; Female - 601
 

Annual Income (₹)
<12000: 902="" br="">

12001 - 24000: 507

24001 - 36000: 26

36001 - 48000: 19

> 48000: 24

 

Eye Care

Total patients: 112
Glasses: 33
Medicines: 77
Surgeries: 02

Antenatal Programme
New registrations: 04
Domiciliary Delivery: 0

Hospital Delivery: 04

Caesarean Section: 01
Abortion: NIL

A Diagnosis of Muco Polysaccharoidosis has been made on this 13 year old. A rare genetic disorder, the parents have struggled to nurse her

July 2013

Its two months into the monsoon and as yet the rains have been very sparse thus far. We had one good shower,about 2 cm and all the ryots were busy planting. After that the rains gave played truant and we are experiencing a long dry spell. As it is borewells are plumbing new depths ~ 800 feet in many cases. What are we going to do about water?
Patients still come in their numbers

Total Outpatient: 1999

 

Below 15 years: Male - 103; Female - 100
Above 65 years: Male: 92; Female - 96
15 - 65 years: Male - 784; Female - 824
 

Annual Income (₹)
<12000: 1197="" span="">

12001 - 24000:713

24001 - 36000:29

36001 - 48000: 22

> 48000:38

 

Eye Care

Total patients: 125
Glasses: 43
Medicines: 75
Surgeries: 07

Antenatal Programme
New registrations: 06
Domiciliary Delivery: 0

Hospital Delivery: 04

Caesarean Section: 02

Abortion NIL 

Meningitis and its Sequelae

Thyrotoxicosis - The stare is typical