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CHRISTIAN' MEDICAL
(
IN
WORK
INDIA
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Report of
a
Study
team set up by
the Executive Committee of CMAI to
review
’the present with recommendations for
the future
- Dr. W.A.M.Cutting,
Chairman
CMAI Study Team
Senior Lecturer in Child Health
Department of Child Life and Health
17 Hatton Place
Edinburgh EH9 1UW
-INTRODUCTION TO THZ STUDY
1• Methods of Review
2. General Comments
3. General Recommendations for the CMAI
4. Annexures:
. (a) Study Team
- (b) Groups Met
(c) Individuals interviewed/met
(d) Itinerary
II.
CHRISTIAN MEDICAL & HEALTH WORK IN INDIA :
Christian Witness and Issues in the Health Care Service®
1. Historical
2. Objects and Goals
3. Contributions of Christian Medical Institutions
4. Perceived Weaknesses:
(a) Limited concept of Health and Healing
(b) Christian Personnel
(c) Poor Personnel and Administrative Planning
(d) Relationship between Church and Medical Work
5• The Concept of Healing
6. Ethical Issues
7. Conclusions
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III.
HOSPITALS : ? nc. . -
1. Issues in Hospital Services:
(a) The Purpose
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(b) Management
Csflnoi yd
ron esorfT
(c) Relationships of Hospitalswith other agencies
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The Church
The Government
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- Other Christian Hospitals
(d) Types of Hospitals
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2. Hospital Services:
(a) Strengths
(b) Problems
3. Specific Suggestions for Institutions:
(a) Witness of the Church and its Hospitals
(b) Spirituality of Management Personnel
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Management Policies
Pe r sonne P'rPoli ci es .7: - n tunnTO o sli 16 ion s'-' .
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Accounting and Audit Systems
Care, for the Less Privilegedr
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(g) Income generating and sharing of experience
(c)
(d)
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IV.
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COMMUNITY HE7kLTH
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1• Strengths
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2. Weaknesses'
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, 3. .•P.oten.tial.s or Recommendations Iiiol^cdelii . I
TRAINING Al^D EDUCATION :
1. History
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2. Type of Education
3. Rationale for Training
4. Strengths DrT5?-
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5<. Problems and Weaknesses: ■
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(a) Curriculam
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(b) Selection of Students
(c) Financing of Education and Training
<.d) Sponsorship and Migration of Students
(e) Priorities in Medical and Health Education
6. Specific Suggestions oh Education and Training
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INNOVATIVE CHRISTIAN HEALTH CARE
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1. Groups with Special needs:
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(a; Those not served by formal health services
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(b) individuals and families who suffer from abuse
of alcohol, drugs and tobacco
(c) The poor and underprivileged
2. Critical Education
3. Suggested emphases.
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INTRODUCTION TO THS STUDY :
In preparation for the Diamond Jubilee of the CMAI in 1986,
the Association set out 'two questions:1. What is the present situation and status of Protestant
Medical and health work in India? and
2. What is the right direction and the appropriate emphases
for this work in the years leading to the 21st century.
1• Methods of Review :
(a) Quantitative aspects of work is being undertaken by
questionnaire review of all affiliated institutions
by Dr.P.S.S. Sunder Rao of the Department of Bio
statistics of the CMC, Vellore. This is comprehensive
in nature covering the administration, staffing,
services, training programmes, finances, community
contacts, religious activities and future plans and
needs.
(b) A travelling seminar team visited a variety of
institutions in the north and south of India, met
with groups representing churches, Christian organi
sations and personnel. The sample included large
and small institutions in rural and urban areas.
Informal discussions were held with the senior staff
and topics generally included enquiries about the
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strengths of the institution,
special problems faced by the service.
methods of management,
methods of funding and state of finances, *
training programmes/
staff pattern and problems,
relationship to the Church,
nature, of and distinctively Christian
features of the service, etc.
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The members of the team and their itinerary is shown
below. In all places the team was made welcome and
staff shared their hopes and fears frankly. All
members of the team were deeply conscious of their
privilege. They hope and pray that their report will
be real value to the CMAI, institutions, membership,
the Church and ultimately the people of India.
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General
Comments
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Durihg the travelling seminar a great variety of
services w^re reviewed. They ranged from the new to
the old; sample to sophisticated; those with strong
individualistic leadership and those struggling because
of inadequate senior staff; new buildings under construction^
and old ones in various states of repair; those which are
financially “successful" by various means, to those
progressively in debt; services which only cater to the
moneyed classes and those which help all, not refusing
some help even to the poorest. >In some places senior
personnel w£re depressed by staff difficulties within and
pressures and competition from outside the hospital. Some
institutions appeared to have lost their direction and
purpose, but In most places there was evidence of deep
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committment anci sincere work being done in the spirit of
Christ. The tq»am was impressed with the volume and variety
of work being d^)ne in Christ’s name.
A major concern in many places is the need for competent
and committed Christian staff. In some services there is
either a lack of strong leadership, or inadequate attention
to preparing the next generation of leaders. The relation
ship with the Church was often unsatisfactory. Sometimes
the leaders of the Church dominated and made hospital
management difficult; in other situations the institution
appeared so independent it was in danger of forgetting its
religious foundation and purpose. A balance is necessary
with the local church taking a responsible role.
Unhappy personal relationships and serious personality
conflicts often marred the work and witness. The Church
needs to be involved in healing the “broken hearted” within
its own membership and in the society in which it is set*
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' 3. General Recommendations for the CMAI :
(a) In recognition of the Christian purposes for which
the medical services were founded and the divine
strength available, the CMAI should encourage and
assist institutions and workers to review and renew
their spiritual lives. A hospital chaplaincy
programme may contribute to this.
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(b) The CMAI should assist in the re-examination of
the institutions to consider that their witness,
and service reaches those in need and if not, in
some instances, the function may be modified to
alternative ministries.
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(c) The CHAI should facilitate and encourage dialogue
between the Church bodies and the medical institu
tions , leading to mutual understanding and colla
borative activities in the ministry of healing.
(d) Committed Christian personnel is a top priority.
The CMAI and Churches should jointly implement
every method of motivation to encourage men and
women to make a long term committment to the
Christian health services. The vital role of the
family in this process cannot be over emphasized.
(e) The CMAI and the Churches should become actively
involved in nurturing and support of Christian individuals and groups Vforking in. secular medical#
nirsing and health services.
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(f) In view of the management and administrative problems
in many hospitals the CMAI could make available a
representative to be on the Management Board of
member institutions.
(g) The CMAI should, through its members. Nursing Boards,
paramedical courses and representation on educational
councils, continue to
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make curricula relevant to India’s health
:needs, and •.
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encourage continuing education m services,
courses, workshops and study visits
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to meet specific needs of personnel in the health
and healing mission of the Church.
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(h) The CMAI should stimulate and assist the Churches
and associated Institutions to review/its priorities
in the face of limited resources. It is periodically
essential to question what activities will most
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effectively influence the health of people in India -
the introduction of cost effective technolgies#
training for different levels of workers etc.
(i) CMAI should help its member institutions’to recognize
that community Health work is more than mere outreach
and requires working with a defined community towards
better health and development. This includes challeng
ing the community to accept its own responsibilities for
the maintenance of health.
(j) CMAI with the assistance of th^church should become
involved in studying ethical issues relating life and
health# relevant to the countries present socio
political situation.
(k) The CHAI should develop a cadre^of ■ consultants to serve
as resource personnel who could be called on to assist
the member institutions in certain and technical fields.
4• Annexures :
(a)
The Study Team;
Dr. Sylvia Babu, Karnataka State Council for Child
Welfare#formerly at the Bangalore Baptist Hospital
Dr. A.V. Choudhrie# Padhar Hospital# Padhar# M.P.
Dr. William A.M. Cutting# Department of Child Health#
University of Edinburgh# formerely at the CSI Hospital
Jammalamadugu# A.P.
Dr. Sarala Elisha# The Kugler Hospital# Guntur# A.P.
Prof. A.S. Fenn# Department of Surgery and former
Principal# CMC Hospital# Vellore# Tamil Nadu
Dr. Ruth Harnar# Christian Medical Commission# Geneva#
formerly at CNI Hospital# Bilaspur and the
Voluntary Health Association of India
Dr. A.K. Tharien# Christian Fellowship Hospital#
Oddanchatram# Tamil Nadu;—
' (b)
Groups Met :
National Council of Churches in India Staff# Nagpur
Board of Nursing Education# SIB# CMAI Meeting# Madras
Church Leaders meeting# Madras (CSI Synod and Madras
Diocese of CSI)
Staff Leaders of Scudder Hospital# Ranipet
Committee of Bethesda Hospital# Ambur
CMC Staff# Vellore
Church and Hospital Staff Leaders# Bangalore
Representatives of VHAI# YMCA# 'X^CA# CASA# Leprosy
Mission# New Delhi
Medical Superintendents# Administrators & Nursing
Superintendents of U.P. Hospitals - Mathura.
Director & Staff of St.Stephens Hospital# New Delhi.
XI. CHRISTIAN MEDICAL AND HEALTH WORK IN INDIAs
Christian witness and issues in the health care
service
1. Historical :
, Modern Health care was started in much of India with
They attempted to meet
the arrival of missionaries.
the felt needs of people in a sporadic way without long
range planning. Most work-was developed in curative
centres on the model of western hospitals. Most were
supported by funds from overseas.
2. Objects and Goals ;
Objects and goals were to heal the body, mind and spirit
and communicate the love of Christ to those who came.
Medical care' was often an entry point for the gospel as
well as part of the good news.
3. Contributions of Christian Medical Institutions :
Christian Medical Institutions are known for the exce.ll.oncc
of their patient care, their compassion, concern, commit
ment and competence. Training for health’ care at various
levels and keeping up fairly-high ' standards is another
useful contribution which Christian medical institutions
are making for the nation. Community Health care has
often been pioneered by Christian workers and is beginning .
to find, a place in the out reach programme of most of the
hospitals. Many institutions meet-the expenses from their
own...Budgets.. 7 ..This is a valuable service to the poorer
sections of the population/ and offers a good opportunity
for the trainees to gain experience and involvement in the
community. . .
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4. Perceived Weaknesses:
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(a) Limited concept of health and healing •
The most urgent need is If or a deeper understanding of
the concept';of Health’ in its "’wholeness - the nabu~. ■ -'t
life” which He came to give7 (Joi..a 10:10); of the
healing ministry which extends outside of the institutions of health and disease as we know them today.
Each and every professing Christ.i an should be made
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aware of the individual and corp- rate responsibility
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to preach, teach and heal - the fact that health is
not the sole perogative of existing medical institu
tions. Thus the local congregation has an Important
role and responsibility, in response to our Lord/ in
Health and Healing.
(b) Christian Personnel
Funding, nurturing and sustaining Christian personnel
and leadership in Christian health services has not
been adequate. Few sponsored candidates expect to
stay in mission hospitals beyond the service period.
Families seem to be exerting a great deal of pressure
on their children to gain admission to medical and
nursing schools.
(c) Poor personnel and administrative planning
Since Independence there has been a progressive with
drawal of foreign missionaries and the material aids
that came with them. But the transition was not well
planned in terms of personnel- and resources, resulting
in p'oor leadership, management and.performance• This
has lead to the closure of many hospitals. In the
struggle for survival some of them have become nursing
home s for the affluent, neglecting the poor community
who are in greater need of care and assistance.
(d) Relationship between Church and medical work
Ther<e is a misunderstanding and sometimes conflict
between official Church authorities and medical pro
fessionals in many places, resulting in each group
becoming isolated. Healing in this relationship and
a clear division of responsibilities between the two
groups will be necessary before each can take its full
and appropriate part in the Christian medical ministry.
There is a need for understanding, mutual trust, co
operation, co-ordination and support.
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(e) Interpersonnel relationships are often unhappy and
strained interfering with the development of team
spirit which is most essential for any meaningful work
and witness.
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5. The concept of healing should go beyond the hospital
boundaries.
There are many newer avenues of effective^
Christian service and witness for our members through
secular and government agencies.
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rf-An awareness of the unique and significant^role of
thd congregation in the process of total wholistic healing
should be developed with different practical models.
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Communicating Christ to the people with whom we come
into contact is one of the main objectives of the ministry
of healing. Often this communication tends to be mechanical
rather than natural and spontaneous resulting in people
turning away from Christ. Sometimes it is neglected in the
pressure of medical and administrative work. There is need
to develop deeper spirituality and Christian commitment
which would reflect Christ more effectively in and through
the services of the institutions
6. Cthical Issues :
The Christian Medical leadership is often looked up to by
many people, and even by the government, to set a good
example in stewardship and to give' guidance about ethics,
and vital social and political issues which relate to health
and wholeness.
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Some examples of issues which need to be discussed are:
Injustice in health services through maldistribution
Rational use of medicines and essential drug policies
Setting priorities when resources for health care are limited
Life and Death issues
Abortion and Euthanasia
Unwarranted use of life support systems
Research, and experimentation or manipulation affecting
human bodies
Nuclear energy.
7. Conclusions :
Vie have to look afresh at the Christian ministry of healing
in the rapidly changing socio-economic and political situation
of today. Despite our limited material resources, one of the
^ireat poetntials of the Church is its people. They should be
inspired and trained to enter into the Church related services.
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They may also make a vital impact by working in secular
and government organizations. They can be leaven within
health care services and in the vrtwle of society. Thus
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-:an investment in people - who take up a life time commitment to a vocation in health, healing and health services is a priority for the Church in India.
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XXI- HOSPITALS :•
!• Issues in Hospital Services
(a) The Purpose :
In the pressure of. work fundamental issues are
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' sometimes neglected.- Basic questions which- deserve/
: re-e*^ation are: .
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+.. Who does the- hospital serve?-+ Who is Ultimately responsible.for binning the
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Cbl. Management :
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Modern systems of management do not exist in many- -hospitals. Few hospitals have systems-suited to thesize and nature of the- work.
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Personnels .-.Leadership is a key issue. A good
leader can make the critical difference.when --'
there are - deficiencies of various, sorts. Job •
descriptionst service rules and work schedules
are not always developed. The lack of personnel
policy and planning is one factor which has
contributed to staff shortages and to inappro
priate and hasty appointments. Relationships
between staff at the same and different levels
is important. Differences of opinion are reason
able, but personality clashes which harm the
work require mechanisms to settle disputes as
well as Christian understanding.
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Finance; Business like procedures with regular
auditing should be part of sound stewardship.
Decisions about expenditure, concessions etc.
should not depend on one powerful individual, ’
nor should they require cumbersome committee
procedures.
Systems for controlling drugs and supplies need
to be properly organized and administered.
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Maintenance of building and equipment requires
regular attention and budgetry allocation including
depreciation. An individual and a committee should
have the responsibility and power for this task.
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(c) Relationship of Hospitals and other agencies;
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The Church s As indicated elsewhere/ the relatironship between hospital. ..and. Church/-.?e.specially,,,the
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committees and leaders/ is often ope of tension.•
There is a need for a more balanced, control of
the work. This includes an appreciation-by :the
Church that it has responsibilities to the Christian institutions as well.as to wider issues
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■i^iof :.health/ healing and: wholeness.
On the other
hand the hospital andjits staff should appreciate
. i.'its’ relationship ito • the Church of which it is the
most obvious manifestation of its healing ministry.
Indeed the most important reason for the existance
of a Christian hospital is to be a part ’ of the
Church’s witness,
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The Government: The 'current government has called
upon voluntary organisations in the health field/
of ..which the CHAI is a major element/ . to contribute
,. to the.Jhealth carei of India’s people;. Working
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with, .government,, is ..very-challenging/ but as for
as .possible/ Christian helath services should
GomplerQQnt/ rather than, ^.compete with/ the much
large,..government, staft and facilities. Co-operation
usually depends on good.local relationships with
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government personnel at the District and local
level. This required continued attention to
ensure regular,supplies of vaccines, simple
medicines and in some states grants for family
planning <»
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Other Christian Hospitals:
In some situations
it is possible for groups of hospitals to share
some personnel aid services or to specilise in
complementary branches of care. This depends
on geographic and personal relationships.. It
has been attempted by the EHA (Emmanuel Hospital
Association) and some other groups.
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(d) Types of Hospitals ;
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In addition to the obvious differences between a
relatively isolated rural hospital' and a1 mQre sophi
sticated urban institution, there are differences in
the style and method of income generation. Most
practice some form of charging differentially to make
the wealthy contribute to the treatment of the poor
and by doing so remain financially stable. Some
function as nursing homes purely for comroer-qtial. consi
der ationsand almost no free qare i^r-3iven| Some
hospitals employ consultants on a pajy^rtime basis with
the objective of providing highly skilled- technical
expertise which is needed for a relatively small
number of their patientsf The impact of such con
sultant services on hospital income varies with
individual consultants. The inherent merits and
dangers in the use of consultants especially in the
area of private patient care are well recognized.
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2. Hospital Services
(a) Strengths :
From a survey done of some of the small, medium
and large mission hospitals in South and North India
it was very encouraging to see how their services
have grown both in quantity and quality« The bed
strength has increased greatly with the addition of
several new buildings, out-patient departments were
teeming with patients and some of the in-patient
war£s were crowded, due to lack of space.
The urban hospitals that showed signs of growth
had departmentalised and had specialists managing
them. Obstetric departments were usually busy and
many had ophthalmology services which are being well
supported by C.B..M., West Germany.
Majority of the hospitals reach out to the
community covering the preventive as well as curative
aspect from the funds generated at the hospital
or from subsidy from a few donor agencies.
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The School of Nursing was supportive to these
institutions in many respects.
The most progressive hospitals seemed to have
leaders who were spiritual, well trained, and experi
enced. Honest and committed financial managers
were also an important element.
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It was heartening to see good support, co-ordination
and co-operation between the parent Church and the
institution in some cases, and among the various
leaders, within the institutions.
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In well organised institutions the management
retained their staff by providing food, housing
facilities^ gratuity/ pension and opportunities for
in-service training and further continuing education
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These institutions were financially viable for
day to day running of the hospital.
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The patient attendance and the income may increase
when the bills are moderate, within the ability of
the low and middle class to pay.
The stable institutions had relatively minor
labour problems and if there were a few major ones,
thesq? were amicably settled. The employees worked
hard J since there was job satisfaction.
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IThe personal concern and care for patients and
theiir families attracted people of all backgrounds.
Adeci[viate private rooms for richer patients added to
■the/ income.
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14any institutions shared common problems relating
-J to j^ack of proper management systems, service rules,
/••'and specific job descriptions were not available
/ in rr^any institutions. This resulted in many labour
problems, particularly among Class IV workers. Lack
of c^learly defined policies led to improper hiring
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practices with relatives of Church leaders or '
heads of institutions being given a preference
for employment. Overstaffing was a problem in
some institutions, sometimes caused by declining
patient numbers. Policies regarding Provident
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Fund and Gratuity payments heed to be standardized
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according to existing Government regulations. The
existing government labour laws need to be studied
and all those in management positions should work
• .within_ the^constraints of, these laws.-
Audit systems
were o4ften lacking resulting in. inappropriate use
of finances, drugs and equipment.
Perhaps the most common problems faced by the
Christi-an institutions today is the lack of committed
personnel at all levels of service but nror©^especially
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at a leadership level.
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This was most often due to
inadequate planning and preparation of second line
leadership although the reason for this was most
often stated ito be due to low salary scales in mission
institutions.f Lack of adequate educational facili
ties for children was another stated reason given
especially for those working in rural areas.
Chruch groups/ though often supportive of the
work of medical institutions, frequently caused
hinderances in the proper functioning of these
institutions. This was true especially in the
area of appointments of key people in Medical insti
tutions. Senior staff often were thrust upon them
by the church, with no relevant consultation or
dialogue.
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3. Specific suggestions for institutions :
(a) Witness of the church and its hospitals
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a continued emphasis on Christian witness
through caring and efficient medical and
nursing care.
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The parent Church must support/ encourage
and pray for the respective hospitals and the
staff need to take an active role in Church
activities.
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3)
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T^e spiritual healing should form one of the.
£iain aspects of care by chapel services/ ward
■. prayers arid praying for individual patients,
(b) Spirituality of Management Personnel >1^
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The administrators must be deeply dedicated
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..Christians/ depending on the Lord for guidance
a/id.'strength.
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5) ' The prayer life' of the
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proup may be the power behind the: institution
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i?he administrators and the administrative
commit,tee need to think.-and plan# socialize and
iray together often. ;
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(c) Management Policies
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institutions should make- Severy attempt to hire
Christian staff. It may have to hire non
Christians but preferably they should not be
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in management positions.
8)
It may be preferable not to employ 2 members
in the same family unless they are .husbandand
••• •
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Wife.
9)
The prgba-tion period to .be kept as 2 years but
deserving canditates may be confirmed earlier.
10)
Clearly defined job de scriptions, ijf or medical
and piirsing Superintendents and for other heads
of/hospital departments are needed-with the
objective of better co-ordination'of activities
within each of these departments..^;;,
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(d) Personnel Policies
11)
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definite service rules should be provided at
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ythe.time of appointment. - •’/
~
£
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12) |Staff may be retained by good salaries/ security#
j pratuity/ pension and additional incentives
/appropriate to the different situations.
13) / It is advisable to send staff for inservice
./
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training and have continuing education programmes
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1^7^^a«^rQhIems~nec-a-^n3e^etbled. prayerful ly,promptly and with frank dialogue.
15)
The Personnel officer managing the maintenance
workers needs to be an able and friendly
Christian who knows the labour laws.
(e)
Accounting and Audit Systems
16)
As part of good material managementt the
purchase and ordering Committee should be
separate.
17)
The personnel keeping accounts and signing
cheques should not handle money.
(18) Finances, drugs and central supply need to
be audited once a quarter checked by a
Chartered Accountant once a year.
(f)
Care for the less privileged
19)
Rural hospitals need to move into villages and
urban hospitals need a strong interest in the
surrounding community.
20)
It is recommended that hospitals consider
mechanisms to serve the underprivileged and
also to retain their charity status. No poor
patient should be turned away as far as possible.
(g)
Income Generation and sharing of Expertise
21)
Urban hospitals by developing good specialities
and increasing the private rooms can boost up
their image and finances.
22)
A group of Christian hospitals should share
expertise, equipment and services in the area.
23)
Every hospital should be encouraged to develop
a plan for financial stability using a variety
of income sources besides patient care services
and fees. This could include some support from
Government, the parent organisation (the church),
public donations, endowments, fees for training
programmes etc.
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IV. COMMUNITY HEALTHg
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1 * Strength8
It is encouraging to note that general awareness
does existyas regards one of the principles of Community
Health, l.e. Many hospital administrators recognise the
need for caring for those who do not ever get to the
hospitals'/
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Some heads 'of 'institutions1 do concede that perhaps
the hospital’ based health'care systems’ have had no impact '
'r
on recognised health indices of a community such as the' P®
Infant Mortality 'Rate'; ' BTrth' Rate and Death Rate.- There '
is therefore'a commitment'; to'"the support of community'' 6n’
health-based programmes. There are others who justify
their committment to community health; based on the"
premise that'too many arera1ready~involved" inrde11very of
services from a hospital and nursing home.
Hospitals'are1 recognised as institutions^ providing
acute episodic care: as serving a focal function in the
delivery of health care services; as a-referral point for
health care problems that cannot be appropriately handled
at community level. There is also in some institutions
understanding of some of the broader issues in Health
maintenancet such as alcoholism and drug addiction. Some
institutions are working with groups such’ as Alcoholics
Annonymous in dealing with such specific issues. Thus
there is some awareness of the need for healing outside
°f the traditional medical models of curative care.
At community level, existing programmes are. addressing
the major health care needs so that maternal .and child
health services are provided by the community health team,
often with the assistance and co-operation of people from
within the community being served. While many community
based programmes emphasise preventive health care,
curative services are also provided by the same team of
people.
There is an increasing awareness ot existing government
resources and use of these in the delivery of services at
Community level. Some programmes have close co-operation
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with Government field staff and work together with them
in implementing Government programmes. Many programme*
recognize that health cannot be improved without,,develop
ment and therefore are involved in implementing .development type activities# many in income genprating projects
Forming of co-operatives# farmers clubs# womens^ .and
toon
youth groups are other examples of social action grpyLps.^3Oj-|
The need for support and encouragement of .community
workers is recognized# and provided for by the- community .f(j.
and some heads of institutions. The neeji £ or, training rvT
community level workers is .being increasingly; ^ecpgnized .,nX
and more relevant training modules are be^pg. developed
a>
by both Government and Non Governmental agenciesThe j.rf..od
necessary .infrastructure for the successful ^iipglementaT
tion of community based programmes is ^ing slowly.
r. J-.cqccd. a
developed.
.• -t ■ ••ioe
Although many programmes are unable, to ■ overtly'
evangelise because of adverse publicity from local,
tiros
political groups# many of these programmes witness to .
the love of Christ through their activities.’
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Weakness :
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There still remains however a confusion regarding
j
the definition of ’Community.’
Who is the-?CommunityL?
which reminds us of the question in the. Bible ^who is
my neighbour?’ Most Institutions# continue to £hink
of the Community as ’’out there”# often a “rural”r.area
io
some distance away from the base hospital. Thus most
community-based programmes still remain only outreach
efforts to deliver a blend of preventive and some curative
type of health services.
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We remain unaware of possible existing indigenous
ci. ■
f uirUxw
resources far healing in the form of local remedies
_ Los/sd
which have stood the test of time and have been used
effectively# providing symptomatic relief for certain
ailments such as uncomplicated upper respiratory
infections# hepatitis# diabetes# hypertension Q.tc./7odT
... ?3 ?mo0
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Perhaps the greatest weakness in many community
based programmes/is a lack of monitoring of the various
activities. Benefits for the community are assumed,
and little effort is put into the documentation and
evaluation of impact on the health of the community»
The local church often remains aloof from the- -various
outreach programmes of the base hospital and in many
places local Christians continue to be a receiving
community rather than a giving community.
?•
Many community programmes are expected to fcleliver
II
free” services/ a legacy of traditional mission outreach
programmes when drugs and services were^indeed handed
out free of cost to the consumer. Thus’the dilemma
of funding for community based programmes and the expec- ‘ •
tation that foreign funds must always supports such work.
Few hospitals are, however/ generating enough income to
financially support their own community health;programmes.
•
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The upgrading of Community level workers needs to be
emphassised. Their experiences at community_J_eve1 should
fee shared with hospital personnel who will benefit from
this deeper understanding of the various factors involved
in health and disease.
I
Ihere continues to be a need for more co-operation
and colloboration with Government agencies and other
non Government agencies involved in Health and development
activities. ;To function in isolation often under- utilizes
the limited resources available.
3.
Potentials orf Recommendations :
(a) CMAI shou'ld assist member institutions clarifying
their whole concept of community - its ’’size” in
terms of 'geographical boundaries and numbers of
people/ 'its location in and relationship to the
local church; its needs and how they are met.
the same time Hospitals must see their role in a
ove,rall Community Health Care approach acting as
a cientre for training/ referral/ support and extension.
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-«or. ™„y ,00a
models of the hospital.being an. integral component *
of Conway Health, Care aer.ieea have been fleve-
l=Pe1. >; ■ -f
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. „..h , ., .a.; h.,
Commun't' H Uh
’
(b) Community Health, worKv must include, monitoring of
objective measurements'of health Impact'I'.e.lHR etc.
This is Important both, for ' ^11: eneoniigement,. '
pr”
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scientific credibility and.responsible and effective
use of. support from internal or external funding.,
(e) CMAI has also a role in the educating, of: donor
agencies - the apparent;, trend in recent years to
provide funds only for*; Community Health Programmes
and no funds for traditional hospitals, has created
much unnecessary turmoil^ and genuine.concern amongst
hospital personnel.- Perhaps donor agencies need to
work more closely with -local ’recipients’ so that
any financial support may be more relevant to local
needs and not necessarily support only outreach
programmes to the exclusion of all hospital based
health car^v service’s
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1. History :
P;<■
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Training and education of personnel required in the
hospitals and health services of the country has been a
function, and even a priority of the' Christi an missions
in India from the beginning. Missionary Doctors who
began small dispensaries to serve the sick, gave an
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Informal on the job training to women, often widows and
• orphans to help them care for patients. This was made
more formal by setting up Examining Boards for Nurses
in tbe MafatBi, North India and" South India areas and
later in Mid5Indian The^latter two Boards still exist
as an integral part of the activities of the Nurses
League of the Christian Medical Association of India’.
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The small, one-doctor dispensaries grew {.nto the
mission.hospitals most of which were giving some kind of
formalized training to their workers. Three of these
developed into medical training centres at Vellore, Miraj
fend Ludhiana, which are known for their high standards of
education.' Their graduates are throughout the world, and
medical diploma from these medical schools is almost
a passport to a position in most countries.
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2. Type- of Education : The kinds of educational programmes
offered in Christian institutions include Medicine,
with many different specialtie and Nursing including
general nursing and midwifery, auxiliary nurse-midwife/
health worker training, BSc. Nursing, Post certificate
B8c. Nursing, Masters in Nursing, and certificate
courses in Nursing Administration, Nursing Education,
Community Health Nursing or Public Health Nursing, and
many clinical specialties such as Operation Room,
Paediatric Nursing, Ophthalmic Nursing.
Para-Medical courses include Laboratory Technician/
Pharmacy/ Medical Records/ Radiographer, (Diagnostic and•
Therapeutic) Leprosy Worker and Occupational Therapy.
More recently, many church related institutions
or projects have begun training a variety of workers
for community health and development work. These include
village health workers (or rural health guides, or
Family care workers) community organizers, health and
nutrition educators, and a whole series of community
health development personnel.
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3.’ Rationale for Training :
;
.
There is undoubtedly a strong motivation in most
of the educational institutions to train professionals,
paramedicals and others to give Christian witness through
service in the medical and health care needs of the people
of India.
There is.also however, the need to prepare
staff members for the hospitals and health programmes
of the Church scattered all over India. Another factor
in training the nurses, especially, is the help given in
the care of patients in a hospital which is a part of
. .
the practical .experience of every student.nurse.
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4• Strengths :
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Is-ipoctni’ fts Co
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It is widely accepted that Church-related.hospitals
and health services have contributed greatly to the
education of health workers at all levels in India, in
the following ways:
(a)
Medical Colleges and Schools’of Nursing have provided
leadership of both doctors and nurses for Christian
Hospitals and.health programmes, as well as in
Government services.
(b)
Standards of teaching and facilities have ^succeeded . £
in meeting and exceeding the requirements of the
Medical and Nursing Councils of India which set the
minimum.'required standards.
(c)
They have provided new models which have later been
accepted or adopted for the entire country. The
Nurse Examining -'and Education..Boards were started
to set standards, examine and issue certificates,
before any of the present State Nursing Councils
i
existed.
(d)
Christian Medical educational institutions have
reported or shared information on new courses or
ideas, successfully used so they have become more
widely accepted. The use of more objective exami
nation questions in place of the essay type questions
is one example of this.
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(e)
Christian institutdLoxis''have been able to take the
risk of.trying out new innovative kinds of. graining.
Even when these fail; they serve the purpose of
1
showing what doesn1t work.in particular circumstances.
(f)
Some innovative ways of selecting students for the •
programmes which have taken into account the abilities
■
and motivation of students in addition to . knowledge
;
.
and aptitude# have been developed.
(g)
Nursing education has- offered, an.acceptable vocation
for women and an opportunity for. Christian witness
through service even in remote areas.
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(h)
Christian medical institutions have provided opportu
nities for; continuing education for their employees,
and have plr.nc-d in service education to irprcve
(i)
Lps and loans have been made available to
Scholarships
ensure that students.from poor• families will* not be ideprived of opportunities to :study medicine or nursing.
(j)
Nu:rsing education programmes have been located not
only in large city hospitals but many exist in the
smaller mission hospitals in remote areas. More
recently training of local people as village health
I
1 workers hag been developed in small hospitals and
village centres/ and. has provided a pattern for this
kind of training for the country.
Prob J. en i s and. Weaknesses:
( a)
Cur r i cu J Aim: although many efforts have been nude to
make medical add nursing education in Christian
institutions more relevant and oppropriate to the
needs of the country/ this is difficult because
of several constraints. One of those is the educational
system itself. Medical and degree level nursing
education must have any change passed by the University
authorities/ or conform to curricula already established.
If a Christian college adds courses or learning
experiences felt to be important such as ethics and
counselling or inter-personal and communication skillS/
these will not be included in the final university
examination and students and faculty may not take them
seriously.
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The Nursing education syllabus is set by the Indian
Nursing Council and then accepted by the States-or
changed as they decide. State Board examinations are?-
based on these decisions. Most' states and the INC are
slow to change these minimum requirements. Therefore,-the
syllabus does not reflect recent trends towards community
orientation of nursing education despite efforts being
made to bring about a revision in the official syllabus.
Fortunately/ the two Nursing Boards of the Nurses League
of the CHAI have been able to make additions/ reorganize
and encourage the general nursing and auxiliary level
I
schools under their authority to make changes in the
teaching methods, learning experiences and examinations
which will make the training more relevant, •n*"
'-vhr
The Mid India Board has worked closely with VHAI to
reorganize the INC syllabus for the ANM/Health Workers to
make it more appropriate for the work they will be asked
to do in the sub-centres where they will be assigned >'7i
after graduation. A plan for an experimental school
includes the change of site fcr the Health Workers training
from the hospital to a village for the first year of the
course/ only then sending students to the hospital to learn
the care of sick patients as a part of the ’’Restoration to
Health" course which covers clinical nursing. The Board of
Nursing Education/ South India Branch has published a text
bock written especially for the reorganized course.
The
MIBE is also having a series of workshops moving towards a
competency based system for practical examinations.
(b) Selection of Students :
While there is no doubt that the system of student
selection developed by the medical schools related to the
Christian Church is more objective than for other schools/
the objectivity inevitably results in excluding of students
from some classes in society/ and from certain states.
Those who have not grown up in families where English
is generally spoken/ or who have not been able to attend
English medium schools/ either because they were not
easily available in the area, or because the family could
not afford to pay for them/ are disadvantaged when it
somes to the English language objective type questions in
the selection tests. Some of these students do not have
the opportunity for other childhood experiences and education
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which make it easy for them to compete' with others whov
have better off families; able to provide a variety ofc
-
experiences;.'^.-
- JoX-xom onl
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v.::n Hoiriw "vonctf?
In trying tp ensure, that all classes be
opportunity tx^benefit from, medica^. education, someoo.if k
State G.cjzernments have reserved seats fcr the scheduled
’ class. But-this has also proved a’ problem in some states
£
where students with higher grades in the examinations have
objected to the reservation of seats with resulting communal
riots and even death A* Sc this dilemma continues-'to be a
F
serious- one for all- medical-schools^ including the'Christian
medical colleges.'
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The high ^status and financial advantages of becoming a
doctor are -factors influencing the tremendous popularity
of medical education which is likely to result in a conti
nuation of this problem, and of the proliferation.jof medir? 1
schools, despite the fact that the doctor to
population
ratio is good.
In contrast, the doctor to nurse ratio is two doctors to one nurse instead of- the goal of three
nurses to one doctor.
While the number of graduatesffrom
medical schools and nursing schools was approximately•the
same upto 1965, the numbers of doctors graduating from
medical schools in India, is now almost three time higher
than the numbers of nurses graduating annually. Yet,
many nursing- schools have been closed because of lack of
finance-, or decreasing patient load in the small mission
hospitals where many of them are located.
The problem of
selection of students, and the bitterness caused in the
minds of those who are not selected, and their families,
is one which is troubling Christian families all over India.
(c)
Financing of Education and Training ;
The financing of medical schools and the Christian
Hospitals to which they are attached is still seen a^. an
essential goal by churches and donor agencies, although it
is carried out with varying degrees of success in the three
Christian Medical Colleges.
Thg "Sponsorship” fee given
to the Medical Colleges by co-operating Churches or missions
is probably a small part of the total cost. It is not a
guarantee of selection of one or more student from the- church
f
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paying the fee. In contrast, many private colleges openly
demand a "capitation" fee which does give, the donor a /on'
seat in the college/
(quite qpart from the under-the counter
"black money" which may exchange hands)• The market value
■ that
■' \ a family may*■ pay up to
of these seats is now so high
admitted.
Rs 3/00/000 to get a son or daughter
<
Nursing education was supported in the mission hospit'-ls
as a matter of course. Nurses were so badly needed in India.
1
Even 40 years ago, there were six doctors tQjevery nurse.
Nurses and nursing care was the need of every, hospxtal.
Not until funds from the Churches abroad to,support medical
work slowed down and stopped was there any question about
the support for the schools of nursing.
Then they began
to be looked at as a financial liability, and students
were asked to pay fees, which seems a reasonable ideas
since they are receiving an education which'will give them
employment Jn the future. No consideration was given, in
most cases, as to the value of the work which the students
did in caring for patients. Some nurse educators tried
to ask the question on how much experience can be consider^
as educative; how many beds does one have to make/ or how
many injections should one give to become competent in that
activity? How much of the time a student nurse gives can
be counted as un-paid service which helps provide the
nursing care for which mission hospitals have been famous?
And should this not be counted as partial payment for the
education she is receiving? These questions have never
been satisfactorily answered. So student nurses continue
to pay fees to cover board and room, tuition fees, and
cost of uniform. In some instances the amount paid by. the
students is lessened by the time she will, '.in addition'
stay at the hospital for a service period of one to three
years after she graduates. Some schools have an arrange
ment whereby a student may pay more, or a sponsor mey pay
a larger amount so tnat she does not have to give the
'
service period.
This system of paying fees results in some support
for the budget of the schools. It also has the effect
of losing many girls to the government nursing schools
were they are paid a stipend which takes care of all
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sed/no n
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nor/.-.-lrlo nwo a f d-ao ip.J obivo-:.<;
’•
. their expenses, and gives them some income. tQi send
home. This latter practice1 also, has the effect.of ? . *
* making the student en^ioyees, father than giving.>her(i. "
'^^Fstudent status W3 is-'a factor • which, the .students'
and the’nursing profession is-trying to change..without
Cl-
much success. '
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cox^f j.4io;.d Lrr. cold ill osi /axorfw asoio Xsxxn nr oxssrt~r Because of the fact .that, nurses now. have a market
“ ^or their services in the. Middle
,an^ sorne' ot^cr
countries, there are increasing numbers of applicants
d for nurses training,.- especially .from South India and
"3oJKerala. ‘ Some nursingsschools h^vd. t^ke^ advantage of this
:ic by asking for an "establishment fee" from.each student
who is accepted by the. school.. The amount varies from
Rs 5000 to Rs 10,000 as far as is known. They pay fees
'in 'addition to this... The practice is justified on the
basis that the girls will be able to make more than that
when they are employed, in the Middle East, in just a
month or two of work. One effect of this was to almost
rule-out the admission of .local girls who were less
affluent, and had no source from which to obtain such
funds, even though, scholarships were available to support
sGrro of these. A decreasing patient census and l'-.ck
of sufficient c^coerience made the quality of trainj.r.g
given in return for the establishment f<c and other
payments very questionable.
This has not happened in the C’-iAT Nursing Board
related schc'-ls where the intake of students is strictly
determined by the number of patients, or where the lack
in clinical experience is provided through affiliations
with other hospitals or health projects. -
(d)
.
Sponsorship and Micrasion of Gredu-.^? "
Closely rcli.oed problems which aro very frequently
■ mentioned areftcie of Sponsorship, C, mmitme.nt and
Migration. Most of the Christian Hospitals, health
projects and .s.chjjls complained of tne lack of leadership,
f.
doctors', nurses, >' md
aid teaching -staf
staff.
Tn3.s was u.-.v-li/
b.I_mad on luck oz: Christian corcmitmoat and concern on the
part of the graduating students. T iis is much to simpliStic a’? enswor, And probably not even true. In the first
ilij:.- the trcmerilous -emptation c5: going abr^ai for
t
become financially independent and able to send-supp§5fe to
of the family, and to bej/
buck to India.for.other members
^specially
provide for one’s own children is very strong,
Studies have
in a country where family ties are important,
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shown, also, that many mission hospitals offe£, little
■
to date equipway of sufficient salaries to live on, up
offer guidance
ment and facilities, senior doctors who can - rTOr'jrr:-J - n
in professional growth, good management practices or
o.
of the hospitals
opportunities to learn a speciality. Many c_. - - . f-j’and amenities are
are in rural areas where facilities u.._
good schools £017.? the
lacking/ or where there are not
Medical schools say that
education of their children,
bodies pay'no attention to their students
sponsoring
■ ’
j but expect them to return, to the
while they are studying/
decides on after these years of■neglect
post the sponsor c—
and expecting them to stay on after
without questioning
service period, .. Many .individual
the required two years
while undertaking their period of service (bon^),;.-folt
had some bad experience which hasn. given them
neglected or -. .
negative approach to mission service. oThe training
institutes also find it very difficult to instill commitalso find it very '
ment and concern for
for students
students of the sponsoring ^rches^or
hospitals in the period of their medical training,!
church has failed to instill Christian values in the
to 25 years before they enter medical school. . Sponsoring
bodies are disappointed when their candidates fail to be
admitted; and if they are, that their values are changed
during their medical school life.
1
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Nursing Education/ especially the
problems, and increasingly so as the
said to have the same ;
abroad increase. Nurses trained
nurses job opportunities
institutions which have a reputation of
in Christian
a better quality education go abroad in a greater
giving
than do those who are government trained.
percentage
the Indian Government allowed and even
When asked why
to migrate in such large nuntoer when
assisted nurses
a shortage in India, the Nursing Adviser in
there was
of Health said that it would not be right
the Ministry
from advancing in,their profession as much
to stop nurses
and that1India needed the foreign exchange
as they could/
than most others, sent back to their
which nurses/ more
families.
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Certainly/ these inter-twined problems of
sponsorship/ capitation fees/ migration and commitment
to Christian service in India are serious/ have influen
ced Christian witness and must receive the combined
attention of the Church/ the Medical Professionals/
educational programmes, and the CMAI.
(e)
Priorities
in Medical and Health Education :
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Christian institutions haVe limited resources for
education both personnel ^n.d financial.
The CMAI should stimulate Christians to think about
their investment in training. Ultimately effective
primary health care may well depend on innovative and
sound training of peripheral ’-'heal th, workers.
6.
Specific Suggestions on Education and Training •
(a) CMAI should continue to encourage the efforts of
members to provide for the varied needs of training
health personnel through advice-' and assistance in
design/ content and methodology of their training
•
programmes.
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(b) CMAI bould encourage and help facilitate new/ innovative
educational programme required to prepare hgalth
personnel to give more relevant service. Change or-new directions in education may be unpopular or even
arouse opposition until they have been proved effective
and CMAI's moral and perhaps financial support would be
welcome•
(c) Selecteon by training institutions should attempt to
include vocational motivation. CMAI should encourage
this by suggesting methods of determining^ motivation.
It should also recommend and help to direct post
graduate students towards specialities for which there
'are particular needs and vacancies in Christian
Institutions.
(d) Working with the medical and nursing institutions and
the Church the CMAI should search for ways to enable
prospective candidates from disadvantaged groups and
areas in India to compete effectively for admission
into the schools, ensuring a fair representation of
these groups.
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I)
: 10 :
(e) CMAI should study present methods of financing the
Christian medical, nursing and paramedical schools,
and in co-operation with them and related chruches,
suggest alternative ways of financing which would be
Biblically sound.-z 1
'
(f)CMAI should help the Church, medical and nursing;
education institution to face the problem of relative
need in deciding how limited resources, both finance
and personnel can be used most effectively in •
changing the health .status of people, (e.g. a new
CATscan machine or an experimental school for pre-,
paring ANM/Health. Workers/MPHWs).
There are different ways of expressing Christian concern
&■
for health/ healing and wholeness.
-a..;
.•
c’r..'J • < t.. ;, . . • >
Because health is defind in terms relating not only
to the Body/ but also to the mind/ spirit and personal
relationships/ there are many states of disease to which
the Christian faith should speak and act.
Christians and the Church should be sensitive and
alert for areas of unfulfilled need and situations that
require particular care. These are very varied as indicated
in the examples below.
■
■
1.
Groups with special needs :
a) Those who are not served by the formal health services
The destitute and deserted with no homes or families.
★
and
★
The terminally ill.
The work of mother Theresa’s homes and Hospices
have set an example/ but cannot fulfill the
need/ especially in big cities.
*
The physically handicapped/ for example those
paralysed by Polio.■
★
Mentally retarded and spastic children.
Much can be done if these can be identified
early and their parents taught how to give
simple speech and physiotheraphy etc. (For
example the work of Ashirvad in Madras)•
I
■k
The mentally ill and recovering/ including those
who have attempted suicide. Half-way homes or
sheltered homes ( for example the Medico Pastoral
Association's Half-way Home in Bangalore).
•k
Counselling Centres for individuals/ families and
those from institutions where personal relationships
r. •
need to be healed and made whole.
Organisations and opportunities to encourage self t
help in health care.
*
Groups supporting women’s health.
.. 2
COMMUNITY HEALTH Cftl
47/L (First Floor) 3;. Marks Road
BAMGAiORE-gaao^-j
: 2 :
★
Groups concerned with improving the disordered
families and life-styles imposed by western
influences and high pressure commercial demands.
This form of health care and disease prevention
needs exploration.
b) Individuals and families who suffer from abuse of
alcohol, drugs and tobacco.
Drugs, both marijuanna and hard opiates, are a ,
serious problem, particularly for young and urban . ..
groups.
groups. Alcohol abuse and addiction threatens the
health and homes of rural people and those at the top
of the social spectrum.
The health hazards of tobacco have not been adequately
recognized'in India.and there is heavy promotion from
i
Indian and multinational companies-*
Some secular and Christian, models of organisations
exist to help sufferers and their families (ex.Alcoholics
Anomymous) but there is a-need to explore.new ways and
adapting the’old to the Indian situation...
c) The poor and underpriviledged.
... '
Although provided for in some programmes, there is
the danger that impoverished families do not receive
the treatment in disease or promotion of health which
they need because of financial constraints.
The roots of ill-health.frequently lie in socio
economic inequality. In these situations "Development
Programmes" are health programmes, Christians have
sometimes pioneered in the area of socio-political
to this approach,
change and a few groups may be called,
'
(A nun involved in such a programme remarded" If you.
treat the symptoms of a dis-eased society. in the way;
Mother Teresa docs, you are called a Saint, If you try
to treat the roots of the dis-eased society, socioeconomic injustice, you are called a marxist and
revolutionary")
2. Critical education
There is. a need for education so that individuals and
■communities can critically review what are the truly
important factors in health. There are many false ideas
i
... 3
: 3
:
about diseases/ special diets# and exaggerated and false
claims about traditional and modern medicines.
There are
no wonder tonics# but simple mixed diets without excesses#
an active life style with regular rest and exercise are all
important to health. Tfyere are many valuable medicines#
some ancient and others recently discovered# but they should
be used for specific disorders and in appropriate doses.
r
3.
Suggested emphases
a)
Because of the standards set by our Lord# every
individual and institution falls short and we are
all called upon to examine the quality and direction
of our work and witness.
•
b)
;' ■ 1.
r ih
i.
'
-V
The Churches and the CMAI are called to examine and
<
become involved in implications of health/ healing and
wholeness.
*
This is much more than the traditional roles of
hospitals and community health services.
*
It fncludes health in personal relationships and
spiritual health. In many situations such healing
will be necessary before the health care can make
progress.
c)
Christian personnel is a top priority.
★
Individuals should be identified/ encouraged/
nurtured and sustained to fulfil their vocation in
health work.
*
i
In particular there is a need for the development of
leaders in medicine/ nursing and paramedical fields.
The present leaders need to consciously encourage/
delegate and stimulate initiative in a second line
of leadership in preparation to take up responsi
bilities.
*
The present leaders should also stimulate junior
colleagues to see the challenge# interest and
satisfaction in long term service in Christian
health work.
.. 4
u
I
4
I
I
Support systems of prayerfunds,-..education for
children and fellowship should be developed for
*
those working in isolated situations.
c)
Christians and the Church as a whole should be alert
and sensitive to the needs of special groups and
individuals who?caAnot help themselves. These include t
ob
-
‘
.
.
'■
.
*
Renewed commitment to the poor <and
-- underprivileged®
—
*
Handicapped individuals and their families.
★
Individuals and families caught in the cycle o-
alcohol/ drug and tobacco abuse.
★
Individuals and families with other disordered
life-styles which damage health and homes, ever,
among more privileged.
e)
There are several agencies both secular and Christie-,
outside the organised church and medical institution:
which are involved in varied efforts towards tne
overall improvement of health ( eg. VHAI,.fWCA, V-l-.-..t
CASA etc). There is a need to be aware of the
existence of such agencies, their strengths andthen
specific areas of service.
A closer collaboration
with these agencies could improve the effectiveness
of all those involved and also avoid the unnecessa.i
problem of duplication of essential services.
V)
INDIVIDUALS MET DURING STUDY TOUR
Mr. Mathai. - Zachariah
General. -Secretary, NCCI, Nagpur
- - , • Dr. S.N.
f--- - Mukherjee
--- ‘
- Mure Memorial Hospital, Nagpur
Dr. D.W. Mategaohkar
.
ii
ii
Miss
Helari
Ratnam
4
vs
Os s L
T
~
Bishop Suhdar Clarke, Bishop in Madras CSI
Rev. Azariah' - —
General
-----■* Secretary,
—p, CSI
Dr. George
(
Joseph - Secretary Board of Healing Ministries CSI
Synod ■
.
Mr. J. Balraj - Director CTVT, ‘ CSI. Synod, Madras>
Mr. Mithra Augustine, Principal, Madras Christian College,
Tambaram
Dr.M.C. Mathew - Director, Ashirvad, Madras (formerly
Secretary of the Evangelical Medical Graduates'.
Fellowship)
Miss A. Kuruvilla - President, CMAI
Miss Manohari Sigamoni,- Secretary, Nurses League - CMAI
Dr. Vizia kumar- Medical Superintendent, Rainy Hospital, ’ Madras
Dr. Rajkumari - Deputy Medical Superintendent, Rainy Hospital,
Madras
Dr. S.P. Sugunaseelan - Medical Superintendent, Kalyani Hospital,
Kalyani H Regional Secretary CMAI
Mrs. Joshua - Nursing Superintendent (Regional Secretary
.CNL for Tamil Nadu of CMAI).
Dr.E. Bhaskar -• Scudder Hospital, Ranipet
Miss G.T. Mary
Dr. Joel Nesaraj - Special Officer at Ambur Hospital
Mr. George William
Mr. Daniel Rajagumbiren
Mr. Manohar
Miss Mary Mcnabb
Miss Alice Brower
Committee for Re-opening .of
the Bethesda Hospital-Ambur
-Dr.B.M. Pulimood - <CMC, Vellore
Dr.Ramani Pulimood
Dr. R.H. Carman
Dr.. Paul- Stevens
Dr. Malati Jadhav
Dr. Abraham Joseph
Drs Jacob John
Dr. K.V. Mathai
Dr. (Mrs) Mathai
Dr. Anand Date
Dr. Rajaratnam Abel
Dr. K.C. Abraham, Director Ecumenical Christian Centre,
Whitefield
Dr. P.C. Benjamin, Marthoma Mission, Hoskcte
Dr. R.L. Robinson, Medical Superintendent, C3I Hospital,
Chikaballapur
Dr. H. Paul, Ag. Medical Superintendent, ETCM Hospital, Kolar
Dr. John Salis, Medical Superintendent Redfern Memorial
Hospital, Hassan (CSl)
Rev. Settian, Moderator's Commissiary - CSI Central Diocese
Dr. Hunter Mabry - Professor UTC
Dr. Mrs. Esther Mabry - Consultant in Community Health to
Methodist Church in India
Rev. Dorairaj - Presbyter St. Andrew's Church, Bangalore
Dr. B. Isaac, Medical Superintendent, CSI Hospital, Bangalore
Mr. Thomas - Principal, St. John's School (CSl) Bangalore
Mr. Kitty David - Medical doctor in Government service
.. 2
r
: 2
Dr. Robins
Dr. Albert Kundargi - Channapatna Ashram Hospital
Dr. B.D.R. Paul, Medical Superintendent, Holdsworth Memorial
Hospital,
Mr. Andanandam, Administrative Officer - Mysore City
' v 4,
Ms. Ln Karunakaran, Principal, School of Nursing
Mr. P. David, Public Health Supervisor
Mr. Christopher Shanthappa, Secretary, Karnataka Southern Dist.
Church of South India, Mysore
Rev. ^arry John, Area Chairman, CSI, KSD, Mysore
Mr. J. Aaron Vistor, CSI, Mysore
Dr. John Sails - Redfern Memorial Hospital, Hassan
Dr. Mrs. S. Sails
Miss Cherian,' Tutor
Miss H. Ratna
MS. Esther Mathew, CHN
Dr. H. Paul - ETCM Hospital Kolar
Dr. Mrs. Aleamma Thomas (Nee Kurien)
Mr., Mithra
Mr. Anand M. Mani
Dr. Victor John, Bangalore Baptist Hospital
Dr. J.S. Michael
The administrator (from USA) Bangalore Baptist Hospital
Dr. A.C. Oommen - UTC, Bangalore
Dr. Ravi Narayan, Convenor Medico Freends Circle
Mrs. John, MPA Halfway House, Bangalore
Mrs Barbara Alderson
Mr. Sathish Raju
Dr. Mrs. E. Thangaraj, Medical Co-ordinator, Leprosy Mission,
New Delhi
Mr. Vinay Crowther - CASA
Mrc’. rr.rabi Pandey - VHAI
Miss Reoha
YWCA
Mr. Devadas ■ YMCA
Dr. R. Sukhanandan, Chairman Christian Physicians Section,CMAI
and Medical Superintedent Philadelphia Hospital Ambala
Dr. Inder Shaw, Director, C.S. Hospital, Bareilly
.*
Dr,. Sydney Thyle, Herbertpur Mission Hospital, Herbertpur
Mr. Peter Finch, -nandcur Community Hospital, Landour, Mussoorie
Mr. Joseph Singh, UP VHAI Secretary
Dr. Morgan
Mr. Deen Masih
Karskanj
Dr. D. Kumar
Methodist Mission Hospital, Nadi ad.
Dr. J. Khristmukti
Mr. J.S. Rawat
Secretary Medical Committee Methodist
Church in India and Chairman CMC Ludhiana
Board of Management
Mrs. Stella Roberts, Mursan Health Centre of Mathura Hospital
Miss Reiduri Refsdal, PHN
Mrs. Rosylyn Bisht, Bareilly
Mr. SK. Abrahmson
Mrs, B.Washington, Mathura
Dr. Lucy Oummen, St. Stephen's Hospital, Delhi
Miss Marian Jarvis - British nurses from Missourie at
St. Stephen's Hospital
Miss R.M. Young
>
I
■ h
i
I ‘
*
I
1
■ Ul'j '• )
■
■
11
..
•
.
''
(
11, | L!, 1 ft
'
I
I • I .. ■ 1,
(1
.. '■
’ CMAI STUDY TEAM TOUR PROGRAMME
...
'■
6th October^
’85
Nagpur
Team assembles: Dr.WAM.Cutting,
• Dr>Av. Choudhrie, Dr.AS.Fenn
and Dr.AK.’ Tharien
Accommodation - Die Arche Guest
House '
:
•
.
./
/
7 th October/
•85
: ■* A.M. Meeting with General
hd?.
Secretary, CMAI
3.00 p.m. Meeting with General
Secretary, NCCI
Nagpur
Dinner - Die Arche
oo;. ■ /
. ,
Nagpur - : Whole day with Mure Memorial
-j , ’ Hospital, Dr,SN. Mukherjee
and Senior Staff.
Dinner with Dr. Daleep S.Mukarji
■■
'
8th October/
*85
9th October/
'85
. .Nagpur
10th October/
*85
Madras
•
:
A.M. Further discussion in CMAI
12.15 P.M. leave by GT Express
for Madras
Dr. AV. Choudhrie leaves'group
7.30 A.M. arrive in Madras
Gurukul Theological College
Dr. Sarala Elisha joins group
11.00 A.M. join Board of Nur
sing Education, SIB at Gurukul
2.15 P.M. visit Rainy Hospital.
11th October> •85
. -J
Madras
9.00 A.M. Rainy Hospital
Community Health Programme
P.M.
Meeting with Church
Leaders of CSI
Dr. WAM. Cutting at Jammalamadugu, CSI Hospital
12th October/
13th October,
•85
Madras
'85
Ambur
Vellore
KV Kuppam:
.M. Visit Ashirvad Centre
CSI Kalyani Hospital
P.M. Dr. Ruth Harnar joins
Dr.A.S. Fenn leaves group
Travel by car to Ranipet
Scudder Hospital
Arrive c t RUT LA for the night
A.M. Bethesda Hospital, Ambur
meet committee on re
opening of Hospital
P.M.
Bacclaureate service.
Meeting with some CMC
Faculty including Dr.B.
’ Pulimood and Dr.RH.Carman
14th October,
'85
Bangalore :
6.00 A.M. Leave RUHSA for
Bangui cog
, r
,
10.00 A.M. Meet Church Leaders
and Hospital Administrators.
Dr.Sylvia Babu joins
Night at CSI Guest House
15th and
16th October,
’85
Field
visits
See separate programmes
i
: 2 :
—
Dr.W.A.M.Cutting
GROUP I:
DATE
Dr*. Sarala Elisha
Dr.Daniel Isaac
— x=<
==;
ss —•ss
Dr. A.K.Tharien
t
’Group.II: Dr.Ruth Harnar
’
‘ Dr.Sylvia Babu
T
8.00 a.m. Leave for Hoskote
15th Octoberi
(Tuesday)
,
' 8,00 a.m. Leave for
. Mysore
i
Visit Channa. 9.30
patna Ashram
•I
Hospital
8.30
Visit Mar Thoma
Mission Hospital
at Hoskote
10.30
Tea
tio. at
ciL- the Hospi(
tai and leave for ,11.00
C’SI Hospital,
Hoskote
i
t
i
Visit CSI Health
Centre, Peri
pheral Unit &
Training Centre
Hoskote
1.00 p.m. Lunch with Isaac
family'and leave
for Kolar
Visit ETCM Hospi
3.30
tal Kolar.* Halt
• fur the night
at the Hospital
11.00
i
i
I
I
Tjea at
Channapatna
Ashram Hos
pital and
leave for
Mysore
• . i
' '
?
I
i 1.00 p.m. Lunch at the
Holdsworth
i
Memorial
i
Hospital,
i
Mysore.
i
Visit the•
1 2.30
i
H Idsworth
Memorial
i
Hospital.
i
i ■
Meeting with
i
Hospital
i
Senior Staff
i
and Church
i
Leaders
i
i
Dinner at
Hassan and .
halt for the
night
)
i
16th October,
(Wednesday) ,
i
5
i
i
i
8.00 a.m. Met Administrative , 9.00 a.m. Visit Redfern
Memprial
Staff
Hospital,
Leave K^lar for
9.00
Hassan
CSI Hospital,
Visit Community
• 11.30
Chickballapur
Health work of
Tea and visit to
10.00
i
Redfern Memo-1
the CSI Hospital i
rial Hospital
1.00 p.m. Lunch at Chick
J 2.30 p.m . Lunch at Red
ball apur
fern Memorial
i
Hospital
Leaye Chickballapur,
2.30
Leave for
' 4.30
Visit Bangalore
3.30
i
Bangalore and
Baptist Hospital
back to
Return to Vishranti.
Vishranti
Nilayam
t
Nilayam
.. 3
1< I
I
it.
1
Position: 981 (4 views)