A Trip With SEESHA

By Dr. Tarun, MS in General Surgery, CMC Vellore

The first time I met Dr. Gnanaraj at our hospital in Thadagam, I remember thinking how lucky we were to have such a skilled laparoscopic surgeon/urologist helping us at our mission hospital. On a later date, when he told me that his team was planning a few surgical camps in Assam, I remember wondering – What?! Assam, the north east…, from Coimbatore? When he added that another senior, experienced surgeon, Dr. Anand, from a mission hospital nearby would also be there, I was tempted even more to join in. Being an inquisitive person, with a thirst for adventure; the idea of joining a team in remote Assam was enticing, the chance to assist in these complex surgeries was a rare opportunity, the logistics of organizing such an expedition was fascinating, and just being with this team was inviting. So, since the dates were convenient and the leave available, I readily signed up.

I met the team halfway through their camps at Guwahati’s train station. We were heading out to New Bongaigaon. Dr. Gnanaraj updated me on how the previous day, they had successfully tried out the laparoscopic video-assisted inguinal block dissection, only eight such attempts worldwide.. wow! Along the way, we gassed about the curious experiences our surgeons had come across along the years and enjoyed our meal of rice and Assamese fish curry. At Bongaigaon a welcome group drove us off to our camp base.

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Crofts Memorial Hospital , Tukrajhar, had its humble beginnings in 1947 and runs akin to a primary health centre. The Boro community are predominantly farmers, and due to the absurdly escalating cost of tertiary level care in the nearby cities, specialist treatment is inaccessible. So Dr. Pradeep, the Medical Director, coordinated with FMPB, The Friends Mission Prayer Band and SEESHA, Samiti for Education Environment Social and Health Action, and was able to organize this camp. He had sent word to the surrounding villages that there would be a team to deal with most general surgical and urological complaints.

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The next day, after our morning prayer, I walked around the hospital to figure out how we’d be going about this camp. I was stunned. In my naivety, I vaguely expected camp cards, BP apparatuses, something along iron and folic acid tablets and a clean minor theatre for most of the procedures… I couldn’t have been further from the truth. There were around 120 patients on each of the two days. As they were called, their details and vitals were entered into a laptop and the entire list was accessible to two other laptops through a wired LAN. When the doctor saw a patient, he’d enter the clinical details into the patient’s online record. The software had a provision to order for an ultrasound or lab tests, which was printed then and there, and handed over to the patient. After the required investigations were done, the medicines could be prescribed, or the patient posted for a procedure, with an accompanying order sheet – all done via the LAN. The cashier/pharmacist was the final stop where the full array of essential drugs were available.

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Sekar ‐ the lab tech

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Adiakulam - the pharmacist

And all the personnel and equipment was part of THE TEAM. This included the two surgeons, a pharmacist/cashier, a nurse/ physiotherapist, a physician assistant, a lab technician and me, a first time sonologist in training. And they brought along all the equipment – the laptops, printers, drugs, stents, disposables, IFT machine, lab analyzers, reagents, the laparoscopic and urological equipment and even a portable ultrasound – all the way from Coimbatore..!

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Dr. Anand explaining the ultrasound

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The Stenting Factory

After the initial day of screening, the second day was dedicated to endoscopically stenting over thirteen patients for various urological complaints. It was amazing how efficiently the team renovated the labour room into a stenting factory. There were a wide variety of cases that we saw. It ranged from the endemic malaria, prolonged fevers and heart disease to chronic cholecystitis, renal/ureteric stones, large fibroids to congenital hernias and various swellings. Dr. Biju, the junior doctor at Crofts, and the students at the bible college were indispensable in translating and coordinating our work there. The next day we shifted post to a larger Catholic hospital in the city nearby. This was where we were to do our major surgeries. After the initial hurdles of checking equipment, fixing leaky valves and organizing patients, we were back to top gear. It was amazing to see how skillfully Dr. Gnanaraj handled those laparoscopic probes and how energetically Dr. Anand kept things going all the way up to half past midnight. The thrill of operating such complex cases and observing how proficiently the surgeons managed the complications was truly amazing. We had done about six laparoscopic cholecystectomies and 2 laparoscopic assisted vaginal hysterectomies. Dr. Anand had solely operated on a fungating breast mass, a congenital hydrocoele and a large ovarian tumour.

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The theatre at St. Augustine Hospital

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It was an action packed trip that lasted 4 days – just the way I like it. I was even fortunate to squeeze some time to see the beautiful country side at Tukrajhar, buy some traditional shawls for my family back home and relish their specialty pork, beef and other local delicacies… I had a blast!

It was only later when I sat down and let the experience of the whole trip sink in, did I actually realize what I was a part of. Here was SEESHA, “Samiti for Education Environment Social and Health Action, a public charity founded in the year 2003 by the world-renowned spiritual leader, educationalist and philanthropist Dr. PAUL DHINAKARAN, with a noble vision to uplift the deprived and destitute people through various programs in the field of health, education, empowerment, environment and rehabilitation,” who had Dr. Gnanaraj, an expertly trained specialist from CMC Vellore who had dedicated his life to mission hospitals around the country, with a world of exposure like few others; a committed and efficient team with the generous resources beyond compare; Dr. Anand, another experienced mission doctor, a neat and fine general surgeon who volunteered for the trip; and a whole lot of others that helped coordinate such a grand venture. This group was providing the finest treatment to the needy in a little village of Assam at rates that were so affordable to the people, but would just about cover the team’s project costs. And I asked myself – WHY?!

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Doctors - Pradeep, Anand, Gnanaraj, Tarun, Biju and Brother Titus

Is it the idea of traveling? Making a profit from these camps? Publicity? Quite evidently not! It does seem that this team is driven by a missionary zeal to reach out to isolated and remote places, to people in need, to provide quality affordable treatment to those who deserve it and encourage these mission organizations in their little villages. I certainly can’t speak for them nor can I fully understand it. But whatever their drive, I was honored to have been part of it. I had a great trip, made new friends, saw a new place, tasted a different culture and learned so much from a medical perspective. I see this as a great opportunity for doctors and medical personnel, both young and experienced to join in, travel, contribute, learn!, explore and relish.. What an adventure!

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