Christian Hospital Mungeli

India

Read the latest update

The Christian Hospital Mungeli has been serving the community for the past 116 years. The hospital, in this past year, has been able to move further in new adventures and strides which has brought recognition and stability. Christian Hospital Mungeli has become known in this region for both sophistication and compassionate medical care for the marginalized at the lowest affordable cost. The addition of the School of Nursing and the addition of the CT scan machine have been major landmarks in this past year. However, these are only some accomplishments among many.

Medical Services

In a year, almost 30,000 patients are seen. This number keeps growing each year. As the population of India increased, the number of infant deliveries also increased this year to 616 and there was a reduction in the number of intra-uterine deaths that often are due to delayed care. It is satisfying to know that patients are coming to the hospital more quickly than before. This is most evident in snake bites and scorpion stings. Originally many patients were brought in too late. Now they are well-aware that the hospital is there and, although some will also try both traditional and hospital care for treatment, in many situations people come directly to the hospital. Sadly there was a shortage of anti-snake venom in the country and it was a challenge to make sure that there was always some on hand.

Surgeries

The surgical department usually experienced an overflow of patients. There was always a flood of students who liked to observe and help in the OR as they came to the hospital for their academic electives. Dr. Deeptiman James has joined the staff, along with Global Ministries staff Dr. Anil Henry, in surgery. He has been able to start off making an impression in the community, as he really cares about the patients that he operates on. It is hoped that his services may be expanded. This might mean that a new OR block would be needed, as joint replacements would be added. Dr. Samuel continues to be one of the pillars of Mungeli but fractured his leg some time ago. He continued hobbling around in a cast with support while the services of the hospital continued on.

Deliveries

There were over 600 deliveries during the past year. There is now some amount of outreach, as the nursing students have been reaching out to the villages as they go on their visits. This will make a difference with the kind of cases coming into the hospital. Dr. Ipsita will be joining the staff as soon as she finishes her studies. The sickest patients that came in were those who came from a long distance and had been rejected in other places, including the government hospital, and thus came for refuge as the last hope of life. Some of these were mothers who came with severe jaundice, anemia, high blood pressure, and convulsions (ecclampsia), a ruptured uterus, or malaria. These cases have a high mortality rate and other hospitals do not want to deal with them. It took much more work and effort to take these patients in the latter stages of sickness and attempt to save some of these mothers.

Laboratory Services

During the past year, lab services increased and the demand continues to grow. There were over 48,000 lab tests that were done by the four lab technicians that we have. Services in haematology, biochemistry, microbiology, and blood banking have been increased as well. The hospital continues to struggle to find donors willing to give blood. There has been some awareness and young students are sometimes willing to come and give, but there is a lot of work that still needs to be done.

Medical Imaging

The medical imaging this year made many changes by getting into digital imaging and then acquiring a PACS, a system by which radiological imaging can be examined, compressed, and transferred through the internet. A new 500 mA x-ray unit for higher penetration was acquired as well as the CR system for digitalization. All of this information needed to be stored, and Mungeli became the first hospital in the region to have a PACS that stores all the images on a large server.

The greatest addition to all this was the CT scanner. This is a special spiral CT which can reconstruct images and do all sorts of fancy things to help recreate a lesion in the body to assist in the treatment. This equipment is a first in the region and the scans are cheaper than those done in any city nearby. The CT scans are read by tele-radiology, which means that a radiologist logs into our machine remotely every day and reads and reports the scans of all the patients that were done that day. A second ultrasound machine was also acquired. This ultrasound is a state-of-the-art machine with facilities for color doppler and cardiac echo.

Dental Services

The dental department has been handled by Dr. Nirmal, who has been a great help. He not only works with his own patients, but also helps out with the load of general patients. He assists in cases in the OR which are maxilla-facial and need suturing, as well as being a part of the big cases that we do for oral carcinomas, where major resections and reconstruction are done.

Physiotherapy Department

The physiotherapy department continues to grow each year with the variety of patients. With the addition of Dr. Deeptiman, a greater need for physiotherapy has been realized. An occupational therapist from Australia joined the staff and has been able to put a different angle on the kinds of activities that go on in the department.

RSBY Smart Card Insurance Program

Mungeli Hospital participates in a government health insurance program for low-income families called RSBY. Basically, the government pays premiums to an insurance company on behalf of families living below the poverty line. This provides a family of five access to care worth Rs.30,000 (approximately $665) in a year. The benefit applies only to inpatient services, and there are packages by which the hospital is supposed to receive reimbursement. It is now alarmingly true that the number of patients that come with these cards is increasing day by day enabling more patients to be helped. The sad part of it is that there are still the poorest of poor who are not able to get this card, as they are left out. As the program continues the poor are getting awareness, and it is hoped that the program will continue to grow as is the plant by the government. As usual with all insurance companies, there is a very large outstanding amount that the hospital is yet to receive.

Accommodations For Relatives Of Patients

The main activity of the hospital is to take care of the patients; however, when there is a group of 10 – 12 relatives that also comes with each patient, they also are in need of attention. A large hall has been converted for their use, called the Dharamshala, which is free of charge. A kitchen provides subsidized meals and a place where they can cook their meals by gas stoves. It has been difficult for the gas company to keep up with the high load which is required; thus, the hospital has had gas crises at times requiring the relatives to go back to burning wood. Wood, of course, is free to them, but the consequences to the environment are evident and sad.

School Of Nursing

The School of Nursing has now completed its first year of existence with a total of 20 students in 2011 and again in 2012. The hospital could actually handle 30 but there is a shortage of accommodations. Once this gets settled, there will be 30 students each year. The presence of the students on campus has changed the atmosphere of the staff. There is a sense of new life, responsibility and, surely, liveliness which the community has experienced with this growth. A “Capping Celebration” was held in February, and Reverend Landa Simmons was the chief guest, along with Debbie Briese. This was a very special occasion, as it was the first of its kind in the community. At this point, the primary focus for strengthening the School of Nursing is to provide enough space to house the two classes of students on two floors above the guest house. A new nursing hostel needs to be built which will accommodate about 220 students and staff. This is being planned, and ground breaking will take place in about two months.

Automation of the cooking facilities is helping to feed these nurses as the number will grow substantially.

Crèche

The crèche is a facility that was recently started with a class of six children. This program is geared for children of working women. The children play and learn songs, alphabets, and numbers. The vision with starting the crèche is:

• To bring in children at a younger age to monitor their nutrition and start them on a good road to health.
• To build up their skills in being able to sit, learn, and play with other children.
• Prepare them to be ready to go on to the Rambo Memorial School.
• Rambo Memorial English Medium School

The Rambo Memorial School is the hope for tomorrow. This is what will bring true change in Mungeli for the next generation. The school has been increasing in numbers each year and now there are more than 600 children. This growth prompted the purchase of a fourth school bus last year and, beginning the following year, a fifth school route was started. It is something special to be teaching village children using an English medium, and it is felt that this will surely be the way to “get the frogs out of the pond” and into the world. Thanks go out to the friends and volunteers who come and assist with classes and enlightening the children both in speaking English and in teaching them about the world that God has made around us with many amazing things. The main way forward has been to work with the Church to get their agreement that the school will be functioning under the administration of the hospital. This is essential as long as the school needs to grow. Right now, the school is basically in a large bungalow and there is no more space available. It is for that reason that ground was broken and a new building is being constructed. Six classrooms are almost complete and, when it is done, this facility will be able to educate 1,000 children.

Capital Projects

This year the hospital has done well, and has been able to do a lot, not only to improve the facilities in the hospital, but also to work with the infrastructure.

Hospital Management Software

A new company was secured, Aavanor, based in Chennai, India, to provide hospital management software. The software has brought about a paperless Outpatient Department, starting with patient registration where a nice hard plastic ID card is given with a bar code on it and the patient’s picture which the patient will keep. This system will also be linked to our new PACS server in the X-ray department so staff will be able to view reports and pictures on any of the computer screens in the hospital. It is hoped that staff can learn and begin the process of storing and viewing images that are saved on the ultrasound and the gastro-scope. This software will be able to give additional accuracy in storing and retrieving data as well as make the work of the hospital more streamlined and easy. There is no doubt that the doctors will have to learn to enter data into the computer and will have to know the software.

Major Equipment Acquisitions

The following equipment was purchased during the past year: more air conditioners, a CT scanner, spiral CT 16 slice machine, a video gastro-scope and video trachea-bronchoscope, a new incinerator, ventilators, a solar water heater for the new nursing hostel and staff homes, a new school bus, a 500mA x-ray machine, a digital CR system for x-rays, new picture archiving and communication system PACS, two water coolers, a cement mixture machine, a cancer therapy machine, new hospital management software, and a new ambulance.

Completed Construction

Renovation and building projects at the hospital continued. This year approximately $75,000 was spent toward these renovations and building of new structures. Completed projects include: Conference room and library, new x-ray room and CT scanner room (x-ray department), burn unit with four private rooms, two apartments above existing staff houses, two floors and extension of the old guest house (now the temporary Student Nursing Hostel), cancer machine and infrastructure placed in the cancer treatment center, renovation and building of the boys’ hostel/old nursing superintendent’s house, and building and furnishing of classrooms for the School of Nursing.

Plans For The Future

Over the past nine years, Mungeli has been dreaming and moving along with a vision which has started new endeavors, but it will be necessary to build up the infrastructure for these. Most of all, Mungeli is an exciting place to be. There is always change and there are always surprises that bring staff to the end of the day praising God for guidance as each project gets completed. This next year, one of the anticipated new projects will be the cancer treatment services. This is a dream which is almost realized. The building is completed and the machine is being installed. The prayer is to find the technical hands and the doctor to head this department. God answers prayers, and Dr. Sudeep Marcus has gotten into the radiotherapy course in CMC Ludhiana and will be done in another two years. He is the future of this project. In the meantime, the project will start with current staff and God will guide the way, as always. Also in the planning are:

• The completion of the new school building. This is something which will take some time. Six classrooms are done, and the other six are being completed on the first floor, with two more floors to go.
• The building of a nurses’ hostel. This is becoming urgent, as housing for the nursing students this next year is desperately needed. This project will start very soon and donations are coming in to help get the work started.
• A new water tank will need to be purchased. Construction on this structure has already begun and this project will also have a water recycling system for grey water. Right now the hospital manages with two 2,000-litre tanks on top of the ward.
• More staff housing is needed. This needs to be done if services continue to expand at the rate they are going.
• Begin, in a small way, a survey and community health project.
• There is also interest by the Damien foundation to start an orphanage. This would be a great program to start since the school and the medical facility are already in place and the food will be the only thing that will need to be added.

Staff Matters

There is no doubt that nothing could be possible without the support of the hospital staff. They are the backbone of the hospital. The pillars of the medical work are the doctors, of course. Then there is the rest of the staff that put in many extra hours of work in order to produce the excellent results that you see in this report. Staff have been able to attend conferences, including one in Chennai where ten staff members were able to attend the CMAI conference. There have been other conferences and meetings in which staff members have taken part, as well.

Religious Life

The restoration work on the Bishrampur church has been completed. This has been a great accomplishment. This was the first church that was built by Reverend Oscar Lohr in 1868, and it was in shambles. The restoration expenses were defrayed considerably by generous donations of from the Whitcomb family and Sandy Springs Christian Church in Atlanta, Georgia. The rest of the load of was then taken on by the hospital. The opening ceremony was attended by the heads of both the United Church of Christ, Reverend Geoffrey Black, and the Christian Church (Disciples of Christ), Reverend Sharon Watkins. It was a grand celebration with about 4,000 people in attendance. A lunch was enjoyed right after the ceremony.

Every morning, the hospital staff meet in the chapel for morning prayers. It is, however, getting evident that the building needs major help. Therefore, a new chapel will need to be built and plans are being made for this.

Update: December 2013

During 2013, the Christian Hospital in Mungeli opened an additional eight beds in the Intensive Care Unit (ICU) so that there now are three areas to keep very sick patients in order to monitor them closely. The Hospital has become a referral hospital for the region and many patients are taken there as well as from the city hospitals because of the high expense of keeping their loved ones in other hospitals. The Cancer Center at the Christian Hospital Mungeli is ready to open and the staff is on board once the government permissions are completed.

An additional six classrooms have been completed during 2013 at the Rambo Memorial English Medium School so that the whole ground floor is completed. The building is to have another two floors and they will continue to work on getting them completed. There now are about 700 children in the school.

One of the areas of identified need is teaching people how to swim. Most people who can swim are over 40. Many younger people do not know how to swim due to the ponds and other swimming areas being dried up or too polluted. After some research, the Hospital decided to build a pool on campus. Work started in December 2013 and should be completed in two weeks. The pool is 50 by 30 feet with a maximum depth of seven feet. It also has a separate kiddie pool in one corner. The pool will be staffed by volunteers from Denmark and the United States who will act as swimming instructors.

The Mungeli Nursing School continues to function well with another 20 girls enrolled. The need for a nursing hostel is great; however, building one with the funds available is a big task. The first floor of the new senior staff apartments has been completed and some of the girls have moved in there The second floor is almost completed and two more floors should be ready to house new nursing students coming in the next three years. By that time, a nursing hostel may be a reality.

A new area of endeavor is the starting of a Community College. This would be the only Community College of its kinds in this region. The plan is to start with instruction in the training of nurses aides, classes in tailoring, tractor and four-wheel drive mechanics, and training of beauticians. The present school building will be used for these classes after school hours.

The Hospital hosted many friends and supporters during the year, including medical students from Denmark, Norway, and the United States. Students from Eureka College as well as some from Butler University and Piedmont College visited in 2013.

The Christian Hospital in Mungeli looks for another successful year of activities in 2014, and leadership and staff are very grateful for all who walk with them on this journey.

Update: September 2014

Outpatient Services

During the past year, all the modules in the outpatient area have become paperless. In addition, patients are given a plastic card with their picture on it and a barcode used as identification as they go through outpatient procedures, x-rays, and the pharmacy. The computer software also is also capable of sending messages to patients asking for feedback and reminding them of their next appointments; the hospital hopes to implement these features in the near future. One of the challenges still being confronted is that almost all patients from the small villages already have seen and received treatment from less than competent village doctors. It makes their treatment at Mungeli more challenging, as most infections are only partially treated. The Indian government is in the process of setting up registrations for hospitals. To obtain licenses, hospitals will have to meet minimal standards. The only thing that has been bringing about change is the continued existence of the Christian Hospital, and this continued presence helps the community to understand that the hospital is dedicated to their wellbeing.

Inpatient Services and Intensive Care Unit (ICU)

The inpatient services of the hospital continue to serve the community well, as does the ICU. Indeed, there were only two ICU wards previously, which was insufficient. A third ICU ward was opened and that has given a strong push forward in caring for the very sick patients.

It is hoped that the inpatient records will go paperless in the near future, allowing better maintenance of medical records. There are also plans to provide some kind of insurance for the public. The government has started the RSBY health insurance program. This program will provide approximately $500 a year for inpatient care for a family of five. Originally this program was only for those below the official poverty level. Now, it is for the rest of the public as well. The Christian Hospital, Mungeli is the only hospital in the region that has been able to take up this program. Private doctors are not wanting to participate, as the insurance company pays much less than if the patient pays out of pocket. In addition, as with all insurance companies, there is no knowing when payments will be received by the doctors. Thus, the motto of the hospital has always been that they will NEVER refuse a patient treatment, money or no money, insurance card or no insurance card.

Surgeries

Surgery is the main backbone of the Christian Hospital, Mungeli, and this is the service that the hospital is most famous for. There are no other facilities in the region that have the medical equipment that the Christian Hospital has. All regular procedures, minor and major, including minimally invasive procedures in urology and laparoscopic surgery are performed there. An eye program is also available. The hospital was able to get a phaco machine to help with cataract surgery, equipping it well. A low cost cancer center is planned and presently quite a few major surgeries for head and neck cancers have been done. It is felt that these will only increase in number. The dream is still to get a new operating room block along with newer facilities for mothers and children.

Deliveries

Over this past year, more than 700 babies were delivered. Sadly, over 400 of them were Caesarean sections. This is because mothers are not being brought early enough to attempt a normal delivery. Sick mothers come to the hospital at the last possible minute. Even today, a little over one in ten mothers return home without a living child. It hoped that there will be a turnaround, as increased care is provided through the village outreach program, and also through the efforts of the nursing school.

Laboratory Services

The lab continued to be active and was busier this year than last. It completed over 60,000 tests this year. The support in hematology, biochemistry, microbiology, and the only blood bank in the region have complemented the services of the hospital greatly. The blood bank has completed five years of existence and went through a rigorous inspection in preparation of getting their license renewed.

X-ray Imaging, Cat-scans, Ultrasounds and Scopes 

The radiology department continued to give great support with the 500Ma digital x-ray machine, the C-arm in the operating room, and the CT scan (which is the state of the art multi slice spiral CT with 3-d reconstruction). The Christian Hospital is the only mission hospital in Chhattigarh with these machines. All images taken by these machines are viewed digitally through a special software called PACS which greatly assists in the treating of patients. It also allows for the transfer of images electronically so that remote consultations can be arranged.

The hospital also has most of the scopes needed. The most useful is the upper GI scope. Upper GI malignancies are very common in this area. The tracheobronchoscope also has been of great use both for diagnosis as well as for difficult intubations in the operating room.

Dental Services

Dr. Arun John has been the backbone of the dental services area and has done a great job. He is also the software engineer and has been a great help in that field. The dental department also just had a face lift, as they got two new dental units and also a new digital dental x-ray unit.

Cancer Department

The opening of the Cancer Treatment Center is very close. The building was started in 2011 and is basically a bunker that has a very deep foundation and very thick roof and walls. The building is completed, and the machines have been installed. The next challenge is the long list of permissions and approvals that are required to actually get the Center up and running. The Cancer Center will be THE ONLY low cost cancer center in the state. There are another three that are owned by private corporations, but they do not serve the poor and marginalized.

School of Nursing

The School of Nursing is one of the most exciting things to have happened in our community. This is the final year for the first batch of nursing students, and this class will graduate in February 2015. The training of nurses is still difficult, as they lack most of the necessary equipment for training. Housing for the students is lacking and they still need a separate nursing building, which is mandated by the Indian Nursing Council. Currently they are using quarters built for senior staff to house the nursing students. It is hoped that construction of a new nursing hostel will begin soon. The nursing school has given a special opportunity to village girls to be able to get nursing training. The training is the cheapest in the area and some students who are unable to pay at all are going through training and will pay the money back when they finish their course and earn a full salary. The opportunity will not only affect the individual but also the family and the community.

Rambo Memorial English Medium School

The Rambo Memorial School has grown greatly from 80 students in 2003 to approximately 700 students, including 450 village children being brought in by five school buses. The next year will see an increase to more than 800 students. The school started out in the beginning as Kindergarten through 8th grade. Over the years, it has grown to cover up to 11th grade and the school plans to start 12th grade in the coming year. The Indian Board of Education requires board exams at 8th and 10th grades. All of the 10th grade students passed their boards last year. This was very special.

Due to lack of space, some younger children were not able to attend the school, and a new building was started in 2011. This year, the ground floor of the new school building was completed. This new school building is designed to accommodate 1,000 children.

Plans for the Future

This next year, the projects for the Hospital and community include:

• The new school building: This is something which will take some time. Twelve classrooms on the ground floor are completed with two more floors to go.
• A hostel for the nursing students: This is becoming an urgent need, in order to house the nursing students this next year and, at this point, the hospital really does not have any space. This project will be starting very soon.
• A new water tank: This project is under construction and has reached about half-way. It is hoped that it will be completed this year. The next step will be a recycling plant for all the waste water on the campus.
• More staff housing: This needs to be done if expansion of the programs and services is to continue.
• Community health: With the help of senior staff nurses and students, this effort has been started, and it is hoped it will continue in a much bigger way.
• Community College: This effort is almost there as plans are in place and help has been identified to take this forward. Several different programs are planned to include training in: nursing aid education, tailoring, beautician skills, and computer hardware.
• New Guest house: This is needed to accommodate the high number of people who are now coming to Mungeli on a regular basis. The guest house will hold both students and volunteers.

The Update on the Christian Hospital, Mungeli concludes by saying: “God has blessed us abundantly and we have been able to accomplish a lot in just this past year. It is our hope and prayers that these efforts will bring forth so that we can move faster in order to catch up with the need that we see in Mungeli.”

View a 5 minute video from: A picnic for staff, students and visitors of the Mungeli Christian Hospital to a nearby reservoir. No commentary provided – just the sights and sounds of the day. By Gregg Brekke.

View a 13 minute video about the Christian Hospital at Mungeli written and directed by Russell Brownley.

Update: February 2015

The community of Mungeli Hospital had a lot to be thankful for in year 2014. The entire hospital got a new paint job and everything is bright and clean. The hospital laboratory has been upgraded with state of the art equipment to include an automatic biochemistry machine, a new cell counter, and a sophisticated blood gas machine. All of these machines interact with the hospital management software program so information can be transmitted to the patient record with little risk of error.

The Hospital has been awarded a large direct grant from American Schools and Hospitals Abroad (ASHA) to purchase monitors, ventilators, and equipment for a Mother and Child Ward, Intensive Care Unit, and Operating Room. A Mobile Outreach Unit will be obtained for making village trips. Other improvements will include a large oxygen plant to be used to fill oxygen tanks as well as a sewage treatment plant and incinerator in order for the Hospital to become more environmentally friendly.

The Hospital’s Cancer Treatment Center has been built, and recently accepted delivery of the cobalt source for the Center’s radiation therapy. This Center will be the only low-cost cancer treatment center in the state.

The Mungeli Nursing School is doing well with a 100% pass rate of all of the fourth year students.

The Rambo Memorial English Medium School is growing and has a total of 800 students. A sixth school bus was purchased during 2014. The school has been recognized for 12th grade and will have their first class of graduates. Read stories of some of the students at the Rambo Memorial School

The Springer Community College is a new endeavor begun during 2014. Programs for training nursing assistants, physiotherapy assistants, computer hardware and networking technicians, and tailoring are being offered. Twenty young adults who are mostly 8th to 10th grade dropouts have enrolled in these courses.  This will allow these young people to make a sustainable livelihood and provide for their families.

Update: February 2016

Springer Community College
The Springer Community College celebrated its first graduation ceremony in December 2015. It was a night of celebration to watch the first class of 19 nursing school graduates prepare for a future career of nursing. The program is a nationally accredited 3.5 year program in General Nursing and Midwifery. This degree program at Springer Community College equips young, rural women for a career in nursing and strengthens the rural health workplace. One graduate from SCC, Vijiya Masih, achieved the 4th highest score on the Mid-India Board of examinations. The college is beginning to start a scholarship fund to pay nurses a stipend, which allows them to pursue further academic studies and receive higher education trainings and qualifications.

Rambo Memorial School
The 2015-2016 school year at the Rambo Memorial School was the first school year they had a 12th grade class of students. Many students in the 12th grade class are already accepted into colleges for undergraduate degrees in Nursing, Engineering, Business, and other fields.  There are currently over 900 students at the school from neighboring rural communities. The largest barrier faced by the school is the distance between the students’ homes and the school. In an effort to lessen this problem, the school now offers a bus service to transport children to and from school. The school’s population is growing rapidly, and is quickly running out of space. Therefore the school has begun to raise funds for a new school with additional educational amenities, such as labs, computers, recreational space, and more classrooms.

Baby Box Initiative
The lack of pre-natal care is the leading cause of maternal and neo-natal mortality in the area of Christian Hospital Mungeli. Last year, the hospital accepted many donations for the Baby Box Initiative for new mothers. Each box contained essential, locally-sourced items for the mother and baby, including blankets, cloth diapers, sheets, a mattress, baby soap, oil, and educational materials on breast feeding and immunization. Over 560 boxes were donated and delivered to new mothers in year 2015.

Read donor stories supporting the Christian Hospital Mungeli:

• First Congregational Church, Guilford, Connecticut
• United Church in Huntsville

Update: October 2016

Christian Hospital Mungeli celebrated multiple milestones in the last year, including:

1. Celebrating the 120th anniversary and the progress that has been made since.
2. Constructed a new health facility for maternal and child health, ICU, and surgical care unit.
3. Opening a Dialysis unit.
4. Inaugurating a low-cost cancer unit, unique to the state.
5. Launching the largest, most comprehensive Mobile Hospital in June 2016.

Global Ministries is excited to share the full update from Christian Hospital Mungeli.