Santhosh's ramblings

A friend sent this picture to me. I have not been able to find the source of this. This graph  highlights the multiplicity of issues that we are currently facing and will be facing as we go through t his season. Most of what is written here is out of “listening to stories from the ground” than from data. Most of the rural health care institutions are trying to get ready and be prepared for the first wave, the anticipated wave of COVID19. They are getting systems and processes in place for triage, isolation, quarantine, care for the moderately and critically ill who might reach institutions tomorrow. But as institutions prepare and wait, they have already started seeing waves of other epidemics around. The most visible is the epidemic of hunger, starvation, homelessness because of the sudden lockdowns. Many in developing nations are facing an uncertain future due to this. In addition, we have started hearing of the emerging epid...

As I started looking around almost a month back and started interacting with friends and colleagues across our nation and beyond, one thing I realized that, I was afraid and there was a “pandemic of fear”. And most of these fears were rational and logical. I am talking about committed  health care professionals like all of us, engaged in good work. But a logical rational fear, due to various reasons. But beyond the rational fear, soon there was an “epidemic of panic”, that has continued but has not changed much. Why this ongoing panic? Because of the myriad of information coming from the nations that are severely affected, and this information creating a deep sense of anxiety, fear and panic among not only the public but also health care professionals. This also emerges from a feeling of uncertainty. We, in the countries that are yet to have a huge burden but locked down to prevent and mitigate, are overwhelmed by the predictions and future potential of how bad the spread could...

Recently I was admitted to a medical college for a couple of days, with a medical emergency, that too amid the COVID19 scare. After 25 days I am still on a learning curve – the lessons I am learning through the ongoing reflections of my time at the other end of the system. I am quite confident and comfortable to be the care provider, the grey-haired senior person in the team supporting and encouraging the team and sorting out challenging issues. And to leave the normal routines to the rest of the team. But to be one of the many patients in the emergency department (ER) of a tertiary care system and subsequently go through the rest of the hospital stay was a new, challenging but rewarding learning experience. As I was wheeled into the emergency department in severe pain and with absolute dysphagia at about 8.30 pm,   (let me not keep you in suspense – I have a uncommon, not so serious disease called Eosinophilic Esophagitis, (EoE) that could lead to food impaction and dysphagia,...

Facing pandemics – four more leadership principles In my previous blog on leadership in pandemics, I introduced six guiding principles: Do not give in to panic; Innovate if we don’t have resources; Be compassionate and protect the most vulnerable; Have faith in God and reflect and learn what he is teaching us; and Review and change things as new evidence emerges  As I investigate my own life and the context around, I observe a ‘continuing panic’. Why? Because of the myriad information coming from the nations that are severely affected. This information is creating a deep sense of anxiety, fear and panic not only among the public but also among health care professionals. This also emerges from a feeling of uncertainty. We in those countries yet to have a huge burden of coronavirus cases but locked down to prevent and mitigate, are overwhelmed by the predations and future potential of how bad the spread could be. The uncertainty is creating sleepless nights, and inability to t...

Christian Medical Comment: ‘Green zones’ for the vulnerable may be a cheap an... : US and Western Europe have so far been the hardest hit by the coronavirus with over 80% of cases worldwide - but there’s good reason to ...

It has been almost a week since the lock down and the steps taken for containment of the COVID19 was set in motion. I found it challenging, initially, to some extend even now! I was to have left the location where I was, to be with family, and was expected to meet up with the extended family and friends. I had 2 tickets booked, one on train and another on flight, making it sure that if one gets cancelled, I have an alternative option. But I never thought that all my doors will be closed, and I would not be able to move out. But that has happened. I am now slowly learning to be content in containment because I understand the bigger picture. I need to respect and support the nation and the steps the nation takes, till the storm passes over. I have nothing much to complain about – since I live in a protected environment though in one of the most impoverished parts of our nation, with my basic needs well taken care of. A good house to stay, food more then enough to eat, social co...

Much has been written and shared about COVID19 and ongoing responses. But mostly from places where the epidemic is quite advanced and more so, from resource rich contexts, struggling to contain and mitigate even with all their resources. The resources they have is not enough for the numbers they are facing. The resource limited nations thus far have much lesser numbers than the richer and developed nations. But for health care professionals in such contexts, this is not a time for complicity, but a time to refocus and reorganize for when we would face similar or many more numbers of patients with much lesser resources to respond with. This article considers some questions that health care professionals in resource limited settings and developing nations need to consider as we look ahead, with a lack of clarity, to what the future holds for COVID19 pandemic. Most of our nations are in lockdown. Experiences from countries that acted early and tried to contain the epidemic, show ...