Steps forward

I have seen tomorrow. And it is here.

We met tonight in the gleaming building that will start to breathe soon as the new Bethany Hospital. We met as a group of volunteers getting ready for the dedication time on the 13th of November.

Dr. Stephen Alfred and Mr. EJ Stephen - the founder and CEO of the hospital respectively - were with us. Dr. S. talked about the 400 sq ft clinic he started out with at Gokhale Rd. in Thane. Then the 2 floor Lok Hospital - which had 2 more floors added on. And now this 8+ floor compact monster. Far beyond what a single person can think - and the result of the inputs of so many - in so many ways.

We prayed and talked about how we would be shepherding the 350 odd selected folks around the new premises. We walked through the gleaming corridors - while workmen were still putting finishing (and the stage before finishing) touches on the place. How such a huge structure can take shape. The 50 odd contractors that the hospital has been working with. The massive investments in equipment and furnishings. A nuclear medicine machine so that radiation therapy can be given for people suffering from cancer. The oh-so-right logic of a ground floor casualty with operating theatre right there for A+E patients to be taken straight in from the ambulances. And hundreds and hundreds of other details.

Breath-taking. Awe-inspiring. I felt like I was walking through Star-Wars. Maybe Star-Wards?

And yet all of this is crumbling ashes if it isn't inhabited with the love of Christ. What good is it to have the most glistening facilities, the most advanced set of specialists (Pediatric Nephrologist, Pediatric Oncologist, Pediatric Neonatologist, Pediatric Nutritionist etc - and that is only in Pediatrics...) - what good are the best docs in the world - if there is no real love - no real hope.

The crashing burden of super modern medicine was brought home to me again earlier this morning as I went down to buy a loaf of bread.

A man who distributes packets of milk was lying on a newspaper. I thought he may be drunk. He wasn't. He was sick.

Murali (pseudonym of course) is from (you guessed it) the south. He has had fever and chills. Malaria parasite negative. Query dengue. No chance of hospital admissions for him. He lives here alone with some other migrants from his area. He has had tests done and has taken meds but is not better.

In fact it gets worse. Murali is trying to pay back a debt. A debt of Rs. 5 lakhs that was incurred when his diabetic father had a heart attack. The hospitalisation and surgery put the family back that much. They sold off a portion of their land. 2.5 lakhs remained to be paid back. Murali has sold off his only 'asset' he has here - his paper route. Now he works for the person he sold it to. And Murali himself is sick - with seemingly no one to help him. All I could do was sit with him and talk. Put a hand on his shoulder and pray - before he went into the bright sunshine of his day - and back to the suburb where he shares his room with others.

We live in such a grim world.

Our prayer is that the gleaming insides of the new Bethany Hospital will be able to look after Muralis - as well as those who have health insurance and company health policies. Our working funds at Jeevan Sahara Kendra come largely from the profits that the current Lok Hospital - which will be shifting into the new Bethany Hospital. We are hugely grateful for this long-standing support for our work. And we are grateful for the huge opportunity that awaits us as we seek to shift the Jeevan Sahara Kendra work to the current Lok Hospital building.

Our Lord was full of grace and truth. May we follow his footsteps with joyful loving hearts.

Lives changing lives

I have measured out my life with coffee spoons says J. Alfred Prufrock in TS Eliot's poem.

We may drink many a cuppa of 'kapi' - and many a more 'cuttings' of chai - but we use a different metric.

We measure our lives with the lives of others.

What a joy to see another remarkable set of three young man pass through Jeevan Sahara Kendra - and leave their own indelible mark.

Paokholun "Lun" Haokip, Nimit Patel, Naveen Bhambal

A mere seven months ago. So long a time it seemed in at the cusp of April. So short an eye-blink it now seems as we edge into November.

Our three friends came from the Union Biblical Seminary. They came to learn. To experience ministry among the urban poor. To get their hands dirty in roll-up-your-sleeves work with a group of people who society abhors. They did.

And now suddenly its time to say 'good-bye.'

Time to take that deep bitter-sweet breath and grasp a firm handshake, give a tight hug, and entrust each other into God's hands.
We gathered at our home on Thursday night to say farewell to our heroes. They have each one of them blessed us immensely. We miss them already - even though they physically leave us only on Monday.

Looking back we are again amazed by what they have added to us this year. The whole process of starting HIV testing camps in local churches came through their sweat work. The amazing time at the Positive Friends Family Bible camp. The new set of worship songs that Naveen took us through.

Besides the sadness we also reveled in hilarity. An amazing game where we tested the depths of how much we knew our special three brought gales of laughter from one and all.

A sobering but challenging message from the Word: God having prepared us and placed us in the unique situations that we are 'for such a time as this' (Esther 4.14). We are not here by accident. There is a huge amount of work to be done. The stakes are sky-high. Literally. And if we do not... well, God can raise up someone else too. The universe does not revolve around us. We are privileged to move forward as part of the amazing set of work the Spirit is doing across the world.

The flip side - something that our friends understand well - is that not everyone always appreciates radical people. Lun, Nimit and Naveen are all headed for pastoral ministry. How many of their committee members want their pastors to talk about HIV and AIDS. Wouldn't they rather have them organise the Christmas pageant and arrange the prayers for young children in their exam times?

We measure our lives with lives. Lives that are shaped and moulded through the fire. Lives that change other lives.

We are humbled to have been a small part in shaping Lun, Nimit and Naveen. Where will they go now? 1.5 more years of seminary - and then out into the world of almost infinite destiny-shaping opportunities. At least in this generation we will be dealing with HIV throughout our lives. They are well equipped to be the servant leaders to help their congregations make a difference.

Our blessings on you three! We miss you already!

Misery Road

We got an email. A cry for help.

A lady who we met at the EMFI conference in Ranchi told us about a Tamil girl who was in Mumbai and had gotten into trouble and did not have a home.

The email said that she was staying at "Misery Road"

Sheba contacted the phone number and was able to talk to the girl. We will call her Mallika.

She is currently being put up with friends of friends of friends in a place called "Mira Road"

But she certainly is living in "Misery Road"

Mallika was sold when she was 9 years old. Her story is very dark. She has seen and experienced some of the worst things that anyone can experience.

A few years ago she was 'rescued' from the notorious brothels of Kamathipura by a pioneering social worker. Then started a long set of shufflings between different organisations. She has been up and down the country, trying to make a life. Currently she has burned some bridges with the latest institution that has been trying to help her.

Oh that we could have an orange button to press and make every thing work out right. Some magic wand to wave over a person and erase the past and make the present perfect.

Not going to happen.

Instead we join the chain of people who have been trying to help Mallika make a new life. Our involvement is small. Listening to her. Praying with her. Seeing what options she has now. Looking to see which of our friends can take the next steps in partnering with her. To move her out of 'Misery Road' and walk with her - for some distance at least - along the road of Hope. To see her come to a place on her pilgrimage where she is more and more of a blessing to herself and to others.

A broken and contrite heart, Oh God, you will not despise...

Welcome the little children

A little premature, underweight baby girl was abandonned at a mission hospital in North India. A nurse from the Nav Jivan Hospital was attending a training at that hospital. She heard about the abandoned child and asked her husband whether they could adopt the baby. He said yes. The nurse was Prabha. Her husband Christochit.

And so little Anushka was adopted by Christochit and Prabha Kerketta.

We are so glad for this couple - who we used to work together with in the community health department of Nav Jeevan Hospital. It is a special joy to us that we helped facilitate them getting married to each other while we were working at Nav Jivan Hospital 10 years ago.

And we are so glad for the lovely little girl - who is growing into a spunky chubby child.

By God's grace and a bit of nudging with the hospital authorities, Prabha was given maternity leave after adopting the baby - something that had not been done before.

It was just a thrill to see this beautiful child having grown and developed so much since we first saw her last year.

As with all of us - Christo and Prabha have their limitations - who among us fit the bill of 'perfect parents' - but what wonderful carers they have been to Anushka!

We are so proud of families who open up their arms for children. Adoptions, foster care, being hospitable, providing a safe place - for a day - for a month - any of these steps always means stepping outside our comfort zones. But oh what oportunities to experience the Father heart of God.

Being the son of an adoptee - and the brother of another - I can totally and unequivocally say - let there be more. We need to see the lonely into families.

Christo and Prabha are among the many unsung heroes who are showing the way. With God's grace and help they should not - and we pray they will not - be the exception. Lets open our arms out wide....

Memento mori

I was just getting used to people not dying.

We had gone by for almost 2 months without a death.

Now we have had three of them.

Bang. Bang. Bang.

One man had a horrible side-effect to his anti-retroviral drugs. Tragically he did not take it seriously - thinking everything would work out ok. He ended up on a ventilator - and then he was just too weak. A tragic wasted life.

Another man was brought to us with severe seizures. He had been hiding his HIV status for years - and was even asked by sympathetic church leaders about it - but he denied having HIV. We were unable to care for his severe situation in our set up and so had to refer him to the main government hospital. He died.

Probably most unexpectedly was a Nepali lady who we have known for some time. She was on ART but since she has HIV2 - which is not very susceptible to the normal HIV meds - she was getting her medication from an organisation called MSF. She died in a road accident. She was crossing a busy intersection (just 300 m from our office) when a motorcycle knocked her down into the path of a bus. A section she had probably crossed hundreds of times before. Spot death. ART does not protect you from rash driving.

3 lives gone. It leaves a hole in us. People that we knew at various levels.

How faint the outlines of our lives are - how thin of skein stretches across the door-step to eternity.

Memento mori.

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.