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RF_DR_22_SUDHA
ANNUAL MEETING OF THE CATHOLIC HOSPITAL ASSOCIATION OF INDIA—1984
Workshop1 on; TOWARDS" A' PEOPLE-ORIENTED DRUfe" POLICY^'
23.11.84
Friday
3.00—4.00 pm
4.30—6.00 pm
Inaugural Mass
Inaugural Session
Keynote addresses:
24.11.84
Saturday
1.
Prof RK Anand, Paediatrician,
Consumer Guidance Society of
India, Bombay
2.
Representative of GK Project,
Bangladesh
9.00—9.30 am
Introduction to Workshop, Objectives/
Program
9.30—11.00 am
SESSION I: UNDERSTANDING THE PROBLEM
Speikers
1.
P'-~ B Ekbal, President, Kerala
Sastra Sahitya Parishad,
Trivandrum; The Indian Drug
Sc-r:e--Jrigs and the industry
end c,■ >yenwent policy.
M"
.7.'".;Voluntary
Health Assbciati'On of India,
. ' New Delhi: Ten Commandments of
the Drug Industry.
2.
3.
Dr
Francis, Co-ordinator,
Continuing Medical Education,
Christian Medical College, Vellore:
Drugs and Primary Health Care.
11.00—11.15 am
TEA
11.15- am tot
1.00 pm
SESSION II: DRUGS AND THE -HEALING
MINISTRY
Spe akers
1. Fr George Lobo, Papal Seminary,
Pune: Ethics of Prescribing.
2. Fr John Desroches, Centre for
Social Action, Bangalore: Church
Health Services—-a' ■social analysis
-
3. Prof. George Joseph, Council for
Healing Ministry, Madras:
Professionals in the Church—
an introspection.
1.00—2.00 pm
LUNCH
2.00—4.00 pm
GROUP DISCUSSION Is FACILITATION TEAM
a.
Identifying the caxises -of the
problem
b.
Identifying barriers to Action
c.
Discovering our involvement in
the problem
: 2:
24.11.84
Saturday
(contd,..)
4.00—4.30 pm
4.30—6.00 pm
TEA
SESSION III; TOWARDS RATIONAL
TI 'TAPEUTICS
1. ti”.
Shiva, Co-ordinator,
All India Drug Action Network;
V??SAA®„Rational Drug Therapy?
2. PA.IA1—Ait tor, Medical Superinten
dent, Star of Hope Hospital,
Akividu, Andhra Pradesh; Banned
AtPA-ArAand_Has_ardo ■s drugs
in_our hospitals.
3. The situation in our hospitals
25.11.84
Sunday
9.00—9.30 am
Review of first day's program
9.30—10.30 am
SESSION IV; WHAT TO DO TO TACKLE
THE PROBLEM?
“
Speakers
1. Dr S Joseph, Medical Superinten
dent, MGDM Hospital, Kottayam.:
What can our Hospitals do?
2. Mr Alan Cranmer, CMAI Consultant
Pharmacist, Mysore; What can be
done at a Pharmacy level?
10.30—10.45 am TEA
10.45—11.45pam SESSION V; SOME INITIATIVES
Case studies on; a. Drug Action
flatsxjc; b. Kerala Sastra Sahitya
Parishad; c. LOcOST; d. Bangarapet
Tablet Industry; e. Kurji formulary.
12.00 noon
to 1.00 pm
SESSION VI; A PEOPLE'S MEDICINE
1. Er Jos_eph Chittoor and
2. Sr_'^r.ocent, Gudalur group:
AAA? - medicines and. Home
Remedies
1.00—2.00 pm
LUNCH
2.00—4.00 pm
GROUP DISCUSSION II:FACILITATION TEAM
What can we do as:—
a a
o ra
4.00—4.15 pm
4; 15—5; 15 pm
5.30—6.30 pm
a. individuals;
b. institutions;
CHAI
TEA
Concurrent programmes*
SESSION VI; CONCLUDING SESSION
; A statement of concern and
soma resolutions
: Summing up
Tel: 310694, 322064
Catholic Hospital Association of India
CBCI Centre, Goldakkhana, New Delhi 110001
SECOND ANNOUNCEMENT
41st Annual Convention of CHAI and Workshop on Drug Issues.
1-
Programme
23 (Friday) to 25 (Sunday) November 1984 : Meeting on —
“TOWARDS A PEOPLE ORIENTED DRUG POLICY”
26 (Monday) November 1984 : Annual General Body Meeting.
2.
Venue
St John’s Medical College, Bangalore 560 034.
3.
Participants
Members of CHAI and special invitees.
4.
Theme
The Indian Council of Medical Research and the Indian Council of Social Science Research have warned in their
“Health for All” report that '‘Eternal vigilance is required to ensure that the health care system does not get
medicalised, that the doctor-drug producer axis does not exploit the people and that the abundance of drugs does not
become a vested interest in ill-health”. This meeting is to understand the issues relevant to drug prescribing, drug
distribution and pharmacy policy in our institutions in the context of the above warning.
5.
General Objectives
5.1.
To inform and make aware the CHAI members of the background to the above problem highlighted by the
Indian Council of Medical Research/Indian Council of Social Science Research.
5.2.
To challenge them to participate in the growing national response to the problem through a —
a)
continuing study of the problem;
b)
5.3.
6.
commitment to action at an individual, institutional, regional and national level.
To do this in the light of CHAI’s new vision and in keeping with the Church’s option for the poor.
Specific Objectives
WHAT IS THE PROBLEM ?
6.1.
To create an awareness of —
a)
6.2.
the health situation in India
b)
the roie of drugs in health care
c)
the pattern of drug production in India vis a vis the people’s health needs
d)
the dynamics of the drug industry
e)
the patterns of drug dislribution/availability in the health system
f)
the'national drug policies and laws.
To create an awareness of the growing —
a)
irrational use
b)
over use
c)
misuse of drugs by health personnel
6.3.
To look at the above issues within the context of the CHURCH HEALTH SERVICES.
6.4.
To try and understand the problem from the people's point of view.
HOW/WHY THE PROBLEM ?
6.5.
At the broader level to discover the social, economic, political, cultural and other factors responsible for this
problem.
6.6.
At a personal level to discover how all of us are part of the problem at the individual and the institutional
levels.
WHAT TO DO TO TACKLE THE PROBLEM ?
6.7.
6.8.
To consider the various responses at national/intcrnational levels by groups/institutions/governments in the
areas of —
a)
consumer awareness and people's movements
b)
continuing professional education
c)
pressure groups on policy makers
d)
search for low cost alternatives
e)
individual/group action
f)
institutional policy changes
To discuss ways and means by which participants can respond to this problem at
a) individual,
b) institutional, and
c)
regional/national levels
and identify ways and means by which follow up action will be taken on this growing commitment.
AN APPEAL
We request all member hospitals and dispensaries to send representatives who are involved with drug
prescribing and or pharmacy policy in their institutions. These may be doctors/nurses/pharmacists or policy makers.
A preparatory check list of how to study the drug situation in your institution will be featured in the special
issue of MEDICAL SERVICE—October-November 1984. Participants should use it to study their local situation
so that their participation will be more meaningful. The special thematic issue will also give adequate background
material for the meeting.
— EXECUTIVE DIRECTOR
Catholic Hospital Association of India
* For further information/suggestions on the theme, write to :
Drs Ravi & Thelma Narayan
Community Health Cell
326, 5th Main I Block
Koramangala, Bangalore 560 034.
* For further information on registration/accommodation/ticket arrangements etc., write to :
Sr. Anna Maria
Secretary
CHAI Annual Convention Committee 1984
St. Martha’s Hospital, Nrupathunga Road
Bangalore - 560 009.
41st Annual Convention of the Catholic Hospital Association of India
Workshop on: TOWARDS A PEOPLE-ORIENTED DRUG POLICY
23-25 November 1984 ; St John's Medical College and Hospital
Objectives
WHAT IS THE PROBLEM
1. To create an awareness of
a.
the health situation in India
b.
c.
the role of drugs in health care
the pattern of drug production in India vis a vis the
people's health needs-/4’
d.
e.
the dynamics of the drug industry
the patterns of drug di'^ftribution/availability in the
f.
the national drug policies and laws,
health system
2. To create an awareness of the rogrowing -
a.
3.
irrational use
b.
over use
c.
misuse of drugs by health personnel
To look at the above issues within the context of the
CHURCH HEALTH SERVICES
4.
To try and understand the problem from the people's point
of view,
HOW/WHY THE PROBLEM?
5.
At the broader level to. discover the social, economic,
political, cultural and other factors responsible for
this problem.
6.
At personal level to discover how all of us are part of the p
problem atthe individual and the institutional levels.
WHAT TO DO TO TACKLE THE PROBLEM?
7.
To consider the various responses at the national/international
levels by groups/institutions/governments in the areas of a.
b.
consumer awareness and people's movements
continuing professional education
c.
pressure groups on policy makers
,
p.t.o...2
2
8.
d.
e.
search for low cost alternatives
individual/group action
f.
institutional, policy changes .
To discuss ways and means by which participants can
respond to this problem at-
a.
b.
individual
institutional and
c. regional/national levels
and identify ways and means by which follow up action
will be taken in this growing commitment.
PROGRAM
11.00 am
Preparatory Workshop for Faciliation Team
17th November 1984
St John's Medical College, Bangalore
11.00 am
Introduction of team/theme and details of
the proor rame
11.20 am
Group discussion;
a. What are the different dimensions of
the drug policy and prescribing issues
in India?
b. What information would we like to have
to further understand and analyse this problem?
12.40 p.m.
Plenary session»
Listing out what we would like to know
1.00 plm.
LUNCH
2.00 p.m.
Information check list
3.30 p.m.
Tea
4.00 p.m.
Planning the group discussion and the
facilitation
5.00 p.m.
Video presentation on the theme.
3
DRUG ISSUES
Information check_list
A.
B.
Drug Industry
Output
Profits
Type
Pattern of production
Structure
Drug Policy
Prices
Quality control
Research and Development
Consumption of :Drugs
Drug Policy Issues (Problems)
Plethora of formulations
Mark up
Brand names
Net worth returns
Fixed drug combinations
Transfer pricing
Bio-availability argument
Sales promotion
Dumping
Samples
Me-too drugs
Advertising
Drug controls
C.
Drug policy Issues (solving Problems)
Essential drug list
Formulary (level of use)
Generic prescribing
Bulk Drug formulation
Price control
Bulk purchasing
Labelling
Quality control
Low cost production
Cooperatives
Herbal gardens
Pharmaceutical code
Physicians code
Counter advertising
Consumer Awareness
D.
Drug Laws/Policies/Reports
Drugs and cosmetics Act
Drugs & Magic Remedies Act
The Pharmacy Act
Hathic Committee Report
p.t^o.^.
4National Drug Policy-
Drug Price Control Orders
Health for All Report
Govt. Ban of 22 drugs
Irrational Drug use/prescribinq types
Types
Extravagant
Overprescribing
Incorrect
Multiple
Under-prescribing
Causes
Inadequate basic training
Lack of continuing education
Lack of supervision
Inappropriate desire for p
prestige
Drug company sales
promotion
Drug company misinformation
Heavy patient load
Patient presssure
Panic/fear inc • v
induced prescription
Incorrect generalisations
Lack of patient
awareness
Doctor-Drug producer axis
Problem Drugs
Specific
Analgin
Amidopyrin
Ancoloxin.
Bromides j
Chloral hydrate
Cloquinols
Dipyrone
E-P Forte
Ergot
Gripe water
Kaolin
Lomotil
Methapyrilene
Nialamide
Oxyphenbutazone
Phenylbutazone
Phenacetin
Practolol
Penicillin
Quinine
Sulphonamides
Strychnine
" Yohembine
Groups
G.
H.
I.
Antibiotic combinations
Anabolic steroids
Analgesics
Antidiarrhoeals
Enzymes
Fixed dose combinations
Placebos
Steroids
OTC Drugs
Unani/Ayurvedic drugs
Church Health Services (context)
Institutional response
New vision/option
Community response
Humanisation
Holistic healing
Issues of social justice
People's Point of view
Availability
Accessibility
Cost
Crossi-cultural conflicts
Mystique of injections
Communication failures
Self prescribing
Low cost home remedies
Initiatives
Meetings and workshops
Newsletters/bulletins
Books/j ournals
Professional awareness
Continuing education
Consumer awareness
Signature campaign
Memorandum to policy makers
Public interest litigation
Low cost drug production
Bulk/central purchasing
Cooperatives
Herbal gardens
Formularies
Codes
J* Case studies
Bangladesh Ban
Operation Medicine
VHAI Cell
Drug Action Network
I'OCU HAI
Social Audit
mfc Rational Drug Policy
Cell
Vincents Case
Ankurap
KSSP
Lok Vidnyan Sanghatana
LOCOST
Bangarapet Tablet Industry
Kurj i formulary
State Forum (AP/WB)
41st Annual Convention of the Catholic Hospital Association of India
Workshop on; TOWARDS A PEOPLE—ORIENTED DRUG POLICY
23-25 November 1984 : St John's Medical College and Hospital
Objectives
WHAT IS THE PROBLEM
1.
To create an awareness of
a.
the health situation in India
b.
c.
the role of drugs in health care
the pattern of drug production in India vis a vis the
d.
the dynamics of the drug industry
e.
the patterns of drug distribution/availability in the
health system
f.
the national drug policies and laws.
people's health needs
2.
3.
To create an awareness of the
..growing -
a.
irrational use
b.
over use
c.
misuse of drugs by health personnel
To look at the above issues within the context of the
CHURCH HEALTH SERVICES
4.
To try and understand the problem from the. people's point
of view.
HOW/WHY THE PROBLEM?
5.
At the broader level to discover the social, economic,
political, cultural and other factors responsible for
this problem.
6.
At personal level to discover how all of us are part of the o
problem atthe individual and the institutional levels.
WHAT TO DO TO TACKLE THE PROBLEM?
7.
To consider the various responses at the national/international
levels by groups/institutions/governments in the areas of a.
b.
consumer awareness and people's movements
continuing professional education
c.
pressure groups on policy makers
p.t.o...2
2
8.
d.
search for low cost alternatives
e.
individual/group action
f.
institutional policy changes
To discuss ways and means by which participants can
respond to this problem at-
a.
b.
individual
institutional and
c. regional/national levels
and identify ways and means by which follow up action
will be taken in this growing commitment.
11.00 am
Preparatory Workshop for Faciliation Team
17th November 1984
St John's Medical College, Bangalore
11.00 am
Introduction of team/theme and details of
PROGRAM
the programme
11.20 am
Group discission;
a. Wnat are the different dimensions of
the drug policy and prescribing issues
in India?
*
b. What information would we like to have
to further understand and analyse this problem?
12.40 p.m.
Plenary session?
Listing out what we would like to know
1.00 pirn.
LUNCH
2,. 00 p.m.
Information check list
3.30 p.m.
Tea
4.00 p.m.
Planning the group discussion and the
5.00 p.m.
Video presentation on the theme.
facilitation
>3
DRUG ISSUES
Information check_list
A.
B.
Drug Industry
Output
Profits
Type
Pattern of production
Structure
Drug Policy
Prices
Quality control
Research and Development '
Consumption of -Drugs
Drug Policy Issues (Problems
Plethora of formulations
Mark up
Brand names
Net worth returns
Fixed drug combinations
Transfer pricing
Bio-availability argument
Sales promotion
Dumping
Samples
Me-too drugs
Advertising
Drug controls
C.
C.
Drug Policy Issues (solving Problems)
Essential druglist
Formulary (level of use)
Generic prescribing
Bulk Drug formulation
Price control
Bulk purchasing
Labelling
Quality control
Low cost production
Cooperatives
Herbal gardens
Pharmaceutical code
Physicians code
Counter advertising
I
' ^.-orts
Consumer Awareness
D. Drug Laws/Policies/Reports
Drugs and cosmetics Act
Drugs & Magic Remedies Ac-t
The Pharmacy Act
Hathic Committee Report
National Drug Policy
Drug Price Control Orders
Health for All Report
Govt. Ban of 22 drugs
Irrational Drug use/prescribinq types
Types
Extravagant
Overpre scribing
Incorrect
Multiple
Under-prescribing
Causes
Inadequate basic training
Lack of continuing education
Lack of supervision
Inappropriate desire for p
prestige
Drug company sales
■ promotion
Drug company misinformation
Heavy patient load
Patient presssure
Panic/fear inc. v
induced prescription
Incorrect generalisations
Lack of patient
awareness
Doctor-Drug producer axis
Problem Drugs
Specific
Analgin
Amidopyrin
Ancdloxin
Bromides i
Chloral hydrate
Cloquinols
Dipyrone
E-P Forte
Ergot
Gripe water
Kaolin
Lomotil
Methapyrilene
Nialamide
Oxyphenbutazone
Phenylbutazone
Phenacetin
Practolol
Penicillin
Quinine
Sulphonamides
Strychnine
Yohembine
Groups
G.
H.
I.
Antibiotic combinations
Anabolic steroids
Analgesics
Antidi arrhoeals
Enzymes
Fixed dose combinations
Placebos
Steroids
OTC Drugs
Unani/Ayurvedic drugs
Church Health Services (context)
Institutional response
New vision/option
Community response
Humanisation
Holistic healing
Issues of social justice
People1s Point of view
Availability
Accessibility
Cost
Crossi-cultural conflicts
Mystique of injections
Communication failures
Self prescribing
Low cost home remedies
Initiatives
Meetings and workshops
Newsletters/bulletins
Books/journals.
Professional awareness
Continuing education
Consumer awareness
Signature campaign
Memorandum to policy makers
Public interest litigation
Low cost drug production
Bulk/central purchasing
Cooperatives
Herbal gardens
Formularies
Codes
J.
,
Case studies
Bangladesh Ban
Operation Medicine
VHAI Cell
Drug Action Network
IOCU HAI
Social Audit
mfc Rational Drug Policy
Cell
Vincents Case
Ankuran
KSSP
Lok Vidnyan Sanghatana
LOCOST
Bangarapet Tablet Industry
Kurji formulary
State Forum (AP/WB)
"DA 2.2.1 2-
ARCHDIOCESE OF BANGALORE
Health
Services
HOSPITALS
(1)
O L of Lourdes Hospital
Kengeri PO 562118
Bangalore District
(2)
St John's Medical College
Hospital
Sarjapur Road
Bangalore 560034
565435
St Martha's Hospital
Bangalore 560009
74081
St Mary's Maternity Clinic
SB Chamarajpet
Bangalore 560018
62392
St Michael's Maternity Clinic
Old Madras Road
Bangalore 56003S
52811
(6)
St Philomena’s Hospital
Nilasandra Road
Bangalore 560007
577994, 52811, 577985
St
(7)
Rita’s Hospital
Kanakapura 562117
Bangalore District
(8)
St Theresa's Sanitorium
Raj aj inagar
Bangalore 560010
(3)
(4)
(5)
80561, 80222
2
DISPENSARIES
1.
Apostolic Carmel Seva Kendra
IV T Block
Jayanagar
Bangalore 560011
2.
Arogya Seva Dispensary
Dodda Alshalli
Kanakapura Taluk
Via Sathanur
Bangalore Dist
3.
Arpana Nilayam Dispensary
Carmelaram PO
Bangalore 560035
4.
Cluny Convent Dispensary
11th Main Road, Malleswaram
Bangalore 560003
5.
Diwan Bahadur Dr T C M &
Mrs Louisa Royan's Child Welfare
Centre
Albert Victor Road
Bangalore 560018
6.
Dr Mary O’Grady Memorial Hospital
White Field 562136
Bangalore District
7.
Holy Spirit Convent
Bannerghatta Road
Bangalore 560032
8.
Karuna Nilayam Dispensary
Carmelaram PO
Bangalore 560035
9.
Lions Club Dispensary
Doresanipalya
Bangalore 560029
10.
Lourdes Hospital & Dispensary
Kengeri PO
Bangalore 562118
11.
Marian Nilaya Dispensary
and Maternity
Banaswadi PO
Bangalore 560043
12.
Missionaries of Charity
Ashoka Road
St Thomas Town
Bangalore 560005
13.
Missionaries of Charity Dispensary
Venkatala Village
Yelahanka PO 562116
Bangalore District
40430
57131
2
2
14.
Nirmala DispensaryInf ant Jesus Church
Viveknagar
Bangalore 560047
577206
15.
Nirmala Dispensary
St Francis Xavier's Church
Somanahalli PC Bangalore
16.
Nirmala Health Centre
Siluvepura
Chikkabanavar PO 562113
Bangalore District
17.
OL of Lourdes Dispensary
Kunigal 572130
Tumkur District
18.
0 L of Lourdes Health Centre
Bon Secours. Convent
Ramanagaram 571511
19.
O L of Perpetual Succour
Dispensary
Harobale 562126, Bangalore District
20.
0 L of Providence Dispensary
Hosur Road
Bangalore 560029
40272
Perpetual Succour Dispensary
26 Davis Road
Bangalore 560005
50411
21.
22.
Prema Mandira Dispensary &
Family Planning Centre
4 Harris Road
Bangalore 560005
23.
Presentation Convent Dispensary
Carmelaram
Bangalore 560035
24.
Sacred Heart Novitiate
Avalahalli
Bangalore 560049
25.
Sahodara Prema Seva Mandir
& Clinic
No.2, IV Street
Bharathi Nagar
Bangalore 560001
26.
Shanti Nilaya Community Health
Care Centre
Kri shnaraj apura
Bangalore 560016
27.
St Anthony's Health Centre
Basavanapura
Gottigere PO 560029
Bangalore
3
3
28.
St Charles1 Maternity
Home & Dispensary
Fraser Town
Bangalore 560005
29.
St Joseph's Dispensary
Asirvanam Monastery
Kumbalgod PO 562118
Kengeri, Bangalore District
30.
St Luke's Medical Guild Free
Clinic
Hennur Road,(Hosur Road
Nehrupuram, Royapuram,
Shantinagar)
Bangalore 5600
31.
St Mary's Convent Dispensary
Chamarajpet
Bangalore 560018
32.
St Mary's Dispensary
Gandhi Nagar
Tumkur 572102
33.
St Michael's Maternity Clinic
Indiranagar
Bangalore 560038
34.
St Paul's Dispensary
Marikuppam
G.F.
K.
563117
35.
St Philomena's Health Centre
Nagawara
Arabic College PO
Bangalore 560045
36.
St Rita's Dispensary
Kanakapura 562117
Bangalore District
37.
St Theresa's Dispensary
J C Road
Bangalore 560002
38.
St Theresa's Dispensary
Rajajinagar
Bangalore 560010
COMMUNITY HEALTH CELL
326 V Main I Block
Koramangala
Bangalore 5C0034
05 November 1984
Dear
This is further to our letter to you dated 26 Oct 1984.
This is to inform you that the Workshop for the Facilitation
Team will now be held on Saturday, the 17th November 1984
at 11.00 a.m. in Room 116 of St John's Medical College, Bangalore.
The details of the meeting, mentioned in cur letter cited above,
remain unchanged.
We hope you have been receiving the background materials. The
Special Issues of MEDICAL SERVICE (CHAI Journal) and the medico
friend circle BULLETIN should also reach you before the 17th.
These will form a comprehensive background for the topics to be
covered in the Workshop,
Copies of other important reference materials are also available
in the Staff Reading Room of St John's Medical College Library.
Please contact Mr K N Kittur, the Librarian, to refer to them.
Please intimate your participation or otherwise.
Looking forward to meeting you on the 17th,
Yours sincerely,
Ravi and Thelma
1.
Fr John Vattamattom; Fr Thomas Joseph; Fr Chacko;
Sr Mariamma; Sr Jeyaseeli; Mr Abraham Mathew (CHAI Team)
2.
Dr H Sudarshan (Secretary, Vivekananda Girijana Kalyana Kendra,
BR Hills); Dr GD Ravindran (Medical•Officer, Holy Cross
Hospital, Kamagere); Dr Gerry Pais (DEED, Hunsur); Dr Ravixaj
Williams (Hoskote Mission Medical Center, Hoskote); Fr Rupert
Rosario (Jnana Jyothi, Anekal); Mrs & Mr Jyothiraj (Rural
Education for Development, Tumkur); Fr Joseph Chittoor (Gudalur)
3.
Dr Prem Pais (St Martha's Hospital); Dr Sukhant Singh (CMAI);
Dr Sylvia Babu (Baptist Mission Hospital); Dr Maya Jacob
(Sumanahally); Dr Gurunath Kilare (Kidwai Hospital); Dr Esther
Mabry (United Theological College); Sr Collette (Good Shepherd);
Br Jose (Sevasadan); Dr Vijay Joseph (Bowring Hospital);
Dr Ramakrishna (ASTRA); Dr Mohan Isaac (NIMHANS);
Siddalingaswamy (Promotional Secretary, VHAK); Fr Francis
Guntipally and Team-(Ashirvad) .
4.
Dr PN Pandit (Assoc Prof Surgery); Dr R Narayanan (Assoc Prof
Obst & Gynae); Dr Mario de Souza (Assistant Administrator);
Dr Patrick Kamath (Gastro-enterology) ; Dr (Sr) Lillian (Obst
& Gynae); Dr Raghuvir (Paediatrics); Dr MJ Thomas (Psychiatry);
p , t. o. ..
2
Sajeev Joseph (Orthopaedics);
Paul Neelamkavil (Dermatology); Leo Menezes (Surgery); Jose
Joseph (Medicine) - St John's Medical College Hospital,
Bangalore
Dr Dara Amar (Head; Community Medicine); Dr MA Nagarani
(Asst Prof Pharmacology); Anura Kurpad (Physiology);
Pruthvish; Kishore Murthy; Shirdi Prasad Tekur (Community
Medicine); SM Subramanya Shetty (Health Education Officer)
—St John's Medical College, Bangalore
For information -Fr Claude D'Souza (Rector, St Joseph); Sr Anna Maria
(St Martha's Hospital)
Fr Percival Fernandez (Secretary, CBCI Society for
Medical Education);
Dr GM Mascarenhas (Dean);
Dr AFA Mascarenhas (Medical Superintendent);
Fr Bernard Moras (Administrator);
Br Vincent (Administrative Officer)
— St John's Medical College and Hospital, Bangalore.
2
Sajeev Joseph (Orthopaedics);
Paul Neelamkavil (Dermatology); Leo Menezes (Surgery); Jose
Joseph (Medicine) - St John's Medical College Hospital,
Bangalore
Dr Dara Amar (Head; Community Medicine); Dr MA Nagarani
■ (Asst Prof Pharmacology); Anura Kurpad (Physiology);
Pruthvish; Kishore Murthy; Shirdi Prasad Tekur (Community
Medicine); SM Subramanya Shetty (Health Education Officer)
—St John's Medical College, Bangalore
For information —
Fr Claude D'Souza (Rector, St Joseph); Sr Anna Maria
(St Martha's Hospital)
Fr Percival Fernandez (Secretary, CBCI Society for
Medical Education);
Dr GM Mascarenhas (Dean);
Dr AFA Mascarenhas (Medical Superintendent);
Fr Bernard Moras (Administrator);
Br Vincent (Administrative Officer)’
— St John's Medical College and Hospital, Bangalore.
COMMUNITY HEALTH CELL
326 V Main I Block
'Koramangala
Bangalore 560034
05 November 1984
Dear
This is further to our letter to you dated 26 Oct 1984.
This is to inform you that the Workshop for the Facilitation
Team will now be held on Saturday, the 17th November 1984
at 11.00 a.m. in Room 116 of St John's Medical College, Bangalore
The details of the meeting, mentioned in our letter cited above,
remain unchanged.
We hope you have been receiving the background materials. The
Special Issues of MEDICAL SERVICE (CHAI Journal) and the medico
friend circle BULLETIN should also reach you before the 17th.
These will form a comprehensive background for the topics to be
covered in the Workshop.
Copies of other important reference materials are also available
in the Staff Reading Room of St John's Medical College Library.
Please contact Mr K N Kittur, the Librarian, to refer to them.
Please intimate your participation or otherwise.
Looking forward to meeting you on the 17th,
Yours sincerely,
Ravi and Thelma
1.
Fr John Vattamattom; Fr Thomas Joseph; Fr Chacko;
Sr Mariamma; Sr Jeyaseeli; Mr Abraham Mathew (CHAI Team)
2.
Dr H Sudarshan (Secretary, Vivekananda Girijana Kalyana Kendra,
BR Hills); Dr GD Ravindran (Medical Officer, Holy Cross
Hospital, Kamagere); Dr Gerry Pais (DEED, Hunsur); Dr Raviraj
Williams (Hoskote Mission Medical Center, Hoskote); Fr Rupert
Rosario (Jnana Jyothi, Anekal); Mrs & Mr Jyothiraj (Rural
Education for Development, Tumkur); Fr Joseph Chittoor (Gudalur)
3.
Dr Prem Pais (St Martha's Hospital); Dr Sukhant Singh (CMAI);
Dr Sylvia Babu (Baptist Mission Hospital); Dr Maya Jacob
(Surnanahally); Dr Gurunath Kilare (Kidwai Hospital); Dr Esther
Mabry (United Theological College); Sr Collette (Good Shepherd);
Br Jose (Sevasadan); Dr Vijav Joseph (Bowring Hospital);
Dr Ramakrishna (ASTRA); Dr Kohan Isaac (NIMHANS);
Siddalingaswamy (Promotional Secretary, VHAK); Fr Francis
Guntipally and Team.(Ashirvad) .
4.
Dr PN Pandit (Assoc Prof Surgery); Dr R Narayanan (Assoc Prof
Obst & Gynae); Dr Mario de Souza (Assistant Administrator);
Dr Patrick Kamath (Gastro-enterology); Dr (Sr) Lillian (Obst
& Gynae); Dr Raghuvir (Paediatrics); Dr MJ Thomas (Psychiatry);
X>R2z: 3
Understanding the Drug situation in your hospital/
dispensary/health centre
(Note : To help you prepare for participation in the CHAI Workshop on "Towards a Peopleoriented Drug Policy" given hereunder is a check list of questions which you should
gothrough along with other members of your team especially those who prescribe
or dispense drugs. This list is not exhaustive but covers the main issues which will
be discussed during the Workshop.).
1.
Range of Drugs
How many drugs are available in your centre?
Do you have a complete list?
Are these classified into groups?
Are there any duplicate drugs? (ie„ drugs of the same type but different manufac
turers)
Do you stock combination drugs?
If so, what are the commonest combinations?
Do you stock non-allopathic medicines?
2.
Which ones?
Drug Selection
Who selects drugs in your institution?
Is this a formal/informal process?
Do you have a selection committee?
If so, who does it consist of?
What are the criteria for selection?
Cost? therapeutic consideration?
Availability? Packing?
Efficacy?
3.
Cultural?
Any others
medical representative?
Dispensing
Who all dispense drugs in your institution?
Do you have a trained pharmacist or any other staff trained in pharmacy?
Do you dispense drugs in situations other than out patient/jnpatient?
Health centres?
School/hostel infirmaries?
Mobile clinics?
Rehabilitation centres?
Any other
Do you have any guidelines for dispensing?
Are these different for different situations, types of staff and level of use?
4.
Purchasing
How do you purchase drugs?
Wholesale?
Retail?
Do you purchase in bulk?
Through medical representative?
Do you purchase by generic names or brand names?
What sort of trade discounts do you allow/accept?
Do you prepare any medicines in the hospital/dispensary?
5
Pricing
How do you price your medicines?
Do you give medicines free or at concessional rates?
Are the 'free' or purchased medicines of the same type?
6.
Drug Information
Do your staff get any kinds of information on therapeutic indications, dosages
or side effects
Are these from medical representatives, drug companies or other sources?
Do you have a locally written—a) formulary
b) therapeutic manual
c) standardised drug regimes?
7.
Pharmacy Facilities
Does your pharmacy have the following facilities?
a.
8.
basic library of reference books, bulletins and information filing system
b.
special locked storage space
c.
refrigerator
Pharmacy Policy
Do you have an institutional policy on
a.
storage and administration of narcotics and dangerous drugs?
b.
adverse drug reaction—monitoring and reporting
c.
Ref Dealing with persuasive pressure tactics of sales representatives
d.
Standardised drug distribution policies for
—ward stock
—prepackaged prescription
—protected drugs
—free drugs
e.
9.
standing orders for department/pharmacy
Expiry Dates
Do you have any policy about use of expired drugs?
If you use some beyond the expiry date, which are these?
For how long beyond expiry date do you use them?
10.
Foreign Drug Donations
Do you get drugs donated from abroad?
Do you have a list of drugs? Sources?
Do they have instructions for use in a language your staff can understand?
If not, how do you get the information translated?
Do you have any in large quantities/or types which you cannot use?
11.
Banned Drugs
Are you aware of the drugs banned by the government in July 1983?
Do you have a banned brand list?
Are your staff aware of the ban?
Have you weeded these drugs out of your practice.
12.
Problem Drugs
Look at the list of problem drugs (p.)
Do you stock any of these in your pharmacy?
Which are the brands?
13.
What are the indications?
Placebos
Do you use any drugs as placebos?
Which are the commonest?
14.
and for what situation?
Initiatives
Have you taken any initiatives in recent years to rationalise your prescription,'dispen
sing practices, in your institution?
What are they?
15.
How successful have they been?
Other information
Is there any other information about your pharmacy/dispensary or about drugs used
in your centre which is relevant but is not covered by 1 to 14?
T^ZZ'.l’r
Drags in Small Rura1 Ho;:., ital
? A repliminary study
Note: Tick where indicated.
A.
General Description of hospital
1.
State in which, hospital located;
2.
Bed strength:
3.
Staff position (specify number and grades):
a.
-^ 25
:-’5O
'25
Medical Of fir ’V
b.
Nurses
c.
Others
4• Facilities available
a.
Laboratory
b. X-ray
c. Pharmacy
5.
Patient load - numbers seen in last year.
a.
6.
d. O.T.
Out-patients:b. In-patients:
Commonest disorders seen (top 5 only)
Medical
Obst & Gynae
Paediatric
Surgical
OPD
______________
_____________________
IPD
B.
Drug Availability (range and type)
7.
How many drugs are available in your pharmacy?
a.
tablets/capsules:
b.
Injections:
c.
Syrups/liquids:
d.
Skin/eye/ear:
e.
Total
p.t.o....2
2
8.
What are the brands you stock in the following categories?
(Mention brand runes (company names in brackets) ego,
Baralgan (Hoechst))
a.■ Antibiotics
9.
b.
Analges?c/antipyrctic
c.
Anti-ii' flan n stcn
d.
Antidiarrhosals
e.
Steroids
f;
Hormonal preparations
g.
Psychotropic drugs
h.
Anti-histaminics
1.
Cough syrups
j.
Tonics/Vitamins
ko
Skin preparations
1•
Non-allopathic drugs
Tor combinations^
m.
Food substitutes
n.
Eye/ear preparations
”
What fixed-drug combination drugs do you stock in the
following categories?
a.
Antibiotics
b.
Vitamins with other drugs
c.
Steroids with other drugs
d.
Antihistaminics with others
3
3
C.
Drug selection/! i?rphase/Pricinq
10.
Who selects drugs in your hospital?
11.
What arc , ?1 the criteri- for selection?
12.
Do you purchase -
13.
a.
whole sale;
b.
by generic names
retail;
or
through medical representative
brand names?
Do you purchase any drugs in bulk? Specify.
\
14.
Do you prepare any medicines/mixtures/ointments in
the hospital? Specify.
15.
Do you get drugs donated from abroad?
(Mention names and sources).
16.
How do you price your medicines?
(What percentage formula over wholesale-retail price)
:•
a. Injections;
b.
d.
%•
D.
Dispensinq/Prescribing
17.
I
Samples;
e. Foreign drugs;
,
r
■ -
c. Vaccines;
;
♦
Tablets/capsules;
What categories of staff in your hospital -
a.
prescribe''
b. dispense?
4
18.Do you have a trained pharmacist?
19. Does your hospital dispense drugs in any of the following
situation? If so, in each one (a) who prescribes? (b) who
dispenses? (c) is there a standardised list for each level?
a. Mobile clinics
(b)
(c)
b.
Village Health Centre/Sub-Centre
(a)
(b)
(c)
c.
School/Hostel/infirmary
(a)
(b)
(c)
d.
Rehabilitation Centre
(a)
(b)
(c)
20.
What is the regime you follow in your hospital for the
treatment of (specify brand names of drugs) -
a. Malaria
aDo
21.
b.
Tuberculosis
c.
Diarrhoea in children
you have any policy about use of expired drugs?
b. If you use
some beyond the expiry date, which are these?
ci For how long beyond expiry date do you use them?
5
Do you use any drugs as Placebos?
22.
Yes/No
If yes, which are the commonest and
for what situation?
Are you aware of the drugs banned ?:y the Government in
July 1983?
23.
Do you have a b rned brrnd list?
Have you weeded these drugs out of your hospital?
E.Drug information
24.
How do you/your staff get information on drug indications/
doses/side effects.
a.
Product literature
- Yes/No
ib.
Drug company handouts
- Yes/No
c.
Any other sources
25.
Do you have in your hospital a. formulary;
b. list of minimum/essential drugs; and
c.
F.
Adverse Reactions
26.
G.
standardised drug regimes?
Have you had any adverse reactions with drugs in your
practice in the last one year?
YES/NO
If yes, specify:
Drug Budget
26.1
What is the annual expenditure on drugs in the last
financial year?
26.2
Did the pharmacy run at a loss or a profit?
If so, how much during that year?
LOSS/PROFIT
6
H.
Additional Information
27.
Have you taken any initiatives in recent times to
rationalise the prescribing/dispensing practices
in your institution?
What are they?
How successful have you been?
28.
If there are any other problems/issues that you
have come across with your hospital, please
mention them here.
29.
Have you identified any forms of irrational prescribing,
over-prescribing, under-prescribing or wrong prescribing
of the medical practitioners in your area through.
prescriptions your patients may have brought with them?
Give details.
7
30.
Are there any pressing drugs issues on which you would
like reliable information?
31.
Do you have any suggestions for issues/problems that
should be discussed/considered at the workshop? Mention.
u
Jg’iD
your prompt attention 'please
GD Ravindran
LT Menezes
Jose Joseph
"
St John's Medical College Hospital
Bangalore 5(0034
24 OCT 1984
Dear
The Catholic Hospital Association of India (CHAI) are holding
a Workshop on 'Drug Prescribing and Drug Policy' as part of
their annual meeting this year. The announcements and details
have been given in the July/August issues of MEDICAL SERVICE.
If we can move towards a rational and low cost drug policy in
our hospitals, we can reduce the burden of our patients, the
community and our institutions. This aim is in keeping with the
CHAI's 'New Vision'.
As a preliminary to the Workshop, we are undertaking a survey
on certain drug issues in our hospital. We would like you to
give us frank feed back so that we can catalyse more relevant
policy decisions.
The enclosed questionnaire should be filled in by you and sent
back to ?
,
COMMUNITY HEALTH CELL
326 V Main I Block Koramangala
Bangalore 560034
by the 10th of November 1984, latest. The short notice is
regretted. However, keeping in mind the importance of the problem
and the need for action, we are sure you will respond positively.
The objective is to highlight common problems and issues not
specific institutional problems.
In case you have instituted certain changes in policy during
your work in the hospital, please refer to the earlier situation
while answering the questions and mention changes brought about
by you in Q. 27.
Remember we are trying to determine what the situation is and
not what it could be. Also none of the questions are a test
of your knowledge 11 or an evaluation of your institution!1
It is just a study to stimulate action in the CHAI network.
For your information, the MEDICAL SERVICE—Oct-Nov 1984 issue
will give useful background information on drugs. Write to
Fr John Vattamattom, Editor, MEDICAL SERVICE, CBCI Centre,
Goldakkhana, New Delhi 110001, for your copy.
Looking forward to an early reply and hoping to meet you
during the Workshop,
Yours sincerely,
GD Ravindran
enclosure
LT Menezes
Jose' Joseph
T2K Z2 ■ "=
41st Annual Convention of the Cat*olio Hospital Association of India
November 23-26, 1984
St John’s Medical College and Hospital, Bangalore 560034
Themes
TOWARDS A PEOPLE-ORIENTED DRUG POLICY
program
FRIDAY, 23 Nov 1984
9.30 am onwards
: Registration (St John’s Medical College)
1,00 pm
: Lunch (Registration continues after lunch)
3.00 pm
: Concelebrated Holy Mass
Chief celebrant: Most Rev P Arokiaswamy
Archbishop of Bangalore
4.00 pm
5.00 pm
: Tea (for delegates and invited guests)
6>tc
S INAURAL SESSION
5.00 pm
Invocation : JANADHARE
5.05 pm
Welcomes Dr GM Mascarenhas
Dean, St John’s Medical College
s Fr Ferdinand Kayavil
President, CHAI '
5.15 pm
s Inaugural address:
Shri H L Thimme Gowda
Minister for Health, Govt, of Karnataka
5.35 pm
: Convention highlights:
Fr John Vattamattan SVD
Executive Director, CHAI
5.50 pm
: Chairman's remarks:
Bishop Gilbert Rego
Ecclesiastical Advisor, CHAI
6.00 pm
: Opening of the exhibition:
Shri J Alexander
Commissioner of Excise, Govt of Karnataka
2
2
6.15 p.m,
s Cultural program on the themes JANADHARE
7.15 p.m,
: Vote of thanks
*
Fr Joseph Kavalippadan
Vice-President, CHAI
: Dinner
7.30 p.m,
SATURDAY 24 Nov 84
8.30—9.0.0 am
: Introduction to Workshop, Objectives/Program
9.00—10.30 am
; SESSION Is UNDERSTANDING THE PROBLEM
Chairmans Dr Zafrullah Chowdhury
Gonoshasthya Kendra, Bangladesh
Speakers*
1. Dr CM Francis, Coordinator, Continuing Medical
Education, Christian Medical college, Vellore;
Introducing the theme,
2. Dr B Ekbal, President, Kerala Sastra Sahitya
Parishad, Trivandrum: The Indian Drug Scene—
Drugs and the industry and government policy.
3. Shri Augustine Veliath, Voluntary Health
Association of India, New Delhi
*
Ten Commandments
of the Drug Industry.
10.30—11.00 am
11.00 am to
12.00 noon
* TEA
* SESSION II
*
DRUG.' AND THE HEALING MINISTRY
Chairman* Fr Percival Fernandez
Secretary, CBCI Society for Medical
Education
Speakers;
1. Fr George Lobo, Papal Seminary, Pune
*
Ethic3
Prescribing
2. Prof George Joseph, Executive Director,
CSI Council for the Healing Ministry, Madras:
Professionals in the Church—an introspection
.3
3
12.00 noon—
1.00 pm
: Sharing the Word (Eucharistic celebration)
1.00 pm - 2.00 pm
s LUNCH
2.30
- 4.00 pm
: GROUP DISCUSSION Ij
Identifying the
different dimensions of the problem in
our dispensaries/hospitals and our role
in it (15 groups)
4.00 pm — 4.30 pm
4.30
: TEA
: SESSION III: TOWARDS RATIONAL THERAPEUTICS
pm - 6.00 pm
Chairman: Prof SV Rama Rao
Speakers:
j
1',
Dr Mira Shiva. Coordinator, All India
Drug Action Network: What is Rational
I
Drug Therapy?
2. Dr DBI Victor, Medical Superintendent,
I
Star of Hope Hospital, Akividu, Andhra
/
Pradesh: Banned, Bannable and Hazardous
-Akvui
Drugs in our Hospitals.
-3. The situation in our hospitals
6.30
pm - 7.30 pm
: Audiovisual presentation on theme
7.30
pm
: DINNER
SUNDAY, 25 Nov 1984
7.30
am
: Breakfast
8.30
am - 9.00 am
8 Review of first day*s program
9.00 am - 10.00 am
s SESSION IV: WHAT TO DO TO TACKLE THE PROBLEM?
Chairman: Er Bernard Moras
Administrator, St John’s Medicd.
College Hospital
Speakers:
1.
Dr S Joseph, Medical Superintendent,
MGDM Hospital, Kottayam: What can our
hospitals do?
2.
Shri Alan Cranmer, CMAI Consult nt
Pharmacist, Mysore: What can be done
.at a Pharmacy level?
4
10.00 am — 10.30 am
TEA
10.30 am - 12 noon
SESSION V: SOME INITIATIVES
Chairman: Sr Isabella Mary, Secretary, CHAI
Case studies on: a. Drug Action Network;
b. Kerala Sastra Sahitya Parishad; c. LOCOST;
d. Bangarapet Tablet Industry; e. Kurji
formulary and others
12.00 noon - 1.00 pm
Sharing the word. (Eucharistic celebration)
1.00 pm - 2.00 pm
LUNCH
2.30 pm - 3.30 pm
SESSION VI: A PEOPLE’S MEDICINE**
Panel discussion on 'HE PEOPLE’S MEDICINE
3.30 pm - 4.0C pm
4.00 pm - 5.30 pm
TEA
GROUP DISCUSSION II
What can we do?
a. individuals
b. institutions;
C. CHAI
5.30 pm ~ 6.30 pm
Demonstration of Herbal Medicines;
Video film on theme and other concurrent
programs**
6.30 pm - 7.30 pm
SESSION VI: CONCLUDING SESSION
: A statement of conern and some resolutions
: Summing up
7.30 pm
DINNER
FOR THE OFFICIAL DELEGATES OF THE CHAI MEMBER
INSTITUTIONS ONLY
MONDAY, 26 Nov 1984
7.30 am
Breakfast
8.30 am
General Body Meeting
Chairman: Fr Ferdinand Kayavil
President, CHAI
♦♦Details will be announced on the 24th Nov 84
5
8.30 am
Introduction! Chairman
8.45 am
Report of the General Body Meeting of CHAI 1983
- Sr Isabella Mary, Secretary, CHAI
9.00 am
Annual Report
Fr John Vattamattom SVD
Executive Director, CHAI
9.15 am
Report of CHD
Fr Thomas Joseph
Programme Director, CHD
9.30 am
Financial Report
Fr J Antony Samy
Treasurer, CHAI
a. Presentation of the statement of
accounts for the year ended 31.12.1983
b. Presentation of the budgets for 1985
9.45 am
Presentation and approval of resolutions and
statement from the workshop by Chairman
10.00 am
COFFEE
10.30 am
Presentation of and discussion on the revised
membership fees
Discussion on the diocesan organisation of CHAI
12 noon - 1 pm
Sharing the word (Eucharistic celebration)
1,00 pm
LUNCH
2.00 pm
Election of office bearers
4.00 pm
TEA
tEhc (HatlwKr Mnspital Associattun of Jnbia
CBCI Centre, Goldakkhana, New Delhi
cordially invites you to the inauguration of
THE 41st NATIONAL CONVENTION AND WORKSHOP
on Friday November 23,1984 at 5-00 p.m.
at
ST. JOHN’S MEDICAL COLLEGE, BANGALORE - 560034
Dr. H. L. THIMME GOWDA
(Hon'ble Minister for Health, Government of Karnataka)
has kindly consented to inaugurate the Convention
and
BISHOP GILBERT REGO
(Ecclesiastical Advisor, CHAI)
will preside over the function.
Convention Theme: TOWARDS A PEOPLE - ORIENTED DRUG POLICY
Duration : 23 - 26 November 1984
[Programme overleaf]
PROGRAMME
November 23, 1984
INAUGURAL SESSION
5.00 p.m.
Invocation
5.10 p.m.
Welcome
:
Dr. G. M. Mascarenhas, Dean,
St. John's Medical College
;
Fr. Ferdinand Kayavil, President, CHAI
;
Dr. H. L. Thimme Gowda
highlights
:
Fr. John Vattamattom, svd
5.50 p.m.
President's remarks
:
Bishop Gilbert Rego, Ecclesiastical Advisor
6.00 p.m.
Vote of thanks
5.20 p.m.
Inaugural address
5.40 p.m.
Convention theme and
Executive Director, CHAI
CHAI
Fr. Joseph Kavalippadan
Vico President, CHAI
6.10 p.m.
Opening of Exhibition
:
Mr. J. Alexander IAS, Excise Commissioner
Government of Karnataka
6.30 p.m.
Cultural programme
'•'ONDAY THE
THEME;
N0V7MBE''.
WORKING AND WALKING TOGETHER
ENTRANCE HYMN ;
WALK WITH ME, O ?4M GOD
Walk with me, 0 my God,
Through the darkest night and brightest day,
Be at my side, 0 Lord,
Hold my hand and guide me on my way.
1.
Sometimes the road seems long, my energy is spent.
Then, Lord, I think of you and I am given strength.
2.
Stones often bar my path and there are times I fall
But you are always there to help me when I fall.
3.
Just ns you calmed the wind and walked upon the sea,
Conquer, my living Lord, the storms that threaten me.
4.
Help me to pierce the mists that cloud my heart and mind
So that I shall not fear the steepest mountain side.
5.
As once you healed the lame and gave sight to the blind,
Help me when I'm downcast to hold my head up high.
GREETINGS s Opening words by the Celebrant
INTRODUCTION ;
Dear friends,
We have come together with hearts full of different
feel-ings and experiences. During the last few days, we
have been listening to each other and asking ourselves many
questions about our healing ministry among the people of God.
As we celebrate today's mystery of the Word, and
the fellowship at the table of the Lord, let us ask ourselves
which spirit shall guide us and move us, when we leave these
premises and begin work at our various institutions.
LORD HAVE MERCY
Lord have mercy, Lord have mercy, Lord have mercy
on us all 9 (2)
Christ have mercy
.........
Lord have mercy ............
COLLECT PRAYER
Lord God, often we hesitate to be life-givers. Often
we stand in silence and resign ourselves to the economic and
social pressures which are at work. Strengthen our faith by
your word and give us the courage to be advertisers of your
spirit in our situations.
EIRST READING
Exodus Chapter 4 ? 10-17
Moses said to Yahweh, 'But,my Lord, never in my life
h'vo I been a man of elequence, either before or since you
have spoken to your servant. I -am a slow speaker and not able
to speak well'. 'Who gave man his mouth? ' Yahweh answered
him. ' Who makes him dumb or deaf, gives him sight or leaves
him blind? Is it not I, Yahweh ?1 Now’goshallthelprypuc to
speak and tell you what to say.'
'If it plea-se you my Lord,' Moses replied 'send anyone
you will! At this the anger of Yahweh blazed out against Moses,
and ho said to him, ' There is your brother Aaron the Levite,
is there not? I know that he is a good speaker. Here he comes
to meet you. When ho sees you, his heart will be full" of joy.
You will apeak to him and tell him what message to give. I
2
shall help you to speak, and his too, and instruct you what
to do. He himself is to speak to the people in your place;
ho will be your mouthpiece, and you will bo as the god insp
iring him. And take this stuff into your hand; with this you
will perform the signs.'
RESPONSORIAL HYMN S
Spirit.of the living Christ come today and dwell in me.
Bathe me in your radiant light, show me how my life should be.
Give me courage from above, give me hands outstretched to help.
May your searing flame of love, burn from me the thought of self.
Holy Spirit make me hear, help me listen to your word.
Ma ke me truthful, free from fear, graciously to servo the Lord.
GOSPEL s Luke Chapter 9 ; 1 - 6
He ca-lled the twelve together and gave them power and
authority over all devils and to cure diseases, and he sent
them out to proclaim the kingdom of God and to heal. He
said to them, 'Take nothing for the journey; neither staff,
nor haversack, nor bread, nor money; and let none of you take
a spare tunic. Whatever house you enter, stay there; and when
you leave, let it be from there. As for those who do not
welcome you, when you leave their town shake the dust from your
feet as a sign to them.' So they set out and went from village
to village proclaiming the Good News and healing everywhere.
COMMENTARY ON THE READINGS
In the first reading, the Lord asks Moses to share his
concerns for the oppressed people. Aware of the various vested
interests that exist, Moses retrea ts from taking up this res
ponsibility. He fells that he lacks eloquence and experience
to show up the manipulation of the self-serving institutions
of his times. Understanding Moses' difficulty, the Lord makes
him awa-re of the fact that he is not alone, but others, perhaps
those of his own household, e.g. Aaron, share his concern.
In the Gospel too, the disciples are told that they are
not alone. Together, they are to spread the good news of God's
healing love for everyone. They are even told to take nothing
for such a journey. Take no staff- in other words, take along
no supports, take no haversack - in other words, do not go
with pre-conceived ideas. Take no bread - in other words do
not be bothered about self-satisfaction. Take no money - in
other words, do not trade with their professions and the sick
whom they cure. The Gospel tells that there will be people
•who will welcome them and will be ready to work with them.
But, there will also be people who will not among such, they
have to leave behind a sign. In any case, the Gospel tell the
decipl-es that they have been given power and authority over
all evils forces and sicknesses everywhere. In other words
the Lord tells his disciples that if they go out together in
his name, they can be sure of unmasking the sources of oppression
and illness
* Are we not disciples of Jesus?
* If we are hesitant like Moses, have we the heart to
realize that there may be others in society who share
God's concern for the oppressed?
* Is our medical calling merely on adventure of our pre
stige and professional gains?
* Is our calling merely a vocation in the hands of the
drug . industrialist.
* Is our calling merely satisfying the drug cravings of
our patients?
3
* As Medical personnel, do we merely serve our individul
prestige, the interests of the drug-pushers and the desire
of the drug-users and the needs of our institutions to
exist?
’• Do we try to crea-te a movement and a new order, where
we are concerned with a wholesome situation for all the peoples?
Evidently, there are institutions existing, there are
powers existing which have their vested interests. But God
assures us that if we are people-oriented in our healing ministry,
then he. along with some others like Aaron, and those who welcomed
jesus1 apostles, will be with us.
PRAYER Of THE FAITHFUL :
Cels
Brotheren, let us express our intentions in this assembly
of God.
Response;
1.
Lord, Make us advertisers of your way.
Lordm we ask for your spirit to Guide and strengthen us with
the good will of our brother and sisters in our endeavours for
your justice.( R)
2.. Lord, shake us loose from the manipulations of the drug
industries. (R)
3.
Lord, strengthen our resolve against the senseless use and
prescriptions of drugs. (R)
4.
Lord, help us to create institutions and movements to check the
abuses in the production and distribution of drugs. (R)
Lord, Amidst the lack of information among consumers of drugs,
■we ask for the courage to enlighten their minds and to lighten
the drain on their purses.
SECRET PRAYER
5.
Hea-venly Fa-ther, hea-r the miseries of your people, liberate
them the bonds which reduce them to acting as-agents of the
interests of prestige and power of drug producers and drug fans.
OFF. HYMN
TAKE MY HANDS
Take my hands and make them as your own,
And use them for your kingdom hero on earth,
Consecrate them to your care,
Anoint, them for your service where,
You may need your Gospel to be sown.
Take my hands they speak now for my heart,
And by their actions they will show their love,
Guard them on their daily course,
Be their strength and guiding force,
To ever serve the Trinity above.
Take my hands. I give them to you Lord,
Prepare them for the service of your name,
Open them to human need,
Ard by choir love they'll sow your seed,
So all may know the love and hope you give,
Take my hands, take my hands 0 Lord.
OFFERTORY PRAYER
Heavenly father, we, like Moses bring our fears, hesitations,
doubts and dilemmas into your presence - Transform this offering
into a source of encouragement for others and ourselves.
? rt?acs c? _ the_day
H_iy, holy, holy, holy, Lord of power, Lord of might
Hear1;1. & earth are filled with glory, sing Hosanna ever more.
Bl ;st and holy, blest and holy. He who comes from God on high
Raise vour voices, sing his glory, praise his name for ever.
EUCHARISTIC £1.
_II
CCl-l'UNTON;
-je are one in the Spirit
:..’o are one in the Spirit,
He are one in'the Lord, (2)
"ri ./e prop v.hac all unity
a? -y one day be restor ed;
Chs And they'll know we are,
Christians by our love, by our love,
les, they’ll know we are Christians
by ou.1: loveZ
He will
walk with each other,
He will walk hand in hand, (z)
A.:d together we'll spread the news,
t :'od fa in our lend.
wi.'.’: work with each other,
He will work si.de by side, (2)
And we’ll guard each man's dignity,
Ard sa-’-tj each man's pride,
ill praise to the Bather
from when all things come.
.I’r? aj.1 praise to Christ Jesus His only Son,
.And o.l. pr:a.i.se
-rhe Spirit,
’.•-a-■ makes -t 1 things one..
CAmplyNICY ’ -PAZJF
: UsCESSj'ONl-J., •,
have uroken your bread, the token of your love,
oqcthcr, keep us together in our resolve to
com- amidst the overpowering-interests of the
krihuuers ano users of drugs . ' Send us out
eon." e as responsible harbingers of your ways.
HCkLD STANDS IN NEED OF LIBERATION
The world stands in need of liberation, my Lord,
It st.'..11 has co feel your power.,
The blind and the deaf, the dumb and the maimed,
All need to feel your healing touch.
The world stands in need of liberation, my Lord,
It still has to learn to love.
lore -are those who have eyes but refuse to see
Their inhumanity to men;
There are those who have cars, but refuse to hear
Tn-:1 cries of men in agony.
There are those who have mouths, but refuse to speak
Against injustice done to men.
There are those who have hands, but refuse to reach
Them out in love and brotherhood,
There arc those who have talents, they do not use
To bv.il-d u new communityAnd ’.-e know that we all have the talent to love
Sic leave it buried in ourselves.
Prepared by the STUDENT FRIARS and SIDNEY MASCARENHAS, ofm
St. Anthony’s Friary, 85, Hosur Road,
Bangalore - 560034.
NEW LIFE
(concftd.)
3.
You. arc the hope of all your dreans
The fountain of our be inc;.
You give us living bread , you bid us cone and eat.
We cone to you,
We thank you for the hope of new life !
4.
You are the joy of all our life,
The source of all our love.
You give us life everlasting, you bid us cone and live.
We pone to you,
We thank you for the gift of new life !
IF WB EAT .OF THE LORD
If we eat of the Lord,
And we drink of the Lord,
Like the Lord we all shall be,
Then we live with His life,
And we share in His love,
And his truth will nake us free.
The Lord tells us His plans,
Listen to His connands :
"To the Father cone through Me,
Share this banquet of love,
Eat ny flesh, drink ny blood,
Do this in ny nenory",
"This cormand"says the Lord,
"Igive specially to you,
Love each other as I love you,
By this sign all will know,
What I have to bestow,
Through this love, nan I renew".
Fron this banquet of life,
Bring ny love to the world,
Be a. sign for all to see,
That I bring nan ny peace,
Through the breaking of bread,
That I cone to make hin free.
CpimUlIIOLI .PRAYER
God our Father, your Son was a good shepherd for his floc?'. He
cared for then. He gave his life for then. May nodical services
arouse
in then the life that you share with us each day at the Eucharist
This we ns?', of you Christ our Lord. Anon.
RECESS,ZONAL
0 GIVE THANKS TO THE LORD
Ch
0 give thanks to the Lord
for ho is good (?)
Yes, eternal is His love.
6
0 GIVE THANKS TO THE LORD (Contd.)
1.
I will sins to ny God never ceasing,
All ny life, I will tell of His wonders,
He's the maker of all earth and heaven,
Of the ocean, the seas and all they hold !
2.
5.
The Almighty is faithful forever,
He is just to the poor and the outraged,
It is He who gives bread to the hungry,
Who delivers the captives from their chains !
He gives sight to the blind in His mercy
And Ho raises the lowly, the humble,
It is He who gives shelter to strangers,
Every orphan and widow He defends !
4.
Prepared
To the just He is gracious and loving,
But the wicked He foils and they stumble,
Yes, the Lord reigns forever and ever,
He is king over Zion without end.
by the FRIAR STUDENTS
and SIDNEY MASCARENHAS
St.Anthony's Friary,
85, Hosur Road,
Bangalore - 5600 34.
ofn
Tel: 310694, 322064
Catholic Hospital Association of India
CBCI Centre, Goldakkhana, New Delhi 110001
SECOND ANNOUNCEMENT
41st Annual Convention of CHAI and Workshop on Drug Issues.
1.
Programme
23 (Friday) to 25 (Sunday) November 1984 : Meeting on —
“TOWARDS A PEOPLE ORIENTED DRUG POLICY”
26 (Monday) November 1984 : Annual General Body Meeting.
Venue
2.
St John’s Medical College, Bangalore 560 034.
Participants
3.
Members of CHAI and special invitees.
4.
Theme
The Indian Council of Medical Research and the Indian Council of Social Science Research have warned in their
“Health for All” report that “Eternal vigilance is required to ensure that the health care system does not get
medicalised, that the doctor-drug producei\axis does not exploit the people and that the abundance of drugs does not
become a vested interest in ill-health”. This meeting is to understand the issues relevant to drug prescribing, drug
distribution and pharmacy policy in our institutions in the context of the above warning.
5.
General Objectives
5.1.
To inform and make aware the CHAI members of the background to the above problem highlighted by the
Indian Council of Medical Research/Indian Council of Social Science Research.
5.2.
To challenge them to participate in the growing national response to the problem through a —
a)
continuing study of the problem;
b)
5.3.
commitment to action at an individual, institutional, regional and national level.
To do this in the light of CHAI’s new vision and in keeping with the Church’s option for the poor.
Specific Objectives
6.
WHAT IS THE PROBLEM ?
6.1.
To create an awareness of —
w a) | the health situation in India
b) I the role of drugs in health care .;
to c) the pattern of drug production in India vis a vis the people’s health needs
u>d) the dynamics of the drug industry
lJ e)
I c
• - Vx
the patterns of drug distribution/availability in the health system
—
1
f) the’nationa! drug policies and laws.
6.2.
To create an awareness of the growing —
■a- a> irrational use
W b) over use
" c) misuse of drugs by health personnel
jprcx-oEXS-1'
6.3.
To look at the above issues within the context of the CHURCH HEALTH SERVICES. 4 CH/'I ■
6.-1.
To try and understand the problem from the people's point of view.
r
J
q
'
HOW/WHY THE PROBLEM ?
6.5.
—
At the broader level to discover the social, economic, political, cultural and other factors responsible for this
problem.
6.6.
At a personal level to discover how all of us are part of the problem at the individual and the institutional
levels.
WHAT TO DO TO TACKLE THE PROBLEM ?
6.7.
To consider the various responses at national/international levels by groups/institutions/governments in the
areas of —
lA_ a) consumer awareness and people's movements
q , ,
-
■
-,j b) continuing professional education
\
■—
L c) pressure groups on policy makers
d) search for low cost alternatives
J e) individual/group action
A f) institutional policy changes
6.8.
To discuss ways and means by which participants can respond to this problem at
a) individual,
b) institutional, and
c)
regional/national levels
and identify ways and means by which follow up action will be taken on this growing commitment.
AN APPEAL
We request all member hospitals and dispensaries to send representatives who are involved with drug
prescribing and or pharmacy policy in their institutions. These may be doctors/nurses/pharmacists or policy makers.
A preparatory check list of how to study the drug situation in your institution will be featured in the special
issue of MEDICAL SERVICE—October-November 1984. Participants should use it to study their local situation
so that their participation will be more meaningful. The special thematic issue will also give adequate background
material for the meeting.
— EXECUTIVE DIRECTOR
Catholic Hospital Association of India
* For further information/suggestions on the theme, write to :
Drs Ravi & Thelma Narayan
Community Health Cell
326, 5th Main I Block.
Koramangala, Bangalore 560 034.
* For further information on registration/accommodation/ticket arrangements etc., write to :
Sr. Anna Maria
Secretary
CHAI Annual Convention Committee 1984
St. Martha’s Hospital, Nrupathunga Road
Bangalore - 560 009.
--
SUNDAY
THE 25th
NOVEMBER, 1984
INVOLYEiiENT
HYJ£
ENTRANCE
OU1:, JOY. 0 LORD, IS IN YOU
1.
Our joy. 0 '.'Lord, is in you, (2)
You gather us around ycur table. (2)
You make us orc nt heart
in peace and levo.
2.
Our light you arc and our life.
You guide your people to the Kingdom
You share with us, 0 Lord
.... in peace and love.
3.
This Joy of yours, Lord , we .hail!
We long to hear your rords of comfort,
and cvorm'ro to live
.... in peace and love.
4.
This tread of life wo shall oat,
We'll share tie cup that brings salvation.
United wc shall be .... in peace and love.
5-
To God the Father give praise
To God the Son and Holy Spirit.
Give glory to the God .... of peace and love.
■CRFAj? INGS: by the Celebrant
. ii-I1
- qAuc ,ii2I1 ’•
As human beings and Christians we are called to be co
creators filth Clod, We arc given the task of restoring to people their
vh.ele person, life and health through our human touch and care. Ft is
through this process that the sick ns well as ourselves becone more
wholesome. The Eucharistic celebration reminds us of the tot .al self
giving of Christ. Let us reflect today on the way wo commit ourselves
to God’s task the people.
LOKDJIATC^SRCY:
_„THEREjS A WIDENESS IN GOD’S .I-EHCY
There's a wide-noss in God's ner-cy, Like the wide-ncss of the
sea; There's a kind-ncss in his justice, Which is more than
lib-or-ty, There is wcl-como for the sin-ner, and more bless
ings for the good;. There is mor-cy with the Sav-ior; There is
healing in his blood.
For the love of God is broad-cr Than the, measure of nan's mind;
And the heart of the- E-tcr-nal Is most won-rder-ful-ly kind.
There is plon-ti-ful ro-donp-'tion In the blood that has been
shod; There is joy for all the ncu-bers Now nt one with Christ
our Head.
—i_>
Glory to Gcd, Glory to God,G1 pry, to,the Father; (2)
To Hin be glory forever (2)
Alleluia
’’
. -3.
Amen
(4).
'Son of the Father
Glory to the Spirit
£OLLECT:
Lord God be with us in the struggle of our eternal vigilance,
that the drug industries may not dxplcitthe people and that the abundance
of drugs nay not becone a vested interest in ill-health. Protect us in
the burdens and challenges of life. Help’ us to become more aware of
your loving design so that wo nay more willingly give our lives in
service of all,
This we ask through Christ your son our Lord.
2
James 3: -13-18
If there are any wise or learned men among you, let then
show it by their good lives, with humility and wisdom in their actions.
But if at heart you have the bitterness of jealousy, or a self-seeking
ambition, .never make any chains for yourself or cover up the truth with
lies -principles of this kind are not the wisdom that comes from above;
they are only earthly, animal and devilish. Whenever you find jealousy
and ambition, you find disharmony, and wicked things of every kind
being done; whereas the wisdom that cones down from above is essentially
something pure; it also makes for peace, and is kindly and considerate;
it is full of compassion and shows itself by doing good; nor is there
any trace of partiality or hypocrisy in it. Peacemakers, when they •
work for peace, sow the seeds which boar fruit in holiness.
J.^L^DIl'G:
RESPONSORIAL ...HYMN •
1.
WHAT.A FRIEND IN
JESUS
What a friend we have in Jesus, all our sins &, griefs to bear,
What a prililege to carry, overthing to God in prayer,
0 what grace we often- forfeit, 0 what needless pain we bear,
All because we do not carry, everything to God in prayer.
Have we trials & temptations, is there trouble anywhere?
We shall never bo discouraged, take it to the Lord in prayer.
Can we find a friend so faithful, who willall our sorrows share
Josi;s knows our every 'arealmess, take it to the Lord in prayer.
Alleluia -
ALLELU, Allelu, Allelu, Alleluiah
Praise ye the Lord.
GOSPEL.
Mark
1; 29-34
On leaving the synagogue, he wont with John straight, to the house
of Simon and Andrew. Now Simon's mother-in-law had gone to bed with
fever, and they told him about her straightaway. He went to her, took
her by the hand and helped her up. And the fever left her and she
began to wait on then.
That evening, after sunset, they brought to him all who wore
sick and those who were possessed by devils. The whole town cane
crowding round the door, and ho cured many who were suffering from
diseases of one kind or another; he also cast out many devils, but
he would not allow them to speak, because they knew who ho was.
COMMENTARY ON THS READINGS;
We come from various parts of India, All of us arc involved
in nodical service. Host probably we have experienced dark, difficult
moments of crisis. Wo experienced various conflicts motivating us.
Wo also face various 'opposing forces in medical services which we
under take.
On the first reading wc- are reminded about various possible f
forces which would motivate our commitment: the commitment of some is
motored by jealous regard for their own privileges.
They quarrel about
their rights, unabashed they seek their oim ambition. Unabashed thay
are concerned about their own positions, glory and fulfillment. They
lack the- critical sense.
They are puppets of various powers. They arc demons, as
St.James calls 'them. Lacking the global view, they merely strive
after their own individual needs and ambitions. Such commitment,
says St.James, is opposed to God's spirit. Such commitment io
opposed’'to divine love and charity.
Such commitment is subservient to
own needs and ultimately lends to he destruction of everything. God's
■ spirit, divine love and charity requires that thei-r involvement
be truthful, open to reason nd other-oriented. - God's love requires
that service is ..equated with compassion.
In other words, God's love
- 3 donands that they involve themselves in the suffering of others, not
merely on m individual but also or. a global basis to their cormitnont,
if it is divine, proceeds from beyond their own needs and desires for selffv.lfilnent. Their commitment, if it is divine, rises above any sort of
rivalry, partiality and hypocrisy. Their commitment, if it is divine- sows
pence.
Peace, which bears fruit, is holiness
ness of health?
r, should we say, wholesone-
In the Gospel reading wo see the Lord, he.nl the mother-in-law of
Peter. He did not trade his healing power for a livelihood. He went
to be"r. He tc-'k her by the hand. He helped her up.
In other words,
he- awoke something in her. He awoke her ful humanity. We read that
when he healed her, she in her turn began to wait on then.
She in her
turn began to serve then. Jesus' healing service awakens nan to his
n..ighbcv.r, Man when touched by Jesus, is rid of his selfish jpowors.
i-'a.i when touched by Jesus, finds his jealousy and the spitit of rivalry
lumbcd. Man, when tous'.hcd by Jesus, finds himself serving the other.
Man, when touched by Jesus, becomes the other-oriented, not self
oriented.
Lot us today reflect on our own involvement in the medical field.
Let us discern today the forces at work in our own com..ituont ns well as
in the commitment of all medical services.
Do we merely 'cure- people of their maladies? Do wo merely trade
for cur livelihood through the- nodical profession. Doos the Spirit of
ou?- commitment enable us to unmask the forces of de-hunanization which
is at work all around us?
Do :,-our medical service re-enforce and
encourage the resources of life in each patient and in society? Do
our nodical services make us craftsman of wholesome humans and societies?
PF. hi HR OF THE FJITHFUL;
gelebrant;
Let us express oar intercessions in the assembly of God.
We pray for this whole congregation . That we nay
bring about a
universal family of love and brotherhood whore everyone's physical
and mental il-.lness is well looked after. For this, we pray to the Lord.
1.
Bee:
Lord make us crafts nan of wholesome human's nnd societies.
2.
Let us pr.ay that wo impart our healing power through the help of
drugs in the spitit of Christ.
Bpg-
Lord make us crafts man of wholesome humans and societies.
3.
We pray that we .may have the courage to work for justice and peace
among all cur exploited sick people.
Rejo:
4.
_Res:
Lord make us craftsman of wholesome huransand societies.
We pray for the wisdom to diagnose patients as your loving gifts to
us and not ns objects of drugs. For this, we pray to the Lord.
Lord make us craftsman of wnolesone humans and societies.
5.
We pray for the spirit of discernment in the natter of our involve
ment and prescription of drugs for your people. For this, we pray
to the Lord.
Res:
Lord make us craftsman of wholesome humans and societies.
Let
God, our Father, listen to the intercessions of your people
Strengthen then in their resolve. This we- ask through Christ our Lord.
C'gTSRTORY
HYIg.
ACCEPT
-4:-E
MY__ L ORD
Accept Lie, ny Lord., accept re for this while,
accept no, :-y lord.
Ref.:
1.
Let th-'se orphaned days that passed
without Thee, be forgotten.
2.
Only spread this little nonent wide across thy lap,
Holding it under thy light.
?.
I have wandered in pursuit of voices.
That drew me, yet led no nowhere
4.
Now let nc sit in peace and listen to thy words
In the soul of icy silence.
5.
Do not turn away thy face
iron r..y heart's dark secrets,
Put burn then till they are alight with thy fire,
SBCRET PRATER:
Cod, author of all life, we offer you bread and wine.
They are the symbols of our involvement in nodical sorviro. Bread
symbolize s the fruits of our trade by which wore able to noct ourdaily
nourishments. Wine signifies the sorrow, the loneliness, the joy and the
Spirit of working togo.ther which wo experience in our nedicnl profession.
Kay this our involvement be transformed into the Spirit of your Son.
This we ask of you through Christ our Lord.
PREFACE.OF KE DAY:
HOLY:
Holy, holy, holy Lord, God of power and night.
Holy, holy, holy Lord , God of power and night.
Heaven, heaven a-id earth are full of your glory.
Heaven, heaven and earth are full of your glory.
Assembly
Leader
ying hosanna
ing hosanna
Assembly
Lender
Sing hosanna
Assembly : Sing hosanna
Lead'er & Assembly : ®ing alleluia
Lender
Assembly
: Blessed, blessed is he who cones in the name
of the Lord.
Assembly : Blessed, blessed, is • he who cones in the none
of the Lord.
Leader : Sing hosanna
Leader
EUCHARISTIC PRAYER
COIHjUEIOll HYMN
:
:
Canon II
NEW LIFE !!
NEW LIFE
!
New life I New life !! You cane to bring us new life.
New life ! New life II We find such joy in your abundant
life.
1.
You arc the source of our groat joy,
The fountain of all life.
You give us living water, you bid us cone and drink,
We cone to you, we bless you, Lord, we glorify your nano !
We praise you, Lord, we worship you ,
We thank, you for your gift of new life !
2.
You are the source of our now life,
In your light, we see light
You show to us your goodness, you bid us tns#c and sec
Wc cone to you,
We thank you for your gif# of new life !
D* 22.:
6
ROLE OF traditional medicine in primary health care
Traditional systems of medicine are deeply rooted in the cigilization of Asian
region and India in particular has recognized systems of traditional medicine- which
have continued to flourish upto modern times. Practitioners of traditional systems of
medicine in like manner have remained a part of the community they serve. Being
sensitive to the traditions,belieVes and customs of the people they exert considerable
influence within the community in relation to health and health related practices.
Recognizing this health man-powey potential in the delivery of primary health care
services the joint UNICEF / WHO study recommended to mobilise and train practitioners of
traditional systems of medicine for primary health care services.
Traditional medicine is the sum total of all the knowledge and practices,whether
explicable or not, used in diagnosis,prevention and elimination of physical,mental or
social imbalance and relying exculsively on practical experience and observation handed
down from generation to generation,whether verbally or in writing.2.
The traditional systems of medicine practiced in our country recognised by the
Government include the Ayurveda, Sidda,Unani,Yoga and naturopathy systems. In our
country today there are 4,50,000^3) traditional practitioners out of which,5,41,408 are
traditionally trained. This includes herbalist,bonesetters,spiritual hosiers and
traditional birth attendants and/another 1,08,592 institutionally qualified practitioners
in various systems of trdditional medicine.
[_ there are
It is unfortunate that a large number of these practitioners are in the field but
largely working outside the National Health Service system. The manpower potential
available may be utilised for primary health care services for achieving tho goal of
health for all by the year 2000.
A comibation of traditional healing and modern medicine appears to be the most
promising and appropriate for the health problems facing the developing countries.
Ayurveda or the "Science of Life"contributos much in this direction as majority of tho
Ayurvedic preparations are ccst-offectivo non-toxic and can be prepared locally.
It is well kr.oirn tfct in many ailments of functional origin liko consltipation
dyspepsia, Indigestion and cases that have proved refractory to modern medical treatment
good results have been produced by the Indigenous system. Yoga practice and meditation,
forms the part of the indigenous system. They were onco considered only as a subjective
experience. These practices have been objectively assessed and their physiological effects
and passible clinical application in many anxiety disorders are being recognised.
The practitioners of Ayurveda normally prepare the medicines needed for the patients
in their own clinics from simple decoctions to powder. The physician also advises tho
patient to prepare thorn in their own homes, from locally available herbs. For example in
villages combination of Thulasi leaves juice,pepper powder and hone.^ for cough is used
which is inexpensive,effoctive and also easily available in rural areas. However in
urban areas the practitioners give prescriptions for patent drugs which are available
at Chemists and Drug shops. The large scale production of Ayurvedic drugs is now undertaken
by many pharmaceutical companies like Himalaya Drug Company,Baidyanath Company and
Indian Medical Practitioners Co-operative Pharmacy and Stores Limited(IMCOPS) Madras
using modern pharmaceutical technology. Those products include patent,proprietary and
classical preparations. Every stato has got its own drug standardisation centre which
supervises and maintains standard of Ayurvedic drugs. There are as many as .4500
pharmacies which produce these drugs in South - Eastern Asia, Statutory controls over
the manufacture cf Ayurvedic drugs are also enforced in some countries.
Ayurvedic pharmacopt"a contains 8000 rocoipcs. Besides these there are large number
of receipes which have not been documented but which are used by tho community in every
day practice.
- “ - “
-
-
- -
c-H-C..
Paper Presented by Dr.T.N.Manjunath,Assistant Nodical Officer,(ISM) CHAD Programing,'-KE,Velio
at the workshop on "Towards a People-oriented Drug policy " at St.Bonn's Modical College,
Bangalore from 23rd to 25th November,1984.
s 2 s
Ayurvedic ’
i medicines arc prepared in the form of distilotos(Arka) fermented
preparations(Asava,Arishta)iinctus
(lohya) incinerated minerals, 9.holls(bhasma) powder
(Choorna) ghoo(Ghritham) Tablets,pills(vati) dccectien(Kwatha).
The Community Health and Development (CHAD) Programme of the Community Health
Department of Christian Medical College is studying the feasibility of incorporating
the traditional practi ’iiioners in tho Primary Health Care. The CHAD Programme
provides services for the entire block of Kaniyambadi with a population of 80,000.
This study is being conducted in a population of 15,000.
Availability of Ayurvedic,Allopathic and Accupuncturo treatment under the samo
roof is a unique feature of the CHAD health programme and is a definite step towards
integration.
The objective of tho study is to identify the constraints which prevents the
effective involvement of practitioners of traditional medicine in primary health care
programme and avolve strategies for their greater involvement in promotion of
Family Planning, Maternal and Child Hcalth(MCH) and immunization programmes. It also
includes their Orientation,training,monitoring and supervision and identify areas
where integration is possible. It also aims to identify possible linkage between
the practitioners of traditional systems of medicine and national health care system.
I
11 Practitioners have been identified in the 15,000 population. These practitioners
were interviewed,and their willingness to participate in tho programme determined. The
practitioners are visited by the Assistant Nodical Officer of Indian Systems of medicine
of the CHAD Programme and their activities are supervised every week^ Oturing which he
tries to establish a good rapport and got their participation in tho health programmes.
Initially they were reluctant to share their knowledge and practices. After
gaining the confidence in the programme through tho repeated visits of the health team
they slow., ly started sharing their knowledge and techniques. They wore also afraid
that their practices may be asked to be stopped or controlled. This was overcome by
assuring them that their practices which are good and helping the community will be
maintained and strengthened . They were also informed of the unhealthy practices like
branding,and persuaded to discontinue them.
They had misconception that vasectomy affects their general health and makes man
very weak and he is suspectible to diseases. This was removed by continued education
by all categories of health workers of the programme.
Initially they were treating evon these conditions which were not responding
to their treatment and af'er education they are convinced that certain conditions like
high fever,of 5 days duration,bleeding should be referred for modern medical care.
Therewas no proper reporting system regarding the type of cases treated. They were
asked to maintain a record in which they have to register' tho Name,Age,Sex,Complaint,
Treatment,Response and referral. This will be scrutinized and supervised.
In the early stages there was over reporting of cases ey the practitioners.
was cross
checked by surprise visits when they were asked to show tho cases.
Following this over reporting camo down.
This
It is observed from the preliminary studios that the traditional practitioners
by virtue of their close association with the community plays a key role as educator
and change agent on matters relating to health and family welfare. Ho,as a part of
health team,actively involves himself with national health progr mmos both as a practii
tioner and as a community leader. They are being used in the
Tuberculosis,
filariasis, RF/RHD,Malaria eradication programmosi
Diarrhoeal diseases which causes high morbidity and high infant mortality needs
promotion of oral rehydration therapy,which would make an impact particularly on the
infant mortality. The traditional practitioners have been educated on the correct use
of oral rehydration salts and its practical application in the treatment of -.acute
diarrhoeas with tho ultimate goal of making oral rehydration therapy for treatment of
diarrhoeas a routine practice in the community.
ORS packets are distributed to them repeatedly and they are taught to prepare
ideal oral rebydration solution in theabscence of readymade packets in which they have
shown a definite improvement in the managemeot 6f diarcboaes.
These traditional practitioners are educated on various health and health
related problems in their own village and in their own language. Oral rehydration for
the child with diarrhoea has also been accepted with enthusiasm in preference to the
crudo cauterisation ~r branding. This is really a ohange
brought abc.r by their
3 :
Education ,helped changing their attitude regarding some beliefs which doos not have
any basis.
The high cost of drugs and inability of many developing countries to purchase
such drugs have prompted several countries to look forward for local products in the
form of medicinal plants and herbal medicines that have proved to bo effective,safo,
in expensive and culturally acceptable.
In this direction a herbal garden is grown in CHAD Campus as a means of home remedy
for common ailments and also encouraging . ■ traditional practitioners to identify
locally available and commonly used medicinal plants and herbs and make use of them in
their treatment. The community is being educated regarding herbs in the Mahila Mandal
(Women's Group) as a means of home remedy to make people becomo mors self reliant and
make herbal medicine as people’s medicine.
A few low-cost effective remedies taught at Mahila Mandal(W.omens Club) meeting
and used by the community.
1. For cold inhalations of eucalyptus oil in boiling water helps much reliving cold
or fumes of turmeric powder.
2.
Pomergranate skin dry powder in buttermilk helps in certain cases in reliving
Dysontry.
3.
Decoction of oman seeds helps in reliving tummey ache in case of idigestion.
4.
For fresh cuts and wounds fresh ginger pasto with Oaggsry helps much in healing
and stops •
pus’ .
formation.
5.
Scabies pasto of margosa loaves mixed with turmeric helps much.
6.
For scorpion stings rubbing a piece of onion on tho site of the sting and refer
to hospital.
7.
For intestinal worms seeds of papaya works effectively.
8.
Clovo oil application for tooth acho.
9.
For certain diabetic cases in tho community bittor gourd has helped much in
bringing down blood sugar level.
References;
tar.
1.
Primary Health Care; Report of the International Conference of on Primary
Health Care, WHO Genova Health for all series No«1,1978
2.
Promotion and development of Traditional medicine,WHO Genova Technical
reports series 1978,
3.
Gunaratna V.T.H.,Voyage towards health, New Delhi, Me Grawhill,19S0.
// /V
- " Z
v /XA4.45 '
SATURDAY THE 2*+th NOV EMBER, 198^
THEME'
:
ENTRANCE
THE GREAT PHYSICIAN: 7;hat is the Lord telling us?
INTROSPECTION
HYMN
LET'S TALK ABOUT JESUS
Let's talk about Jesus,
The king of Kings is He,
The Lord of Lords supreme;
Thro'out eternity.
The great I AM the way.
The Truth, the Life, the Door.
Let's talk about Jesus more and more.
Le t's talk nbcu t Jesus,
Let all the world proclaim;
The Pow'r and Maj e s t y.
Of such a wondrous•name,
The Babe of Bethlehem,
The Bright and Morning Star,
Let's sing His praises near and far.
Let's talk about Jesus,
The prince of Peace is He,
The great Physician too,
Down thro' all history,
The Lily pure and white
The Rose of Sharon fair,
The shepherd of such tender care.
GREETINGS
:
Opening words by the Celebrant.
INTRODUCTION :
Dear friends,
Today we gather around the table of the Lord: The Great Physician.'
'7e want to open our minds and the medical profession to the illnesses of
the people, rather than the needs of the medical industries, the medical
institutions and our professional needs. Let us celebrate God's word and
see how the Lor*1, approaches his people in their illness.
Let us see
how God heals us, God, the Great Physician.
COLLECT (Introductory Prayer)
Lord God, our loving Father, we, your children, have come around
this table to listen to your word. We,
your people, are burdened with
the excessive use of drugs.
Look upon the affliction of your people.
Liberate us. Heal us, so that we may move towards a wholesome situation.
Through Christ our Lori, Amen.
1st Reading: Exodus 3: 7 - 12
And Yahweh said, 'I have seen the miserable state of my people in Egypt.
I have heard their appeal to be free of their slave-drivers.
Yes, I am
well aware of their sufferings. I mean to deliver them out of the hands
of the Egyptians and bring them out of that land to a land rich and broad,
a land where milk and honey flow, the home of the Canaanites, the Jlittites
the Amorites, the Perizzites, the Hivites and the Jebusites.
And no'w the
cry of the sens of Israel has come to me, and I have witnessed the wn‘,y in
which the Egyptians oppress them, so’come, I send you to Pharaoh to biting
the sons of Israel, my people, out of Egypt.
Moses said to God, '.Who am I to go to Pharaoh and bring the sons of
Israel out of Egypt?
'I shall be with you,' was the answer' and this is
the sign by which you shall knot? that it is I who have sent you ...
After you have led the people out of Egypt, you are to offer worship to God
on this mountain.
FOB YOU ABB MY GOD
RESP07IS0RY :
For you are my God, You alone are my joy.
Defend me, 0 Lord.
Ch :
i.
You give marvelous comrades to me,
The faithful who dwell in your land;
Those who choose alien gods
Have chosen an alien band.
2.
You are my portion and cup;
It is You that I claim for my prize.
Your heritage is my delight:
The let You have given to me.
3.
Glad are my heart and my soul;
Securely my body shall rest.
For you will not leave me for dead,
Nor lead your beloved astray.
4.
You show me the path for my life;
In your presence the fulness of joy.
To be at your right hand forever
For me would be happiness always.
JESUS IS LORD
ALLELUIA
Hallelujah,
Hallelujah,
(2) give thanks to the risen Lord
(2) sing praise to His Name.
Jesus is Lord over all the earth,
He is the King of Creation
Spread the good news around the earth,
Jesus had died and is risen.
We have been crucified with Christ,
Now we shall live forever.
God has proclaimed a just reward
Life for all men Hallelujah.
• GOSPEL READING
:
Mark 5 ;
- 34.
Jesus went with him and a large crowd followed him; they were
pressing all round him.
Now there was a woman who had suffered
from a haemorrhage for twelve years; after long and painful .treat
ment under various doctors, she had spent all she had -without being
any the better for it, in fact she was getting worse. She had heard
about Jesus, and she came up behind him through the crowd and
touched his cleak. 'If I can even touch his clothes,' she had told
herself 'I shall be well again.' And the source of the bleeding
dried up instantly, and she felt in herself that she was cured
of her complaint. Immediately aware that power had gone out from
him, Jesus turned round in the crowd and said, 'Who touched my
clothes ?' His disciples said to him, 'You see how the crowd is
pressing round you and yet you say, "Who touched me ?" But he
continued to look all round to see who had done it.
Then the
woman came forward, frightened and trembling because she knew what
had happened to her, and she fell at his feet and told him the whole
truth. 'My daughter,' he said 'your faith has restored you to health
go in peace and be free from your complaint. '
3
COMMENTARY ON THIS HEADINGS
In the first reading, we come to know something about the God we
believe in. We come to know something about his acts, how he relates
Himself to people.
...
'
.
He tells us : ''I have seen the miserable state of my people in
Egypt."
God sees the miseries of people.
people have to undergo.
He is not blind to the oppression
Not only does he see, he even hears their appeal.
have heard their appeal."
He says; "I
Further, God does not merely hear their appeal, he analyzes their
situation. He examines'the forces which are at work and causing His
people's oppression. He notices that among men there are slaves and
the slave-drivers. He does not stop with an analysis of human society.
He does not stop at a medical diagnosis. He goes further. He also
hears their plea to be free from their oppressive forces. He says :
"I have heard their appeal to be free of their slave-drivers."
Our God is a God who is well aware of His people's sufferings.
But awareness alone is not enough for our God. He is a God who
acts. He tells Moses : "I mean to deliver them ovt of the hands of
Egyptians and bring them out of that land, to a land rich and broad.
A land where milk and honey flows."
In other words, our God is a God who means to deliver oppressed
people out from a situation of conflicts and oppression.
Our God gives
his people a hope of a wholesome situation. This process and wholesome
situation is to be a sign that he is at work.
Our God thus leads his
people towards a wholesome situation, where men search ways . in order
that they may nob oppress their fellowmen. Such is pur God according
to the first reading.
In the Gospel text, we hear about crowds following Jesus pressing
all around him. They followed him and press him with request for
instant-noous healing.
There was also among them a woman who suffered from a haemorrhage
for twelve years. She had undergone long and painful treatment under
various doctors for twelve years.
This woman searched for Jesus.
che had faith in him. She does
not say : "Lord, heal me instantaneously." She rather touches him
quietly. She longs for the moment when she could tell her whole
story to Jesus of Nazareth.
Josus on his part, shuts those who followed Him, with request
for instantaneous healing. He refused to be a wonderman.
He refused
to provide wonder-prescriptions and drugs for healing. Whereas with
regard to the woman with the haemorrhage, who sought to tell him the
full story, He turned around tc listen to her.
He made time so that
she could tell him the whole truth. Then only was she restored to
whole health, through her faith in Him.
Then only could He truly say
to her, 'Go in peace and be free from your complaint. '
How do we medical personnel respond to the patients who visit us?
Do we merely play the wonderman, providing instantaneous relief with
the help of drugs ? Do we merely prescribe a pill for every ill and
an ill with every pill ? Do we like Yahweh discern between the
oppressive forces and the oppressed ? Do we like Yahweh give our
patients the hope of a wholesome situation, a land o.f milk and honey ?
Do we like Jesus of Nazareth, provide the time, so that the whole truth
can be related to us by the patients ? Do we like Jesus of Nazareth
seek to restore whole health to our patients ?
It is only when we seek the cause of oppression and offer a
situation to our patients, that we witness that God has sent us
to them and that we are revealing God's love for them.
PRAYER 07 THE FAITHFUL
Response
Brothers and sisters, let us make known our needs
to,the Lord. ■
:
Celebrant
:
:
Hear our prayer, 0 Lord.
"1.
That the medical personnel be liberated from prescribing people
merely pills for every ill and an ill with every pill.
For this
we pray to the Lord.
2.
That we realize that drugs alone do not make people whole
this we pray to the Lord.
3.
That the numerous villages in our country receive the basic medical
care for a wholesome and happy life.
-For this let us pray to the
Lord.
A.
That we have the courage to create time to encounter people with
your saving touch. We pray to the Lord.
Let us pray
:
OFFERTORY HYMN
-For
God our Father, you sent your only Son, Jesus, as the
Saviour and healer of humanity.
We too have been
called by you to continue the good works he has
begun. Help us in our endeavours.
We make this
prayer thru Christ Our Lord.
Amen.
I SURRENDER ALL
All to Jesus I surrender
All to Him I freely give
I will ever love and trust Him
In his presence daily live.
Ch : I surrender all, I surrender all
All to thee, my blessed Saviour
I surrender all
All to Jesus I surrender
Humbly at His feet I bow
Worldly pleasures all forsaken
Take-me Jesus, take me now.
All to Jesus I surrender
Lord, I give myself to Thee;
Fill me with Thy love and power,
Let Thy blessing fall on me.
5
OFFERTORY PRAYER
Everloving Father, accept these gifts of bread and wine as symbols
of ourselves. As you transform them into the body and blood of your
Son, transform us likewise. May we bring true healing to all those
in need, just like your Son who offered genuine service not for His
glorification, but unto your glory. ‘This we ask of you through
Christ our Lord. Amen.
EUCH .RISTIC PRAYER
COMMUNION HYMN
:
Canon
II
SONS OF GOP
'Ch
Sons of God, hear his Holy Word,
Gather round the table of the Lord
Eat his Body, drink his Blood,
And we'll sing a song of love,
Allelu (3) alleluia.
1.
Brothers , asisters, vie are one,
And our life has just begun;
In the Spirit we are young;
We can live forever.
2.
Jesus gave a new command
That we love our fellow man,
Till we reach the promised land,
Where we'll live forever.
3.
If we want to live with Him,
®e must also die with Him,
Die to selfishness and sin,
And we'll rise forever.
Make the world a unity,
Make all men one family,
Till we meet the Trinity,
And live with them forever.
5.
With the Church we celebrate
Jesus' coming we await;
So we make a holiday,
Sq we'll live forever.
DEEP CALLS TO PEEP
1.
Deep calls to deep, and my soul finds no resting place but him,
He is my God, the yearnings of my heart his touch can still.
Ch
;
And each rare moment that I've felt his presence,
I shall remember and forever cherish.
2.
Deep calls to deep, and at his feast I am welcome guest,
He gives me food, the hunger of my soul is laid to rest.
And each rare moment
3.
Deep calls to deep, for he created me to be his own
He understands the joy and pain of life he too has known.
And each rare moment
THANKSGIVING PRAYER
:
Heavenly Father, thank you for the bread of heaven with which
you have nourished us and have revealed to us your loveing care and
concern. We make this prayer through Christ our Lord.
Amen.
RECESSIONAL HYMN
GREAT, BIG WONDERFUL GOD
We've got a great bi^ wonderful God, Hallelujah;
Great big wonderful ^od,
A God who's always victorious,
Always watching over us,
Great big wonderful God.
We've got a great big wonderful God, Hallelujah;
Great big wonderful God,
A God who loves every one of us,
Does so much for all of us,
Great big mderful God.
He never, : 'ver, leaves us,
He's alwayt standing by,
To pick.us up if we stumble,
We're the apple of His eye.
We've got a great big wonderful God, Hallelujah;
Great big wonderful God,
Oh what a glory it is to sing
Praise to our coming King,
Great, big, wonderful God.
We've got a great, bit, wonderful, marvellous,
glorious We've got a great, bit, wonderful God I
Prepared by the FRIAR STUDENTS and SIDNEY MASCARENHAS,
of St. Anthony's Friary,
85, Hosur Road
"Bangalore - 56OOJ4.
O.F.M.
THE CATHOLIC ASSOClATION OF INDIA
THE ^Ist NATIONAL CONVENTION AN.d WORKSHOP
INAUGURATION MASS, FRIDAY 2jx-d NOVEMBER, 1 £84.
THEME
ENTER INTO OUR EXPERIENCES WITH OPENNESS AND THE INSPIRATION
:
OF GOD'S SPIRTT.
3HAJAN
Om Bhagavan (3)
Om Bhagavan Prabhu Pita Bhagavan
Om Bhagavan (5)
Om Bhagavan Prabhu Christa Bhagavan
Om Bhagavan (3)
Gm Bhagavan Prabhu Atma Bhagavan.
:
ENTRANCE
LISTEN
Listen., let your heart keep seeki
Listen to his constant speaking,
Listen to the Spirit calling you.
Listen to his inspiration,
Listen to his invitation,
Listen to the Spirit'calling you;
GREETINGS
1.
He's in the sound of the thunder, in the whisper of
the breeze.
He's in the might of the whirlwind, in the roaring of
the seas.
2.
He's in the laughter of children, in the patter of
the rain.
Hear him in cries of the suffering, in their moaning and
their pain.
3.
He's in the noise of the city, in the twitter of the
bird.
And in the ni ghttime the stillness helps you listen to
his word.
4.
He speaks through all your companions, thru the friendly,
thru the foe.
Therefore give ear to the Spirit wheresoever He may blow.
:
Opening words by the Celebrant.
INTRODUCTION :
Dear friends,
We have come here with different experiences. 'He use a
lot of drugs which are dumped on us by industries.
Often, we feel
forced to play up to the expectations of people, lest we be considered
useless doctors and nurses. Most of us do not have time to address
ourselves to the real needs of people.
We are drowned with specimens
of pills for every ill.
We cannot spread too much time in listening
to the needs of people, lest we be considered incompetent and
indecisive. 'He come from the situations which are appalling and lack
basic health amenities.
Today as we listen to God's word and celebrate the Eucharist,
let us ask ourselves how are we to address ourselves to the real needs
of the people during the coming days. Let us pool our experiences in
order that the whole well-being of humanity may find peace and joy in
their hearts.
COLLECT (See the last page)
LORD KA’TS MERCY
Lord have mercy on your servants
Lord have mercy Ln us all.
(3)
Christ have mercy on your servants (J)
Christ have mercy on us all.
Lord have mercy on your servants (3)
Lord have mercy on us all*
GLORIA
Glory to God, Glory to God, Glory to the Father;
To him be glory forever (2)
ALLELUIA Amen (4)
2.
Son of the Father
3.
Glory to the Spirit
Ifet Reading ;
(2)
Exodus 2; 11 - 15 ( See Page 3)
RESPONSOR! - Oh^ The Love_Of my_Lord
1. Oh, the love of my Lord is the essence
Of all that I love here on earth.
All the beauty I see he has given to me
And his giving is gentle as silence.
2. Every day, every hour, every moment
have been blessed by the strength of his love
At the turn of each tide, he is three at my side.
And his touch is as gentle as silence*
3.
There've been times when I've turned from his presence
And I've walked other paths, other ways.
But I've called on his name in the dark of my shame.
And his mercy was gentle as silence.
Alleluia
1. "/ord of God, come down on earth, alleluia
Touch our hearts and bring to birth, alleluia
Faith and hope and lasting love, alleluia
Word of God , come down on earth.
2. Speak to us, eternal Word, alleluia
You who brougt all things to life, alleluia
Word that came from heav'n to die, Alleluia
Speak to us, eternal Word.
3• Speak and heal our mortal ills, alleluia
Word that caused blind eyes to see, alleluia
Deaf we are, our healer be, alleluia
Speak and heal our mortal ills.
4.
lord made flesh, we long for you, alleluia
//ord that speaks the Father's love, alleluia
Word that sends the Spirit blest, alleluia
Word made flesh, we long for you.
-5 -
Moses, a man
by now, set out at this time to visit his countrymen
and. he saw what a hard life they were having; and he saw an Egyptian ■
strike a Hebrew, one
of his countrymen.
Looking round
he could see no
one in sight, so he killed the Egyptian and hid him in the sand.
following day he came back, and there were two
said to the man who was in the wrong,
Egyptian?'
the man retorted''to
be
Do you intend to kill me as you killed the
When Pharaoh
that business has come to
'Clearly
Moses was frightened,
.light' he thought.
He
'What do you mean by hitting your
And who appointed ..you'
fellow countryman?'
prince over us, and judge?
On the
fighting.
Hebrews,
heard of the matter ho would have
but Moses fled from Pharaoh and made for the land of Midian
killed Moses,
And he sat down beside a well.
St. Luke
Gospel :
10:
37.
29 -
But the man was anxious to justify himself and said to Jesus,
who is my neighbour?'
Jesus replied,
'A man
'And
was once on his way down
from Jerusalem to Jericho and fell into the hands of brigands; they took
all he had, beat him and then made off, leaving him half dead.
Now a
priest happened to bo travelling down the same road, but when he saw the
man, ho passed by on the other side.
In the same way a_ Levite who came
to the place saw him, and passed by on the other side.
traveller who came upon him was moved
But a Samaritan
with compassion when he saw him,
He went up and bandaged his wounds, pouring
'oil and wine on them.
He
then lifted him on to his own mount, carried him to the inn and looked
after
Next day, he took out two denarii and handed them to the
him.
innkeeper.
"Look after him,"
he said "and on ray way back I will make
good any extra expense you have,"
Which of these three, do you think,
proved himself a neigh be>ur to the man who
hands?'
fall into the brigands'
'The one who took pity on him' he replied.
Jesus
said to him,
'Go, and do the same yourself'.
C omment<nry~ on^ _the „readings
Dear friends;
Today's two readings are
us have heard them many times.
very beautiful stories.
Most of
Yet let us once more dwell on them and
see their meaning for us Doctors, Priests, Nurses, Nuns and health
workers.
If wo arc part of this world, we
Conflicts always exist.
always experience conflicts between vested interests.
As long as Moses lived in the palace, he also experienced
conflicts.
He saw an Egyptian
solved the conflict.
ing.
strike
a
Hebrew.
He
When ho asked his fellow man "who was in the wrong:
by hitting your follow countryman, the man retorted;
to be tho prince and judge over us.
the Egyptian."
thought ho had
But the very next day, ho saw his own people fight
'What do you mean
"Who appointed you
Do you moan to kill mo ns you killed
This made Moses frightened and made- him get cold foot.
It made him retreat
from entering into and resolving the conflict.
He
fled the place and sat down by a wcll-a well, the
source of life!
In the Gosp:l text we have the response of Jesus to the lawyer.
The lawyer wants to crtch Jesus on his words and justify himselfnis self-complacency. He rhetorically asks Jesus: 'Mho is my neighbour?'
Ho was convienced that each mftn lives his own self - that each neighbour
is an extended ego of himself that each man minds his own business and
leaves the fate- of the conflicts around him in the hands of God.
He was
convienced that he should love his neighbour merely to inherit eternal
life. To this self-complacent lawyer Jesus told the story of the good
Samaritan. Ho told him of a man who lay by the way side- beaten up and
half dead, most probably this man was a Jew. A priest happened to
trhvoll on the same road. A leavito also travelled on the same road.
Both the- priest and levite were also Jews. ~
But probably, they suspe
cted this was a trap set up by brigands. So if they stepped they would
themselves be the victimos of the gand. But a Samaritan, a rival of Jews
who, perhaps, also was aware of the brigands who trapped and ovex’ laid
travellers on the road, stopped. He h’d compassion. Ho took upon himself
the suffering of the man along tho way side. He decided to be responsible
for the victim of Hie conflict, although as Samaritan ho was dcspiccd by
the Jews. Ho did not leave this victim who rivalled
him to his
fate.
In our world of Medical Service no one can deny that there are con
flicts between vested interests, Wo .have cone here together to share our
experiences of being victims of vested interests.
What arc these vested interests?
■.
Drugs have become commercialized, they have bedome an industry.
They are profit oriented. They are not health oriented. People want
doctors to proscribe then the latest drugs.
They want drugs - not
health. And lastly, vested interests want certain banned drugs to be
produced despite the knowledge of their ill-effects on the health of
people.
Doctors are tantalized with the financial and material gains which
are offered if they proscribe certain drugs. Their prestige in the eyes
of patents is. heightened with tho help of wonder-drugs which cure instan
taneously
and keep them unaware of impending illnesscss caused by these
sane drugs.
In short, it looks us if man is doomed to frugs and drugs
are not produced to restore health. There is a drug for many ills, and
an illness from many drugs.
Where do we stand amidst these conflicts of vested interests? Do
wo like Moses take flight and floe the situation?
Are wo like the
lawyer very complacent and legal-minded? Are we like the priest and
leovite who are afraid to take the risk of burdening themselves with
the victims of such conflicting situations? Or are wo going to be like
the Samaritan, burdening ourselves with the sources of this conflict
and searching for the human even in the nan who is his victimised
rival?
Cel; -
Brothers and Sisters, let us express our intercessions before
the Lord.
Pnyer of
the
faithful;
Heavenly father, we come here to be .opened and challenged by you.
Let your wisdom and love possess us. For this, let us pray to tho
Lord.
Ros:
Jesus we trust in you.
1.
2. Physicians prescribe medicine of which they know little, to cure
diseases of which they know loss, in human beings of which they know
nothing. Grant that in these coning days we may deepen and strengthen
our service of healing. For this, let us pray to tho Lord,
Res:
Jesus we trust in you.
3, Lord Jesus, our people are oppressed by drug culture and by the vest
ed interest of drug industries. Help our people to make then roaise
what is really good.For this, lot us pray to tho Lord,
Res:
Jesus
we trust in you.
4.
0 god, you arc ■ great physician, give us the right knowledge and
visdon to diagnose the real cause of sickness. For this, lot us
pray to the Lcr'i.
Jesus wo tyust in you.
Res:
Vic prr.y for each individual who has gathered here- nay wo learn
fror Jesus the healer and thus practice his love and concern in
cur lives.
For this let us pray to the Lord.
5.
Jesus wc trust in you.
Sos;
Prater;
Lord, hoar the prayers .of your faithful. Strengthen their will
to be open to your Son end the guidance of your Spirit in what they
share during the coning days.
This wo ask through your Son and your
Spirit, one God forever and ever,
Ar.o.n,
_A c cejrt Jfe_ My.
:
Accept no, ny Lord, Accept no for this while,
accept no ny Lord.
1.Let those orphaned days that passed without thee be forgotten.
Chorus;
2. Only spread this little nonent wide across thy lap holding
it under thy light.
5.
I have wandered in pursuit of voices that drew ne yet led no nowhere.
4>. Lew let no sit in peace and listen to thy words in inc soul of ny
silence.
5.
Do not turn away thy face fron ny heart's dark'jsccrots,
burn then till they arc alight with thy fire.
but
Secret Prayer:
Lord, God, we cone here with heavy hearts, often we
.feel ourselves the vic tin of frug industries and drug cravings of
peoplo. Grant that our service nay be life giving just as this bread
and wino is a source of whclesorje life for all tines.
Pre. fa c e _o f _ tho_.day.j_-
Hcly;
Eoly, holy, holy, holy, God of night and God of power
Glory fills all earth and Heaven, sing hosanna to the Lord.
Blessed is the one who cones, cones in the .
.'glory fron the Lord
Raise your voices sing his praises, sing hosanna to the Lord.
C oi.igj.nicn;
jJc.sus
i-.r.2_J2y _sa_lyati.on
Jesus, you a e :y salvation,
Jesus, you 're ny inspiration,
Jesus, you're the treasure of ny life.
Jesus, you offer new sight to the blind,
Healing the crippled, the deaf-and the nuto,
Cleansing the leper and banishing ills,
Raising the dead to life.
2.
Jesus, you nurture the hungry with bread,
Stilling the tunpost and calling the sea,
Turning life's water to glittering wine,
Shedding' your blood for me.
Jesus, ny refuge, in you do I trust,
Jesus, r.’.y Saviour, in you I rejoice,
Jesus, ny way and ny truth and ny lift
Jesus who sots no free.
! -6-!
Jcsus, the wisdom ".nd power of the Lord,
J e sus, our high priest, our passover Lamb,
J O SUS, the brightness and imago of God,
Jesus, the King of ponce.
Cqmnuninn _Pra_^or;
J osus, wo have partaken in the bread of life and in
the experiences of your people. Grant that in the coning days wo nay
continue this sharing so that your will be done. This we ask of you
through Christ cur Lord.
Recess ionalj.
1.
ITJ,S
. JTO _MB
There's :.,y neighbour so lone '’’.id forgotten,
It's up to r.o to make things lighter for him.
There's my neighbour solans and forgotten.
It's up to tie to help him through.
If I can work with courage for the rights of men,
Then ny neighbour, so lone and forgotten,
Hay find the strength to live to-day.
L ove and friendship have a power,
Love and friendship can bring new Joy
and hope to men.
2.
COLLECT
There's my neighbour who can't get employment
3.
There's ny neighbour who's seeking a lodging.
4.
There's ny neighbour who can't get a hearing.
5.
There's my neighbour so tried by injustice.
PRAYER
0 Cod, we have come together to pool our experiences
in the field of nodical Service. Open our eyes, hearts
and minds, so that we may touch by the real "question
of Service. As wo listen to you, nay our vocation
of service find now dimensions and bo inspired by your
spirit, not by our cravings or our societal fads.
Prepared by the STUDENT FRIARS and SIDNEY jIAS C ARENHAS, ofm,
St. Anthony's Friary, 85, Hosur Road,
Bangalore - 560054.
3m Z'Z ■ y .
Workshop on 'TOWARDS A PEOPLE-ORIENTED DRUG POT,ICY'
24-25 Nov 1984: St John's Medical College, Bangalore
Brief resume of resource personnel
' c
Francis
First Director of Sri Chitrathirunal Medical Research Center
Trivandrum
Ex-Dean of St John's Medical College
Ex-Director of Salgaoncar Medical Research Center, Goa
Presently Coordinator, Continuing Medical Education,
Christian Medical College, Vellore
Fr George Lobo, sj
Professor of Moral Theology in Jnana Deepa Vidvapeeth, Pune
Chaplain of Indian Federation of Medical Guilds
Member, CBCI Theological Commission
Author of 5 books including Current Problems in
Medical Ethics
D B' I Victor
Medical Officer in Baptist Mission Hospital during 1966-69
Head of Surgical Unit, Scheifflien Leprosy Research
Training Centre, Karigiri
Member of Rehabilitation team, Govt of Tamilnadu
Director of Eye Services, Star of Hope Hospital
Presently Superintendent of Star of Hope Hospital, Akividu
Was elected Member of the International Leprosy
Association,in 1981
George Joseph
Ex-Professor of Community Medicine at the All India
Institute of Medical Sciences, New Delhi
Presently Executive Director of the Healing Ministry
of the CSI, Synode Secretariat, Madras
Samuel Joseph
Working with the MGDM Hospital, Kangazha, Kottavam,
for the last 17 years as Chief Physician and
Medical Superintendent
Project Director, Community Health & Development,
MGDM Hospital, Kangazha
President of the Kerala Voluntary Health Services
Hon. Editor, Journal of the Christian Medical Association
of India
Alan Cranmer
Member of the Pharmaceutical Society of Britain
Worked with the Hospital Pharmacy Services of Great Britain
from 1960 to 1966
In 1966joined the Holdsworth Memorial Hospital, Mysore
as Chief Pharmacist
In 1970 became Consultant Pharmacist to the CSI Karnataka
Inter-Diocesan Medical Board
From 1973 onwards Consultant Pharmacist to the Christian
Medical Association of India
f.Cro
contd... from pre-page
Mira Shiva
Coordinator, Low Cost Drugs and Rational Therapeutics
VHAI
Member of the medico friend circle
Coordinator, All India Drug Action Network
Member, Health Action International
CHAI
.CRK-HOP ON * TOD ARI’S A PEOPLE—ORIENTED DRUG POLICY
23-25 Nov 1984
Resource persons - accommodation
Name
Arrival
Departure
Accommodation
1. Prof George Joseph
2. Mrs George Joseph
23.11.84
26.11.84
12.30 pm
Guest House
4, Dr Manjunath
23.11.84
26.11.84
-do-
5. Dr Pratap Naidu
23.11.84
26.11.84
-do-
6. Dr Zafarullah
23.11.84
25.11.84
(evening)
-do-
7. Mr Alan Cranmer
23.11.84
25.11.84
Dr Mario’s
residence
8. Dr RPI Victor
23.11.84
26.11.84
12.30 pm
-do-
9. Mr Badal Sengupta
23.11.84
25.11.84
Guest House
10. Fr George Lobo
22.11.84
(evening)
25.11.84
5.00 pm
SJMC Hospital
3. Dr Ekbal
11. Augustine Veliath
12. Fr Joseph Chittoor
13. Sr Innocent
-do-
()
( (
(
(
(
(
To
Mrs Chary# Guest House Caretaker
hr Mario D*Souza
SJMC Hospital Reception/enquiry
Sevasadan
cc Fr Bernard Moras
CHAI Office (SJMC Camp) - for information
Seva Sadan
facilitation team
1, Dr H Sucarshan
Hon. Secretary
Vivekananda Girijana
Kalyena Kendra
B R Hills 571317
Mysore Dist.
10. Dr Sylvia Babu
Director of Community Health
Bangalore Baptist Hospital
Bellary Road, Hebbal
Bangalore 560024
2. Dr GD Ravindran
Holy Cross Hospital
Kamagere
Kollegal Taluk 571443
11. Dr Maya Jacob
.
SUMANA-ALLI
VOld St Mary's Seminary Building
99 Residency Road
• Bangalore 560025
Y
3. Dr Gerry Pais
DEEDS
HD Kote Road
PC Box No.20
Hunsur 571105
12. Dr Gurunath Kilare
Kidwai Memorial Institute of
Oncology
Hosur Road
Bangalore 560029
4. Ravi Raj Williams
Hoskote Mission Medical
Center
Hoskote 562114
Bangalore Dist.
13. Dr Esther Mabry
Director; Community Health
United Theological College
17 Millers Road
Bangalore 560046
Fr Rupert Rosario
Jnana Jyothi
Anekal 562106
—
Bangalore Dist.
14. Sr Collette
Good Shepherd Convent
Museum Road
Bangalore 560025
6. Mr &Mrs Jyothiraj
Rural Education for
Development
SIT Extension
Tumkur 572103
15. Br Jose
SEVASADAN
Post Box 3417
Koramangala, Bangalore 560034
16. Vijay Joseph
7. Fr Joseph Chittoor
St Mary's Church
Puthur, M J Nagar
Gudalur
Nilgiris 643250
8. Dr Prem Pais
Consultants Medicine
St Martha's Hospital
Bangalore 560009
38 Berlie Street
Bangalore 560025
<•
9. Dr Sukhant Singh
CH & FP Department
CMAI, 197/C VIII—B-Main
Jayanagar III Block
Bangalore 560011
17. Dr Y Ramakrishna
a
ASTRA
Indian Institute of Science
Bangalore 560012
18. Dr Mohan Isaac
Dept of Psychiatry
NIMHANS
Hosur Road
Bangalore 560029
19. Shri Siddalingaswamy
Promotional Secretary
VHAK
St John's Medical College Hospital
Bangalore 560034
20. Fr Francis Guntipally
and Team
,
C/o ASHIRVAD
St Mark's Road
Bangalore 560001
21. Dr PN Pandit
Assoc Profs Surgery
St John's Medical College
Hospital
ejBangalore 560034
22. Dr R Narayanan
Assoc Prof: Obst & Gynae
St John's Medical College
Hospital
Bangalore 560034
23. Dr Mario de Souza
Assistant Administrator
St John's Medical College
Hospital
Bangalore 560034
24. Dr Patrick Kamath
Asst Prof: Gastro-enterology
St John's Medical College
Hospital
-4..
Bangalore 560034
25.
Dr (Sr) Lillian
Dept of(Obst & Gynae
St John s Medical College
Hospital
Bangalore 560034
26.
Dr Raghuvir
Paediatrics
St John's Medical College
Hospital
Bangalore 560034
27,
Dr MJ Thomas
Psychiatry
St John's Medical College
Hospital
Bangalore 560034
5^
28.
Sajeev Joseph
Orthopaedics
St John's Medical College
Hospital
Bangalore 560034
Fr Claude D'Souza
Rector
St Joseph High School
Museum Road
Bangalore 560025
29. Dr Paul Neelamkavil
Dermatology
St John's Medical College Hospital
Bangalore 560034
30. Leo Menezes
PG Student in Surgery 4St John's Medical College Hospital
Bangalore 560034
31. Jose Joseph
PG Student in Medicine
St John's Medical College Hospital
Bangalore 560034 yl..
32. Dr Dara Amar
Head: Community Medicine
St John's Medical College
Bangalore 560034
33. Dr MA Nagarani
Asst Prof: Pharmacology
St John’s Medical College
Bangalore 560034
34. Dr Anura Kurpad
Physiology
St John's Medical College
Bangalore 560034
35.
S Pruthvish
Community Medicine
St John's Medical College
Bangalore 560034
36.
S P Tekur
Community Medicine
St John's Medical College
Bangalore 560034
37.
SM Subramanya Shetty
Health Education Officer
Community Medicine
St John's Medical College
Bangalore 560034
38.
Ki shore Murthy
Community Medicine
St John's Medical College
Bangalore 560034
Fr John Vattamattom
Executive Director, CHAI
CBCI Centre, Goldakkhana
New Delhi 110001
Sr Anna Maria
St Martha's Hospital
Bangalore 560009
IX 2-2 ■' £
Annual Report of the Community Health Department
of Catholic Hospital Association of India (CHAI)
(NOVEMBER 1983—NOVEMBER 1984)
Introduction
With great pleasure we present before this august Assembly the annual
report of the Community Health Department (CHD) of Catholic Hospital Asso
ciation of India (CHAI) for the year 1983-84. This department was set up in
CHAI in November 1981. Until April 1983 the department concentrated its
attention on orientation programmes in Community Health (CH) and training of
village health workers. With the addition of more personnel in the department,
the entire team with few more resource personnel spent about three months for
study and reflection, and formulated a philosophy and vision to base its activities
in future. Ever since, the CHD team spared no efforts to translate this vision
into action through various activities at different levels. Since you were kept
informed of these from time to time through our journal, we will limit this report
only to high light some of our activities since last convention at Bombay. The
team's involvement consisted mainly in promoting people based Community
Health programmes especially in the rural areas of our country.
1.
The Major Thrust of CHD of CHAI
The team involved in the promotion of Community Health believes that,
by and large the entire health care system in the country serves the interests of
the elite and is hardly capable of responding to the real needs and problems of
the people. We strongly believe in the power of the poor and the marginalised
in this country to maintain their own health; provided they can meet their basic
needs and rectify the social imbalances. Through our programmes we try to
inculcate in our trainees the awareness of the existing situation, newer attitudes
and proper skills condusive to the transformation of the society to make it more
humane.
2.
Training Programmes
The team has developed two types of training programmes meant mainly
for the middle level personnel or the people at the supervisory level. The uniquencess of our training programmes consists in its nonformal approach, partici
patory method and inbuilt theological and pastoral reflections.
a.
Community Health Team Training (CHTT) Programme
This training programme is spread over a period of fifteen months with
theoritical and practical training. The trainees are followed up through field
visits and imput sessions at regular intervals. This course aims at building up
teams to work in village communities with a comprehensive understanding and
integrated approach in people based health and development activities, and
oriented towards building up healthy communities. At present we have two such
programmes, one in Ajmer, organised by the Mission Sisters of Ajmer and ano
ther at Varanasi, organized by the Bishop. Both training will get over in
April 1985.
b.
Short-term Programmes in CH.
\Ne have evolved a 3 weeks intensive training meant for people involved in
Community Health programmes. This short term programme aims at sharing
our philosophy and vision, clarifying concepts in Community Health and upgr
ading skills. We have conducted two such programmes in Kerala. Also we
assisted as resources personnel in the following programmes:
a.
Seminar on CH at Satna.
b.
Workshop on CH at Hyderabad.
c.
Seminar on CH and development in the Diocese of Ootty.
d.
6 weeks training in CH organized by Deenabandhu (T.N.)
We are also closely associated with the on
health programme of the Diocese of Allahabad.
3.
going people based community
Workshop in Community Health (CH)
Apart from working with other national organization, we organized the
workshops, the first one for the sisters involved in CH, in the Arch Diocese of
Delhi and the second one at Thanjavur for the sisters working in the rural health
centres; and the third at Hyderabad for the staff of Andhra Pradesh Social
Service Society (APSSS).
4.
Assistance in Planning Community Health Projects
During the reporting period we rendered assistance to the Arch Diocese
of Delhi and the Vincentian Sisters at Alirajpet (A.P.) in planning community
health project.
2
5.
Collaboration with like minded agencies and groups
Two meetings of the different Delhi based national organization were
held to work out possibilities of mutual collaboration in the promotion of Com
munity Health. Apart from the sharing the vision the meeting was also meant
to draw up common strategies to intensify efforts in the promotional work.
Along with short term programmes organized by ourselves, we worked with
National and Regional Organizations in Community Health promotional work.
We have established a close link with the Voluntary Health Association of India
(VHAI) both in the planning and evaluation of our various programmes.
6.
Discussions with financing Agencies
During the reporting period we had discussions with team from Cebemo
and Misereor. We shared our vision on Community Health and have requested
them to finance projects falling in line with this vision, more in future. Both
the organizations have been very much appreciative of our programmes and are
showing keen interest in our approach in Community Health.
7.
Evaluation of the Activities
The Community Health Department has got regular evaluation and plann
ing of its activities, both by the team members themselves and with the assis
tance of other resource personnel. We have three meetings of the former type
a year; and one of the latter, which is called the annual evaluation and study
session, which lasts for ten days. This year's session was at Bangalore in the
month of May. Usually it is on such occasion that we broadly plan our activi
ties for future. A brief report of this was published in the May-June and August
issues of our Journal, "Medical Service".
8'
Team development programme
The team members are encouraged to attend short term course and seminars,
depending of the interests and need of each member. The following are some of
the programmes we attended during the reporting period to update our own
skills.
i.
Seminar on tools of Analysis at Ujjain, organised by Caritas India.
ii.
Symposium on Christian Perspectives to stewardship of earth's,
resources, at C.M.C. Vellore, organised by Ruhsa.
iii.
Follow up get together of the former trainees at Deenabandhu.
iv.
One month course on Hindi at Navsadhana, Varanasi.
v.
Seminar on Religion in different modes of production at ISI
Bangalore.
vi.
Training in Women's development programme at National Institute
of Rural Development (N1RD) Hyderabad.
3
Apart from this we have regular team meeting for internal evaluation and plann
ing of our work. During these occasions, different topics are discussed, and
this forms part of our on-going study programmes.
9.
Allied Programmes
(a)
Exhibition at Bombay Convention
The community health department put up an exhibition stall in the con
vention premises during the annual convention and exhibition at Goregaon,
Bombay from 6th—10th Nov. 1984, along with sample home remedies. We
were encouraged by the written comments received on the exhibition.
(A)
Herbal Medicines and Home remedies
In our Community Health programme we have realised the importance
of this and we are determined to promote these fast dying practices among the
common people especially the rural flock, due to the unhealthy influences and
pressure of the modern drug industry. We are collecting information from diffe
rent parts of the country on various herbal and home remedies, which are being
practiced today.
fc)
Doccumentation
We are making efforts to collect as many resources materials as possible
on Community Health and development to share with individuals and groups
involved in this field. Efforts are being made to translate some of these
materials to regional languages, to reach it to the people at the grass roots. Also
we are building up a small library in the department.
(d)
Integrating Community Health and development training in the religious
formation
Efforts are being made to integrate the Community Health and develop
ment training into the religious formation. We form part of a big team involved
in this attempt with the Franscican Brothers at Bangalore, during their two year
formation period.
(e)
Workshop on "Towards a people oriented drug policy"
The CHD team was also involved together with other facilitators and
resource persons, in the preparation of two day work-shop on "towards a
people oriented drug policy" in connection with the annual convention of CHAI,
in Bangalore.
(/)
4
Exhibition on the concept of CH based on new vision and on herbal
medicines
The CHD team was also responsible together with some others in the
preparation of an exhibition on the concept of Community Health based on the
new vision of CHAI and also on herbal medicines along with this year's conven
tion in Bangalore.
10.
Future Plans
There are a number of requests from the Dioceses, Religious Congrega
tions and groups for conducting training and orientation course. We have to
continue the 2 CHTT programmes which we have already committed to in the
dioceses of Ajmer and Varanasi. We will also be making some commitments
to the diocese of Karwar and to the Franciscan Brothers at Bangalore. But with
limited number of persons at the central team we will not be in a position to
take up too many programmes. However our attempt will be to create linkages
with other resource teams in the country and collaborate with them where by
making CH a movement in India. This is a dream for the realisation of which
we are committed to. We count on the cooperation, help and suggestions from
all concerned.
11.
The Present Team
At present we have a five member team and an office secretary in the
department. Miss. Rita and Miss. Lovely who were with us from the beginning
left the organization after their marriage in April and May respectively, we are
indebted to them fo'r the contribution they have made to this department. Mr.
Abraham Mathew joined the team in March 1984 and Mr. K.A. Antony in
October 1984.
The following persons constitute the present team.
Sr. Jeyaseely F M.M,
Sr. Mariyamma F.M.M.
Mr. Abraham Mathew,
Mr. K.A. Antony,
Fr. Chacko Paruvanani, (Part time)
Fr. Thomas Joseph.
12.
Conclusion
In our last annual evaluation and study session we have realized that our
future efforts should be concentrated more on making Community Health a
movement, and not limit our activities, merely to training programmes and
workshops. The strategy we have worked out is to identify as many likeminded
individuals, groups and institutions, to share our new vision and philosophy on
Community Health and eventually to work with them and through them as our
allys and partners. For, we are aware that any movement can be only at the
people's level and hence it is absolutely necessary to join hands with every one
who is interested in people's growth and development.
5
With the motto "Health for many more" we are moving ahead steadily,
making honest and serious attempts. We hope and pray that many of our
institutions will reflect seriously on the prevailing situation of thousands
around them, for whom in most cases we have started the very institution itself.
Finally, before we end this brief report we place on record our deep
gratitude to so many people who encouraged, supported, guided, criticized, and
questioned us. And with the assurance of your continued support, guidence
and suggestions we look forward to the future with much hope and courage,
Thank you.
New Delhi
26-11-1984
6
Sd/Fr. Thomas Joseph
for the CHD of CHAI
Annual Report of the
Catholic Hospital Association of India (CHAI)
(NOVEMBER 1983—NOVEMBER 1984)
1.
Introduction
It is a matter of great pleasure to present before this distinguished assem
bly this brief report of the Catholic Hospital Association of India (CHAI) the
various events and happenings since our last convention and General Body
Meeting in Bombay. Yet another year has slipped in to history bearing witness
to many events the most shocking of which was the ghastly assassination
of our beloved Prime Minister Mrs. Indira Gandhi on the morning of
31st October 1984.
As Executive Director of CHAI this is the fifth annual report I am privile
ged to present to you. As usual, in the first place I thank the Lord for
all His blessings He has showered on our organisation during this one
year. Weatever we have achieved it is through His grace and secondly
through the wonderful cooperation I have enjoyed from the part of our
member institutions, staff and friends. I would be failing in my duties if
I do not place on record my gratitude to all of you here present and all
others who could not be here today for one reason or the other. Through
our journal. Medical Service, you were already kept informed of the
important events from time to time. What follows is only a brief report
of the activities during this one year and the present situation.
2.
Membership
It is gratifying to note that CHAI is growing year by year During the
reporting period 98 new institutions have joined as members besides associate
members and diocesan Social Service Societies. Hence, as on 15.11.1984
the position of our membership is the following :
Hospitals :
Dispensaries & Health Centres :
Diocesan Social Service Societies :
Associate members:
Total
499
1274
45
62
1871
Regarding the payment of the membership most of the institutions are
regular.
During the reporting period a sum of Rs. 2,13,474/- was
collected. There are still some who have not yet paid their dues. I do
hope they will do so soon and I request them the same.
3.
Medicine Supplies
The Catholic Medical Mission Board (CMMB), through CRS continues to
assist our institutions by supplying medicines etc. freely.
During the
reporting period 2015 cartons of various medical supplies were received
worth US $ 900,822-23 as per their calculation. These were received by
418 institutions in different parts of the country. Application froms for
further supplies were received from the member institutions and forward
ed them to CMMB through CRS, New Delhi. We place on record these
great help of both CMMB and CRS especially for smaller institutions in
rural areas.
4.
Pastoral and Spiritual aspect of health care
The importance of this in the field of health care can hardly be exaggera
ted. However not enough attention is paid to this in our country. We
are trying in a small way to bridge this big gap. However, what is being
done is insignificant to what remains to be done.
During the reporting
period, one preliminary course and one follow up course for sister doctors
and one follow up course for sister nurses were conducted. The prelimi
nary course for sister-doctors was at Amarjyoti, Kattappana was sixteen sisterdcctors participated in it. The follow up courses for sister doctors and sister
nurses were held at Ishvani Kendra, Pune, in which 12 sister-doctors and 17
sisters-nurses participated. These courses are very much appreciated by the
participants.
We had also a two day consultation of resource persons on pastoral care
to discuss and plan for future course of action. Seven persons were
present for the meeting which was held at Holy Spirit Hospital, Bombay.
The need was felt to continue similar programmes for all the health care
personnel. Also it was proposed to design a full fledged course for
hospital Chaplaincy to train sister nurses as Chaplains. The work is in
progress. Eventually we hope to have a separate department of pastoral
care in CHAI with necessary staff. It is to be noted that these courses
were subsidised by the generous contribution from MISSIO, Aachen,
West Germany. During my recent visit to MISSIO, they have promised
to continue to help us in the programme.
5.
Pro-Life Movement
This again is an important aspect for us to take serious note of. It is hoped
that like in the case of pastoral care we will build up a separate depart
2
merit for Pro-Life in CHAI eventually with necessary staff and other
arrangements. During the reporting period, the follow up of last years
convention theme was done by taking again the same theme Respect
Life for this year's Hospital Sunday Celebration. A good number of our
institutions took real pains in organising this and the reports were sent.
But unfortunately due to pressure of work and want of space this could not be
published in our journal. I apologise for this.
In the national level a cohsulation was held in Bombay on 4th and 5th
October 1984 on Euthanesia. More than 40 people from various parts of the
country participated. The consultation studied about the possible threat to life
if a bill on euthanasia is passed. The consultation was held in connection with a
proposed bill in Maharashtra Assembly by one of the members. The consulta
tion urged the concerned authorities not to introduce such a bill.
I also had the opportunity of attending the International Pro-Life meeting
in Mexico City in August 1984 along with the U N. Population Congress. The
meeting was organised by PLAN an international organisation promoting respect
life. Some of the delegates for this meeting also attended in U.N. meeting.
A brief report of this was published in the September issue of our journal.
6.
Film on Abortion
A i hour long 16 mm film in colour on abortion entitled "A matter of
Life or Death" in English was prepared with the help of Amruthavani, Communi
cation Centre, Secunderabad. Unfortunately the Sensor Board has not given
the certificate for this film yet. Therefore we cannot make the copies of this
film available in English and other regional languages. We have appealed
to the Board again and hope to get the certificates soon. After that the film
will be made available to those who need it. The purpose of the film is to
educate the public about the scientific aspect of human conception and life and
what heappens when an abortion is done.
The necessary financial help for the preparation of the film was obtained
from MISSIO, Aachen, West Germany. We place on record this thier generous
help.
7.
Community Health
Our attempt in the promoting of Community Health and Primary Health
Care is meeting with great success. To make Community Health a movement
rather than a programme is the need of the time. A separate report will be
presented on Community Health department. Besides, what is given in that
report, I had the opportunity to speak to the delegates of the provincial chap
ter of Holy Spirit Sisters and Augustinian Sisters in Bangalore during their
3
Provincial Chapters. In two sessions of the Project Selection Committee of
Caritas India presentation was made on the various aspect of Community Health.
A paper was also prepared. This will be made available to you through Caritas
magazine.
8.
Medical Service
Our journal "Medical Service" is gaining more and more acceptance.
During the reporting period the editorial board met twice, both in Bangalore, to
discuss about the possible improvement. Though there is considerable improve
ment, yet there is pleanty of room for further improvement. We do hope to do
more in the future in this regard. Our regular columns like Medical Ethics
Forum, Legal Education, People, Pills and Prescription are very much appreciated
by our readers. Your suggestions, criticisms, etc. for the further improvement of
our journal are most welcome.
9.
NFP
Our involvement in NFP is becoming more and more important. This is
not only because it will form part of our Community Health Programme, but we
may have to assist our member-institutions to promote this, in this connection
I must say that the world famous scientist doctors the Billings from Australia
made a six (6) weeks tour in India during February to April this year. As per
their request the tour programme was arranged by me. They had very enthusi
astic response from all the places they went. We also had occasions to meet
some government level people like the health secretary Dr. Vaidyanathan, the
Commissioner Family Planning Dr. R.P. Kapoor, Dr. B.N. Saxena, Senior Deputy
Director General of 1CMF, Prof. Kavoori, the Executive Director Family Planning
foundation etc. They all were very enthusiastic about this programme. It will
be up to us how we can make best use of this good will from the part of the
government by giving a well planned project to them.
The book and slides of Fr. Joe Menezes, NFP in pictures, published by
CHAI are gaining acceptance more and more. Now it is available in Hindi and
English. Efforts are being made to print it in other regional languages too.
For the publication in English and Hindi we were financially assisted by Misereor,
and another organisation known as "Church in need", both in West Germany.
10.
Employment
We assist our member institutions to get medical personnel and medical
personnel to get employment by publishing the requests in the employment
column of our Journal. This service is done free of cost.
11.
Projects
a.
Discretionary Fund
We have this scheme of assisting small institutions and groups in the
initial stage of their health care ministry to buy some medicines and small equip
4
ments. A maximum of Rs. 5000/- is given for this purpose from a block grant
we receive from MEMISA and Dutch Bishop's Lenten Fund in Holland. During
the reporting period a sum of Rs. 5,61,000.00 was given to 143 applicants, as
on 15.11.1984 there is still a balance of Rs. 1,15,244.04 in this fund to be
given for deserving applicants.
b.
Memisa Projects
We are assisting Memisa in Holland a funding organisation for Medical
projects in studying the project applications they receive from India. During
the reporting period we received 34 projects for study. This service is very much
appreciated by both Memisa and the applicants.
c.
Medical Relief Fund
This is a small fund to help individual applicants for medical treatment etc.
A maximum of Rs. 500/- is given to the deserving applicants from this fund.
A sum of Rs. 8,129,65 was given to different applicants and at present we do
not have any amount left in this fund. Your generous contribution towards this
fund is requested.
12.
Rural Placement of St. John's Medical Graduates
CHAI continues to assist St. John's Medical College in their Rural Places
ment Scheme by meeting the administrative expenses of this scheme. During
this reporting period a new step was taken in this line. A two day sharing
session for the doctors from this scheme was organised in collaboration with
St. John's on 1 9th & 20th May 1984. During the two days deliberations along
with some resource persons and our Community Health team, the participants
brought out positive, constructive and frank suggestions for the improvement of
this scheme. A detailed report was sent to all concerned, for further action
along the suggestions made. This was the first such attempt and the same was
appreciated by all concerned.
13.
Hospital Sunday Celebrations
As usual many institutions have celebrated Hospital Sunday (3rd Sunday
in March). The theme for this years celebration was again "Respect Life" as
a follow up of the last convention. Due to the unavoidable circumstances, we
could not publish the reports of this year's celebration in our journal. This is
deeply regreted. However I request all the institutions to celebrate this day
with added enthusiasm.
14.
Meeting on National Health Policy and 7th Plan
By a letter from the Director General of Health Services, dt. 25th February
1984, CHAI, was requested to give some suggestions within the over all ambit
of National Health Policy Document for being considered for incorporation in
5
the ensuing Seventh Five Year Plan. A meeting of the National and Church
related organisations was called by CHAI to discuss this and suggestions were
sent to the Director General of Health Services accordingly.
15.
Central Purchasing Service (CPS)
Eversince its inception in 1974-75, CPS of CHAI is doing commendable
service to the people of India through various institutions and organisations of
social objectives irrespective of any religious affiliations. CPS is well known
and our services are appreciated by all in the voluntary sector.
During the reporting period the total value of orders placed for various
products is worth Rs. 19.37 million at the deemed export price. Another Rs. 2
million worth orders for products have been scrutinised and awaiting order
placement.
Yet another activity of the department was organising Centrally Purchas
ing of Medicines. This was started as an experimental basis in Kerala in colla
boration with Kerala Unit of CHA. Now the detailed working out of the project
is entrusted to Kerala Unit of CHA.
In this connection I have to inform you that Mr. C.T. Thomas, Head, CPS
department has submitted his resignation from the organisation on 1st August
1984. His resignation has been accepted and he has been relieved of his
responsibilities in the organisation wef. 15th of October 1984. He has left
us for better prospects. We place on record his services to the organisation
and through it to the people at large for nearly 7i years. We wish him well
in his future carrier.
16.
CHAI Office
Work regarding the construction of our office premises in Hyderabad is in
progress. Meanwhile a project for the possible financing of the office building
was submitted to Misereor, West Germany and Cebemo, Holland to be consider
ed jointly. I am happy to inform you that our request has been considered
favourably by both organisations and the necessary amount (Rs. 16 lakhs
approximately) will be placed at our disposal shortly. Meanwhile preparations
are going on to obtain the necessary permissions etc. from the authorities and
the construction work may begin at any time.
17.
Towards self-reliance
So far ours was a hand to mouth existence as far as the financial position
is concerned. It is time for us to think of ways and means to move towards
self reliance. With this in view in consultation with our auditors a proposal to
start a Corpus Fund for CHAI was presented by the Executive Director to the
Executive Board is its meeting held in May at Dotty. It has been accepted by
6
the Executive Board and now everything is ready to start this fund. We need
to raise a substantial amount the interest of which will be used for our various
administrative expenses. This amount will have to be raised during the next
three years. Appeal will be made from time to time to the member institutions,
friends, benefactors, funding agencies and others for collecting the required
amount.
I appeal to all of you now to think of various ways and means to raise
this amount and respond generously to the appeals as and when it comes. Self
reliance is a real sign of growth. It is a challenge. Let us meet this challenge
courageously and with full of hope.
18.
Conclusion
More than in the past, this reporting year has been of hectic activities.
Much has been done and achieved, no doubt. But much more still remains to
be done. We are at a cross road in the f ield of health care. The future of the
health care activities in our country especially in our Church sector will depend
on which way we are taking. The signs of the time are clear who look for it
sincerely and with an open mind. This is a great challenge before us. Honesty
and hard work and Christ like concern and commitment to the cause of the poor
can only help us to meet this challenge. There will be difficulties and dis
appointments. Even may be also misunderstandings. But these are only natural
and we should be able to see beyond all these. Let me close this report with a
word of gratitude to all of you and others who have made our work possible.
New Delhi
November 15, 1984
Sd/
Fr. John Vattamattom SVD
Executive Director
7
^1 ST ANNUAL CONVENTION OF CHAI AND WORKSHOP ON DRUG ISSUES
ST. JOHN'S MEDICAL COLLEGE
BANGALORE-560 034 •
23 - 26 NOVEMBER, 1984
LIST OF DELEGATES
Si..
No.
Name <4 Address
SL.
No.
Name <4 Address
14.
Sr. Catacina A.C.
Fatimagiri Health Centre
Nilambur 679 330
Kerala.
15.
Sr. Evelyn UMI
Karunashray Hospital
Civil Lines
Sultanpur 228 001, U.P.
16.
17.
18.
Mother Marie Renee
Sr. Leene
Dr. V. Krishnamurthy
Sacred Heart Leprosy Centre
Sakkottai - 612 401
Kumbakonam R.S.
Thanjavur Dist, T.N.
19.
Sr. Hermine
St. Joseph's Convent
Cheyyur PO, Chingleput Dt,
Tamil Nadu 603 302
20.
Sr.'Dr.) Scholastica Thompra
Community Health Centre
Near Block Office
S.Bathery PO, Wyanad,
'■>
Kerala 673 592
Sr.(Dr.) Marie Therese
St. Joseph's Hospital
Tindivanam, S.A. Dt,
Tamil Nadu 604 002
21.
22.
Sr. Immaculata
Sr.(Dr.) Herman Joseph
St. Jude's Hospital
Sipri PO, Jhansi,
Uttar Pradesh.
Sr. Anna Patricia
Sr. Hyacinth
St. Joseph's Hospital
Santha Pet
Nellore 524 001, A.P.
23.
24.
Sr.(Dr.) Carmel Kalayathinal
Sr. Lea Thailammanal
Mary Immaculate Hospital
Krishnanagar
Nadia Dist, W.Bengal~74l101
Sr. Jacinta DSA
Sr. Ethelina DSA
Ranchi Archdoicese Health
Service, c/o Catholic
Charities, Purilia Rd.,
Ranchi, Bihar 834 001 ■
25.
Sr. Sudha A.C.
Sancta- Maria Health Centre
Palliagaram PO
Chingleput Dist
Via, Salavakkam
Tamil Nadu 603 107
26.
27.
Sr. Teresita MSJ
Sr. Mary MSJ
Fatima Hospital
Maunath Shanjan
Assamgarh-275 101, U.P.
1•
2.
Sr. Luke
Sr. Rosita
St. Anthony's Hospital
Madhavaramhigh Road
Madras-600 060
3.
4.
Sr.(Dr.) Prema Devaraj
Sr. Shaila
Khrist Niketan Disp.
New Area, Sasarani. PO ,
Rohtas Dt,
Bihar-821 115
5-
Sr.(Dr.) Emily Susgi FMM
Assumption Hospital
Thomaspuram, Avanashi PO,
Coimbatore, T.N. 638 654
6.
7-
Sr. (Dr.) Louie
Sr. Tresa
Josgiri Hospital
Tellicherry-670 101
Kerala.
8-
9.
10.
11.
12.
13.
Sr. Anne Mathew FMM
Annai Mary Dispensary
Malayampalayam PO
Kilambady, Erode
Periyar Dist,
Tamil Nadu.
Contd..2/
2
S.No.
Name « Address
28.
Sr. Gratia
St. Anne's Hospital
Kumbakonam 612 001
Thanjavur, T.N.
29.
30.
Sr. Flavia
Sr. Lucy Jose
Bp. Vayalil Medical Centre43Moolamattom 685 589
44.
Idukki Dt. Kerala
31 .
32.
Sr. Teresita
Sr.(Dr.) Baptista
Catholic Mission Hosp.
Kalunga PO
Sundergarh Dist
Orissa.
S.No.
4I .
42.
Name A Address
Sr. Annette Mary
Sr. Salette Mary
Loka Rakshaka Hospital
Thevalakara PO
Ouilon Dt.
Kerala 690 524
Sr. Linde Roseline
Sr. Regina
St. Mary's Hospital
Arisipalayam
Salem-9, T.N.
45.
Sr. Philo Machado
Child Jesus Hospital
Trichy-620 001
46.
47.
48.
Sr. Augustine
Sr. Therasa Joseph
Sr. Gabrial
St. Theresa's Hospital
Sanathnagar
Hyderabad.
49.
50.
Sr. Leema Josephine
Sr. Sebastina
Damian Lep. Control Centre
Diravianagar, Nilakottai
Madurai, T.N. 624 208
51 •
52.
Dr. M. Fernanda
Sr. Lilly Jose
Mariampur Hospital
Shastrinagar, Kanpur
U. P. 208 005
33.
34.
Sr.(Dr.) Peter Claver
Sr. Elsy
St. Joseph's Hospital
18, Romain Roland St.
P.3. Ko.32,
Pondicherry 605 001
35.
Sr. Pushpa Poriyath SCJM
Comm. Health Centre
Jyotiniketan Ashram
Kareli, Bareilly
U. P. 243 404
36.
Fr. Joseph Chungath
Damien (l) Institute
Ayyappenkavu, Trichur
Kerala 680 751
37-
Sr. Josephtine JMJ
53Our Lady of Lourdes Hosp.
Koilakuntla 518 134
Kurnool Dist., A.P.
Sr.(Dr.) Tresa
KarunaHospital
Nandini Road,Khursipur PO,
Bhilai-2, Durg Dt. M.P.
38.
Sr. Mary Paul JMJ
St. Theresa's Hospital
N.R. Pet, Kurnool Dist
A.P.
518 001
54.
55-
Fr. Emmanuel Maniamkott
Sr. Albertha SABS
Social Hospital
Kalamassery, Kerala.
39.
Sr. Mildred
Asha Niketan Rehabilita
tion Centre
Private Sector e/6
Bhopal 462 014 (M.P)
56’
Fr. J. Antony Samy
Udhagamandalam S.S.S.
Bishop's House Complex
Udhagamandalam 643 001
Tamil Nadu.
40.
Sr. Marykutty Thomas FMM
I. C. Convent Hospital
Big Bazar Street
Coimbatore-641 001
J
Sr. Daya Christine
Sr. Josephine Munthode
St. Luke's Hospital
Shrirampur 413 709
Ahemednagar, Haharastra.
dontd...3.
3
SI.No.
Name & Address
SI.No.
Name & Address
59.
Sr. Hilda FCC
Pushpa Dispensary
R.D.S.S. Pushpa Social C.
Silwani PO, Raisen Dt. ,
Madhya Pradesh-464 886
73.
74.
Sr.M. Immaculata Joseph
Sr.(Dr.) Ippolita
St. Ann's Hospital
Fat iinanagar
Warrangal-5^6 004
60.
Sr. Joanna Thomas FMM
St. Joseph’s Hospital^
Arokiapuram PO
Tuticorin 628 002
75.
Sr. Jacinta
St. Ursula Hospital
Kombir-Naatoli-835 229
Dt. Gumla, Bihar.
61 .
Sr. G. Mary
St. Anne's Dispensary
Ongur, Uthiramerur PO
Chingleput Dt. T.N.
76.
Sr. M. Rosaria SMA
St. Theresa's Mission Hosp.
Thandla PO, Jhabua Dt.,
M. P. 457 777
62.
Fr. Cyril Lobo.
Sacred Heart of Jesus Disp.
Sandesh Sedan,
Seoni 480 661, M.P.
77.
78.
7980.
63.
64.
Sr. Ancy
Sr. Grace
St. Vincent Hospital
Vincentgiri, Vernon PO
Manathavady 670 645.
Sr. Stella
Sr. Marline
Sr. Isabel Mary
Sr. Mary Bridget
Holy Cross Hospital
Kottiyam, Quilon.
81 .
65.
Sr. Rosemond CMC
Centenary Hospital
Vijnthala,
Palayamparambu PO
Kerala 680 7'41
Sr. Bridget Francis
St. Joseph's Poor Lep.Hosp.
Greengardens
Shertally PO, AUeppey Dt.
Kerala 688 524
82.
83.
Sr. Mathew
Our Lady of Fatima Hosp.
Porumamilla 516 193
Cuddapah Dt., A.P.
Sr. Sabina Mary
Sr. Bridgit Berucliet
S.H. General Hospital
Green Gardens, Shertally
Kerala 688 524
84.
Sr. Suchita George
Holy Cross Hospital
Kunkuri 496 225
Dist Raigarh, M.P.
66.
67.
Sr.(Dr.) Grace Kujur
At. Angela's Hospital
85.
Chandmari Road
Chakradharpur PO
Singhbhum Dt., Bihar 833 102
68.
69.
Sr. Ros-ila
Sr. Saly
Archana Hospital
Perurnpunna PO
Peravoor, Cannanore Dt. ,
Kerala.
70.
71 •
72.
Sr. Francis S.H.
St. Mary's Hospital
Ariankavu PO
Kalthurrutty, Quilon Dt. ,
Kerala-691 316
86.
Sr. Philomina T.M.
Srs of St. John the Baptist
341 Anna Hagar
Madurai-20, T.N.
Sr. Martha Macedo
St. Mary's Convent Disp.
Kotagiri-643 217, T.N.
8788.
89.
Sr.(Dr.) Lauretta SRA
Sr. Gracia SRA
Francispur Hospital
Via Rasra, Dt. Ballia,
U. P. 221 712
Sr. Lily Thomas D.M.
Sr. Vincent D.M.
Sr. Paschel D.M.
St. Joseph's Hospital
Anchal, i<uilon Dt.
Kerala.
90.
St. Philomina
St. Joseph's Hospital
Palakurichy
Trichy Dt. T.N.
Contd...4.
4
SI. No .
Name & Address
91 .
92.
93.
94.
Fr. Mathew Arackal
Sr. Francis Therese
Sr. Judith
Sr. Francina
High Range Medical Centre
Pallikunnu P0
Peermade 685 531, Idukki
Kerala.
95.
Sr. Mary SSA
Arokia Annai H. Centre
Kadapakkam
Madurandhakam,
Chingleput Dt.603 304
96.
Amulya (Sr.)
Ursuline Convent Disp.
Samtoli P0, Simdega
Dt. Gumla-835 223
Bihar
97-
Sr. Stella Maria FCC
Providence Clinic
Palai, Kottayara Dt.,
Kerala.
98.
99.
Sr. M. Bertilla
Sr. M. Harriet
Our Lady of Lourdes
Charitable Hospital
Xelgori Hoad
Dharwar 580 008
100.
Sr. Mary Arackal
Jyoti Health Centre
Kometleputta P0
Rayagada, Koraput Dt.
Orissa 765 001
101.
102.
103.
Fr. Joseph Karmathukuzhy
Sr. Michael SABS
Sr. Elizabeth SABS
Vim'ala Hospital
Vellathooval
Idukki Dist,
Kerala 685 563
104.
Sr. Ann Thomas
Holy Cross Hospital
Ambikapur P0
Surguja Dist
M.P. 497 001
105-
Br. Antony Palumattom
St. John's Hospital
Kattappana 685 508
SI. No .
Name & Address
106.
107.
108.
Fr. Joy J. Chittoor
Sr. Roseline
Sr. Prema
Peermade Devpt. Society
Comm. Health Programme
P.B. No.11, Peermade
Kerala 685 531
109.
1 10.
Sr.(Dr.) Jessy Maria SH
Sr. Lourde Mary SH
Medical Centre Hosp.
Nagampadam, Kottayam-1
Kerala 686 001
111.
Sr. Ursula SH
A K M Hospital
Pazhayidom
Via Kanjirapally
Kerala
Fr. Kurian Thomas
Sr. Mary Anthony
Sr. Louis Marie
Madras Social S. S.
Catholic Centre
Madras-600 001
112.
113.
114.
Sr. M. Lucina
Roberts Nursing Home
Residency Area
Indore-452 001
Sr.(Dr.) Adele Thaliyan
St. Joseph's Dispensary
C/o Sisters of Charity
P0 Krishnagar City Jn.
Nadia Dist; W. Bengal
Sr. Rita
Little Flower Dispensary
Kochuveli, Titanium PO
Trivandrum 695 021
Sr. Loretta
Sr. Emma
Sr. Agnes
Carmel Hospital
Ashokapuram
Alwaye 683101, Kerala.
Sr. M. Alma Augustine
Lourdu Matha Hospital
Thallada
Khammam Dist
Andhra Pradesh 507 167
Sr.(Dr.) Clarissa
Kota Stone Mariam Hosp.
Ramganjmandi
Kota Dist.
Rajasthan 326 519
Contd..5•
5
SI. No
Name & Address
SI.No.
1 23.
124.
Sr. Galgang SABS
Sr. Mary Koduyan SjIBS
M. A. J. Hospital
Edappally 682 024
Ernakulam, Kerala.
138.
139.
Sr. Euscbia Mary
Sr. Rosary Mary
Bp. David's Health Centre
Santhavasal PO
N. Arcot Dist. T.N.
125.
Sr. Pradeep Tirkey SOJM
Dur Lady of Fatima Disp.
Hulhundu PO, Ranchi,
Bihar 835 221
1 40.
Sr.(Dr.) Sarto Mary
Assisi H.D. Hospital
Talavady PO 638 461
Sathyamangalam
Periyar Dt., T.N.
1 26.
Sr. M. Paula
Our Lady of Health Hosp.
■ Arulanda Nagar
Thanjavur 613 007
1 4l .
Sr. Bernarditte SM
Nirmala Hospital
Anicadu 686 503
Kottayam Dt., Kerala.
142.
1 43.
144.
Sr. Victorine JMJ
Sr. Alphonse Mary JMJ
Sr. John JMJ
St. Joseph's Hospital
Guntur PO,
Andhra Pradesh 522 004
145.
A. John Berchmans
Ozanam Free Dispensary
St. Joseph's College,
Tiruchi-2, T.N.
146.
147.
Fr. Antony Purayidom
Sr. Jessy
Vimala Hospital
Chemperi PO
Cannanore Dist
Kerala 670 632
148.
Mr. J.E. Selvadoray
I G S S S
28, Lohi Road,
Institutional Area
New Delhi-110 003
1 49.
Sr. Lydia
St. Joseph's Hospital
Dindigul 624 007
Madurai Dist., T.N.
150.
Sr. Rose s/N
St. Joseph's Dispensary
Thathoor PO
Via Karunkuzhy, Chingleput
Tamil Nadu.
151 .
Sr. Mary Rexaline
Social Action Dispensary
S.H. Seminary, Poonamallee
Madras 600 056
1 52.
153.
Sr.(Dr.) Philomina Joseph
Sr. Elsy Francis
St. Isabel's Hospital
18, Olivar Road,
Mylapore, Madras-600 004
127.
1 28.
129.
Sr. Elsy James
St. Mary's Hospital
Karimannoor, Thodupuzha
Kerala 685 581
Sr. Faustina DM
St. Joseph's Hospital
Panachamood, Mancodo PO,
K.K. Dist, Via Edacode
Tamil Nadu 695 152
Sr. Bridget Francesca
Bharat Mata Hospital
Cheta - Muri PO
Ranchi, Bihar 835 101
1 30.
Miss Louisine Lopez
St. Xaveir's S.S.S.
P.B. No.4088, Navrangpura 9
Ahraedabad 380 009
131 •
1 32.
Sr. Rose Mary RJM
Sr. Rita RJM
Jesus & Mary Mission Disp
Chalil, Copalapetta
Tellicherry 670 102
Kerala.
133.
134.
135-
136.
137-
Sr. Alexa Alapatt
Adelbert Alapatt
Assisi Hospital
Kanjikode PO,
Palghat 678 621
Sr.(Dr.) Luka Kolencherry
Mercy Hospital
PO Poreyahat
Godda Dt.,Bihar 8l4 153
Fr. X. Barrett
Sr. Catherine
Katra Hospital
Mandla Dist
Madhya Pradesh 481 661
Name & Address
Contd. . .6.
6
Si. Ng
Name & Address
SI.No.
Name & Address
154.
155*
Sr. Fabiola
Sr. Roseline
Deva Matha Hospital
Ko c that tukulam
Ernakuiam Dist
Kerala 686 662
166.
167.
Bro. Leopold C'ST
Sr. Fatima CSN
Mar Augustine Golden
Jubilee Hospital
Mookkannur 683 577
Kerala.
156.
Dr. K.E. Eapen
Kadanipuzha Hospital
Kanjirapally 686 507
Kerala.
168.
169.
Sr. Leonard CMC
Sr. Celestine CMC
K.C.M. Hospital
Nooranad L.S.PO
Alleppey, Kerala.
157-
Sr. Judith. S.D.
Ashadhani Hospital
Wirur, Chandrapur Dt.,
Maharastra 442 905
170.
Sr. Leoni Mary
Jyoti Health Centre
Charoda BMY
Durg, M.P. 490 025
158.
159.
160.
'■ o . .
162.
163.
164.
165.
Sr. Zacharia
Asha Bhavan H. Centre
1 71 <>
Semari Kalan, Sultanpur pi 1,
Raisen Dist, M.P. 464 986
Sr. Lucy Alilakuzhy
Vincent Health Centre
Alirajpet PO,
Gajwel Dt, A.P. 502 281
Sr. Mary Jacob
Holy Cross Dispensary
C/o Holy Gross Convent
Teppukulam PO
Tiruchirapalli 620 002
Jr. csurge Purathoott
St. Thomas Hospital
Kirathoor PO, K.K. Dist.,
Tami1 N adu
172.
Sr. Mary Agnes IBMV
Misereor Hospital
PO Shahpur Pati
Dist. Bhojpur
Bihar 802 165
173.
174.
Sr. Therese
Sr. Ainala
Cherupushpam Trust Hosp.
Palai, Kerala 686575
175.
Sr. Bensy CMC
Vimala Hospital
Sirvel PO, Kurnool Dt.,
A. P. 518563
Sr. Anastasie
St. Mary's Maternity Home 176.
Chamarajpet
Bangalore 18
Sr.(Dr.) M.K. Gesualda
Good Shepherd Hospital
Vayithiri, Wyanad
Kerala 673 576
177.
Sr. Gemma
178.
Vijaya Marie H. Centre
Siruguppa PC, Bellary Disi
Karnataka 583 121
Sr. Elizabeth Thomas
Nirmala Nursing Home
Finger Post
Ootaccamund 643 006
Sr. Annamma 0 . P •
Jeevadhara Hospital
Kutjtsicad PC, Pariyaram ,
Trichur Dist., Kerala
179.
Sr. Linet
Christanand Hospital
Brahmapuri, Chandrapur Dt.,
Maharastra 441 206
Sr. Josita
St. Joseph's Hospital
Attur, Salem Dt.
Ta'mil Nadu 636 102
Sr. Evangelist S.D.
Samaritan Hospital
Pazhanganad, Kizhakkambalam
Kerala 683 562
Sr. Julia Lukens
Infant Jesus Dispensary
Mulagumoodu 629 167
K.K. Dist. T.N.
Contd..7•
7
31.No.
Name <1 Address
SI.No.
Name & Address
198.
199.
200.
Sr. Fatima Ignatius
V. Irudayaraj
S.M. Regina Cazabon
Hemerijckx Rural Centre
Rawttakuppam, Auroville,
S.A.Dist. T.N. 605 101
201.
Sr. Dorothy
St. Ann's Maternity Hosp.
Jaggayyapet 521 175
Krishna Dt., A.P.
180.
Fr. John C. Puthenveedu
St. John's Hospital,
Kuriode, Chadayamangalam
Quilon Dt. Kerala.
181.
182.
183.
Fr. Mathew Thayil CHI
Sr. Merlin Jose CMC
Miss Mollykutty P.O.
St. Rita's Hospital
Nalukody PO
Changanacherry 686548
184.
185.
Fr. Wenceslans CMI
202.
Jaisy Carmel CMC
St. Antony's Mission Hosp.
Kainakary, Alleppey.
186.
Sr. Blaise Maliekal
Holy Cross Hospital
Kamagere PO 571 443
Mysore Dt. Karnataka.
203.
204.
205.
Sr. Redempta
Sr. Felix
St. George's Hospital
Vazhakulam PO
. Muvattupuzha, ..Kerala.
Fr. Isidore Fernandes
Sr. Leoni
Sr. Julita
Narareth Hospital
13-A, Kamla Nehru Road
Allahabad 211 001
206.
207.
Sr. Mary Tom S.H.
Jayainatha Hospital
Odanavattom PO
Kottarakara 691 512
Sr. Anita
Sr. Nirmala
Navajeevan Health Centre
Raj aw a 11 ip ur am
Tirunelveli Dist 627 359
208.
Sr. Elizabeth George
St. Theresa's Hospital
Bommidi P0
Dharmapuri Dt.
Tamil Nadu 635 301.
209.
Dr. John Philip
Archbishop Aitipetty M.
Disp. & Welfare Centre .
c/o St. Joseph's Convent
Kalamassery P0, Kerala
21°-
Sr. Francisca
Fatima Hospital
Jayankondam, Trichy Dt. ,
Tamil Nadu 621 802
21 1 .
212.
Sr. Regis
Sr. Augustine
Holy Family Hospital
Sa.tnapalii 502 403
Guntur Dt.
Andhra Pradesh.
213.
Sr. Antoinette
St. Joseph's H. Centro
Periyathachur
Anilady P0, T.N. 605 651
I87.
188.
189.
190.
Sr. Kochuthresia
Devamatha Hospital
Kpratty, Trichur,
Kerala.680 308
191.
Sr. Carmela
Arokia Matha Nilayam
Gangavalli, Attur
Salem Dt.,T.K. 636 105
192.
193-
Sr. Anacleta FCC
Sr. Liberia FCC
St. Joseph's Hospital
Mangalamdam
Vandazi, Palghat.
194.
195.
Sr. Lisieux
Sr, Ritty
Carmel Hospital
Mahudanr, Palamau Dt.
Bihar 822 119
„
196.
197.
Sr. Gratia Rasiah
Sr. Spphia Puthenpurayil
Hoiy Redeemer Hospital
Theni 626 531
Fr. S. Kulandaisamy
Tiruchirapalli Multipurpos
Social Service Society
Bishop's House, P.B. 14
Tiruchirapalli-620 001
Contd. ... 8.
8
31.No.
Name & Address
214.
2!5.
Dr. R.A. Frinjery
Sr.(Dr.) Beena
St. Joseph's Hospital
Choondal, Trichur
Kerala 680 502
21 6 .
217.
21 8.
Fr. Antony Kalathiveetil
Sr. Maria Teresa
Sr. Massimila
Lourdes Hospital
Ernakulam, Cochin-12
219.
220.
221 .
222 .
223.
224.
Fr. Stephen Kottackal
St. Joseph's Hospital
Manantoody, Wyanad
Kerala 670 645
Sr. Albina S.D.
St. George Hospital
Chemmanathukara,
Vaikom, Kottayam
Kerala-686 606
226.
Sr. Pavitra S.D.
Golden Jubilee M. Hosp.
Chempu PO, Vaikom
Kerala 686 615
227 .
Sr. Carmela
St. Mary's Health Centre
Katipalla PO
South Kanara,
Karnataka 574 149
229 .
Name & Address
230. Sr. Annie Maria CMC
Alphonsa H.D. Hospital
P.O. Baromasia
Via Pathargama, Bihar8l4l47
231 . Sr. Grace Madamana
St. Joseph Hospital
Calimpur, Barior TO
W. Bengal 731 220
232. Sr. Rose Mary
Prakash Health Centre
Prakashpalayaiji, Kothanur P0
Mysore-571 440
233. Sr. Alice S.C.
234. Sr. Grace S.c.
Srs. of Charity Disp.
Fr. Thomas Becket D'Souza
Dudhani, Durnka PO,
The Organisation for the
Bihar
814 101
Development of People
Clergy House,
235- Sr. Bapista D.M.
Bannimantap 'B' Layout
Nirmala Mission Hosp.
Mysore-570 015
Payyanamon PO
Konni, Pathanamthitta Dt.
Sr. Assunta
Kerala
Sr. Selma
Sr. Marietta
236.
Dr. Prem Pais
St. Ann's Hospital
237. Sr. Anna Byrne
Vijayawada-2, A.P.
238. Sr. Anne Mary
239. Sr. Anita Hodges
Sr. Luke D'Souza R.J.II.
St. Martha's Hospital
St. Joseph's Dispensary
Naupathunga Road,
Catholic Church,
Bangalore 560 009
Kham’oho 1-388 620
225.
228.
SI.No.
240. Mr. Thomas Umminithottam
Bp. Vayalil Medical Centre
Moolamattom,
Kerala 685 589
241. Sr. Mary James S.H.
242. Sr. Jane Mary S.H.
Christuraj Hospital
Thokkilangady
Nirmalagiri PO
Cannanore Dist. Kerala.
243- Sr. Valentina Cotta SFK
244. Sr. Ssperanca Gracias
Fr. Faustino D8 Souza
Charitable Dispensary
c/o Holy Family Convent
P.O. Cortalim, Goa-403 710.
Fr. Joseph ICurinj iparampil
Good Samaritan Hospital
Sr. Catherine
Amboori PO, Trivandrum
St. Ann's Health Centre
Kerala 695 505
Kondapalli 521 228
Krishna
Dt., A.P.
Sr.(Dr.) Scholastica
Pillar Clinic, Haddo PO,
Port Blair 744 102
Contd...9
9Sl.No
246.
24-7.
Name & Address
SI.No.
Name & Address
Fr. Joseph Vazhuthanapally
Nav Jeevan Dispensary
259- Sr. Francis FCC
Khadi PO
Holy Family Hosp.
Sunlersi, M.P. 465 113
Kodarma PO
Hazaribagh Dist.
Fr. Samuel Edamannil
Bihar 825 410
St. Johh's Lep. Hospital
260. Fr. James Puthenpura
Pirappencode PO
Quilon Social Service Soc.
Vejraramoodu 6y5 607
Kerala.
Fatima Road, Quilon.
248.
Sr. Adelaide CHF
St. Joseph's Hospital
Poovathussery
Parakadavu PO
Kurumassery-683 579
Kerala.
249.
Sr. Marie—Lourdes
Assisi Dispensary
St. Francis Convent,
Raisen-464 551, M.P.
250.
266. Sr. Pauline
Sr. Crizy FCC
267. Sr. Amedee
Nirmal Public Health
St. Joseph's Hospital
Service Centre
Maryland
Nawadah PO, Bihar 805 110
Visakhapatnam, A.P.
Sr. James J MJ
268.
Prof. Gerson Kannikal
Sr. Praxedas JMJ
Vincentian T.B. Clinic
Nirmala Maternity & Gen.
Kalamassery P0
Hospital.
Ernakulam Dist, Kerala
Masapeta PO, Cuddapah, A. p.
251..
252.
261.
262.
Sr. M. Theresia
Sr. M. Valeria
St. Theresa's Hospital
Agashi PO, Via Vir.-r
Thane, Bombay 401 301
263« Sr. Silvana Lobo
264. Sr.(Dr.) Florence Athickal
265. Sr.(Dr.) Mauricia
Nirmala Niketan
Vijayawada 520 008
253.
269. Sr. Lissy
Sr. M. Gertrude
St. Joseph's Dispensary
St. Josepjh's Hospital
Thiruparkadal 632 503
Chamaraj Nagar PO
N.A. Dist, Tamil Nadu
Mysore, Karnataka 571313
254.
270. Sr. Rita Mary
Sr. Kensie Mary
Sacred Heart Hospital
Maria Mater Gen. Hosp.
Tuticorin 628 002
Arokia' Nagar..
Tamil Nadu.
Sarakanei, Ramnad 623 405
255.
Fr. Augustine OCD
Carmel Hospital
Manalikarai
Kanyakumari Dist
Tamil Nadu 629 164
256.
257-
Dr. Angel Mary
273.
Sr. Annaclate
Sacred Heart Hosp.
Payankulam, Maliakombu PO
Thodupuzha, Idukki Dt. ,
Kerala.
274.
Sr.(Dr.) Mary Rose
275«
St. Rita's Hospital
Manikpur PO, Banda Dist
Uttar Pradesh-210 208
258.
271.
272.
Sr. Hope
Sr. Lucia D' Cruz
St. Thomas Hospital
Vadakangulam 627 1 1 6
IJirunelvely,
amil Nadu.
Sr. Rosaritta
Nitya Sahaya Matha Hosp.
P0 Adat, Trichur 680 554
Kerala.
Sr. Mary Melani S.S.
Sr. Elizabeth Ancitta S.S.
Lourdes Hospital,
Mannuthy, Trichur, Kerala
. . 10.
10
SI.Wo.
Nano & Address
SI.No.
Name & ^ddrsss.
276. Fr. Kuriakose Kavalakat
277. Sr. Virginia
S.. Joseph's Hospital,
Vellad, Karuvanchal,
Alakode 670 571
Cannanore Dt. Kerala.
291. Sr. Fausta
292. Sr. Prisca
Daughter of St. Mary of
St. Mary's Paediatric Hosp.
Moondrumavadi ,
Madurai-7, T.N.
278. Sr. Philomina
279. Sr. Christina
St. Louis Hospital
Krishnagiri HO
Dharmapuri 635 001
293- Sr. Aloysius MSJ
294. Sr. Fatima MSJ
St. Joseph's Hospital
Kothamangalam
Kerala.
280. Sr. Mary Teresa
St. Jerome Hospital
Kunnam PO, Mavclikara
Kerala.
295.
Sr. Mariantonia
Divya Jyoti Community H.
Mundgod, N. K. ,
Centre
Karnataka 581 3^9
281.Sr. Libia Mary
Benziger Hospital
Beach Hoad, Quilon-1
296.
Sr. Raphael
St. Ignatius H. Centre
Durgi-522 612
Macherla, Guntur Dist,
Andhra Pradesh.
282. Sr. Lorena Mary
Assisi Hospital
Channapetta NO
Kerala 691 311
283. Dr. Ancilla
Nazareth Hospital
Mokama 803 302
Patna, Bihar.
284. Sr. Ajaya
Notre Dame Disp.
Jamalpur, Monghyr Dt •
Bihar 811 214
285, Sr. Suso Maria
Assumption Hospital
Melukavumattom PO
Kottayam Dist
Kerala 686 652
286. Sr.(Dr.) Rose Korah
Sagaya Hatha Hospital
Balaclava Hill
Coonoor, Nilgiris 643102
287. Sr. M. Anita SRA
288. Sr. M. Sandra SRA
289. Dr. Antony Fernandes
Goretti Hospital
Santhekatti PO
Udupi, Karnataka-576 125
290. Sr. Mary George
St. Luke Hospital
Pedda Dornala PO
Prakasam Dt. A.P.
297- Sr. Cresentine
St. Xavier's Hospital
Xavierpet, Ongole
298.
299.
Sr.(Dr.) Jose Maria
Sr. Elcitta
San Joe Hospital
Perumbavoor 683 5^2
Kerala.
300.
Sr. Andrea Mary
Maria Goretti Disp.
Edacochin, Cochin-6
301.
Sr. Tessy
Nirmala Dispensary
C/o St. Charles Convent
Richards Town, St.Thomas TownPO
Karnataka 560 084
302.
Sr. Dora Mary
Assisi Hospital
Punnapra, Alleppey-4.
303.
Sr. Theresa George
Karunalay Mission Hosp.
Anklav, 388 510
Gujrat.
304.
Sr. Pauline
St. Ann's Convent
Mambakkam, Tiruvanakoil PO,
Chingleput 603 106
Contd..11
11
__ baffle <i_Address
SIM-Io. _ Name_&_Address
305.
Sr. Shantal Mary
Sneh Swasthaya Kendra
Hardee Project, Korba
Bilasjinr, M.P. 495 686
324.
Sr. Georgia Mary
Amala Health Centro
Purnea P0
Bihar 854 301
306.
307.
Sr. Grace MSJ
Sr. Bridget MSJ
Assumption Hospital
Kanhirap uziia,
Palghat Dist
Kerala 678 591
325.
Sr. Karuna D.M.
Bethany H. Centre
C^o Bethany Ashram
Nedumangad 695 541
Trivandrum, Kerala.
308.
309.
Armida Colombo (sr.)
Sr. Maristella Saldanha
"Snehalaya"
Solur P0, Hagadl,
Bangalore Dist. 562 127
326.
327.
328.
Fr. Louis Philipose
Sr. Florence D.M.
Sr. Sherlet D.M.
Vimal Mission Hosp.
Kalluvathukal PC
Quilon, Kerala 691 578
310.
Sr.(Dr.) Agostina Thomas
Asha Hospital
Gollepudi
Vijayawada Tk, Ap521 225
311.
312.
Fr. Thomas Parecattil CMI 330
Sr. Sonia C.S.F.
Sant Paul Health Centre
Satpuli, Pauri-Garhwal
U. P. 246 172
331
332
Sr.(Dr.) Jose Mary
Sr. Helen
Nirmala Hospital
Marikunriu PC, Calicut,
333
Kerala 673 012
313.
314.
315-
Sr. Emma
Providence Dispensary
Lady's Seat Raod
Yercaud 636 601
Taini 1 Nadu.
329. Sr. Constance
Rural H. Programme
Sevanalaya, Pambanar RO,
Peermade 685 537
334
316.
317.
318.
319.
320.
Dr. .Ilfred Mascarenhas
Dr. Mario C.De Souza
Sr. Lissia
335
Sr. Ignatius
Fr. Bernard Moras
St. John's Medical College
Bangalore-560 034
336
321.
322.
Sr. Theodore Isaac
Miss Louise Duncan
Nirmala Rani Health Centre
Cluny Convent
Devikapurarn, N.A. Dist
337•
Tamil Nadu-606 902
323-
Sr.(Dr.) Lucian
Leonard Hospital
Qatlagundu 624 202
Madurai, T.iJ.
Sr. Ancy Job CMC
St. Joseph's Hospital
Pathikonda, A.P. 518380
Sr.(Dr.) Consilia Fernandes
Sr. Annunciata Colaco
Vijay Marie Hospital
Saifabad, Hyderabad-500004
Mary Pete
St. John's Health Centre
Kadambathur P0
Chengelpet, T.N.
Sr. Gerome
A.A.J.M. Hospital
Thuruthipuram
Via Kodugaloor
Ernakulam Dt.
Sr. Beatrice S.D.
St. Thomas Hospital
Meloor, Kerala.
Sr.(Dr.) Angela Rodrigues
Daya Sadan Dawakhna
Zankhave
Via Surat Dist
Gujrat.
Sr. Mary-Jo
Srs. of Mary Immaculate
Krishnagar, Nadia
W. Bengal 741 101
338. Sr.(Dr.) Vilma Nazareth
Dayanand 'Hospital
Talasari 401 606
Maharastra.
Contd
12
12
Sl^No.__ Name & Address
Sl.No^ _
339- Sr. Mary
Fr. Patrao Hospital
Darlee PO, Puttur
D. K. , Karnataka.
352. Sr. Simon
Snehamatha Nursing Home
Rajamattom, Tnottakadu
Kottayam.
340. Sr. Mary Joseline
St. Paul's Health Centre
Thondamanthurai 621 103
Trichy, Tamil Nadu.
333.Fr. a. Michael,
Thanjavur Multipurpose
Social Seryice Society
P.B. K.j 77, Trichy Road
Thanjavur, T.N.
341• Sr. Conard Mary
De Britto H.Sec. School
Devakottai 623 303
Rainnad Dt. , T. N.
342. Sr. Christina
Christu Deepalaya
Court Road
Doddaballapur
Bangalore Dist.
3^3- Sr. Annie Puthiyadathukunnel
Sr. Marianos
Holy Ghost Mission Hosp.
Muttuchira PC
Ko 11 ayara Dis t.
Kerala 686 6l3
3^5* Sr. Cecily Jane
Fatima Hospital
Kadagathur
Dharmapuri Dt.
Tamil Nadu.
346.
Sr. Flora
V. G. Hospital
Srs. of Charity,
Convoy Road,
PC Boiragimath
Dibrugarh
Tamil Nadu 786 001
347.
348.
Sr. Raymond
Sr. Betina
Uphara Mata Hospital
Koduvila PC
Fast Knllada, Quilon Dist
Kerala 691 502
349.
350.
Sr. Rose Mary
Sr. Mary Joseph
St. Joseph's Health Centre
Pulivendla-516 390
Cuddahpha, A. P.
351• Sr. Bruna
Our Lady of Dolours
R.C. Hospital
Mogaltur PO 534 218.
W. Godavari, A.P;-'
Name & Address
354. Sr. Stella Ruby
St. Kulandi Theresa H.Cent
Kolpet, Mambalapet,
ViUupuram, S.A. Dist. .
Tamil Nadu-605 303
41st ANNUAL CONVENTION
CATHOLIC HOSPITAL ASSOCIATION OF INDIA
23-26 NOVEMBER 1984
WORKS FIOP„ ™EMS s
towards a people-oriented drug policy
'Eternal vigilance is required to
ensure that the health system
does not get medicalised, that the
doctor-drug producer axis does
exploit the people and that
not ex;
the ab
abundance of drugs does not
become a vested interest in ill-health'.
-- ICMR/ICSSR Health for All Report.
Venues ST JOHN'S MEDICAL COLLEGE, BANGALORE 560034
SIGNIFICANCE OF THE THEME
2
THE Workshop is to help participants understand the
issues relevant to drug prescribing, drug distribution
and pharmacy policy in our institutions in the context
of the ICMR/ICSSR warning and to challenge them to
participate in the growing national response to
the problem..
WHAT does the :abundance of drugs' mean to the millions
of the poor in our country who struggle in life to
make both ends meet? Can they ever have access to the
modern health care system which has become a business
today, rather than remaining at the service of humanity
at large? Do they have essential and life saving drugs
at their reach within a price range they can afford?
IS our drug policy today more profession-oriented, drug
industry-oriented rather than patient-oriented? Whose
interests are we serving in our institutions?
HOW can we move towards a more people and patient-oriented
drug policy?
THESE are some of the QUESTIONS which we shall respond to
in our Workshop.
ooooooooooooooooooocooooooooooooooo
"Community Health is a process
of enabling people to exercise,
collectively their responsibi
lities to maintain their health
and to demand health as their
right. Thus it is beyond mere
distribution of medicines,
prevention of sickness, and
income generating programmes".
—CHAI new vision
0000000000000000
0000000000 00000000
OBJECTIVES
1.
3
TO CREATE AN AWARENESS OF;-
the health situation in India, the role of drugs
in health care, the pattern of drug production
in India vis-a-vis the people's health needs, the
dynamics of the drug industry, the pattern of drug
distribution and availability in the health system,
the national drug policies and laws.
2.
T0 CREATE AN AWARENESS OF:-
irrational use, over use and misuse of drugs by
health personnel.
3.
TO DISCOVER
the social, economic, political, cultural and
other factors responsible for this problem.
4.
TO DISCOVER
how all of us are part of the problem at a
personal level.
5.
TO CONSIDER
the various responses at national/regional levels
in the areas of :— consumer awareness and people's
movements; continuing professional education,"
pressure group on policy makers," search for low cost
alternatives; individual/group action; institutional
policy changes.
6.
TO DISCOVER
ways and means by which -we can respond to this
situation at individual, institutional and
r'■gional/national levels.
4
PROGRAMME HIGHLIGHTS
iiSessions on:
Understanding the problem
Drugs and the healing ministry
Towards rational therapeutics
What to do to tackle the problem
Some initiatives in the country
The people's medicine
ii;Group discussions on:
What/why the problem in our health institutions?
What can we do to tackle this problem?
ijjLiturqy
’ Reflecting on our calling and the faith dimension
of our response
;;^Exhibition ons
Socio-political dimensions of Health and Drugs
Rational Drug Therapy
Home remedies and Herbal medicines
jiiStudies on:
Drugs for a Community Health Center
Understanding the injection/tonic culture
Use/misuse of drugs in surgery
Drug situation in small rural hospitals
Cost of treatment
;i^Cultural Programme
Understanding the problem from the poor man's
point of view.
5
SYNOPSIS OF PAPERS
Prues for Primary Health Care (C M Francis)
An integral part of our commitment to primary health care is
the provision of essential drugs to all those who need
them, in adequate quantity and quality and at affordable
prices wherever the person is. The various aspects of
the drug problem needing our attention include production,
what drugs are required, choice of drugs, National Drug
Policy, selection of drugs, drug production and procurement,
logistics of supply, quality control, regulating the drug
trade, drugs for immunization, drugs for cure, drugs for
symptomatic relief, search for new drugs, drug information
and the need for evaluation of the efficacy of primary
health care including drugs.
The Ten Commandments of the Drug Industry (Augustine Veliath)
1. Thou shalt have tens of thousands of drugs
2.
Thou shalt not question the price .of a drug
3.
Thou shalt not tamper with nature's garden
4.
Thou shalt respect they doctor more than thyself
5.
Thou shalt betray thy people and thy nation for petty rewards
6.
Thou shalt not covet, court, or subscribe to any other
system of medicine
7.
Thou shalt never reveal company secrets
8.
Thou shall first seek remedies for fashionable ailments
9.
Thou chalt be a dumping ground for banned drugs
10.Thou shalt be- a guinea pig for new and untried drugs.
6
The Ethics of Prescribing (George Lobo, sj)
Discusses reasons for the unfortunate situation related to
drugs prevalent today, viz., technological model of
health care leading to .manipulation of the patient,
search and demand for instantaneous cure of symptoms,
mystification of medicine, profit motive and 'free
enterprise1 of the pharmaceutical industry, a deep
rooted cultural' alienation from the people, exploitation
of dependent developing countries, decreasing emphasis
being given to preventive medicine and other systems
of medicine.
The use of drugs should be regulated by the principles of
totality (overall good of the patient) and,of double
effect (the good effect overriding any harmful effect).
It suggests remedies for the development of a personcentred and holistic approach to health care.
Professionals in the Church - an introspection (George Joseph)
Serious questions hdve been raised about the institutional
witness of the church in India, particularly its
relevance in the social context of today. In the case of
the Healing Ministry there is urgent need to critically
look at our priorities and commitment and our style of
functioning in the light of the gospel. The role of the
professionals have to be reassessed as part of an
overall effort to bring back the true spirit of 'Diakonia'
into this ministry.
The whole issue regarding the need for evolving a 'rational
drug policy' has to be seen in this perspective.
You take
all the
medicine now
.... we will
see the rest
later...
I.
£)
O^/
fe
<j
M
A
7
What is Rational Drug Therapy? (Mira Shiva)
Rational drug therapy means practice of socially
conscious, relevant, concerned and yet scientifically
sound medicine. It recognizes the non-role of drugs
in certain conditions, the role of alternative systems
of medicine and recognizes the limitations of Western
Medicine in our social context.
It emphasises selective use of drugs based on essentiality,
efficacy, safety, easy availability, easy administration,
quality drugs preferably of indigenous production.
Rational Drug Therapy recognizes the concept of essential
drugs and the concept of graded essential drug lists for
different levels of health personnel. It recognizes the
right of health personnel and consumers to drug information
and its effective communication.
It is taking of a conscious decision to boycott certain
drugs and use others only when needed. It means
prescription with awareness, to avoid as far as possible
— iatrogenesis (drug induced problems, drug interactions,
adverse drug reactions and emerging drug resistance).
It is understanding the role of drugs and rational drug
therapy in the emerging health movement.
What can be done at a pharmacy level (Alan Cranmer)
(a)
Management of Pharmacy Services include involving the
users of the service; the Pharmacy Committee - its
constitution and functions, viz., implementation of
hospital policy, selection of medicines, sources of
medicines, cost versus quality, basic drugs and formula
tions, medicines banned in India and abroad, medicines
from other systems; stock control; prescribing
discipline and pharmacy discipline.
(b)
Good dispensing services involve need for good
profe. sional service to patients, proper presentation
of patient's medicines, preparation of medicines in
the pharmacy compared to purchase, medicines in the
pharmacy and at clinic level.
contd..
7
What is Rational Drug Therapy? (Mira Shiva)
Rational drug therapy means practice of socially
conscious, relevant, concerned and yet scientifically
sound medicine. It recognizes the non-role of drugs
in certain conditions, the role of alternative systems
of medicine and recognizes the limitations of Western
Medicine in our social context.
It emphasises selective use of drugs based on essentiality,
efficacy, safety, easy availability, easy administration,
quality drugs preferably of indigenous production.
Rational Drug Therapy recognizes the concept of essential
drugs and the concept of graded essential drug lists for
different levels of health personnel. It recognizes the
right of health personnel and consumers to drug information
and its effective communication.
It is taking of a conscious decision to boycott certain
drugs and use others only when needed. It means
prescription with awareness, to avoid as far as possible
— iatrogenesis (drug induced problems, drug interactions,
adverse drug reactions and emerging drug resistance).
It is understanding the role of drugs and rational drug
therapy in the emerging health movement.
What can be done at a pharmacy level (Alan Cranmer)
(a) Management of Pharmacy Services include involving the
users of the service; the Pharmacy Committee - its
constitution and functions, viz., implementation of
hospital policy, selection of medicines, sources of
medicines, cost versus quality, basic drugs and formula
tions, medicines banned in India and abroad, medicines
from other systems; stock control; prescribing
discipline and pharmacy discipline.
(b) Good dispensing services involve need for good
profe. sional service to patients, proper presentation
of patient's medicines, preparation of medicines in
the pharmacy compared to purchase, medicines in the
pharmacy and at clinic level.
contd
8
(c)
Relationships with suppliers, ie . , with representatives
in the pharmacy and an assessment of products offered
and their sources.
(d)
Educational requirements - basic courses, legal
requirements, course content, continuing education for
pharmacists.
(e)
Relationships with hospital colleagues.
INITIATIVES IM THE COUNTRY
(1)
Arogya Dakshata Mandal, Pune has been raising awareness
about drug related issues among medical professionals
and the lay public since the past 8 years. They publish
a monthly--1 Pune Journal of Continuing Health Education' —
on drug issues and are also bringing out a book .
'Rational Drug Therapy' in December 1984.
They launched a movement called 'Operation Medicine' in
1977 against irrational prescription cf vitamins, tonics
and tinned foods.
(2)
All India Drug Action Network? A number of groups have
been working in the field of drug related issues at
various levels during the past 3-4 years. They have
been in contact with each other and have been working
informally together sharing information, putting forward
a memorandum (demanding a Rational Drug Policy),
participating in campaigns, lobbying with government etc.
In August 1984, they felt the need to have a more organized
base and have formed the All India Drug Action Network.
CHAI is also a member of the Network.
(3)
Lok Vigyan Sanghatana, Maharashtra, or the People's Science
Movement have launched campaigns about anaemia and
irrational anti-anaemia drug preparations and also about
over the counter drugs. They organize jathas, hold district/
town seminars, write in the mass media etc.
(4)
Kerala Sastra Sahitya Parishad is a voluntary non-government
organization consisting of scintists, doctors, engineers,
social scientists, teachers, students, workers, peasants,
technicians who are committed to popularising science and
channelising it for social revolution. The KSSP has recently
decided to take- up the Drug issue and initiate a big campaign
to expose the anti-people and exploitative tactics of the
Multinational Drug Companies. The questions of essential
versus non-essential and dangerous drugs, the inadequacy
of drug safety control measures, the rising prices- of
life saving drugs and the non-implementation of the Hathi
Committee recommendations are the highlights of the
programme.
10
(b)
LOCOST or Low Cost Standard Therapeutics is a collective
voluntary enterprise for rational therapeutics. LOCOST
aims to promote low cost, scientifically tested medicine
under generic names. LOCOST is a response to a growing
demand and challenge of the voluntary health sector to
meet the needs of the deprived sectors of the society
for not only low priced but also good quality medicine.
LOCOST inc-udes procurement, quality testing and control,
distribution and educational efforts. and is located in Gujarat.
(6)
Banqarapet Mission Tablet Industry in Karnataka is a
successful small~scale venture providing jow cost, good
quality formulations to some mission hospitals in the.
country.
(7)
Low Cost drugs and Rational Therapeutics Cell of the
Voluntary Health Association of India, New Delhi, has
been instrumental in bringing together various groups in
India on the issue of drugs. They have been providing
informational backing to these groups, organizing meetings,
informally coordinating some actions etc.
(8)
medico friends circle is a group of socially conscious
individuals, interested in the health problems of our
people. Through their monthly bulletin, they discuss
drug issues among others. They have formed a Rational
Drug Policy Cell and have launched a campaign on antidiarrhoeals.
(9)
The Kurji Holy Family Hospital Formulary is the result
of the accumulated experience of the hospital over the
last 10 years. It gives a comprehensive, list of drugs
to treat 98% of the hospital admissions. It also gives the
generic name, dosage, indications, contra-indications
and side effects of these drugs. Information about
comparative cost of treatment is also provided.
11
(10)
State Forums:: ' During the past year drug action forums
have been active in Andhra Pradesh and West Bengal.
Drug Action forums are also being initiated in Gujarat
and Orissa.
unbiased technic-.1 information er drm -s and therapouti
vucrch ■■ wr-publication 'The Drugs Bulletin'.
(12)
Others; The following organizations have also been
involved in drug r:luted issues and are part of the
All Irdia Drug Action Network;
Consumer guidance Society of India, Bombay
Consumer Education Research Centre, Ahmedabad
Federation of Medical Representatives
Association of India
Health Services Association, Calcutta
Delhi Science Forum, New Delhi
People's Participation in Science and Technology,
Madras/Banga.lore
Centre for Science and Environment, Delhi
Centre of Social Medicine and Community Health,
J N University, New Delhi
W h at
we
c a n
d o ?
— Support them
— Join them
— Keep them informed about what you arc doing
12
RESOURCE MATERIALS
B People, Pills and Prescriptions, column in MEDICAL
SERVICE since May-June 1984.
i; Objectives of the Workshop, a handout.
Understand:.ng the Drug situation in our Hospitals,
a check list.
Towards a People-Oriented Drug Policy, Special
Convention Issue of MEDICAL SERVICE (October-Novembe
1984) and a supplement to this issue will be
distributed during the Workshop.
Drugs awareness and Action, mfc BULLETIN Special Issue
No.107 November 1984.
;; DECCAN HERALD Supplement on the Workshop.
'What people really need, first
and foremost is clean drinking
water, latrines,
school and
land, not urban hospitals with
their wonder drugs".
— Planning Commission
AN INSPIRATION
13
Reading
The story of the sickman
at the pool of Bethsaida
John 5s 1-9
Reflection
The action of Jesus in bypassing the pool is an
invitation to us to look more critically at
our own health care system. Thanks to our
emphasis on curative health care, we have grown
accustomed to thinking solely in terms of the
health needs of the individual rather than addressing
ourselves to the community as a whole. While
concentrating on the symptoms, we have failed
to take into account the environment and other
social factors. Poor sanitation, polluted water
supply, the- superstitious beliefs and taboos
of the community are also related to sickness and
disease.
Further, rhe miraculous pool in its ineffectiveness is
a symbol of our own ineffective health care system
despite the highly qualified doctors and nurses,
well equipped private and public hospitals, medical
research centres and multinational drug industry.
The poor man in the gospel story lived very close to
the pool, yet he was helpless because of his
poverty. In like manner the poor in our midst
remain helpless in the shadow of an expensive,
curative health care system that is geared
exclusively to the service of the rich.
Source: The Bible; Aspirin or Dynamite
by Cedric Rebello s.j.
-Z
A?/'o'Z
p^lz)U,r->
41st Annual Convention of the Catholic Hospital Association
of India
Workshop on; TOWARDS A PEOPLE-ORIENTED DRUG POLICY
24-25 Nov 1984 ; St John's Medical College, Bangalore
group allotment
of FACILIATION TEAM
Group _1
Group 2
1.
2.
3.
4.
1.
2.
3.
4.
Fr Thomas Joseph
Dr S Pruthvish
Dr Vijay Joseph
Dr Zafarullah
Group 3
Dr Dara Amar
Abraham Mathew
Dr Srinath Dore
Dr Manjunath
l.Dr Pratap Naidu
2.Sr Jeyaseeli
3.VJ Joseph
4.Dr George Joseph
Group _4
Group _5
Group 6
l.Dr PN Pandit
2.Fr Rupert Rosario
3.Dr Naveen Machado
4.Dr Mira Shiva
l.Dr R Narayanan
2.Sri SMS Shetty
3.AJ Perumpanani
4.Dr S Joseph
l.Dr MJ Thomas
2.Sri Siddalingasamy
3.Dr Gerry Pais
4.Dr DBI Victor
Group 7
Grotip 8
Group 9
l.Dr K Keshavan
2.Dr Raghuvir
3.Dr Sukhant Singh
4.Sri Augustine V
l.Dr Neelamkavil
2.Sri MC Raj
3.Sr Collette
4.Dr A Kurpad
l.Dr GD Ravindran
2.Mrs Jyothi Raj
3.Dr Patrick Kamath
4.Dr CM Francis
Group 10
Group 11
Group 12
l.Dr Kishore Murthy
2.Fr Chacko
3.Dr Sajeev Joseph
4.Dr Vijayan
l.Mr RavlrajWilliams
2.Sr Mariamma
3.Dr Loo Menezes
4.Prof SV Rama Rao
1. Dr Prem Pais
2. Dr Ramakrishna
3. Dr Jose Joseph
4. Dr Ekbal
Group 13
Group 14
Group 15
l.Dr Sudarshan
2.Dr SP Tekur
3.Rajiv Thomas
4.Fr George Lobo
l.Dr Mohan Isaac
2.Dr Mario D'Souza
3.Sr Lilly Rodrigues
4.Sri Alan Cranmer
1. Dr Lillian
2.Dr Maya Jacob
3. Fr Joseph Chittoor
4. Sr Innocent
NOTE; iXlroup Discussion Venue (group numbers in brackets)
Chapel Verandah (1, 2, 3, 4, 5)
Ground Floor Foyer (6, 7)
Room 116 (8)
Room 117 (9, 10, 11)
Room 118 (12.)
Convention Hall (14, 15)
Room 119 (13)
2.
Each team wili select a chairman and two rapporteurs
for the discussion
3.
A short summary of the discussion should be handed over
in the session following the discussion
Workshop on: TOWARDS A PEOPLE-ORIENTATED DRUG POLICY
SESSION IV: WHAT TO DO TO TACKLE THE PROBLEM?
What pan be done at a Pharmacy level?
Main points of talk
1 Control of Pharmacy Services
a) Involving the users of the service
b) The Pharmacy Committee its constitution
c) The Pharmacy Committee and its functions including the
implementation of Hospital policy, selection of medicines,
sources of medicines, cost versus quality, basic drugs and
fsimulations, medicines banned in India and abroad,
medicines from other systems.
d) Good management techniques for stock control
e) Prescribing discilpine and Pharmacy discipline
2.
a)
b)
c)
d)
Dispensing Services
Need for good professional service to patients.
Proper presentation of patients' medicines.
Preparation of medicines in the Pharmacy compared to purchase.
Medicines in the Pharmacy and at clinic level.
3. Relationships with Suppliers.
a) Representatives in the Pharmacy
b) Assessment of products offered and their sources
4. Educational Requirements
a) Basic courses. Legal requirements. Course content
b) Continuing education for Pharmacists
5. Relationships with Hospital colleagues
Notes.(NOT FOR INCLUSION IN THE BROCHURE)
1. I trust that this is what you require, but please feel free
to edit or reduce if if you desire. Date for the return of the
notes to you is very close, and hence a fuller summary is
difficult to give at this stage.
2. Some of these topics will overlap what is to be included in
other sessions so these will be dealt with very briefly.
3. The questions and discussion afterwards may help to bring
out the points of particular interest to the participants.
4. I will do my best to keep to the 20 minutes allocated so
that others are not inconvenienced.
5. I will do my best to bring some duplicated notes if time
permits for preparation.
Alan Cranmer
Consultant Pharmacist
Christian Medical Association..
WORKSHOP DN; TOWARDS A PEOPLES-ORIENTED DRUG POLICY
SESSION II; DRUGS AND THE HEALING MINISTRY
'PROFESSIONALS IN THE CHURCH-AN INTROSPECTION'
(DR. GEORGE JOSEPH)
RESUME;
Serious questions have been raised about the institutional
witness of the church in India, particularly its relevance
in the social context of today - In the case of the
Healing Ministry there is urgent need to critically look
at our priorities and (Commitment and our style of
functioning, in the light of the Gospel - The role of the
Professionals have to be reassessed as part of an overall
effort to bring back the true spirit of 'Diakonia' into
this institutional ministry . The whole issue regarding
the need for evolving’a rational drug policy'has to be
seen in this perspective.
22.'.1\
IO Commandments of the Dmq Companies.
(TPI- Pharmaceutical and Allied Manufacturers and.
DistrilDUtors Ltd. is most active and most powerful political.
lobby.
MNC: Multinational Corporations
TIC: Transnational Corporations
Organisation of Pharmaceutical Procedures in India are against
Generic names.
1.
Thou-shalt have tens of thousands of drugs. Most drugs are
imitative 'me too1 drugs.
effects..
Too many drugs increase side
Drug companies make so many unjustified claims.
Side effects are not well emphasized.
■
drug companies in the world.
There are 10,000
These 10 Commandments belong
to a new God - the Drug Companies. Meoscht annual budget
is higher than the annual budget of many African countries.
There are 30,000 drugs in the market in India, all branded.
We need only 18 (ICMR) 115 Hathi Commission 1975, 225 WH045 Community health, Arole says 32 in CH. Drug companies
make so many unjustified claims. Brand names can be
reduced to 2-300 Generic name drugs. These can take care
of 9C% of the health problems.
2.
Thou shalt not question the price of a drug. Some are
200% above production rate, some are 6,000 X more than
the cost. Nobody questions it. Surplus money goes into
marketing. Rs. 48,OOo/year/doctor is spent by drug
companies. Money surplus goes to developed countries.
The prices charged in India by Glaxco, Pfizer, Hoechst,
Cibageign and Hoffman, La Roche are on the average 375%
higher than those listed in Western Countries where these
firms have their own home offices, Charles Levinson
in ValErum Zum Beispiel quoted in Illich P-79 You pay for
the advertising agencies who may know nothing of the drugs.
You pay for the samples the doctors get free and again
when he sells them to you! You pay for well dressed,
fast talking, medical representatives. Nine Times the
Price of Gold was printed in Germany about drugs - it
disappeared from, the market!
Hoechst buys blood $5
in Brazil and processes and. sells it in Germany for $65C,
and 7% had Syphilis, 37% were too animic to donate blood,
3.
Thou, shalt not tamper with nature's garden. We will
process tham for .yoti and sell them at 50 times the cost.
Protinex costs Rs.1-Packing 2-Charge Rs. 15. Ragi will
be processed by Nestles and charge high prices.
2.
-2-
4.
Thou shalt respect thy doctor more than thyself.
He knows best. Obey him at all times and under all
circumstances. If anyone disobeys this Commandment, who will
defend the doctors? - the drug companies and their
Assoccationsl!I 75% of doctors over prescribe, because
patients demand it, and drug salesman push hard.
5.
Thou shalt -betray thy people and thy nation for petty rewards.
One medical representative for every 30.doctors in USA,
in Tanzania, 1 Med. Rep for every 4 doctors. Some are
anything but petty rewards I E.G. Gifts, travel, 1
Pediatrician in Delhi gets a USA trip every other year,
Doctors get TV sets refrigerators, cars etc.
6. Thou shalt not covet, court or subscribe to any other
system of medicine•
Ayurveda
Naturopathy
Homeopathy
Acupressure
Unanai
Siddha
Hydrotherapy
Massage
Acupuncture
Marina Chikitsa Other drug less therapies
7.
Thou shalt never reveal Company Secrets:
If thou must have truth, thou shalt have it in diluted
doses.. If you know company secrets, never divulge them.
.Stanley Adams was an Englishman and he reported Roche's'
antinational activities and they were fined 1,160.000.
Adams was Research Director, he was fired and his life
was so harrassed, his wife committed suicide. She was an
Italian. He was killed in a road accident! Only consumer
movements can fight drug companies, by boycotting their
products.
8.
Thou shalt first seek remedies for fashionable ailments.
25% of drug companies production is in tonics, vitamins,
and antibiotics - only rich can afford. TB is the main
health problem in India, but TB receives only 1.4% of
investment - and Dapsone only 1.3%.
9.
Thou shalt be a dumping ground for banned drugs.
USA has EDA (Federal Drugs Administration) they dump drugs
in South america, India'E.G. Thalidomide - used extensively
in leprosy work in India. Lomotil causes respiratory
depression, Tetracyclin has a bad effect on foetus-noban
in 3rd world countries.(See handout on banned drugs).
3.
10.
Thou shalt be a guinea pig for new and untried drugs.
U.K's special commission on Internal Pollution (SCIP)
found Research: gave wrong data and falsified records
1/3 of the reports submitted, the trial wasn't done at
all, 1/3 didn't follow the manufacturers protocol,
and only 1/3 were results of any scientific value. All
drug corqpanies make excessive claims- You pay for
research that is not taking place or which produces
no results. No money wont-into Research in India from
1902-1981.'Research studied by FDA says 80 are the same
drugs, 17 are slight variations.
These 10 Commandments can be compressed into the following 2:
I.
Thou art'stupid and shall remain so.
II.
Death is thy destiny and to death we shall lead you. It is
our privilege.
10 Commonest Diseases of the Doctors:
Inforasmus: The Doctor who suffers from this deseases is a
severely malnourished doctor. His brains get no continuing
education. He survives on the colorful, if adulterated,
diluted doses of information sent by the drug companies.
2. Prescripo-melitus: Doctors who suffer from this are the
trigger happy ones. They prescribe 5-6 drugs where only
one or two are needed. They do this to assure themselves
that they are uptodate^ They try to impress you.
1.
Chemistofilia: Doctor asks the patients to buy from a
particular chemist shop- he has a tie up with the Chemisteither owned by the doctor or his family member, also
there with drug company.
4. Testo-enterttis: Order for a number of tests and X’rays even
before he sees the patient. Cause: too much unneeded
equipment in the hospital
5. Sampleria: Enjoys meeting drug representatives. Collects all
samples possible free. Sells the samples to the patients.
Root Cause: Little hard up for money — wants a little more
than others.
6. Paisaplegia: Insensitivity to patients, their economic
condition, heart does not influence the brainl
7• Colledital Malformation: Plenty of black money with parents
pay their way into Medical School- and through iti
8. Pillarpostitis: One doctor sends you to another' and vice
versa, they adjust their commission in between. Common in
cities where there are two many doctors.
9. injectiyitis: also known as Capsuloris given a chance he
would inject. But capsules rather than tabletsL
10. Surgico. IfegaloPania: Conducts Remurectomies . More than 90%
of all tonsillectomies performed in the U.S. are technically
unnecessary.
3.
********** *****r*i**4t
FBM/ip
TITLE PATTERNS OF MEDICAL USE OF DRUGS
A PILOT SURVEY
Brief Review of literature
The prescribers and dispensers of drugs have a professional
obligation to consider methods for the development of more
efficient systems that will enhance their ability to optimise
the quality of care when prescriptions are indicated. Neverthless the data regarding this area is scanty in our country.
Surveys in the United States indicate a doubling of their
consumptions of proscribed drugs during the decade ending in
1973. The total economic value of all ordered pharmaceutical
services in the United States during the year 1973 amognted
to about eleven billion dollars. This doubling effect of
ethical pharmaceuticals has been estimated after adjustment
for a 10% increase in population and a siae of 3% in wholesale
druci prices. (Drug use - Data sources and limitations, Rucker
TD, JAMA, 230, 1974, 038 - 090).
There is some basis for believing that the proportion of
the public using medications has no changed significantly during
this interval. Surveys by Spitzer et ali (Patterns of medical
drug use ~ a community focus, Spitzer Wo, Roberts R.S, Delmoere,
Canada Medical Association Journal, 114, 33-37, 1976) confirms the
previous findings of extensive medical use of drugs indicating
that 60% persons in the community take at least one medicine
at any given time and 30% ara taking at least one drug precribed
or suggested by a doctor.
Approximately 90% of the total figure is represented by
the private sector of the health care system and 70% of the
prescriptions written in the private sector reflect drug use
by persons in ambulant status.
Vitamins and tonics are the most commonly used drugs,
They may be used by 25 to 23% of the population 40% of whom
use them as a result of a physcians prescription. Various
estimates of patterns of use show that femalas obtain about
50% more prescriptions per year than males and white persons
receive about 60% more prescriptions. Variation is per capita
drug use are also associated with differences in such things
as income, education and geographic location etc.
Since a large proportion of the population using prescribed
drugs in our regiment involving multiple prescriptions drug
induced illness leading to morbidity and mortality has become
a significant public health issue (Rucker TD, JAMA, 230, 1974,
888-890). The annual direct and indirect cost to society from
combined effects of morbidity and mortality attributable to
predicatable, hence preventable, reactions has been estimated
at nearly from billion dollars in 1973, in United States,
In a
three year survey of medical services, 2»9% of the admission were
due to drug induced illness, excluding suicide attempts and drug
abuse. More than 6% of these patients died.
In 82% of the
cases no over the counter drug was implicated.
2
The data that is presented above indicate the gravity
of the counter productive results achieved in the developed
world. do doubt there is a considerable placebo effect, that
is beneficial to the patient. However the cost of this placebo
effect when considered in relation to the adverse effects
appear enormous. The history of camphor can be cited as an
apt example to highlight this point. Traditional use of
camphor dates back to Chinese medicine. It had been used as an
abortifacient, contraceptive, cold remedy, aphrodisiac, anti
aphrodisiac, supressor of lactation and antiseptic. Albeit
no longer used for there ends, camphor continues to be an
ingredient of a number of over-the-counter remedies. It has been
estimated to 100,000 gallons of camphorated oil and 137,000
gallons of spirits of camphor were produced in the United States
in 1975 and marketed in packages without safety caps.
It is
now marketed largely in multi-ingredient lineaments for symptomatic
relief of "Chest Congestion and muscle aches.
They contain
1 - 20% camphor.
The committee an accidents and poison prevention in the
United States has endorsed the following conclusion on the use
of camphor. Firstly, it has no established therapeutic role
in scientific medicine. Secondly, it hoc potent serious toxi
cologic actions. The ingestion of relatively small amounts has
proven fatal. Although accidental eardlingestion is the most
common route of intoxications, significant quantities can be
absorbed percutaneously and isxx via inhalation. The transpla
cental transfer may be toxic to the fetus. Thirdly camphorated
oil, in particular, is the worst offender in accidental ingestion
because it is mistaken for over-the-counter products and is also
accidentally ingested by toddless. Lastly the committee suggests
that oediatricians should warn parents of the danger of camphor
containing products in the h home as long as the camphor
containing products continue to be marketed (Camphor, who needs
it? Committee on drugs, pediatrics, 62, 1978, 404-406).
Aims and Objectives
To analyse the cost difference between the definitely and/
cr possibly useful drugs versus definitely not useful drugs
prescribed to patients attending psychiatric out patient with
a psychiatric illness.
Material.
The tudy was conducted on ten patients who druing the months
October and November 1964 attended the psgshalsM psychiatry
out patient at 5JMCH.
Only such patients who were able to furnish prescriptions of
treatment previous to the present management were included.
It was ascertained that there prescriptions have been used for
a per od of at least 3 months.
The patients included have a
psychiatric diagnosis and are between 20 and 50 years of age
both inclusive.
Those patients who were treated for noon-psychiatric illnesses
were excluded.
Method
All pr scriptions were collected from the patient at the
out-patient visit. Prescriptions used for the present complaint
were sorted out from other prescription, not related to his
present complaint. The drugs in these prescriptions are separated
into two groups based on the consultant psychiatrists diagnosis
. .3. .
Gp I - Drugs possibly ar definitely effective.
Gp II » Drugs definitely not effective.
Following this the following comparisons are made between
the two groups.
1 .
2.
Total quantity of drugs used.
Total number of drugs used
3.
The cost of drugs.
4.
Number of days for which the drugs are prescribed.
Statistical Analysis
The abova comparisons are made between the two groups.
In the final analysis the standardised unit of
C05T/DAV/PATIEKT is made.
The students " t test " is used to check for any statistically
significant variation in the two groups.
^lr)i
- G>-/</_
----- -
. ■ l.-L^c.!--
h>. /^' . .
SATURDAY, Nov. 24, 1984
8.30- 9.00 a.m.
9.00-10.30 a.m.
Introduction to Workshop, Objectives/Program
Session I : Understanding the Problem
Speakers :
1. Dr. CM. Francis, (Coordinator, Continuing
Medical
Education, Christian
Medical
College, Vellore) : Introducing thetheme.
(2.> Dr. B Ekbal, President, (Kerala Sastra Sahitya
Parishad, Trivandrum) : The Indian Drug
Scene - Drugs and the industry and govern
ment policy.
:
:
3
10.30-11.00 a.m.
11.00 am.-12.00 noon
Shri. Augustine Veliath, (Voluntary Health
Association of India, New Delhi): Ten Com
mandments of the Drug Industry.
Tea
Session II : Drugs and the Healing Ministry
:
:
Speakers :
Fr. George Lobo, (Papal Seminary. Pune):
Ethics of Prescribing
2. Prof. George Joseph, (Executive Director,
CSI Council for the Healing Ministry,
Madras) : Professionals in the Church - an
introspection
Sharing the Word (Eucharistic Celebration)
1.
12.00 noon-1.00 p.m.
:
1.00-2.00 p.m.
2.30-4.00 p.m.
:
:
4.00 p.m.-4.30 p.m.
4.30 p.m.-6.00 p.m.
:
6.30 p.m.-7.30 p.m.
:
7.30 p.m.
:
:
Lunch
Group Discussion I : Identifying the different
dimensions of the problem in our dispensaries/
hospitals and our role in It (15 groups)
Tea
Session 111 : Towards Rational Therapeutics
Speakers :
(jfy Dr. Mira Shiva, (Coordinator, AH India
Drug Action Network) : What is Rational
Drug Therapy ?
2. Dr. DBI Victor, (Medical Superintendent,
Star of Hope Hospital, Akividu, Andhra
Pradesh): Banned, Bannable and hazardous
Drugs in our hospitals.
3. The situation in our hospitals
Audiovisual presentation on theme
(Centre for Non-formal Education)
Cultural Programme (Jyothi Nivas)
Dinner
SUNDAY, Nov. 25, 1984
7.3o a.m.
8.30 a.m.-9.00 a.m.
:
:
:
Breakfast
Review of first day's programme
Session IV : What to do to tackle the problem ?
Speakers^
<2>c^o-r> Ch
Dr. S. Joseph, (Medical Superintendent.
MGDM Hospital, Kangazha) : What can
our hospitals do?
2 Mr. Alan Cranmer, (CMAI Consultant
Pharmacist, Mysore) : What can be done
at a Pharmacy level ?
10.00 a.m -10.30 a m.
: Tea
10.30 a.m.-12 noon
: Session V : ** Some Initiatives
I. rfr
Case studies on : (a) Drug Action Network ;
2., TD-,s'c>~
(b) Kerala Sastra Sahitya Parishad; (c) Locost;
■3
/-'J
K-n -■&
(d) Bangarapet Tablet Industry;
(e) Kurji formulary and others
12.00 noon-1.00 p.m.
: Sharing the word (Eucharistic Celebration)
1 00 p m.-2.00 p.m
: Lunch
2.30 p.m.-3.30 p m.
; Session VI: ** A people's Medicine
I
Panel discussion on "The
: Tea
3.30 p.m -4 00 p m
; Group Discussion II
4.00 p.m.-5.30 p.m.
What can we do?
|>7~ZZL_/.
-■5-v-rcUci
(a) Individuals
Lj. oca
p -->7
,
(b) Institutions j j
•
S
'
(c) CHAI
9.00 a.m.-10.QOa.m,
5.30
p m.-6.30 p.m
--------------- '
;
:
Demonstration of Herbal Medicines :
Video film on theme and other concurrent
programmes**
6.30
p.m-7.30 p.m.
-------------------------------- —
:
Session VII : Concluding Session
: A statement of concern and some
resolutions
: Summing up
7.30
p.m.
■ Dinner
** Details will be announced on the 24th Nov. '84.
FOR THE OFFICIAL DELEGATES OF THE CHAI MEMBER
INSTITUTIONS ONLY
MONDAY, Nov.26, 1984
7.30 a.m.
8.30 a.m.
:
Breakfast
General Body Meeting
Chairman : Fr. Ferdinand Kayavil
President, CHAI
8.30 a.m.
8.45 a.m .
10.00 a.m.
Introduction : Chairman
Report of the General Body Meeting of CHAI
1983 : Sr. Isabella Mary, Secretary, CHAI
: Annual Report : Fr. John Vattamattom, SVD
Executive Director, CHAI
: Report of CHD :
Fr. Thomas Joseph, Programme Director, CHD
: Financial Report: Fr. J. Antony Samy,
Treasurer, CHAI
(a) Presentation of the statement of accounts
for the year ended 31-12-1983
(b) Presentation of the budgets for 1985
: Presentation and approval of resolutions and
statement from the workshop by Chairman
: Coffee
10.30 a.m.
:
12 noon-1 p m.
1.00 p m.
2.00 ^a.m.
4.00 ^.m.
:
:
:
:
:
:
:
9.00 a.m.
9.15 a.m.
9.30 a.m.
.
9.45 a.m.
Presentation of and discussion on the revised
membership fees
Discussion on the diocesan organisation of CHAI
Sharing the word (Eucharistic Celebration)
Lunch
Election of office bearers
Tea
''One of the most distressing aspects of the present health
situation in India is the habit of doctors to over prescribe or to pre
scribe glamourous and costly drugs with limited medical potential. It
is also unfortunate that the drug producers always try to push doctors
into using their products by all means — fair or foul ........If the
medical profession could be made to be more discriminating in its
prescribing habits, there would be no market for irrational and
unnecessary medicines.”
— ICMR I ICSSR, Health for AH Report
Concern over mcreasmg soraty
areas of concern.
'
Govt, list endorsed: The convention fully en
Ofe saving drfflgs dorsed
the Union Government's list of bannec
From Our Special Correspondent
BANGALORE, Nov. 27.
Over 500 delegates to the four-day 41st
annual convention of the Catholic Hospital As
sociation of India (CHAI) on the theme "to
wards a people-oriented drug policy", con
sisting of doctors, nurses, pharmacists, hospital
administrators and health activists representing
around 1,900 member hospitals and health care
institutions, which concluded here, has ex
pressed concern over the increasing scarcity
of essential and life saving drugs, as against
wasteful abundance of non-essential drugs and
formulations..
The excessive number of over 30.000 drug
formulations, as against the Hath! committee
and WHO expert committee recommendations
of 116 and 200 respectively, the continued
availability of banned drugs despite the Govern
ment bans, the continued availability of ban
nable and hazardous drugs in spite of the moun
ting scientific evidence and directives of
various courts, the spiralling cost of drugs as
against the decreasing purchasing power of the
people and the continuing domination by the
multi-national drug industry as against the na
tional policy of self-reliance were the other
drugs and agreed to implement it in its organisa
tions and urged all sister institutions to do like
wwise.
It asked the member institutions, to prepare
a list of essential drugs along the lines of the
Hathi/WHO committees for immediate ad
option in all institutions, urgently take steps tc
reduce the present unhealthy and unethical in
fluences of the drug industry on the medical
and allied professions and mobilise public
opinion against the apparent lack of concern
of State Governments and professional and ex
pert bodies on this vital issue.
The convention resolved to appoint an ex
pert body to formulate a rational drug policy,
which is people oriented within the context of
a health care strategy and policy benefiting the
national commitment to health for all by 2000
A.D.
At the 41st annual general body meeting,
Fr. Ferdinand Kayavil of Benzigar Hospital,
Quilon. Kerala, Sr. (Dr.) M. Fernandes. Marianpur Hospital, Kanpur, U.P., and Fr. Antonyswamy of the Diocese of Ooty, Tamil Nadu,
were electd President, Secretary and Treasurer
respectively of the CHAI, for a term of three
years.
77/<r Mi.xjpv
. 5'S“~‘'St,
^2:^
We, ©v r 500 dolega es to the 41st Annual Convention of
the Catholic Hospital Association of India (CrAI) on the
theme " < '
.<? L -OKU
O hfflJG !uh t, consisting
o: doctors, nurses, pharmacist;’-, hospit .1 administrators
en" h-’ al th activists repr -sentin around 1900 member hospitals
■•nd he 1th cere institutions, assembled at St John’s Medical
Collego, Bangalore (23rd-26th November 1984) to express our
deep concern over the increasing scarcity of essential an- life s ving
drugs as against wart ful afcurWonce of non-essential
drugs and formulations?
2,
the excessive number of over 30,000 drug formulations as against the Hnthi Committee and WHC Expert
Committee r cosmsc-n tions of 116 end 200 respectively,
3.
the continued availability of Banned l-rugs in spite of
ths Government orders of bans?
4,
the continued availability of bannable and. hazardous
drugs in spi-e of the mounting scientific evidence
■and even dir .ctives ci various courts in this country?
5,
the spiralling cost of drugs as against the decreasing
purchasing power of people?
6.
the continuing domination by the- multi-national drug
industry as against the National Policy of selfreliance? and resolve -
1.
to fully endorse the Government of India’s list of banned
drugs and hereby accept to implement the same in our
institutions orth with and urge all our sister
institutions also to do the same?
2
2.
to pi'-’-yaro c .list of o® •■■■ i- 1
rm
alony the
lines of Hath!/ h: Cornttlttvas ; a lirer-.di.?te
adoption In -all our institution:;;
3.
to uxcontly vako stc-ps <■■ radv.c- the present
unh althy an ■ unat-hicai influences of the drug
Industry on tlic tr.e.ri c<?l and allied profess! ns;
4.
fc:. mobili c public opinion - ..ihst the apparent
lack of cc.nvcrv of the State.- Gov rrmontf- and
professional and ewrt bo les on this vital
i.cue; end further resolve
to e;p: l.r,t an e>.p<jrt icds
fomulate a i'ctisnol
dru-; policy wblc 1* people oriented v.-lthin the context
ot s health Lv.r•• str. t.-. -;y anii policy* hcfittlnp the
Siational •'.'ok.: .it.tr: ;nt to H :
or all by 2000 <W.
also authorise the Executive Board and the
Executive Mr-.ctor to eke adequate steps to implement
the above*
Zac tho 41st annual pcntrel
na-.ot.-.np hela on
26 i'icv 19f<4# - r Fr-r'.inand Knyavil o. .Hr:-:.-.-... .i Hccp-i 1,
..uilc-n » Kerala, ■'■ £ (■ r) .' f "X'n 'i.da, Ma.ri- npuc Hosy-itul,
Kcnpur, UP an’ Fr Antony .-,ja;--,y of the 'bxo Coty*
Tanil Nadu* '.x-re slotted President, iecrcitary cmTreasurer respectively of the CHA'l, .'-o.’’ e tcrr-i of
three year®.
CULTURAL
PROGRAMME
by
JANADHARE
ON THE INAUGURAL DAY OF THE 41st CONVENTION
OF CATHOLIC HOSPITAL ASSOCIATION OF INDIA
23rd NOVEMBER 1984
- 2 PROGRAMME
1.
Invocation Dance ::
;iPrabhu Pi thane Sharanam"
by Clementina
Lyrics and Music by Vincent
2.
Song ::
3.
rfMooka Baya Beli-Olage:i (The Fenced Dumb) - a play^
"Yelegalu Nooaru" (The leaves are
hundreds but the colour is green)
Script and Direction by Vincent.
4.
Dalit Songs : "Sahukarara Bagilige Namme Mooleye
Thwarana" (for the doors of the
rich, our bones are the decoration).
■'•Yarige banthu Nalavathelara
Swathanthara” (To whom did the
1947 Independence come ?)
5.
Kolata :
A folk art of Karnataka,
This art express the joys and sorrows
through song and dance during festive
seasons. Janadhare would like to revive
this xolk form. They are adopting the
songs to bring out the cry and the
anguish of the peopleP
'
Today's programme consists of 4 songs with-'
four different rhythms/steps in the''Kolata.
- 3 -
SYNOPSIS OF THE PLAY
This play represents the people’s angle to the
problem of the medical care.
The poor, illiterate and mostly rural based
masses are the ones who are greatly alienated
from the present health system as prevalent in
the Government system of health care or the
voluntary and charitable institutions of
health.
OHThough many of the hospital® run by religious and
' charitable institutions were primarily started for
the service of the poor, yet in most of the
situations the very purpose is defeated by the
nature and function of the professionals and the
institutional structure. For example, the way the
medicine is dispensed, the hospital set-up and
village set-up etc.....
To the non-availability of the heal services the
primary causes are the people's situation of
poverty, concentration of progress in the towns,
illiteracy and exploitative situations at all levels.
For the heroine, in the last scene, pleads for the
life of the dead husband. In that context she
raises a few questions ;
Why is the access to modern medicine denied to the
poor ?
_ Do poor have any right to live ?
^l/hy no alternative inexpensive medical care is
" thought of or worked for the poor ?
Further she laments ; We are in tatters so that you
can have a ward-robe full of clothes.
We go hungry sc .that you may have plenty to eat and
relish in delicacies.
Our poverty is your wealth,
Our ignorance your wisdom,
Cui' misery, dirt and squalor afford you to have
acalth and decent living.
We ire human beings we too have a r.: gnt for a decent
jr Ing., WHY DO YOU EXPLOIT US ?
- 4 -
TO TALK ABOUT JANADHARE:
Janadhare "PEOPLE'S STREAM" is a cultural
troupe of twentyfive youngsters who are
socially involved.
They try to express
the aspirations and struggles of the
people through cultural media.
In cultuisl. action they bring out the
"Culture of the Oppressed", reinforce
their value system and initiate an
educational process provoking debate.
JANADHARE was formed in 1982.
On the stage:
Lilly Theresa, Shantharaj,
David, Xavier, Upakari,
Clementica, Jacintha, Carmela,
Hridayaraj, Raju, Lawrence,
Nicholas, Prakash Raj, Prasad Rai
2 2--^
41st ANNUAL CONVENTION
of the Catholic Hospital Association of India
November 23 - 26, 1984
St. John's Medical College and Hospital, Bangalore - 560 034
Theme : TOWARDS A PEOPLE - ORIENTED DRUG POLICY
PROGRAMME
FRIDAY, Nov. 23, 1984
9.30 a.m. onwards
1.00 p.m.
3.00 p.m.
4.00 p.m.
5.00 p.m.
5.00 p.m.
5.05 p.m.
5.1 5 p.m.
5.35 p.m.
5.50 p.m.
6.00 p.m.
6.15 p.m.
7.15 p.m.
7.30 p.m.
:
:
:
Registration (St. John's Medical College)
Lunch ("Registration continues after lunch)
Concelebrated Holy Mass
Chief celebrant : Most Rev. P. Arokiaswamy
Archbishop of Bangalore
: Tea (for delegates and invited guests)
: Inaugural Session
Invocation : Janadhare
Welcome : Dr. G. M. Mascarenhas
Dean, St. John's Medical College
: Fr. Ferdinand Kayavil
President, CHAI
: Inaugural address :
Shri. H. L. Thimme Gowda
Minister for Health, Govt, of Karnataka
: Convention highlights :
Fr. John Vatta'mattom, SVD
Executive Director, CHAI
: Chairman's remarks :
Bishop Gilbert Rego
Ecclesiastical Advisor, CHAI
: Opening of the exhibition :
Shri. J. Alexander
Commissioner of Excise, Govt, of
Karnataka
: Cultural program on the theme : Janadhare
: Vote of thanks :
Fr. Joseph Kavalippadan
Vice - President, CHAI
: Dinner
SATURDAY, Nov. 24, 1984
8.30- 9.00 a.m.
9.00-10 30 a.m.
:
:
Introduction to Workshop, Objectives/Program
Session I : Understanding the Problem
Speakers :
1. Dr. CM. Francis, (Coordinator, Continuing
Medical
Education,
Christian
Medical
College, Vellore) : Introducing the theme.
2.
3
10.30-11.00 a.m.
11.00 a m.-12.00 noon
:
:
Dr. B Ekbal, President, (Kerala Sastra Sahitya
Parishad, Trivandrum) : The Indian Drug
Scene - Drugs and the industry and govern
ment policy.
Shri. Augustine Veliath, (Voluntary Health
Association of India, New Delhi): Ten Com
mandments of the Drug Industry.
Tea
Session II : Drugs and the Healing Ministry
Speakers :
Fr. George Lobo, (Papal Seminary, Pune) :
Ethics of Prescribing
2. Prof. George Joseph, (Executive Director,
CSI Council for the Healing Ministry,
Madras): Professionals in the Church - an
introspection
Sharing the Word (Eucharistic Celebration)
1.
12.00 noon-1.00 p.m.
:
1.00-2.00 p.m.
2.30-4.00 p.m.
:
:
4.00 p.m.-4.30 p.m.
4.30 p.m.-6.00 p.m.
:
Lunch
Group Discussion I : Identifying the different
dimensions of the problem in our dispensaries/
hospitals and our role in It (15 groups)
Tea
Session III : Towards Rational Therapeutics
Speakers :
1. Dr. Mira Shiva, (Coordinator, All India
Drug Action Network) : What is Rational
Drug Therapy ?
Dr. DBI Victor, (Medical Superintendent,
Star of Hope Hospital, Akividu, Andhra
Pradesh): Banned, Bannable and hazardous
Drugs in our hospitals.
3.
The situation in ®ur hospitals
Audiovisual presentation on theme
(Centre for Non-formal Education)
2.
6.30 p.m.-7.30 p.m.
:
7.30 p.m.
:
:
Cultural Programme (Jyothi Nivas)
Dinner
SUNDAY, Nov. 25, 1984
7.3o a.m.
8.30 a.m.-9.00 a.m.
Breakfast
Review of first day's programme
Session IV : What to do to tackle the problem ?
Speakers :
1. Dr. S. Joseph, (Medical Superintendent.
MGDM Hospital, Kangazha) : What can
our hospitals do?
2. Mr. Alan Cranmer, (CMAI Consultant
Pharmacist, Mysore) : What can be done
at a Pharmacy level ?
Tea
Session V : ** Some Initiatives
Case studies on : (a) Drug Action Network ;
(b) Kerala Sastra Sahitya Parishad; (c) Locost;
(d) Bangarapet Tablet Industry;
(e) Kurji formulary and others
Sharing the word (Eucharistic Celebration)
Lunch
Session VI: ** A people's Medicine
Panel discussion on "The people's medicine''
Tea
Group Discussion II
What can we do?
(a) Individuals
(b) Institutions
(c) CHAI
Demonstration of Herbal Medicines :
Video film on theme and other concurrent
programmes**
9.00 a.m -10.00a.m.
10.00 a.m -10.30 a m,
10.30 a.m.-12 noon
12.00 noon-1.00 p.m.
1 00 p m.-2.00 p.m
2.30 p.m.-3.30 p m.
3.30 p.m -4 00 pm
4.00 p.m.-5.30 p.m.
5.30 p m.-6.30 p.m.
Session VII : Concluding Session
: A statement of concern and some
resolutions
: Summing up
: Dinner
** Details will be announced on the 24th Nov. '84.
6.30 p.m -7.30 p.m.
7.30 p.m.
FOR THE OFFICIAL DELEGATES OF THE CHAI MEMBER
INSTITUTIONS ONLY
MONDAY, Nov.26, 1984
7.30 a.m.
8.30 a m.
:
Breakfast
General Body Meeting
Chairman : Fr. Ferdinand Kayavil
President, CHAI
10.00 a.m.
Introduction : Chairman
Report of the General Body Meeting of CHAI
1983 : Sr. Isabella Mary, Secretary, CHAI
: Annual Report : Fr. John Vattamattom, SVO
Executive Director, CHAI
: Report of CHD :
Fr. Thomas Joseph, Programme Director, CHD
: Financial Report : Fr. J. Antony Samy,
Treasurer, CHAI
(a) Presentation of the statement of accounts
for the year ended 31-12-1983
(b) Presentation of the budgets for 1985
: Presentation and approval of resolutions and
statement from the workshop by Chairman
: Coffee
10.30 a.m.
:
Presentation of and discussion on the revised
membership fees
12 noon-1 p m.
1.00 p.m.
2.00 a.m.
4.00 a.m.
:
:
:
:
:
Discussion on the diocesan organisation of CHAI
Sharing the word (Eucharistic Celebration)
Lunch
Election of office bearers
Tea
8.30 a.m.
8.45 a.m .
9.00 a.m.
9.15 a.m.
9.30 a.m.
9.45 a.m.
:
:
•■'One of the most distressing aspects of the present health
situation in India is the habit of doctors to over prescribe or to pre
scribe glamourous and costly drugs with limited medical potential. It
is also unfortunate that the drug producers always try to push doctors
into using their products by all means — fair or foul........ If the
medical profession could be made to be more discriminating in its
prescribing habits, there would be no market for irrational and
unnecessary medicines."
— ICMR I ICSSR, Health for AH Report
CC5~r->hrk
c I.
c(
pc__
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■'■.^
ETHICS
M E !' I C A L
Ethical Problems of DrugK Prescri
Drugs are supposed to be prescribed for a healing or beneficent
purpose. But the harm done to the patient by
over-prcing,
the increasing BYsrspres*
over-prescribing and mis-prescribing
of drugs is becoming manifest. The purpose of this short paper is.
to uncover the reasons behind
this unfortunate situation so
effective remedies may be found to
l)
that
tackle it.
Modern life is being increasingly regulated by the technologies
mode1J Instead of technology
being at
being ruled by technology. The
its success,
the
service of m^n,
technical order,
man is
in the first flush of
is entering into every noo1; and crany of our life and x
to brook no inherent limitations. Thus human existence seems to
see-is
be moving from qualitative progress to mere quantitative development
which lias little use for Ise basic human values that cannot be measured
on the quantitative scale of external results.
2 <) This has an effect on the understanding of health,
and healing.
disease
Instantaneous cure of the symptoms is becoming the goal
of medical procedures. -The search is for wonder drugs which can
provide quick relief,
but tekishxnayxisnexhihxrid leaving the underlyin.
cause of the disease untouched or even aggravating it. The apparent
efficacy of drugs leaves behind a host of what are called
’side
effects’ when often they become the malignant ’main effects'.
we h ive an increasing unumber of ’ iatrogendtlt? (doc tor induced^/
3)
Thus
disease^
1'he personal model of healing is being replaced by the man inn 1-
ation of the patient.^ Instead of a personal dialogue corcernigg the
deeper cause of the distress,
tujrst is placed on the efficacy of
biochemistry. The concentration is on artificial labels of sickness
to be
treated by mechanical means. The value-free or value-neutral
model of science derived from physics and chemistry is quite appro
priate when Jstric t ly confined
itself
to these disciplines.
But it acquires a dangerous
extends to
tone when
the manipulation fr eed^Ly
the sphere, of huatm life. fton the manipulator ultimately
ends up being man
the manipulated. Human intervention,
serving the true interests of man,
instead of
tends to the violation of basic
human values and rights.
The
4)
primitive witch doctor sought to create an air of mysti
fication by his magical incantations. The modern
similar effect by prescribing
therapist crefes a
g x o tic
«s«isxx« drugs wiih esoteric
names and whose action he himself scarcely understands.
5)
Modern life
to copc with
tends to reduce the capacity of man
pain and other forms of distress. nence the desire for quick relief.
The patient looks for magic/pl results and seeks out
those who will
provide them. The physician is tempted to yield to this irrational
urge vzi th^paying sufficient attention to the long term consequences.
There is thus a vicious
circle of mutual manipulation which diminish!
the humanity of the patient as well
practitioner.
The capitalist system with its insistence on the
6)
and
as the medical
'free enterprise’
’profit motiv<
leads is the multinationals and local big firms
to exploit the consumer without caring for his true interests, ’.'bile
tie pharmaceutical industry is meant to c ter to
the people,
the health needs of
the people become means of easy enrichment. Human persons
become a jeans instead of being an end
The deep rooted cultural alienation,
7)
colonialism and one of
which is an aftermath of
more pernicious manifestations of
the
produces a g/lamour for everything that is foreign.
neocolonialism,
The educated and even the neoliterate regard with awe /the modern
system of medicine because of its alien origin and with diffidence,
if not contempt,
at systems that are indigenous.
acceptance of potent allopathic drugs and
rejection of local remedies.
Hence
the uncritical
the equally uncritical
Superficial fascination for modern life
enables drug companies to push their products ta by cosmetic embellish
ments and elegant packing for which the poor consumer has
to .pay
heavily.
8)
The dps dependent
status of developing coutries enables the
multinationals to put undue pressure on the local authorities to
permit
their nefarious activities.
The multinationals find a ready
ally in local big firms even when their commercial
certain extent clash.
interests may to a
Thereby, drugs that are unproved in the country
of sxg origin or even those
that have been proved dangerous or
ineffective can be pushed with impunity. The whole matter can be
mystified by false claims like of special
'bio-availability'. Any
attempt at regulating the distribution and use of drugs or <•>■£ banning
dangerous ones can be countered by visible add invisible pressures
with the connivance of alienated ms specialists.
The present craze
for uncritical opposition to all governmentai policies contributes
to governmental inaction.
9)
One of the consequences of mechanization of health care is
that initiative
in drug development has passed from the medical
profession to the pharmaceutical industry. Traditionally pharmacy
subordinate
to
the physician.
Now the physician is constrained
to
perform the phra pharmacological task assigned them by the drug
industry. The inadequate pharmacological education of the medical
school graduate does not provide the background to examine critically
the claims of the industry for its products. Even research is often
influenced by the interests of the drug industry. Medical journals
become
the vehicle of promoting the same interests. Companies use
them as advertising media whxsh overwhelming the physician not only
but also with article after article on the product
with publicity,
that is being promoted at the
time. Thus they hinder legitimate
scientific indnstry enquiry by placing articles designed to reflect
industry views.
10)
Bourgeois competitive values induce the phyeiciansjto seek
the maxi,num advantage. Not only are they misinformed by cleverly
prepared ..nd attractively got up brochures regarding the efficacy of
the drugs, but
they are influenced by physician samples,
(often sold),
and other forms of inducements like pend,' diaries and even conference
attendence costs.
It is indeed a sad fact that the continuing educatior
of doctors is largely carried on by medical representatives and
information material containing a lot of half-truths.
undue desi^re for gain
of the disease and
'broad spectrum'
able
the pin pointing
leads the physician to neglect
to prefer 'fixed combination^'
their
Besides,an
anti-biotics and
drugs to care of multiple eventualities and
thus be
to process a large, number of cases during a working day. Thus
there is an unhealthy and in many ways corrupt relationship between
the medical profession and
11 ) On the other hand,
the drug industry.
research on the therapeutic value of
medicinal herbs and roots, presented in some rare journals,
dust in reference libraries. However,
of non drug therapies lilie Yoga,
fortunately,
collects
the healing value
Pranayama, jteotxxtis Meditation and
Accupuncturc is being increasingly raaiixisd recognized.
Strangely,
these are being patronized by the well-to-do than by the poor.
12) The
technological and manipulative menaytlity is a block
against the promotion of preventive health.
realized
It is yet
to be fully
that clean water is much more important than anti-biotics,
wholesome food
than vitamin pills, vaccination than expensive drugs
or gadgets.
13) The technological menality also leads to the transgression of
the legitimate bounds of human experimentation.
It is not
permissible
to use a drug unless it has been sufficiently tested in the laboratory
and on animals. Further?an experimental drug may not be used when
a certainly effective remedy is available,
tolerable and
there is at least the
the patient." The practice of
the risk is proportionately
reasonably presumed consent of
trying out experimental drugs on patients
in poorer countries is to be condemned as a grave offence against
h uma n i t y.
4
The Kemedy
.he very exposition of these evils regarding drug prescription
suggests a programme
to combat
them. However,
some of these will be
here briefly mentioned.
l)
1'here is need of evolving a
approach to health care.
of the patients.
lore humane and person-centred
This should above all seek the true interest
For this the
time honoured' principles of totality
ard of double effect must be clearly understood and applied.
2)
fhe physician must regain hisxs the autonomy and ideals of
Ills noble profession.
3)
3Cks Cultural alienation and political interference of foreign
powers muc t be unrealised and vigorously countered.
4)
There is need for counteracting the pernicious aspects of
materialism and capitalism.
There
should be a massive movement against
the manipulation
of drug comp nies. While the more immediate perspective of abuses in
the filled of drugs i*eed-s—to be attended to,
cultural roots of the problem need
to be
the deeper
political and
tackled.
6) The well-intentioned efforts of the government to check the
abuses in the production,
distribution and use of drugs needs to be
suppor ted.
7) Especially urgent is the effort to reduce prescription to
essential drugs
roughly 200
(WHO estimated with
generic names so that £ost,ancl efficient and safe drugs are available
to everyone.
Willaim Barett
1. See.The Illusion of Technique, ttaren City,
A.—
■*
N.Y. Anchor Press,
1978.
2.
For Clinical Iatrogenesis and
see Ivan Illich,
3.
Limits to Medicine,
Publications,
L
1077.
Concerning the modern tendency to manipulate human beings,
se„ Bernard Haring, -iani pula tion,
4.
the Medicalization of Life,
Calcutta, Rupa,
Slough,
jdKnipulatisn St.
Paul
1975*
For -th® a more complete
treatment of SihiKai ethical principl
regarding Medical Experimentation,
see my book, Current Problems In
kedical ethics,
100-105.
3rd ed. ,
1080,
pp.
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