Nuzvid, India, February 2005
Gifford Memorial Hospital
Mohan Sehdev, MD
Global Outreach Faculty
Loma Linda University Medical Center
Dr. Mohan Sehdev is a retired oncology surgeon who was born in India and raised in Africa. After his surgical residency in Hawaii he completed a fellowship in surgical oncology at Memorial Sloan Kettering Hospital and then practiced at an Adventist Hospital in Hackettstown, New Jersey for 30 years. Since his retirement, Dr. Sehdev has committed much of his time to international outreach and teaching. In 2004 he spent four months as a volunteer surgeon for Adventist Health International at Ile Ife Hospital in Nigeria. In 2005 he was named as a Voluntary Global Faculty member in plastic surgery at Loma Linda University. His trip to Nuzvid with our residents was the first of what we hope will be many more outreach/education programs.
The month of May 2005 saw the very first visit of two very curious and enthusiastic third-year residents from Loma Linda's plastic surgery program to AHI's Gifford Memorial Hospital in Nuzvid, India. For the first two weeks Brinda Thimmappa, and for the second two weeks Jaimie Shores participated in educational activities and surgical procedures at this institution.
Nuzvid is a town of about 300,000 people. The economy is made up mostly of small farms and small shops but with some seasonal mango pulp canning factories. There is a science college and an engineering college in town. The Indian government has erected and staffed a government general hospital about two kilometers from Gifford Memorial Hospital. The latter, known locally as the American Hospital, is named after a British army officer who was a friend of the landowner who donated the land for the hospital's creation more than 75 years ago.
The month of May in this part of India is very hot. The temperature hit more than 100o F almost every day while we were there. It starts to get hot at about 6.00 am and continues to toast the land till about 7:00 pm. But, it is also the month of mangoes. Nuzvid is the mango capital for this part of India.
On our first day, we got up early and went to make rounds and get acquainted with the staff. Dr. Rao, surgeon and medical officer, took us around the wards. Maternity, pediatric, surgical, and medical wards were empty. The day we left there were about 60 patients in the hospital.
Ophthalmology is the backbone and main support that keeps this hospital functioning. Dr. Bernard, the ophthalmologist, was on vacation when we arrived, but was fully engaged by the last week of our stay. So, the census of 60 patients also had about ten cataract patients. It is of interest that Dr. Bernard can do a cataract with phyco-emulsion and lens implant in seven minutes under peri-orbital block and has done up to 70 cases in one day. A German charity--Christofel Blinden--pays for the surgeon and supplies and all the equipment including operating microscopes and implantable intra-ocular lenses. The Indian government gives a monetary subsidy for each cataract surgery done in India.
The hospital public relations started announcing the presence of the American Surgical team by pamphlets and over loud-speakers mounted on motor-scooter rickshaws. We started seeing patients in the outpatient department with Dr. Rao and Dr. Linu (general practice) and scheduling operations the same day. The volume of patients increased as the days passed and patients who had operations went out and gave testimonials of care they received.
Dr. Thimmappa did hydrocele, hernia, skin grafts, thyroid, and parotid operations and participated in treatment of a snake bitten patient with hemolytic symptoms. She conducted lectures and workshops on breast self examination for the nurses, nursing students, and hospital employees and their female friends. The nurses decided to do breast self-examination there and then with Dr. Thimmappa supervising. A Telungo translation of the breast self examination pamphlet was prepared by the hospital nursing service and given to the attendees who could not read English. No one had ever given a lecture or taught them about breast self examination. In a country where women do not like male doctors doing breast examination, awareness and knowledge of this was felt to be a very important and useful contribution.
Dr. Thimmappa had an opportunity to visit Vijayawada and Amrawatti. She fully got into the spirit by visiting a temple in Vijayawada and climbing 350 steps to a cave temple across the river from there.
Dr. Shores did hydocele, hernia, thyroid, dermato-fibrosarcoma protuberans excision, skin grafts, and excision of a huge lipoma on the neck. We could have done more thyroidectomies if we had had an anesthesiologist willing and able to give general anesthesia to patients with large goiters. Some days the operations started at 8.00 p.m. and went on till 3.00 a.m. to accommodate the anesthesiologist's availability.
Dr. Shores conducted lectures and workshops on cardio-pulmonary resuscitation (CPR) for three different groups of hospital personnel, nurses and nursing students. Demonstration of CPR on each other was supervised and taught to all who attended. In addition, Dr. Shores gave in-service lectures to nurses and nursing students on cervical cancer, wound care, and wound healing. All lectures and demonstrations were well attended and greatly appreciated.
Attendees to the breast self exam course and the CPR training were given a Loma Linda University certificate of completion for having successfully taken these classes. Elder Don Schatzschneider, hospital administrator, Dr. Linu, and Ms. Kennedy, head of the nursing school, gave speeches of thanks for our contribution to Gifford Memorial Hospital. The patients expressed their gratitude for the American ways of treating them with respect and taking time to explain their disease and the details of operations and possible complications.
Dr. Shores had an opportunity to give a testimonial to the nursing students on an outing to the top of a hill in Nuzvid. He also had a chance to taste Indian food at a wedding reception after climbing 700 steps to a Shiva Temple on top of a hill in Aggrapalli.
Dr. Thimappa and Dr. Shores were a delight to work with. They never complained in spite of great hardships, they were always willing to do anything for the patients and the staff, and they made my stay with them an occasion to cherish. They both have heads bursting with knowledge and energy looking for outlets to expend it on. I am confident they are an asset to the profession of surgery, and I enjoyed the opportunity to watch them in action.
This outreach program was supported in part
by a generous contribution from Mohan Sehdev, MD.