5.1.2019
Sheba is in the hospital at this point. Its a cold evening in Lalitpur, the electric heater is on, the kids are studying hard.
Today is our weekly half-day which we get 3 Saturdays a month. But Sheba is back in the hospital. The phone rang a few minutes ago. A pregnant lady has come for admission. Sheba is on call. She has been on call every day now for about a month. Its a doctor's life.
The call came from "Matt." Not Mathew or Mathilda. It was from the Maternity Ward. On Sheba's mobile, when we hear the loud caller tune the first question is - who is calling now. If it is "Mat Ward" then she is told that "Matt" has called as the phone is handed to her.
If the phone is from the General Ward ("Gen Ward" on her mobile) - then she gets the cheery news that "Jen" has called her.
Sometimes "Matt" or "Jen" is a nurse asking for advice, or reporting on the result of a test that Sheba had ordered previously. Sometimes it is the news that a patient's relatives want to take them away - or that a patient's condition has worsened. Sometimes it is a call to announce that a new patient has come.
All these call are 'outside' working hours. In big hospitals the number of calls are high. But then there are also a string of doctors who share the burden.
In small hospitals, struggling to exist (like ours) every call is vital. The most challenging ones come at night. A family bringing a lady with delivery pains. Can we admit. Sometimes they have been told by the government hospital across the road to go to Jhansi (120 kms away) but they anyway give us a try to see if we can help.
We are struggling here because after three quarters of a century of delivering babies, our previous colleagues lost a mother who had been referred to us from the government hospital. The family of the dead lady was enraged and beat up our doctor friends. The government health authorities got involved and launched an inquiry.
The inquiry found that our doctors had done nothing wrong - everything possible had been done, but the patient died. The authorities, however, questioned why we were conducting emergency obstetric care without a gynaecologist or surgeon on staff, and why we had been using a nurse-anaesthetist instead of a doctor. We were informed that we would not be 'spared' if another incident like this happened.
So here we have the conundrum. We want to care for women in distress, and especially for those who have high-risk pregnancies. Our nurses have many years of experience in deliveries. In Lalitpur we have generations of people who have been delivered at our hospital. But that number is gradually eroding, and we hardly do any deliveries anymore.
We don't because we are ethical. We know that most deliveries will take place normally - even in high-risk ones. But there is always the chance that there will be a difficulty - and so we have to tell the family that we are unlikely to be able to do an emergency caesarian section if needed. In reality we should start surgery within 15 minutes of detecting foetal distress or seeing that a mother's life is in danger. We are unable to provide this guarantee at this point. And so we have to tell mother after mother to move to Jhansi (120 kms away) while she is still stable.
These are some of the hardest calls for Sheba to take as a doctor. To go and tell people who have come hoping for help that they should go somewhere else. It is soul destroying - especially if the mother is a woman we have been looking after in our ante-natal clinic over the months - but now that she is in possible distress we cannot help...
But some calls result in smiles on our faces.
The other day a woman came early in the morning from the govt. hospital. Sheba assessed her and realised she needed a caesarian section a.s.a.p. The child was in distress. Sheba called the surgeon who was still asleep. But, he was in town and ready to help but asked Sheba to make sure the anaesthetist was available. She then called this gent who said he would come in 15 mins. Sheba called the surgeon again. Both showed up soon after and the surgery went without incident. A call from "Matt" which ended in a life saved - and a happy family!
In another recent incident we had an elective caesarian section. There was a small delay in one of the team coming, and the family became a bit worried. We assured them that since it was an elective surgery, it would not matter if it was done a few hours here or there.
But when the surgery was done and the baby was born the surgeon told Sheba something after he saw the child. She could not hear him properly from under his mask. Then she saw what he was telling her. The baby girl had a cleft lip.
How to tell the family, who were already a bit worried because of the slight delay in the surgery?
Sheba prayed, took a deep breath and met with the family. God helped wonderfully. Sheba found a video from Smile Train in Hindi which showed how a child born with a cleft lip or palate can be surgically helped. There was also a video showing how to feed a child with a cleft lip.
Sheba told the family that we have a wonderful surgeon Dr. Rajiv Choudhurie who does this surgery - and who after the child gains a bit of weight (usually after she is 6 months old) will be able to do the surgery - completely free!
The family took the news so well. They watched the film about feeding and in 2 days the baby had learned to feed.
Your prayers for the on-going work of HBM Hospital are deeply appreciated.
We have some distance to go as the current patient load is very low. Our staff levels are unsustainable at this point - given the low footfall and admission rates. At the end of the day we want to see people who are sick here in Lalitpur district be blessed. Be fully and completely cured.
To do so we need to have a complete medical team on the campus. Unless the full suite of curative services are offered in a consistent way, how will families bring their patients to us?
We want to see more patients be blessed by "Matt" as well as by "Jen!" In the mean-time, Sheba bears the brunt. We are putting it back in the Lord's hands - and trying to move forward in faith - and by faithfully doing what we can.
Sheba is in the hospital at this point. Its a cold evening in Lalitpur, the electric heater is on, the kids are studying hard.
Today is our weekly half-day which we get 3 Saturdays a month. But Sheba is back in the hospital. The phone rang a few minutes ago. A pregnant lady has come for admission. Sheba is on call. She has been on call every day now for about a month. Its a doctor's life.
The call came from "Matt." Not Mathew or Mathilda. It was from the Maternity Ward. On Sheba's mobile, when we hear the loud caller tune the first question is - who is calling now. If it is "Mat Ward" then she is told that "Matt" has called as the phone is handed to her.
If the phone is from the General Ward ("Gen Ward" on her mobile) - then she gets the cheery news that "Jen" has called her.
Sometimes "Matt" or "Jen" is a nurse asking for advice, or reporting on the result of a test that Sheba had ordered previously. Sometimes it is the news that a patient's relatives want to take them away - or that a patient's condition has worsened. Sometimes it is a call to announce that a new patient has come.
All these call are 'outside' working hours. In big hospitals the number of calls are high. But then there are also a string of doctors who share the burden.
In small hospitals, struggling to exist (like ours) every call is vital. The most challenging ones come at night. A family bringing a lady with delivery pains. Can we admit. Sometimes they have been told by the government hospital across the road to go to Jhansi (120 kms away) but they anyway give us a try to see if we can help.
We are struggling here because after three quarters of a century of delivering babies, our previous colleagues lost a mother who had been referred to us from the government hospital. The family of the dead lady was enraged and beat up our doctor friends. The government health authorities got involved and launched an inquiry.
The inquiry found that our doctors had done nothing wrong - everything possible had been done, but the patient died. The authorities, however, questioned why we were conducting emergency obstetric care without a gynaecologist or surgeon on staff, and why we had been using a nurse-anaesthetist instead of a doctor. We were informed that we would not be 'spared' if another incident like this happened.
So here we have the conundrum. We want to care for women in distress, and especially for those who have high-risk pregnancies. Our nurses have many years of experience in deliveries. In Lalitpur we have generations of people who have been delivered at our hospital. But that number is gradually eroding, and we hardly do any deliveries anymore.
We don't because we are ethical. We know that most deliveries will take place normally - even in high-risk ones. But there is always the chance that there will be a difficulty - and so we have to tell the family that we are unlikely to be able to do an emergency caesarian section if needed. In reality we should start surgery within 15 minutes of detecting foetal distress or seeing that a mother's life is in danger. We are unable to provide this guarantee at this point. And so we have to tell mother after mother to move to Jhansi (120 kms away) while she is still stable.
These are some of the hardest calls for Sheba to take as a doctor. To go and tell people who have come hoping for help that they should go somewhere else. It is soul destroying - especially if the mother is a woman we have been looking after in our ante-natal clinic over the months - but now that she is in possible distress we cannot help...
But some calls result in smiles on our faces.
The other day a woman came early in the morning from the govt. hospital. Sheba assessed her and realised she needed a caesarian section a.s.a.p. The child was in distress. Sheba called the surgeon who was still asleep. But, he was in town and ready to help but asked Sheba to make sure the anaesthetist was available. She then called this gent who said he would come in 15 mins. Sheba called the surgeon again. Both showed up soon after and the surgery went without incident. A call from "Matt" which ended in a life saved - and a happy family!
In another recent incident we had an elective caesarian section. There was a small delay in one of the team coming, and the family became a bit worried. We assured them that since it was an elective surgery, it would not matter if it was done a few hours here or there.
But when the surgery was done and the baby was born the surgeon told Sheba something after he saw the child. She could not hear him properly from under his mask. Then she saw what he was telling her. The baby girl had a cleft lip.
How to tell the family, who were already a bit worried because of the slight delay in the surgery?
Sheba prayed, took a deep breath and met with the family. God helped wonderfully. Sheba found a video from Smile Train in Hindi which showed how a child born with a cleft lip or palate can be surgically helped. There was also a video showing how to feed a child with a cleft lip.
Sheba told the family that we have a wonderful surgeon Dr. Rajiv Choudhurie who does this surgery - and who after the child gains a bit of weight (usually after she is 6 months old) will be able to do the surgery - completely free!
The family took the news so well. They watched the film about feeding and in 2 days the baby had learned to feed.
Your prayers for the on-going work of HBM Hospital are deeply appreciated.
We have some distance to go as the current patient load is very low. Our staff levels are unsustainable at this point - given the low footfall and admission rates. At the end of the day we want to see people who are sick here in Lalitpur district be blessed. Be fully and completely cured.
To do so we need to have a complete medical team on the campus. Unless the full suite of curative services are offered in a consistent way, how will families bring their patients to us?
We want to see more patients be blessed by "Matt" as well as by "Jen!" In the mean-time, Sheba bears the brunt. We are putting it back in the Lord's hands - and trying to move forward in faith - and by faithfully doing what we can.
Love Chai Chats!
ReplyDeletethanks Rita! We have a young lady who we are praying will be your 'neighbour' this Fall (God of wonders needs to do some big miracles of course...)
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