India : July, 1995, (cont.) At 8:00 Wednesday morning, Samuel called me from his house in Salem. He had already talked to Benny and said that Benny would stop by the hotel at 11:00 to make sure I got back to the airport in good shape. Benny had taken off work and had ridden the train for over seven hours from Salem to Madras to meet me at the plane. Now he would deliver me to the airport and then head back to Salem on the night bus, which would arrive sometime the next day. As I left Benny at the Madras airport, I thanked him and gave him a box of English toffee for his family.
Samuel was at the airport to meet me, and we drove for another hour and a half to Erode were I was to do the Needs Assessment Study for Project C.U.R.E. The hospital was directed by Dr. Vizia Kumar. For years the hospital had also run a nurses’ school. The patient load was about 2,500 per month, of which less than 50 percent of patients had any means to pay. Their per capita gross income for the year was less than $150. The hospital tried to charge the other 50 percent of the patients some amount that the market would bear. The hospital received no government assistance because it was a Christian organization in an area of India that was 98 percent Hindu. The London Missionary Society started the hospital in 1903, and in the hallway there was a plaque that made a big deal out of the fact that in 1933 electricity was brought into the building. Even today there are rows and rows of kerosene lamps on shelves for use during frequent power failures.
What did the hospital in Erode need from Project C.U.R.E.? Everything! They did have a Siemens X-ray machine that looked pretty good but was only a 200 milliamps (mA)—not very powerful. They had one EKG machine, but it wasn’t working. The emergency room needed to almost start over again with different equipment. The hospital, overall, was perhaps cleaner than some of the bad ones we had assessed in Africa, but not much better equipped. Most of the equipment and fixtures were, without question, pre–World War II.
From Erode we drove about another one and a half hours to Salem, the city where Benny had said he lived. Salem was a city of two or three million people, and the headquarters for Samuel’s ministry. Samuel and his wife run an orphanage and a school for three hundred abandoned kids. Samuel’s great-grandfather was the first Christian convert in India. He was royalty, but when his family found out he had converted, they repeatedly tried to kill him and have him killed because of the shame that it brought on the family name. Finally he ran away and was raised by missionaries from England. But for four generations now, all of the offspring have been Christian and involved in ministry. The orphanage and school are located outside the main area of Salem on a twenty-acre plot of land.
As we drove up to the orphanage, the driver stopped the car and Samuel said that we would walk from there. As we walked in through the gates, I had a surprise awaiting me. Lined up in two straight lines on either side of the entry drive were about three hundred kids. They were very quiet and orderly, and several came and put a large ornamental necklace over my head. Then the children began singing and throwing flower petals on Samuel and me. They were not in the least rowdy, but they certainly enjoyed welcoming their guest.
Samuel and his wife live in a house on the complex. They have two children of their own. One daughter who is finishing high school, and a son who is also off at boarding school. However, personally, they had adopted five other children ranging in age from one and a half years to seven years. They were all abandoned babies when Samuel and his wife received and adopted them. Quite a family! I stayed there in Samuel’s house in an upstairs guest room.
Thursday, July 13 At about 4:15 a.m. I was awakened by roosters crowing. I went back to sleep until about 5:30, when I began to hear voices of lots of happy kids. Breakfast was served for Samuel and me at 8:00. But just prior to our eating, the air was filled with a three-hundred-voice kids’ choir gathered in a building next door to eat their breakfast. They were singing a prayer before they ate. I couldn’t resist … I had to go next door and see all the kids. They were lined up sitting at long tables. In India most of the people use no silverware service. So in front of each child was a large metal pan, about ten inches in diameter, filled with hot cereal and fruit. The kids were greatly enjoying themselves as they scooped up the cereal by hand and ate it.
The driver took us first to the large regional government hospital. This one hospital served over twenty million people in Salem and the surrounding area. Seventy-five thousand patients passed through its doors monthly. As our car drove up to the side door, it was apparent that the hospital staff knew we were coming—a delegation of doctors and hospital officials was waiting for us on the curb. The procession was led, then, up a flight of stairs to the hospital director’s office. They presented me with a large, thick research packet, which laid out the activities and goals of the hospital. I asked enough questions to fill out my assessment forms and then asked if they would mind if I took pictures as we toured the hospital facilities.
The hospital was quite typical of a large African or Asian government institution—pathetic. Samuel told me as we walked that they had really cleaned it up when they heard that the American was coming. All of the services at this hospital were covered by the government and were free to the people. So it tended to collect some pretty sorry cases. Some parents here in India will actually cripple their children in order to give them a competitive advantage at begging. But, of course, only a very small portion of the injuries are intentional or self-inflicted.
A great number of the hospital beds did not have mattresses but, rather, a metal or wooden bottom. Many of the emergency gurneys were two-wheeled rather than four and were made out of bicycle parts and wheels. This large hospital had only one small X-ray machine.
I was impressed with their blood-bank and eye-bank setup. The doctor who headed up the eye bank told me that he now had over forty eye donations for their future eye surgeries.
As we passed the hematology section, I noticed a small ward where they had four dialysis machines in operation. The machines were exactly like the ones I had sent out in different container loads. I asked if they kept those machines busy. The doctor told me that those four machines were used almost continuously for victims of poisonous snakebites. I stopped and looked at him with surprise. “Snakebite victims?”
He said that this area produced a lot of chickens and eggs. Where there were lots of eggs, there were lots of viper snakes—very poisonous. “A lot of people are bitten by the snakes,” he told me. “Most would die without the dialysis machines. The machines purify the blood before the venom overloads the kidneys and shuts them down, thus causing death.” What a great use for a dialysis machine!
© Dr. James W. Jackson
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