MD,FRCOG,DTM&H - Gynaecologist and Obstetrician.
Fully trained in UK
MD, MRCPCH, MRCPI, DCH, DRCOG- Paediatrician with special interest in
neonatal medicine. Trained in India (CMC Ludhiana) and UK.
Motivated by Christian love, we are interested in alleviating the health needs of
the people of rural India. We are concerned about social injustice and the huge
income gap between rich
Following completion of specialist training in the United Kingdom (UK), Elisabeth
came to India as a volunteer in 1993. We met when both working in a rural mission
hospital in Bankura district in West Bengal and married in 1996. Shubhro completed
postgraduate training in paediatrics in CMC Ludhiana and, following a further period
of working in the same rural hospital, we then went to the UK to work and for Shubhro
to further his paediatric training in the year 2002.
We came back from the UK to the same mission hospital in West Bengal in 2009. At that time the hospital faced financial and staffing issues that threatened its ability to continue. Shubhro worked as the medical superintendent cum paediatrician and Elisabeth as senior gynaecologist/obstetrician. As a result of our work (see below), the hospital was on a secure financial footing when our time there came to an end in November 2014.
We were then approached by St Luke’s Hospital in Hiranpur (Dist Pakur, Jharkhand), which had recently had to close because of financial and staffing problems, to consider trying to re-establish medical work there.
Due to our training and experience, our main focus clinically has always been on maternal and child health. In the hospital where we worked from 2009 till 2014 we introduced what we called “The Sarenga Model” (Sarenga is the name of the place) ; this is a protocol-driven model for maternal and neonatal care. As a result, maternal and neonatal deaths reduced drastically (by more than 50%) in a very short time and, as staff bought in to the concept, the improvement was sustained.
We served in that hospital for 9 months each year and worked as locums in the UK for the other 3 months; this pattern of working allowed us to be partly self-financing as well as to remain in good standing with the UK General Medical Council. We travelled to the UK for a month 3 times a year. We envisage continuing to follow this working pattern.
We have always worked closely with colleagues in other specialities and envisage the work at St Luke’s growing to encompass the full range of services needed in a rural general hospital. In particular, St Luke’s historically provided an excellent ophthalmology service and we are keen to attract ophthalmology colleagues to revive this. Community health and preventative medicine has always been part of the ethos of Christian health care, and one of our aims is to facilitate this.
As stated above, our philosophy is based on Christian principles. We are particularly concerned about the suffering of disadvantaged people in rural communities.
India has dual public and private health care systems. The public sector is suffering from a lack of government funding. Only a small proportion of the annual budget is allocated to health services. Consequently, government hospitals are bursting at the seams but are not in a position to provide the standard of care they would like. Most of the doctors in India work in urban areas but most of the population live in rural areas. Private health care is centred in urban areas and its cost is prohibitive so the general public of India is unable to access good quality medical care.
Corporate hospitals have made inroads in the health sector in urban India. They are perceived to provide state of the art service with the latest medical knowledge, skill and gadgets. However, for the private sector, health care is a business like any other. Although there are many excellent doctors in private practice we have reservations regarding the quality of treatment that some of them provide. Some health managers have become corrupt and take short cuts to run their hospitals for maximum profit. Because of such concerns, new laws have been introduced to try to ensure uniform high standards in private hospitals.
For over a century, Christian mission hospitals have been providing good quality health services to the masses. These hospitals are non-profit institutions following Christian values and the mandate of Jesus Christ to serve fellow human beings. There were more than 100 such mission hospitals all over India till the last century but many have been closed down due to lack of funds and hence manpower. St Luke’s is an example of this - it is surprising that, in spite of its closure, no new private hospital has come up in the area. This shows that there is no financial incentive to run this hospital.
A vital part of rural health care lies in the hands of the community itself. We have a responsibility to encourage the adoption of health promotion and preventative measures to reduce people’s need to seek care at all. This is an aspect of Medicine which does not fit well with the aims of the private sector, but is integral to the ethos of Christian health care.
An unintentional consequence of the legislation to standardise services provided in private health care has been the application of these standards to charitable hospitals. It is almost impossible for the surviving mission hospitals, already financially challenged, to provide all the services stipulated in the government guidelines. It seems that the authorities in India are trying to implement western standards in a system which is unable to sustain them due to lack of manpower and financial shortfall.
There are two Christian Medical Colleges (CMCs), one in the north and one in the south of India, which train Christian students as doctors, nurses, dentists and paramedics who can staff mission hospitals. If we lose these mission hospitals the purpose and character of the CMCs will also be lost.
Our aim is to provide the people of Hiranpur with safe, accessible health and maternity care, implementing protocols, training local people and attracting staff who share our motivation so that the service becomes sustainable. Thus we aim to work ourselves out of a job!