The Annual Report of the Medical Superintendent Christian Hospital, Bissamcuttack 1 st April 2013 31 st March 2014 Our Mission Patient Care Training in Health Education for Children CHRISTIAN HOSPITAL, BISSAM CUTTACK, RAYAGADA DISTRICT, ODISHA, INDIA 765 019 phone : 06863-247333 ; fax : 06863-247333 ; e-mail : chb.orissa@gmail.com
The Report of the Medical Superintendent, CHB For the Year 2013-2014 I welcome all the honourable members of CHB Society to this Annual General Body Meeting, and thank Almighty God for strengthening and enabling me to present my third Annual Report. With your permission, I take this opportunity to welcome our new Bishop of the JELC, Rt Rev Julias Sontosh, and look forward to working with him over the coming years. We have now completed 6 decades of service by CHB Society. It is now 60 years since, Dr Lis Madsen first started a small dispensary here in Bissamcuttack. This Annual Report 2013-2014 will tell you of how much it CHB has grown since then. It highlights the performance of our team work in the service of people in need. This has been a very busy year, with increasing patient numbers and shortage of doctors and other technical staff. I would like to acknowledge and place on record my sincere thanks to our Chairman, Dr Santosh Nag, and all the members of the CHB Society General Body, who have been Instrumental and Inspirational for the Institution. I would also like to thank my Deputy Medical Superintendents and Administration team. As I present this report, I would also like to acknowledge the help and effort that I have received directly and indirectly from a range of members of the CHB team in the preparation of this report. I will now share with you the reports from the various service areas of the institution. PATIENT CARE SERVICES The primary reason for existence of this institution is the care of patients. Located as we are in one of the most needy and under served parts of the country the junction between Kalahandi, Kondhamal and Rayagada Districts, the needs and demand for health care is far greater than the supply. This last year has been the busiest in our history in terms of patient numbers. Annexure 1 provides a page of hospital statistics. At this point, we will only give you some of the Highlights. Out-Patient Services : With 6 full OPD days a week, CHB served 72,576 patients over the last year; an average of 235 patients per working day. This is an increase of 13% over last year s daily average of 208 patients. New Consultations decreased by 2452 while Repeat Registration increased by 5342 from the previous year. In-Patients Services : This year, 12,057 patients were admitted to and cared for in the wards, which is a 6% increase than last year. However, as the Average Duration of Stay increased 6 days this year, this meant the wards were actually busier. The average number of patients in the 200-bedded hospital on any given day was 194, giving a healthy Bed Occupancy Rate of 97%.
Surgical Services : The surgical department had a very busy year with a total of 5,023 surgeries, which is an increase of 8 % over the last year. Of these, General Surgeries were 3,408. There were 1,545 O&G Surgeries and 267 Sterilization Operations. 33 Eye Surgeries were undertaken. I express my appreciation to Dr Sunil Jiwanmall, Dr Suranjan Bhattacharji, Dr Shiva Pratap, Dr Anupam Dey, Dr Jerry Joseph, Mr Pratap Korad, Sr Maguni Sagar, Sr Anita Lima and all in the Surgical team. Maternity Services : The number of children born in our hospital was 2,760, which is 560 or 25 % more than the previous year. Being a referral Hospital for complicated cases from two districts, 35% or 977 of these were abnormal deliveries (LSCS 646, Forceps 40, Vacuum - 291), with a Caesarean Rate of 23 %. We are accredited by the National Rural Health Mission for the JSY programme. I express my appreciation to Dr Padmashree Sahu, Dr Priyanka Daniel, Sr Sudarshini and the whole Maternity Department for their work this year. Medical Services: The Medicine Department has very busy Out Patient and In Patient loads, with a number of Emergencies and Complicated patients coming in. Under the leadership of Dr Pragya Jiwanmall, Dr Riya Mathew, Sr Kumari Oscar and the rest of the team, they have worked very hard to cope with the patient numbers. Given the increasing numbers and complexity of the patient load, we hope to upgrade the facilities available in this area. Child-Health and Newborn Care : In the absence of a trained Pediatrician, Dr P Mohapatra has continued to respond to the needs of sick children in the OPD and the Wards. We are grateful that we now have one doctor training in Pediatrics in CMC, Ludhiana. The Neonatology services are also very busy with both in born and referred neonates arriving for ccare. Sr Sarojini Dip leads the Nursing team in the Nursery. Dental Services : We are grateful to our new Dental Surgeon, Dr Camy Thomas, who treated 1,141 dental patients this year, besides helping in the general patient care too. We are also grateful to CMC Ludhiana for sending her to us. Community - Based Patient Care : This year over 5000 patients were treated through CHB s community health services through village health workers, sub centre nurses and mobile clinics. The team holds clinic visits to 50 programme villages each month. Nursing Services : CHB has always had a good reputation for our Nursing Care. This forms the backbone of in-patient services. Given that nurses trained in CHB are quickly picked up by Government and Private Hospitals, the increasing patient numbers have put a lot of pressure on the Nursing team. But they have responded well. I am grateful to the Nursing Superintendent, Mrs Manisha Nayak, the Deputy NS Mr Rajesh Walter and all the nurses, nurse aides and support staff for the tremendous work they have put in over this year.
Allied Health Services : : There are many other parts to the hospital that all function quietly in the background, to enable the patients coming to us to get the care they need. - Mr Vineeth Choudharie and his 5 colleagues in the Hospital Laboratory undertook a total of 5,15,804 lab investigations, working day and night to serve the patients. - Mr Bidyut Lima, our sole radiographer enables patients to get their x rays done; a total of 11,725 for the year. - The teams in Pharmacy, Medical Records, Laundry, Security and Maintenance all do their part to ensure the smooth functioning of the services. I want to especially place on record my gratitude to the Administration and Finance teams headed by Mr Solomon Nayak and Mr Luthar Kondpan, who hold the whole process together, and make things happen. They fill many gaps and provide the crucial frame that enables the clinical work to carry on smoothly. I would also like to report on some important events of the last year related to patient care : - CHB Blood Bank was re-opened in July last year, after a gap of over 3 years. We are grateful to the Health Secretary, Govt of Odisha, the Drug Controller and all others who helped us get our Blood Bank License back. There are many within the institution who worked very hard to raise our standards well above the level required. Today, the Blood Bank services led by Mr Bimal Bibhar and Mr Ravikumar are making a big difference to patient care. One of my many roles is that of the Blood Bank Medical Officer. - The Govt of Odisha invited CHB to be an official referral hospital under the Odisha State Treatment Fund. The MoU signed with the State Govt in July 2013 allows for re-imbursement of costs of any patient referred to us by the CDMO. - This year, we received the renewal of our Clinical Establishment License from Govt of Odisha for the period 2012-2014. Applications have been submitted to the DMET for the next renewal. - CHB has also been selected for a model Bio-Medical Waste Management Project being undertaken by the National Pollution Control Board and UNIDO. This is in the planning stage. I am grateful to the Administration Team which has worked hard to keep all these and other Statutory Licenses valid and up to date.
COMMUNITY HEALTH DEPARTMENT : MITRA CHB has a history of Community Health work, from it s very inception, initially through Dr Madsen s village clinic visits and later under the leadership of Mrs Henry. The work of CHD continues to grow and extend the impact of CHB in the villages around us. The work of the Department is called Mitra and functions in 3 units : - The Mitra Project, works with about 12,700 people in 53 predominantly tribal villages, towards the dream of Health, Education, Economic Security and Social Empowerment for all. This is carried out through a network of 3 Cluster Teams, 2 Village Health Centres and about 75 Village Volunteers, supported by a Base Team at CHB. The Primary Health Care programme includes Mobile Clinic visits to each village every month, with focused initiatives for Malaria, Nutrition, MCH, Sickle Cell Anemia, Hypothyroidism and Care of the Elderly. A Community Based Health Information System provides indicators that help focus the work based on the evidence. YEAR 1995 2012 2013 COVERAGE 9,071 pop 38 villages 12,271 pop 50 villages 12,375 pop 50 villages CRUDE BIRTH RATE CRUDE DEATH RATE INFANT MORTALITY RATE UNDER-5 MORTALITY RATE MALARIA PARASITE RATE (<5) 32.8 20.8 201.3 295.3 NA 18.8 9.8 73.5 103.8 27.1 % 23.4 7.7 48.6 86.8 11.5 % The reduction in Malaria appears to be providing a parallel reduction in child mortality. The Community Health programme is coordinated by Ms Atulya Khora. Through the Mitra Education initiatives, CHB pursues the goal of universal access to Primary Education, through the following o o o The MKB programme : Community-run play centres for pre-school children, managed by Sishu Didi s and Mothers Committees. There are now 12 MKB centres now. The AQTE programme, that seeks to Add Quality To Education in village primary schools through the placing of Volunteer Teachers, supported by a Village Committee. There are currently 13 AQTE centres serving 473 students. Summer Coaching Camp for 10 th standard students. In May-June 2013, over 50 students from the 53 villages, received coaching in academics and life-skills.
A survey undertaken in May 2013, showed the change in Literacy levels in the 50 focus villages : YEAR TOTAL LITERACY RATE (>6yrs) FEMALE LITERACY RATE (>6yrs) 2001 24.2 36.7 2013 12.1 28.5 The Education Programme is coordinated by Mr Surendra Gadika. - The Mitra Residential School, Kachapaju, a joint initiative of CHB and the people of 16 hill-tribe villages, has now completed 16 years. This is a unique Adivasi Primary School that provides education in the tribal ethos. In June 2013, the community organized a celebration of the completion of 15 years, with felicitation of all the Matriculates from their villages, whose number has grown from 2 in 1998 to 85 in 2013. The old students of the school now include 3 nurses, 2 sarpanches and 3 Government School teachers. In October this year, MRSK published the first Children s Song Book in Kuvi, and this has been shared with all the Residential Schools of the Tribal Welfare Dept in the Block. MRSK is led by Mr Chandrasekhar Ray as honorary Principal with a team of 12 staff. - The Mitra Training & Resource Unit, continues to take the lessons learnt from the field and share them with others through Training, Consultancy and Publications. Some of the groups we have contributed to during the year include the TMST (Technical & Management Support Team, OHSP, Govt of Odisha) and the SDTT Malaria Network of 9 NGOs in South-West Odisha. On the Education side, we have been working with the JELC Schools towards quality enhancement in Education, sharing our experience and learning there. During the year, we hosted 3 workshops towards this goal. As of 1 st March 2014, Mitra.CHB has started a new 5-year phase with the support of the Jamsetji Tata Trust, Mumbai. This will enable Mitra.CHB to sustain the Community Health and Development programme in the 53 villages, and initiate new focus areas of work, including : - Developing and Operationalising Community Strategies on Hypertension, Diabetes, Chronic Renal Failure, Mental Health and Disability. - Youth Initiatives to engage the young people of the 50 focus villages in a time of transition and confusion, through the formation of youth organizations, provision of scholarships for studies, and starting of two training programmes for Health Care Assistants and Tribal Education Volunteers. - The establishment of a 10-week course in Community Health, and the hosting of 4 Technical Workshops on Community Health annually. The Community Health work of CHB is managed by Dr John Oommen and his team.
SCHOOL OF NURSING The Nursing School is lead by the Principal Mrs Mercy John and her experience team. I present some of the highlights of the year. Students : In October 2013 we admitted 20 ANM & 20 GNM students, bringing our student numbers to 120 - most of them again from the KBK districts. Faculty : Ms Samarpita Pramanik, MSc(N) came back after their higher studies at Vellore. Our old students Taramoni Topno, Alka Oskar, Victor Pani, Sakuntala Mandal and Parijat Nayak came back after their PBBSc Nursing training to join the Faculty. Mrs Treesa Ravikumar, MSc(N) also joined us. Mrs Madhu Walter, Vice Principal, retired after 27 years of service to CHB. She has trained generations of nurses in Community health Nursing. We are grateful to gher for her faithful and dedicated service. Mrs Prabhasini Margaret Bora, senior Tutor of SON, has succeeded her as Vice-Principal. During the year, some of our tutors left us after excellent service Ms Nilophor, Ms Nissi, Ms Reecha and Mr Victor left for other assignments. Besides the regular academic work, our faculty continue to serve as Inspectors and examiners for the MIBE. Examinations & Results : In Sept 2013, the MIBE annual exams were held and our students fared well, giving us a 100% pass result. Workshops / Conferences Our staff and faculty attend workshops and conferences to upgrade their knowledge. They also go as resources person to conduct workshops. Conferences participated in by Faculty included CMAI Biennial at Coimbatore, MCCI workshop, Kolkota, ANSWER, Hyderabad and TMM, Thiruvalla. Finances : CHB continues to support about 50 % of the School of Nursing Budget, with student fees covering the rest. The students contribute back while serving in the hospital for two years after training. Since many students are unable to even afford these subsidized fees, the Mennonite Central Committee, Kolkotta gives a grant of about 3 lakhs in scholarships to 25 students each year, which is a great relief for the parents. The Hospital also offers a facility of interest-free loans to students who need more help. Indian Nursing Council : Application of renewal of affiliation for the institution was done and sent as required. Faculty data and photos were uploaded on the INC website. Ms M Walter, Ms Prativa and Mrs M John were requested to be inspectors for the INC to Chattisgarh, West Bengal and Andhra Pradesh. Mrs Madhu and Mrs Manisha were MIBE Inspectors. Partnership with TSWT, Mumbai : Our project with the Tata Social Welfare Trust is now completing two years, with three components :
a. Roshni Training for Village Girls: We had the second set of Roshni training programmes for young adolescent village girls in maternal and child health. To date, we have trained 324 girls. b. NERU Workshops : The Nursing Education resource unit shares our expertise with nurses and tutors from outside. To gain more experience, three of the faculty made a visit to the Skills Lab at ANSWERS, Hyderabad. We have conducted four workshops this year on skills enhancement and educational methods. Mrs Rebecca Herr, US and Mrs Shimy Mathew, MIBE Secretary were external resource persons, in addition to our own faculty inputs. Through these workshops the skills and competence of our faculty also improved markedly with relation to communication, computer skills and other technology skills. c. Nursing Education Building : The second Nursing Education Building is currently under construction, with Nirmaan Architects, Vishakhapatnam doing the designing and Kalki Engineer, Vishakhapatnam undertaking the construction. The Ground Breaking ceremony was done on 09-01-2014 by Dr Sahu and Dr Hema. Site clearance was started on 25-01-2014 and the digging of column pits began on 05-02-2014. The First floor slab was cast on 04-05-2014. It is anticipated that the 3-storey building will be completed by November-December this year. While the TSWT has provided about 40% of the funds needed, we are trying to raise the remaining resources from friends of CHB. Nursing School Equipment and Furniture : With support of MCC & TSWT, we have been able to procure many modern and useful teaching models, mannequins and equipment for the nursing students and the Skill labs. Chairs and tables for students and offices have been also purchased for the new building. Capping & Graduation Ceremony 2013 Dr and Mrs Henry were the Chief Guests for the function which was held on 26 th October 2013. Students from CMC Vellore We continue to host nursing students from College of Nursing, CMC Vellore for their secondary hospital posting ; ten BSc students came this year for a week Consultancy services We continue to provide inputs to the TMST of Govt of Odisha, With the formation of the first Nursing Directorate in the country and the need to enhance quality in Nursing Education and Services, we are receiving more requests for inputs in Bhubaneswar and Berhampur. I wish to thank to the Principal, the Vice Principal and all the team members of the School of Nursing for their intensive and high quality work.
NEW LIFE ENGLISH MEDIUM SCHOOL Our school has now completed 28 years of service to the community. The school strength is now 480. In the ICSE exams 2013, all our 12 candidates passed, with 5 getting distinctions, 5 first class and 2 second class In Sports and Games, our athletic team participated in ICSE Athletic Meet at Rajkumar College, Raipur and bagged two gold medals : Abhisekh Banchhar for Discus and Samson Pani for High Jump. They had also participated in the National level Meet in Kerala. In the Talent Search Examinations conducted by the Association of Odisha-Chattisgarh ICSE Schools, our students performance was commendable. 8 students got cash prizes for securing high ranks in State level and 4 in School level. The School celebrated the Annual Day on the 2 nd of February 2013. The Chief Guest of the Day was Prof. S.N. Tripathy, Rayagada College and the Guest of Honour was Dr Suranjan Bhattacharji, the former Director of CMC Vellore. Our teaching staff comprises 19 members. Miss Sujata Mali, a Science teacher who had been working here for 4 years, had left to get married. Miss Rajashree Bardhan has been appointed in her place. The School collected and donated Rs. 23,436/- towards the Cyclone Relief Fund, initiated by the Association of Odisha ICSE Schools. It is heartening to see that the alumni of our school are doing very well in the places they are in. 14 batches have passed out successfully. Many of them are now contributing back to their alma mater. My sincere thanks are due to the Principal and his team for their work of the last year. CHAPLAINCY The CHB Chaplain, Rev. Bimal Kumar Samantray has continued to lead the spiritual activities of the hospital. While he is available to any patients who ask for prayer or support, the main focus of his work is the spiritual care of staff and students. His key contributions include : Morning Devotions : Each working day starts with 30 minute time of devotion. The Chaplain provides food for thought, inspiring and stimulating the CHB family for service. Bible Class for Nursing students : The Chaplain leads the Bible class for first and second year of nursing students twice a week, with a Bible exam at the end of the year.
CMAI Healing Ministry Week : in the second week of February, we celebrated the Healing Ministry Week. Each evening, the staff and students gathered in the Chapel for meditations on the theme, led by different staff members. On Sunday, the whole CHB family joined in the Healing Ministry Sunday worship at the CHB Chapel, Bissamcuttack. Special occasions such as Founders Day, Christmas, Republic Day and Independence Day are occasions when we as a CHB family take time to specially reflect and thank God. We are grateful to our Pastor, Rev Samantaray, for his contribution this year. INSTITUTION DEVELOPMENT PROJECT In June-July 2013, staff met in a series of brain-storming sessions to plan how we need to develop CHB over the next five years. The ideas were put together as a proposal submitted to the Sir Dorabji Tata Trust, Mumbai in August. Consultants from Mumbai and Coimbatore came to assess the proposal and our systems in December. The Jamsetji Tata Trust sanctioned a major Institution Support Grant for a 5- year Institution Development Project. We are grateful to the JTT for the trust and encouragement this symbolizes. While a Report on this project will be presented separately, I include only the main features here. The Project has multiple components that will enable CHB over the next five years to undertake the following : A. Deepening and Widening the scope of CHB s service in Community Health and Development through the Mitra programmme. B. Enhancing and Renewing Hospital Infrastructure to fulfill the growing needs and the new Statutory requirements, including an OPD Building, Medical & Pediatric Wards, Day Care Surgery, and Residential Facilities for Working Women and Staff Families. There are also projects for Bio-Medical Waste Management, Solar Energy, Campus Roads, Telephone Networks etc. C. Enhancing the Diagnostic and Patient Care Services through added equipment for the Laboratory, Radiology, Blood Bank and Critical Care areas. D. Starting new Training programmes in Lab Technology, Community Health, Health Care Assistant Training and Tribal Education. I want to express my sincere thanks to the JTT for giving us this grant that enables us to undertake essential development without burdening the patients financially.
STAFF MATTERS The biggest strength of CHB is our staff. We now have 239 regular staff, besides the 80 Nurses doing their Service Obligation periods. As we grow, the challenge of holding it all together increases. As with any other year, there are some who join us newly, and others who leave. The details will be presented separately to the Board for ratification. We are grateful especially to - Dr Tanushree, Ms Taramoni Topno, Ms Samparpita Pramanik and Mr Ravi Kumar who joined us after finished their respective courses from CMC, Vellore - Dr Suranjan Bhattacharji, retired Director of CMC Vellore, who joined us in July 2013. It s a great privilege for us. - Mrs Madhumalti Walter, Vice Principal of School of Nursing and Mr Dandasi Bibhar, Maintenance Worker, retired during the year after decades of service. We wish them well. - We are grateful to the Martin Luther Christian University, Shillong which sent us three graduates of the BSc Community Health Practitioner Course, for 6 months of their internship. They have been a great help in coping with the clinical work given our shortage of doctors. We are grateful to each of them for their contribution. HUMAN RESOURCE DEVELOPMENT We need to constantly seek to upgrade the skills and capacities of our staff. Some of those who are undergoing higher studies are : Mrs Padmini, Miss Deepika and Miss Sephali are doing PCBSc Nursing at CMC Vellore at present with financial support from CHB and sponsorship from the JELC and will return to serve here in September 2014 Dr Dorcas Grace is doing her MS in General Surgery at Vellore and will return to serve here in 2015. Dr Priyanka Mohapatra is doing her MD in Radiology at CMC Vellore, and returns in 2016. Ms Prativa is doing her MSc Nursing at CMC Vellore and will return to serve here in 2015 This year, Dr Alfia Khaki joined for her MD in Medicine at CMC Vellore. Dr Alice Sujatha began her Diploma in Child Health at CMC Ludhiana. They will return in 2017 and 2016 respectively. We are grateful to the JELC for sponsoring them for selections at CMC Vellore and Ludhiana. After a gap of many years, we once again have doctors from CHB and JELC doing post-graduate studies.
EXTERNAL ROLES AND RESPONSIBILITIES Some of our senior staff have roles and responsibilities outside the institution as well. This too is a part of our mission. - I serve as a member of the Governing Board, Christian Hospital, Nowrangapur and as a member of the CMC Vellore, Council. - Dr John Oommen is a member of the CMC Vellore Council. He is also a Board Member of the ERBHS group of Hospitals, Asha Kiran Hospital, Lamtaput & Graham Staines Hospital, Baripada. He is also Secretary of the JELC Sponsorship Committee, Advisor for the ELIM initiative, Koraput, and a member of the Study Group on Mission and Healing of the World Council of Churches, Geneva. - Dr John Oommen and Mrs Mercy John are Consultants to the Govt of Odisha as members of Technical & Management Support Team, OHSP. - Mrs Mercy John is Chairperson of the MIBE, Nagpur, and a member of the Board of Asha Kiran Hospital, Lamptaput and Swasthya Swaraj, Thuamal Rampur. - Mr Luther Khondpan is the Regional Administrators Section Secretary for CMAI, Odisha. - Mrs Manisha Nayak is a member of the Board of Christian Hospital, Nowrangapur and in MIBE. IN CONCLUSION As I come to the end of this report of the work of the year gone by, I have so many people to thank for making all this possible. I would like to express my heartfelt gratitude to all those who are part of CHB directly and indirectly, to all those who contribute in their own way, regardless of geographic location. I wish to thank all the board members, friends in India and abroad for the support, guidance and cooperation we receive in abundance. I wish to thank all our friends Friends of CHB in Denmark led by Dr Frederik Zeuthen, Dr Niels Erik Moller and Dr Ib Bygbjerg; the friends at DMS, Denmaark, DANIDA and the Danchurchaid; organization like V M Tarm and the Marie Dybron Hoff Foundation; numerous other individuals like Kristina Thorsteinson, Ellen Blaesbjerg, Bodil Jensen and many more.
Friends in Germany, especially Rev. Eberhard von der Hyde, Dr Axel Siegemund and all at ZMOe, and friends at EED, Bread For The World, EMW and DIFAM. Friends in USA like Rebecca and Eric Herr, Dr Shobha Sharma, Common Global Ministries of the United Church of Christ, MCC and many others. Friends in India including MCC, Kolkotta, CNI, New Delhi, CMC Vellore, CMC Ludhiana, Christian Hospital, Nowrangapur, Christian Hospital, Berhampur, CMAI, New Delhi, H. Naik & Co, Cuttack, the Sir Dorabji Tata Trust, Mumbai and others. I wish to specially thank our Church, the JELC, and all the members of the General Body and Board of Management of the Christian Hospital, Bissamcuttack Society. I thank each and every member of staff and students of CHB, whose hard work is what this report is about. I thank God for guiding and helping us in each step throughout this year. As we enter into another year of challenges and service, we ask for your continued prayer and support. Thank you all once again. Dr Hemaprabha Mohanty Medical Superintendent 31 st May 2014