Falling sick, falling into poverty

A sobering thought.

A huge number of people are made poor each year in our country because of hospitals.

I think I heard a figure like 4 million a year during the EMFI conference in Ranchi. That figure sounds too high - but whatever the real figure is - the fact is that every year people slip into poverty through their encounter with the money-heavy medical profession.

How does this happen?

A person falls sick. They get rushed to the hospital. The hospital makes them give a deposit for admission. The treatment takes place. The bill comes. It is in the thousands of rupees. The family pays up. In order to pay they liquidate their assets. Or borrow money from money-lenders. Or both. This drives them into poverty. This happens over and over again. The doctor/hospital administrator says that all of this is not their business - they are providing a life saving service.

Driving to the Nav Jeevan Hospital from Ranchi, I was talking to Dr. Arpit Mathew - currently serving as a surgeon at Robert Hospital, Shillong. He told me a chilling story (I may have missed some of the details, but the core of what Arpit told me is here):

A man had been treated from a rural mission hospital. The (heavily discounted) amount that was finally to be paid was Rs. 1500. The family paid up. As he was being discharged he was asked how he got the money.

"From the money lender"

"What will the interest be?"

"1 rupee for every 10 rupees - per month"

"But that is 10% per month! How can you repay this?"

"I cannot"

"What will happen if you do not repay?"

"I will have to work on the field of the money-lender till I repay the amount"

The conversation continued and the man told the doctor that this was a good thing. By working on the field he was guaranteed a meal every day.

How heart-breaking to know that our country still sees not only the worst gut-wrenching poverty - but the willing submission into serfdom (slavery) - because of the desire for the basic necessity of food.

There are no easy answers for these issues - but at least some doctors are trying to make a difference through low-cost effective care. Their heart-breaks are the hope that we have for change in our country.

Thank God for a few who are putting their lives in the gap. May their tribe increase!

Travelling

Life is a journey. Over the last month this has been quite evident for us as we have had a burst of travels - including a trip down to Vellore and Chennai for me - followed by a weekend camp at Igatpuri as a family - and then the next week travelling to Ranchi and our old hospital in Palamu District.

The highway down the hill from Igatpuri - looking out the window of John and Nalini's car

We have travelled in so many modes - by car, train, bus, auto-rickshaw, jeep, airplane... We have travelled alone and together - and the journeys have been all the sweeter by the shared conversations with old friends.

And what sights we have seen. The photo below is not taken at 9000 m altitude - but at about 200 m altitude - while driving down the ghats to Thane from Igatpuri - shot out of the window of a moving car!

Our most recent travel was the epic trip to Jharkhand. A flight from Mumbai to Ranchi (via Patna). 4 days in Ranchi at the EMFI conference. Then a 120 km drive to the Nav Jeevan Hospital in Palamu Dist. 2 nights and a day there. Then the same drive back to Ranchi and a shot through the sky back to Mumbai.
We hit Ranchi at the peak of the Dasserah festival - and drove by a large open space where the images were being readied for the night bonfire.

The road side bazaars looked just the same from 10 years ago. Perhaps without the bicycles and motorbikes it would be the same for 100 years ago too.

Green fields also look age-old. Except that they are not. So much of the rice planting is from the last few decades. Previously people used to plant more hardy dry-land crops like millets. The shift over to a rice-based cultivation - and diet - is still relatively new - and we really do not know what the effects of this nutritional shift really are - especially on the poor.

Lives flashed by. Three children walking home from school. An old man sitting by the wayside. The overloaded jeeps with people and produce heading for a market.

As we came to the forested belt we saw fewer people. The tropical decidous forest of Sal and Teak took over the landscape.

A sobering sight was a small cross in the jungle between Chandwa and Latehar. About 3 years ago a group of Maoists killed a Roman Catholic priest on this spot - waylaying the vehicle that he was travelling in. The fact that there is a low-grade war going on was clear with armed policemen manning fortified pickets in all of the main bazaar towns.

As we passed through one forested stretch we saw a man on the road and an over turned motorbike. Another man was with him. Was it a set-up? The thought went through my mind.

We decided to stop. A more qualified set of helpers you could not ask for: out stepped a general surgeon (Arpit Mathew), a medicine specialist (Philip Finney) and an orthopaedic surgeon (Kenny David) - who specialises in spinal injuries. In the van were an aneasthetist (Leejia Philip), an Family Medicine dr. (Sheba), a public health specialist (moi), a dentist (Aji) and an MBBS doctor to round it off.

The man was checked for broken bones - none. He was semi conscious with blood coming from his nose. Another motorbike stopped and the man was recognised. Both bikes were actually policemen. They called their pickets to report the accident. We offered to put the man in our vehicle - but they wanted to take their man in their own. After stabilising the injured man and being assured that it was ok to move on we did.

Kenny David making one of his hilarious points... just about to let out a guffaw

The trip from Ranchi to Nav Jivan hospital was replete with raucous laughter as we held forth on 'the olden days' when we all had worked at Nav Jivan Hospital. It was also seen through a number of new eyes - Philip and Leejia Finney's two sons Vinay and Rohan were making the trip for the first time.

Philip and Rohan take charge in the front of the vehicle

Sadly Leejia and Vinay were car-sick the whole way up to Nav Jivan Hospital - and back. The 120 kms over bumpy bumpy roads is not easy for anyone. It took us over 4 hours each way.

But for those of us blessed to not be car-sick... what better than the wind through our hair as the vehicle dodges on-coming traffic big and small!

How strange to have this earth-bound crawl bracketed by a shot through the skies.

To be in an airplane remains such a thrill for me. My family is slowly taking to the skies - Asha took to this trip because of the joys of a mini-TV in front of her.

Enoch still holds my hand tightly at take-off and doesn't want to look out the window - but is earning his wings too.
Sheba is no friend of invisible air-pockets.

To be 10 kms above the ground - flying at a ground-speed of almost 1000 kms/hr in sub-zero temperature - to see the glorious clouds from above - what a miracle!


Our flight back took us less than 2 hours, flying from the Eastern part of our country to the West coast.

Landing in Mumbai at 6.30 PM.

We had the memories of sun-lit clouds in our mind - as we ground through bumper-to-bumper traffic in muggy Mumbai. The taxi took over 2 hours to get back to Thane - longer than the flight from Ranchi!

Life is a journey.

Ranchi ho!

Going to Ranchi. My mind goes back almost 3 decades ago 28 years to when I ventured out on my first real 'journey' - a trip from Bombay to Ranchi.

I was a callow 13 year-and-a-few-odd-months-old. Those were the days before there were direct trains from Bombay to Ranchi. I took a train to Patna. Then was supposed to be picked up at the railway station by someone from OM and put on the bus the next morning.

It was the days before mobiles. The days when even phones were scarce.

No one came to meet me at the railway station. I ended up sleeping the night on the platform. The next morning I took the first bus down to Ranchi.

The thrill of travelling on my own. Of exploring things and making decisions. The joy (and relief) of making it safely to people who love you.

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Tomorrow we head off to Ranchi in a very different fashion. As a family we will be flying with Kingfisher Red from Mumbai to Patna and then on to Ranchi. Leaving Mumbai 11.40 AM - arriving in Ranchi at 3 PM. To do it all in so short a time...

We are off to the Evangelical Medical Fellowship of India's National Conference - held once every 2 years. This time Sheba has been asked to share her story on one of the evenings. We are also hoping to meet budding doctors and interns and tell them about the opportunities at the expanding work at Jeevan Sahara Kendra.

And then there is the matter of meeting so many old friends. And making new ones of course. And going up to our old hospital - Nav Jeevan Hospital - which will be kicking off its 50th anniversary celebrations with an all-campus dinner and a special chapel on the morning of the 18th which we and some of the old stalwarts of yester-year will be attending.

Ranchi - here we come! This week is going to be a dream...

Living life abundantly...

There is only so much we can do in a camp. But then again - there is SO MUCH we can do in a camp.

you just can't argue with a view like this!

Getting away from the day-to-day struggle. Taking time to be quiet - to listen and to learn. Living together, eating together, playing together and praying together. 86 people. HIV positive and negative. Youngish and oldish. Rich and poor.

We were blessed to have old friends of Jeevan Sahara - Sam and Margaret Thomas come along with us.

Sam explored relationships with us. Looking at the giving Father heart of God through the story of the man with two sons. And helping us recognise our own 'younger brother' and 'older brother' lostness - and the 'foundness' that emenates from Father's embrace.

We explored the life of David - going through the terrible tragedy of the selfish decisions which lead to death in his family. Sam led us to see David's failures as a husband and a father - and recognise our own selves in his story. Oh that we will learn - and not go through those dark valleys. At the same time, we also looked at the way that David's heart was tender to God and open for change. We saw our own brokeness and the hope of real reconciliation.

The two days of the camp were chock-full of activity and joy. Its always great to sing songs of praise to our wonderful Creator and Redeemer!

The kids (and there were many) had a superb time with Peter and Daisy Chettiar and their team. They discovered the life of Ruth and Boaz through activities and games and songs. A major theme for them was on 'friendships' - with lots of activities around that too. These kids are full of energy - we saw plenty of in the frenetic way the carromed around the beautiful Satyagiri Retreat Centre. "Why walk when you can run?" seemed to be the kids unspoken but constantly implemented motto.

I have a feeling that the good Fathers who run the institution were slightly bemused but the noise levels (what is the fun with running without shouting?) - but they were too kind hearted to bring it up to our notice.

Sheba discussing the life of Ruth and Naomi with our ladies group

How do we live the abundant life - especially in the particular situations that we are facing? We used specific small groups to help unpack this. Sheba led a group of single ladies - all who have lost their husbands - through the amazing stories of Naomi and Ruth. As always - when you dig deep into something you are blessed as you are a blessed - which was Sheba's experience with the sessions she held with these dear ladies.

The camp was enriched by the new generation of young people. And they in turn were enriched by having John and Nalini Gabriel spend one on one and small group sessions with them.

For marrieds we had Sam and Margaret Thomas walking our couples through the practical ways that we can grow together, communicate, and forgive.

And it wasn't all serious stuff either - there was plenty of fun too with some hilarious games. Not surprisingly the loudest laughs were there when the couples competed with each other...
... or helped each other out - like the game where one of the partners had to walk on pieces of paper placed forward by the other.

In between so many conversations. Cups of tea. Meals shared together.
Late night talks in the rooms. Times spent together in prayer. Opportunities to be in community. To be in a place and a time of community.

All of this made possible through the hard work of the JSK team who worked tirelessly behind the scenes to make sure everything clicked. Transport was organised. The food was served. The materials were ready. The many, many little details looked after. Kudos to the whole team!

Our only regrets: that some of the families we counted on to participate were unable to come at the last moment - and that our camp had an end!

We left the beauty of Igatpuri with memories...

There is only so much we can do in a camp. But then again - there is SO MUCH we can do in a camp.

Morning walk

Many of our Positive Friends have never left their homes on anything else than a medical emergency or some (generally onerous) family repsonsibility.

What a privilege to be with them in a place of beauty.

We took a small walk yesterday to the reservoir at Igatpuri.

Dawn had broken. Low-lying clouds rested on the tops of the surrounding hills. The crisp cool was mirrored in carpets of dew-beaded green grass on all side.

So totally different from the concrete jungle we live in.

We walked out - women and children - the occasional man with us too - gaping at the spectacle around us.
These are precious slices of beauty - ones that will be nested in the hearts of our dear friends.


It was fitting that it was a Sunday morning - and what else could we do but praise our living God.

Glory be to God for dappled things—
For skies of couple-colour as a brinded cow;
For rose-moles all in stipple upon trout that swim;
Fresh-firecoal chestnut-falls; finches’ wings;
Landscape plotted and pieced—fold, fallow, and plough;
And áll trádes, their gear and tackle and trim.
All things counter, original, spare, strange;
Whatever is fickle, freckled (who knows how?)
With swift, slow; sweet, sour; adazzle, dim;
He fathers-forth whose beauty is past change: Praise Him.

- Gerard Manley Hopkins (1877)

Precious cargo

This afternoon a very special bus brought back an amazing group of people back to Thane. A good 50 odd JSK staff, positive friends and their family members.

Here are some of the kids.


Each one such a bundle of energy. Why walk when you can run?

Each one totally unique. Shaped in different ways from each other. Facing many challenges as they grow up. Many have come face to face with sickness and death from their very earliest days.

Each bearing the finger-prints of an amazing loving God who has shaped them and made them very special.

Our future. A great beacon of hope. Rough diamonds. Due to face an on-going life of challenge. But in each of them the potential to be a world-shakers. In the whole group the opportunity to see a different future written.

Camp

Less than a day away - 3 days with perhaps up to 100 people - most positive. A camp for families. For singles. For widows. A camp where we are all family.