Santhosh's ramblings

Leading self and others in an ongoing season of crises and uncertainty. Three to four months ago, we thought the challenge and crises we are facing will soon end. “This too will pass”, was the advice many of us had to give to others and even remind ourselves. Even during fear and internal challenges, we looked forward to a near future, when things would normalize. As days go on, and as we continue in this season of uncertainty, it is becoming clear that this season is not going to end soon. Not only it may not end soon but also there may not be a post covid19 context, rather more of a living with an ongoing covid19 endemic! In an article written by Andy Crouch, Kurt Keilhacker, and Dave Blanchard in March, it was shared, “this is a time to urgently redesign our work in light of what we believe is not just a weeks-long “blizzard,” not even just a months-long “winter,” but something closer to the beginning of a 12–18 month “ice age” in which many assumptions and approaches must change fo...

I was preparing for almost three months. To move from rural Bihar back to Delhi. I was to have shifted end of March, but the lockdown had affected my movement. My wife already in Delhi and I was trying to get to Delhi from late March itself. I went through option after option, train, bus, taxi, flight once it opens etc. Multiple opinions from well-meaning family and friends came. The gist of the advice was – do not risk yourself.   Take your time, go slow, once everything is fine and clear, pack your things, send the truck and them move, well protected. A good advice that I decided to follow. And I waited. There was this 4-hour notice given before the national down. The exodus started. Millions on the road, trying to get back to their homes and family. With all their belongings in couple of bags they could carry. On the road, for days and days, some fell sick on the way, some collapsed, some died. Most were forcibly quarantined in centers en-route, far from home. Having left thei...

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 ...