December/January Newsletter from KSN Hospital Sarenga

Dear Everyone,

First let us wish you all a very happy and blessed 2012.

As the year drew to a close we had much to be thankful for and we acknowledge God’s faithfulness

to us.

Boundary wall completed – not quite as quickly as Nehemiah

completed the Jerusalem walls, but close – finished by the

beginning of November. This was only a dream a year ago, but

came to fruition because of the generosity of the Methodist

Missionary Society, and particularly we thank Steve Pearce

(Asia Secretary – MMS) who was paramount in releasing a

number of endowment funds bequeathed to Sarenga Mission

Hospital.

Permission to take a fresh batch of GNM nursing

students. West Bengal Nursing Council stipulated

there should be purified water for students (has

been provided), and that there should be

library/computer facilities for the students (has

been provided) Our existing 3rd Year GNM

students have just sat their final exams, so it was

a real joy to welcome a fresh batch of 1st years in

September, after a two year gap.

Water Mission International’s perseverance to bring us a water purification unit.

It was Dr. Mike Sabback who in conjunction with WMI worked

tirelessly to bring purified drinking water to KSN. It sounds simple,

but there were a lot of hurdles, and had it not been for the

perseverance of Joe Wilson, Director Water Mission International,

and for the generosity of our friends in Sea Coast Mission…Those

that deserve thanks for the WMI, LWTS system include: Seacoast

Church Hope Epidemic, Branchville SC Christian Church, Water

Missions International, and 3 private donors who wish to remain

unnamed. It was a miracle that this system could be procured,

shipped and installed after so many obstacles but it had to be the

hand of God that made it all happen! We wish to sincerely thank all

those who worked so hard, gave financially, travelled here to see the

installation, gave of their time and energy and above all never gave up praying, believing in an

amazing God who can move ‘’Indian mountains’’

Visitors from Scotland, England, New Zealand and USA and India who have put up with us and

encouraged us.

The continual stream of emails, cards, letters and ‘phonecalls from friends and family which have

spurred us on, and kept us reminded of the One whom we are serving.

For ‘’time out’’ from the hospital, to stand back and reflect on what we are doing and where we

are going next.

Much of this has been unplanned

travel by road and rail , for

hospital work, but these times

have been a blessing for both of

us, and also for the KSN staff, who

gain the confidence to carry on in

our absence. For mobile ‘phones,

(which even work on trains !!!) – so we can be in communication and

able to discuss difficulties and advise on management from a distance.

Making Christmas cake – the Indian way.

Christmas cake as we know it is a relatively new thing in India, and all the big superstores have

jumped on the bandwagon of selling fruit cake, marketed as ‘’Christmas’’ cake from November

onwards. But to make ‘’homemade’’ cake is not that simple………..the majority of homes do not have

ovens. Everyone goes to the nearest bakers, carrying all the ingredients, booking their slot in the

queue for the mixing, baking in a massive kiln, amidst the hubbub and excitement of festivities. Let

the photos tell their own story…………

Some of our patients stories

Sarala was married at the age of 12, and was investigated for ‘’infertility’’ at the age of 15, was

given medicine to help her have a baby, and delivered a little boy when she was 16, but he only lived

for four days. Then she had a five month miscarriage, so in desperation went back to the doctors for

the medicine to ‘’make her have a baby’’ So, she presented to us, without any antenatal care with

eclampsia. Although only 18 years old, Sarala looked twice her age, was severely anaemic and

poorly nourished with signs of several vitamin deficiencies, and various skin infestations. Sarala

herself was unconscious, but her family assured me she still had two months to go. We treated her

convulsions and high blood pressure, and Elisabeth was fairly convinced there were two babies Since

we do not have a scan machine, it was Shubhro who had the bright idea of doing an x-ray, and there

we found two heads. We had given Sarala steroid injections soon after she was admitted, and the

injections to treat her convulsions had brought her back to consciousness, so we explained there

were two babies, but they were too small to survive, yet they needed to be delivered or Sarala

herself may start having convulsions again Elisabeth’s plan was to give medicine to start her labour,

but after 24 hours, it had not worked. So on the second morning after Sarala was admitted,Elisabeth

prayed for a sign – any sign of deterioration in Sarala’s condition, which would help her come to a

decision to push forward with delivery. About three hours later, one of the student nurses came

running into the antenatal clinic, so out of breath she could not speak…..saying ‘’she can’t see, she

can’t see’’Elisabeth eventually clicked……it was Sarala who could not see, and so she cycled straight

back to the maternity ward to find lots of relatives crying, and Sarala’s blood pressure again

dangerously high. We only have two blood pressure medicines available here , and only in capsule

form, so if the patient is unconscious, we have to prick the capsule, and put three drops of the

medicine under the patients tongue. Once, when Elisabeth was working in London St Thomas’s

Hospital a patient with eclampsia lost her sight for 24 hours till after her baby was delivered. In

Sarala’s case the loss of sight was more transient,

but it was the sign, and so we got her delivered

by Caesarean within a couple of hours. She had

two sons – identical 1.1 and 1.2 kg in weight.

Sarala and the babies all did well, going home

after three weeks with the twins now 1.4 and

1.45 kg. Elisabeth went to take a photo on that

day, and when Sarala was asked which is

number one, she pointed to the baby her mother

was holding, but her Mum said ‘’no –you have

number one…this is number two’’…the problem

was their ID tags had fallen off, so this may be an

ongoing source of much family discussion !!!!

Jyotsna’s story

Several years after her marriage Jyotsna had a daughter whom she named Krishna – Krishna is now

19 years old, and is married with a little girl of her own. Jyotsna had been trying to have another

child since Krishna was 2 years old but it never happened. After Krishna’s marriage she forgot about

having children herself, and when one day she noticed her tummy was getting big it never crossed

her mind she was pregnant. She went to see a doctor who told her she had a

cancer with ‘fluid’ in her tummy, and he referred her to a hospital for an

operation. Fortunately at the hospital they did a scan first …….. and found a

baby. Jyotsna and her husband were taken aback, but over the moon….she a

grandmother expecting another baby. Everything seemed to go fine until

around 8 months when Jyotsna had pain and bleeding, and a scan found the

afterbirth to be low, but also coming away from the wall of the womb, so

putting the baby’s life at risk. We gave her injections to mature the baby’s lungs and kept an eye on

the baby’s heart rate round the clock. The afterbirth was on the front wall of the womb, so the baby

had to be delivered through it with quite a bit of bleeding as a consequence. The baby, a little boy

was still two months premature, and had a fairly stormy first couple of weeks, but once he learned

to suck properly, he made good progress, and grandmother and baby discharged home well and

happy.

A new lease of life

We told you in our August/September newsletter about the significant numbers of elderly ladies

who have problems with ‘prolapse’, be it uterus, bladder or bowel. This condition can be managed

medically using simple ‘ring pessaries’ and we were able to get a good supply of these rings from

Kolkata in October. But in some women, even putting in a double ring does not hold everything

inside, and the only option then is surgery. This is not a life threatening problem, but still causes a lot

of misery, and the surgery is expensive, and out of the reach of the majority of village folk. A number

of friends from the UK have given generous donations,

so we have used some of this

money to perform several

such operations on people

who would otherwise not be

able to have surgery. This

eighty plus year old lady, who

has thirteen living children,

(one son and daughter-in-law

in the photo with her) had a

vaginal hysterectomy and anterior and posterior repair operation. One

month later……….and looks 10 years younger !!!

‘’I was blind, but now I can see’’

A team of dedicated eye surgeons regularly come to KSN to do eye camps, and those of you who get

our newsletter have read of this in past letters. The Government of India are nowadays subsidising

cataract surgery so that all patients have intraocular lens fitted at the time of surgery, and do not

have to wear the thick glasses they used to. And it provides a new lease of life for many elderly folk –

there is never a dearth of patients for these camps – 73 operated on 30th January.

Waiting outside the theatre……………………………and inside, BP and other checks before surgery

But we have another story regarding getting back sight, this time for an 18 year old girl. Jyoti was

in her first pregnancy, only married less than a year. As often the case, she had received her

antenatal care outside, and looking at her hand held card, there had been no complications, and her

last blood pressure reading three weeks previously had been normal. But in the early hours of the

day she came to us, she had been woken by a severe headache. Her mother had given her a glass of

water, which she had promptly vomited back, and then she had a convulsion. The family were

frightened by this, and immediately made plans to get the ambulance to get her to hospital. This

took some time, and on the journey Jyoti suddenly could not see. You can imagine how terrified she

was on admission – these young girls are naturally frightened having their first baby – it is usually the

first time they have seen the inside of a hospital, so even a frightening experience when everything

is going normally. But if you suddenly lose your eyesight,…….. This is now

the third time Elisabeth has seen eclampsia present with sudden loss of

sight, and on the other two occasions it was reversible, following

magnesium sulphate. But no amount of reassurance could allay Jyoti’s fear

that she would never see again. She had her first dose of magnesium

sulphate, and then 4 hours later a second dose, but she was still blind – I

then went off to the clinic, and once it was finished returned straight to

see Jyoti – she was sitting up in the bed with a huge smile on her face, and

greeted me ‘’I can see, I can see – bless you’’ and Elisabeth responded ‘’

Bless God, that He has provided us with this special medicine, for it was

that which has brought your eyesight back. And Jyoti went on to have a son, both of them returning

home a week or so later.

Anita visits us from New Zealand

Anita came to India in her early 20’s and worked

there for the best part of 2 years with an

organisation called YWAM – Youth With A Mission.

Elisabeth met up with Anita briefly in December

1993, and they have kept in contact infrequently but

regularly by airmail and latterly email. So when Anita decided she wanted to visit India again after 17

years, she was keen to come to Sarenga also. It was a real joy to have Anita with us – amazingly she

could remember quite a bit of Bengali, so our student nurses were quick to make friends with her.

Anita’s Mum had knitted lots of wee baby clothes, and being

December, and with our usual run of tiny premature babies,

these were really appreciated. The wee one pictured to the

right here originally had this oversize pink hat before Anita

produced the perfectly sized white one knitted by her Mum.

And one of Anita’s good friends had donated lots of baby

clothes also which were gratefully received by some of the

new Mums – like this one pictured here who was

unexpectedly blessed with twins (diagnosed when she came

in labour!) after 10 years of infertility. Anita also spent time

in the wards, sitting by patient’s bedsides, befriending

patients and their families and praying for them, and we very

much valued her prayers – some of which were instantly

answered.

It’s not fun for any child to be in hospital, but Anita

made even this experience good for

the children, occupying them with

various balloon tricks.

The run up to Christmas was unusually

hectic in the hospital, and Anita helped in

lots of little ways – she wrapped up all our

Christmas presents, and so beautifully too.

Fire regulations

Some of you may have heard in the international news of a terrible fire in a private hospital in

Kolkata, where nearly one hundred patients lost their lives. The majority of the patients were

recovering from cold surgery, and could have been rescued, had their relatives been allowed to go

and take them from the hospital. There is a big enquiry in process, but the Government of India have

produced new fire regulations for all hospitals, which are going to be expensive to introduce –

94,000 rupees. As you can imagine from the photos KSN Hospital is all one ground level, and much of

it open to the elements, so such fire regulations are not really necessary, but regulations will have to

be followed. Shubhro and our administrative superintendent are working on this together.

Resuscitation equipment donated by Ayrshire Maternity and Neonatal Unit, Fullarton Church

Ayrshire, and friends from Department of Genetics St Mary’s Hospital Manchester.

It was in our August newsletter that we told you of the emergency ‘’skills and drills’’ course that we

participated in Madhya Pradesh – a state in central India where maternal and child mortality is even

higher than here. In response to that letter Ayrshire Maternity and Neonatal Unit adopted us as their

Christmas charity and pledged money towards buying resuscitation training models. Fullarton

Church in Ayrshire added to these funds, but what made it ultimately possible was an extremely

generous cheque from the Genetics Department at St Marys Hospital Manchester together with

several very generous individuals who clubbed together and made it possible for us to buy

resuscitation teaching models and two mother and baby models for teaching about normal labour

and labour complications. Our first hands on ‘’skills and drills’’ session did not happen till the

beginning of February, so photos will come in the February/March newsletter.

Gateway to Nepal

It is a prerequisite for Elisabeth’s Indian visa that she leaves the country

every six months for it to remain valid. In 2009 and 2010 this was taken

care of by trips to Bangladesh to teach on the Life Savings Skills Course,

but on the 2011 course we were not

needed, so we made a brief trip to

Nepal, staying for 17 hours only, just

across the river from Raxaul in India.

There is an EHA Hospital in Raxaul,

Duncan Hospital, and we stayed there briefly, and were touched

by their welcome and friendship.

7.30 AM – patients queuing up for OPD Raxaul

Capping Ceremony 1st Year GNM Students

Jeanne Sabback, Dr. Mike’s wife was the chief guest at the Ist Year GNM

Nursing Students ‘’Capping’’ ceremony in January. She gave an encouraging

but challenging message entitled ‘’Compassionate Nursing’’. Our 1st year

student nurses are spending time chatting with patients, listening and

interacting more – so thank you Jeanne – they have clearly taken to heart

what you were saying.

Dr. Kuheli’s 1st

Caesarean baby Dr.Kuheli did her first Caesarean section

from start to finish in early December, and has subsequently done a

further five, under Elisabeth’s supervision. It was not until Elisabeth

had been through two years of training that she was permitted to do

Caesarean from start to finish, so Kuheli should feel very proud of this

achievement.

Installation of WTS – KSN Hospital gets the very first safe drinking water in Bankura District

The water purification unit arrived safely one evening late in January amidst great excitement. This is

a ‘’first’’ in the whole of Bankura District. Ned and Barbara Simmonds, who had never installed such

a system in their lives, followed the written instructions they had been provided with, and with

prayer support from around the globe they successfully set up the unit in 24 hours. We now have

purified drinking water available to all inpatient and outpatient areas, but also to our operating

theatre for scrubbing. We are so grateful to all the donors in the USA and Scotland who gave

sacrificially to make this possible. One very good friend from Scotland, who wishes to remain

anonymous gave a donation which covered the building of a small brick ‘house’ for the water plant,

and all the water pipes, basins, taps and their installation costs. Such generosity always generates

curiosity and many folk have come to the hospital to ‘’see the new water plant’’ and ‘’get a health

check up while they are here’’.

Seacoast mission team with the local team installing the living water in purpose built brick home

And this comes with our love and heartfelt thanks to all our friends and

family ...... Shubhro and Elisabeth