Makunda Christian Hospital
Through High-Risk Obstetric Treatment
Caring for the Littlest Ones
Despite the fact that EHA's Makunda Christian Hospital currently only has 8 infant beds, the staff there deliver almost 5,000 babies each year. That's about 14 babies a day! The facility at Makunda has become a referral center for high-risk obstetric care, and the staff there are grateful to God for the opportunity to take care of high-risk neonates (babies in their first month of life), both those born in the hospital and those referred from other facilities. Gifted nurses provide the backbone of the infant care, and their commitment has been instrumental in increasing Makunda's services to meet the ever-growing need.
Pompa Das' baby was born 32 weeks early and weighed only 3 pounds. In many places in India, this would be a death sentence, with nowhere to take the infant for neonatal care. Another mother, Rupali Malakar, also delivered her infant at 32 weeks and was referred to Makunda for their expertise. Both of these babies had an uneventful three-week stay in Makunda's nursery, and both families were counseled as to the best way to care for their premature infants. After this time in the hospital, the babies were developed enough to go home and mature on their own.
The need for neonatal care in India is staggering; of the 26 million babies born each year in India, almost 1 million die in their first month of life. Most of these deaths are preventable, so infant nursery care is vital. At Makunda, the rough construction of an 18-bed NICU has already been completed, thanks to generous donors. Now they just need to purchase equipment such as infant warmers, phototherapy units, and monitors in order to be ready to care for more of these tiny patients. If you feel led to give toward meeting this need, please visit our website to learn more about donating.
Despite EHA Staff's Best Efforts
Reality of Rural Health Care
Brought into Makunda Christian Hospital, Maya, aged 32, was in her fifth pregnancy. Only two of her children had survived. Maya came to the hospital days later than she should have because of the practical and financial difficulties of travel for the poor. She was known to be part of the Reang Community, an internally displaced tribal population living as refugees in modern-day India.
When she arrived, Maya was unconscious and experiencing seizures. The parts of her brain that process stimuli were functioning poorly. She was diagnosed with eclampsia. When the doctors examined Maya, they realized that her baby had already died. Saddened by this news but determined to save her life, the doctors hooked Maya up to mechanical invasive ventilation. Not every EHA hospital has this equipment, but thankfully Makunda does. Soon they delivered the baby and Maya was weaned off the ventilator. After her recovery, she was released with no neurological aftereffects.
Eclampsia, a condition that causes seizures, affects pregnant women around the world. Estimates range from five to ten percent of all pregnancies globally. In the United States, with our advanced healthcare, only three to five percent of women are affected by eclampsia, but it is estimated to cause 40 to 60 percent of all maternal deaths in developing countries.
In India, the management of eclampsia has been revolutionized with the use of magnesium sulfate. But the reality in rural India has been that despite the advances in medicine, access to a health service facility which is affordable to the poor and that strives to deliver high quality services is often a distant dream. EHA is working to make that dream a reality at all 20 of their hospitals.
The medical staff at Makunda was grateful to God for the equipment available at their location to be able to mechanically ventilate Maya and for granting the health team the skills to manage a ventilated patient. Through saving Maya's life, the staff had an opportunity to see how God touches the lives of the needy through the work at Makunda.
Vijay Anand Ismavel Reminisces
Life After a Heart Attack
It has been three years since I had my myocardial infarction (heart attack). My wife, Ann (an anesthesiologist), my two young daughters, and I had just returned from a 200 km road journey (on mountain roads) from Agartala (capital of Tripura) after a brief stopover at Ambassa, where we have a branch hospital. I was driving and tired.
We went straight to the hospital where I did a neonatal colostomy and a Caesarean section. The baby took time to come out of anesthesia, so I left Ann to extubate the child and went home. I parked the vehicle in the garage and walked home in the dark. When I reached the bottom of the stairs to my home (there is a steep climb of about 40 feet), I found it very difficult to take a step forward. I tried shouting for help but no sound came out. I managed to crawl up all the steps and reach home where I sat on the floor. I told Hannah, our eldest daughter, to call Ann. Ann thought that I was just tired. A little later, I vomited and started experiencing severe chest discomfort.
Ann and other doctors came home and lifted me down in a blanket and took me to the hospital. An ECG confirmed an acute anterior wall myocardial infarction (MI). We did not have streptokinase in stock. Ann sedated me and called my classmate, Ravikannan, at the Cachar Cancer Hospital in Silchar (120 kms away) and he brought the streptokinase. I had severe chest pain for a day. Ann managed me calmly (although she confesses to having some unease when she arranged the resuscitation tray with endotracheal tube at my bedside). In a few days, I was well enough to be wheeled around the hospital. All the staff, family, and friends prayed for my recovery and took good care of me. I did an echocardiography on myself and found a poorly contracting heart with an ejection fraction of about 35% – I could not believe that it was my heart! After about a week, one of the staff nurses had acute appendicitis and I managed to do the surgery from a wheelchair with the operating table lowered completely. Our obstetrician assisted me and closed the abdomen. I was then brought to the Christian Medical College at Vellore where I underwent angiography and stenting of my left anterior descending artery. I spent about a month at Vellore and Bangalore – there was no further change in my heart, and we returned back to Makunda.
My father and some other close relatives had coronary heart disease, and my father had died of an acute MI. Ann had taken me to a cardiologist a few months before my MI – all biochemical tests were normal and I was able to complete a full treadmill test without any signs of ischemia or discomfort. I had also started to exercise. I had no other risk factors (except family history). I was told (after my MI) that I had developed an acute coronary thrombosis.
After my return to Makunda, we found that I had to work as much as before my MI. There was no additional help, a lot of pending bills had accumulated, and workloads had increased. I started tentatively at first but was soon doing as much surgery, ultrasound, and other work as before. After an experience like this, every twinge in the chest is taken seriously (as you don’t want to have another one)! I avoided long surgeries, but sometimes I had no choice. There was a patient with tracheo-esophageal fistula who would have died if I had not operated. There was a patient undergoing laparoscopic cholecystectomy who developed a biliary leak and I had to do a hepaticoduodenostomy. Since I knew that there was no one else to take over, I just took deep breaths and completed these and other such surgeries one stitch at a time. When I was tired, I had a bed put in the hospital where I could lie down a time.
I was asked to walk 2 kms every day. I found this tiresome and took my daughters along. One day I noticed a tapping sound and found an unfamiliar woodpecker pecking on a dead bamboo stump. I photographed it and posted it on Flickr and it was identified as a relatively rare woodpecker (Stripe-breasted woodpecker – Dendrocopos atratus). I became very interested and started noticing all sorts of interesting birds and insects. I upgraded my equipment to a Nikon D300s with Sigma 150-500mm OS lens and also bought a 27″ iMac for editing the photographs. The home equipment budget was passed by Ann under the heading “Cardiac Rehabilitation Expenses!” I found that observing, photographing, and reporting the wildlife in the campus and surrounding areas was very relaxing and added new meaning to my walks.
I have been to cardiac reviews every year. I have not become any better (the ejection fraction is still around 35%) but I haven’t become any worse. I am able to do almost all the things I did before my MI. I cannot run or do anything which demands exertion. I am happy with my lot – it is God’s portion for me. We have to accept the whole package and cannot pick and choose the things that please us. It is also God’s way of telling us that He is sufficient and that in our weaknesses, we experience His strength. I have never questioned why I should experience this – in His infinite wisdom, God permitted it and that is enough. We need to trust God absolutely and in everything.
This experience has brought our family closer. We have realized the shortness and unpredictability of life. It also has made me look at everything with a greater heavenly perspective. We are citizens of the kingdom of heaven temporarily posted to this earth. We should not develop any deep roots here. The values of this world are temporary and not eternal. We should rather invest on those things that have eternal value – those things that find God’s approval. We should live for His approval – that the thoughts, plans and purposes of our hearts find His approval. This is our strength and that is sufficient.
Should my life be different? I think I should just go on being the person He wants me to be. I am not perfect but will become more and more like Him. Our physical bodies degenerate with the passage of time but spiritually we become stronger as we experience His faithfulness and learn to trust and obey Him. When I was young, I did not want to commit my life into the hands of my Lord and Saviour Jesus Christ. I felt that this would lead to a loss of control over my life and I wanted to enjoy life in the way I wanted. Later, when I made the commitment, I knew it would be for life – a vow had been made like the one at the time Ann and I married – I will seek your will and follow it all the days of my life (in sickness or in health).
Many people advise me to rest and relax. I find that doing the work that is pleasing in God’s sight brings the greatest rest and relaxation. Contentment and happiness are the rewards of obedience. Strength and health are given as the need arises. I spent several years after my undergraduate days spending time with young Christians, challenging them to find the same fulfillment that comes only by walking in God’s path, holding His hand. After joining the team at Makunda, this became difficult as work took a lot of time. I think that I may again be able to do this as more time becomes available. I find that even if I don’t physically travel to other places, I can still communicate with people over the internet. I look forward to whatever God has in store in the days to come. My ambition is to live a life pleasing to Him when on this world and to be welcomed back as a servant who has completed the task given to him when I go to be with God in heaven.
After Difficult Travel and Surgery...
Glad to Be Alive!
She came to EHA from a refugee camp in the neighboring state of Tripura. Twenty-four-year-old Kamirung Reang and her husband are internally displaced people who are landless, having been pushed out of Mizoram and into a refugee camp where they have scraped out a living for ten years. Needless to say, they are not wealthy. Many Indian women in her situation would have stayed at home to deliver their babies -- and died. Too many Indian women die in childbirth, either because they refuse to go to a hospital, are not allowed to go by their families, or are too poor to go. Many who do go to a hospital must sell all they have -- house, land, and livestock.
Kamirung had two previous Cesarian sections and she knew her labor wasn't progressing well this time either. Her only option for help was to travel 55 miles to Makunda Christian Hospital -- with the first part of the journey accomplished by carrying her on a hammock to the road. They reached Makunda late at night and emergency surgery was performed. If she had been delayed any longer, she likely would have died and lost her baby as well.
|Kamirung Reang and family
She was able to come to Makunda because they strive to provide quality treatment at a cost poor patients can afford. They provide charity to the poorest patients, including food and lodging, so that they can still be treated. Maternal and child health are a priority since these are healthy patients who have a good chance of a long life if prompt treatment can save them. Thank God for the good people at Makunda who reach out and help patients like Kamirung.
At Makunda Christian Hospital...
Time for a New Facility
Many EHA facilities are old and in need of replacement, but staff just continue to make do. The funding simply isn't there for new buildings. At Makunda Christian Hospital, the current maternity ward is housed in a WWII aluminum Quonset hut. Both the inside and outside are dilapidated.
Each year, this facility sees 4,300 babies delivered. When there are no more beds available, patients are admitted onto wooden benches. In really busy times, patients are simply turned away.
Recently, work has begun on a new facility at Makunda, and the foundation and posts have been completed. The next stage, which includes the roof and infrastructure, is expected to cost $32,000, $24,000 of which will be covered by the government. The remaining building work, including the floor and walls, is expected to cost $16,000.
|Outside of the current building
If you feel led to give toward this building project, you can donate on our website by clicking here.
|New building under construction
Seeing God's Hand in the Details...
A Tiny Girl Finds Relief Through Surgery
She swallowed a piece of jewelry and it was sharp! The two-year-old girl came to Makunda Christian Hospital struggling with breathlessness. She had been playing with her mother's jewelry, and the x-ray showed that the piece was lodged in the right bronchus.
Makunda's doctors advised the mother to travel to a different hospital because their bronchoscope forceps were broken, but she explained she was a single mother with no means of traveling. When the doctor did the bronchoscopy, the pin was removed on the first attempt.
Amazed, the doctors looked to see what had caused the removal to go so smoothly. In fact, there were two depressions on either side of the pin, and the jaws of the forceps had fit exactly into these holes so that it was firmly held. This was God's hand on the surgeon -- when we are vulnerable, He provides.
One Young Boy Says...
I Want to Go to School, Too
Young Wan-bar Casia walked his Kindergarten sister to school each day. One day a hospital doctor saw him crying bitterly under a tree. She asked him if he was ill, and he replied, "No, I just want to be like my sister and go to school and study. After I go home, I'll be asked to bundle up pan leaves and do so many chores to support my family." After discussing his plight, common to so many local children, the Makunda Christian School staff decided to offer Wan-bar a free education.
Without this quality education, many of the 645 children who attend the school would grow up to be pan leaf pickers, making just 10 cents for a bundle of leaves that they have to climb up very high trees to pick. Through education, the school hopes to transform families and eventually communities.
Teacher Elson Tonsing sees his classroom as his mission field, often talking about God in the classroom. He knows he doesn't need to travel to a distant mission field, but can share the message of God's hope with these children. Transformation is happening, one child at a time.
At a Makunda Community Health Project...
Health Education in a Tea Field
It's a win-win situation. The nursing school students gain experience, and the community gets education in health care issues.
This small Community Health Project out of Makunda Christian Hospital was started in 2006 in the midst of a tea field. Twice a week nursing students teach villagers on topics such as nutrition, sanitation, and simple treatment for common local diseases. Many of these families struggle with poverty, so malnutrition and lack of health care for children are common problems.
Nursing students visit expectant and new mothers to talk about proper, healthy care for young children. Vaccines are provided. School children are also taught, and due to their enthusiastic sharing with their families, the knowledge spreads. This causes the entire village to hear about and think about health issues. One specific issue addressed by this program is the use of latrines.
Before this project began, less than two percent of the villagers used latrines, causing human waste to be a serious sanitation issue. Due to the work of the nursing students providing education about sanitation, 20 percent of the villagers now use latrines. Reaching out with the love of God to make a difference in these villagers' lives is an integral part in the training of Makunda's nursing students.
About Makunda Christian Hospital
Makunda Christian Hospital was begun in 1935 by Dr. Crozier as Makunda Christian Leprosy and General Hospital. He began medical work at that time with the poor in Alipur, and the focus of the hospital today remains serving the poor. Makunda Christian Hospital is located in a tribal-populated area at the junction of three northeast states – Assam, Mizoram, and Tripura. There are no other quality hospitals located in these areas, so Makunda is the main provider of healthcare for this region. The service priorities of the hospital include surgery and pediatric surgery, obstetrics and gynecology, pediatrics, anesthesia, and dentistry.
Also focusing on offering training programs for health professionals, Makunda has a strong impact on areas such as maternal and child health mortality in these rural areas. The ANM nursing school trains local women in healthcare techniques, and they then return to their villages and help care for the women and children. They offer health education on all the major diseases, including tuberculosis, HIV, leprosy, as well as on immunizations.
The spiritual side of Makunda Christian Hospital is evident in the prayer rounds that occur in the wards, the chapel services, the staff retreats, and the studies offered in the school as well as the Nursing School hostels.
It was long a dream of Makunda to operate a Christian school, and it has become a reality. They started out a few years ago with about 200 students, and currently 645 children attend the school. They provide a quality education to children from poor tribal areas of the northeast area of Asam. This education will pave the way for transformation for these children and their families. The long-term vision is to see the community changed by impacting future generations. The school also provides a ready means to share about God with the students and their families.