Santhosh's ramblings

Three stories from last couple of days in the hospital…. Story 1 - 65-year-old man came to us with a severe peripheral neuropathy, secondary to a burnt out Hansen’s (Leprosy) and our Junior Medical Officer diagnosed him very well. Put him on just a simple tablet of “Pregabalin” and send him home. He comes back to us 4 months later with a bag full of investigations and a pharmacy. Though from a poor background, his children decided, their father has to be taken to Delhi. Took through multiple centers spend about 20,000/- (or more,) with MRIs and scans finally ended at AIIMS. At AIIMS, a burnt-out Hansen’s with peripheral neuropathy was diagnosed and was send back on the same tablet “Pregabalin”. He returned to us, a few thousands less just to confirm if AIIMS was right. And to check with us – which takat ka drug he should take from the bag full of multiple multi vitamins, of various companies, prescribed by each practioner he saw, each time adding on to his home pharmacy, prom...

Recently discussing changing global context with the CEO of an international charity organization on the context affecting voluntary sector, the discussions were quite disturbing and challenging. Of the many changes that is affecting – I zeroed in on three that seemed most pressing. One – the scramble for resources. Money seems to be drying up fast, the donor fatigue seems to be at unprecedented levels, and there seems to be intentional efforts from various players to limit access to funds of the voluntary sector. Any CEO or leader today, need to have sufficient resource generating skills whether it be money or manpower. Resource mobilization seems to be up most in the agenda of many such CEOs and leaders. When Jesus started off His ministry, the offer to him in the desert also was similar. You are appointed for a great task, you have the skills to generate resources (right skills for the job at hand). All you need to do it to put your skills into action. Create bread out of ...

The decision to start on such a trek was not easy. All were in latter side of youth as WHO recently described. Youngest bring 47 and eldest being 63. It was told to us that the trek is a tough one - uphill and downhill and might take anywhere between four to seven hours. But the pictures of what to anticipate at the summit, the Annapurna ranges was so overpowering that the fear of toughness was set aside. How like our own journeys? The vision of a potential future is what should drive us to set aside the reality of fear overpowering us. We started the journey at about 11, traveling up. The initial few meters itself was discomforting - a introduction to the potential challenges ahead. There were discussions on the wisdom of continuing the journey, at least for some. There was serious consideration of alternate plans. It was at that time, as we turned around the corner, we saw the mountain ranges - the camp to where we were heading. That view was enough to enthuse all and set as...

As we look around, and listen to the global, national, and systemic and structural discussions, there are a few words that seems to describe the “spirit of this age” in which we are living. Uniformity - the quality or state of being the same : the quality or state of being uniform or identical, Conformity - behavior in accordance with socially accepted conventions or standards, Singularity   - the state, fact, quality, or condition of being singular, though this word is also uses for a hypothetical moment in time when artificial intelligence and other technologies have become so advanced that humanity undergoes a dramatic and irreversible change: These three emerges out of the desire to have a Predictability – which is the degree to which a correct prediction or forecast of a system's state can be made either qualitatively or quantitatively. Ultimately these emerge from a need to be in Control - the power to influence or direct people's behavior or the course ...

“See I am doing a new thing. Now it springs up; do you not perceive it? I am making a way in the wilderness and streams in the wasteland…...” This is the God we worship and follow. This is the God who has put His nature and likeness into us. The nature of creativity, newness, innovation, and disruption. The ability of creativity – for Him to create out of nothing “ex nihilo” but His creation, humanity – creative engagement from the created and revealed things. The character of “new ways of doing things”, freshness and newness every morning – for humanity - to thinks through ways of doing things differently and with newness. This newness being “innovative” – better solutions to meet new requirements, un-articulated needs or existing needs. And many times, these innovations – being a disruptive way of doing things from the existing paradigm of ways. In God’s creation – we find Him creating “Ex Nihilo” – out of nothing. In the redemption process – he uses a disruptive and inn...

Traveling through the roads in the state I currently reside, I was taken back in memories to 20 years. 20 years back, there were no real roads or to call something a “road”. We used to say, the fields are better than the so-called road. But the 50 kilometers to nearest town with all these challenges used to take only 1 and half hours. 20 years later after 10 years of constant development we have now a half built road. And the same distance takes anywhere between 2 and half to four hours. The so-called half developed road is daily being dug and rebuilt for the last 10 years.  Where there were about 1500 trucks crossing this Indo- Nepal border town 20 years back, today you find more than 3000 trucks. From 12 wheeler it has gone to 32 and 64 wheeler. Many a day half the road, up to 30 kilometers is blocked with 2 lines of parked container lorries awaiting crossing of the border. And the town as usual is filled with dusty trucks and horse carts, rickshaws and cycles, cars and buses wi...

We were traveling in the neighboring state visiting friends. And listening to friends share stories of contexts and challenges. We heard about patients traveling 100km or more in search of accessible and trust worthy health care. We heard about many maternal deaths in villages. We heard about rupture uterus's presenting to institutions every other week. We saw in small clinic 7 cerebral malaria patients all with Hb less than 5 or 6 gm/dl. We heard about 80% institutional deliveries of which only 20% only happens in institutions, rest at home, the data cooked up for reimbursement of health care staff under NHM. We heard about early data from a study on malnutrition where 80% of kids are completely off the road to health chart - they needed to create a separate chart (weight was off the basic minimum). We heard about the need of a bribe of Rs 3000/- to get blood from a state blood bank. We heard about large numbers of patients with partially treated TB landing up in these clinic...