KHT Annual Report 2009-2010

Introduction

From 1950 to 1966 Dr Derek Jenkins was director of the Neyyoor Hospital — a 300 bed mission hospital run by the London Missionary Society — the mission arm of the UK's Congregational Church. In it's hay-day the Neyyoor Hospital complex, with it's smaller district clinics and outlying leprosy hospital, was the largest mission hospital in the world.

In the 1980s Neyyoor Hospital was taken over by the Church of South India. In 1986 Derek Jenkins, along with the hospital's former director, Dr Vimala Charles, started the Kanyakumari Health Trust in the bustling city of Nagercoil, some twelve miles South East of the village of Neyyoor (now called Neiyyur).

Nagercoil, with a population of more than 180,000 (2001 census) is the twelfth largest city in the South Indian state of Tamil Nadu. Serving the district of Kanyakumari, with a population of 1.8 million, KHT seeks to provide free health care for the poorest people.

Vimala Charles has been the director of the Kanyakumari Health Trust since 1986.

Derek Jenkins writes:

Dear Friends... unfortunately I haven’t been well, and have only recently acquired the material for this report. However I’m glad that I can now make it available to all you wonderful people who help make this work possible.

The creation of extra wards and facilities at the KHT base in Nagercoil has provided opportunity for great improvement in our work. These include expanded training facilities on the land on which the Mary Jenkins Memorial Hospice stands. In the year to August 2010, twenty female student nurses, seven laboratory technicians, and four X-ray technicians were trained. All were given extra tuition in laboratory work through a local university which makes their facilities available to us.

As usual the terminal care hospice has been busy. One of the patients, Mr R.K., aged 65, was found to have cancer of the prostate, which is an unusual condition at the hospice. Investigations showed that he had secondaries in his lungs and bones. Although there was little hope for his healing, he was kept pain free until he died, which was greatly appreciated by his family.

Another patient, Mrs. X, aged 50, had a condition which is sadly very common in this region. As a result of many years of chewing tobacco, with Betel leaf and Arica nut, she had a badly ulcerated mouth. Palliative radiation gave her some relief, but the pain was getting worse. We kept her comfortable, and again her family were very grateful for the care she was given.

At the hospital the work continued to grow during 2009/10, with large numbers of patients passing through. Facilities have significantly improved there also. The primary health care work in the mountains continues unabated, aided by the improvements already mentioned.

One exciting development has been the setting up of a new improved primary health care system in the Nagercoil city area. This has had a marked impact, to the point that the health care received in our area has become comparable to that given by the National Health Service in the UK. Indeed, as an NHS surgeon for many years, I can truthfully say that the primary health teaching in the Nagercoil region exceeds that given by many NHS trusts.

Improvements have also been made in the care of fishermen and their families who still suffer from the effects of the tsunami of 2005. Thankfully they now all have replacement fishing boats, of improved design, which means that their work is providing them with better incomes than they received before 2005.

A new facility has also been set up for people who are in situations where they may have to give first aid. Examples might be truck and coaches drivers attending to accident victims. With so much traffic in the area this is a very valuable scheme. They and others are being trained to apply first aid to people involved in any kind of accident.

It amazes me to see how much is being achieved, in addition to the serious operations performed at the hospital. In one example this year, a person’s life was saved after a four hour operation.

An urgent problem we now have is the need for a new ambulance. The existing vehicle has served us well for ten years, taking free medical facilities to the very poor communities in the hills and surrounding areas. Without this link to our work in these scattered communities the work cannot continue. The vehicle is old, however, and in need of replacement with an upgraded model. Please consider carefully if you might be able to contribute to this urgent need.

As usual, we have had significant help from IPM in the USA, and the Bishops Appeal in Ireland, both of which we are very grateful for... as we are to all the Neyyoor Hospital Friends for all of you are doing to make this project possible, and to keep it going.

KHT’s work on the ground involves effective cooperation between people of many religions, and other political and philosophical persuasions. Seeing these groups working harmoniously together is a lesson to us in the Western world who so often fail in this regard.

One major problem which concerns all involved in primary health care is that of flu pandemics. So called “bird 'flu” has been found in animals, including cats and tigers, which means that it is mutating into other forms. The World Health Organisation is trying to make primary health care a priority in all developing countries. Through our contacts in many parts of the world we are stressing the importance of the WHO’s work, and are encouraging people to participate in it.

If you would like to join the Friends of KHT and donate to this wonderful work in South India, please contact the treasurer or myself. It’s a work which will add to the safety of all Mankind, since the preventing of a 1918 type pandemic starts on the ground with projects such as ours.

Please advise us of any change of postal address, and please also help us to reduce mailing costs by giving us an email address wherever possible.
Email us at: neyyoor.hospital.friends@gmail.com

With best wishes
Derek Jenkins

Hon Sec: Dr. Derek Jenkins FRCS
Address: 50 Breton Road, Rochester, ME1 2JH, UK
Tel: +44 - (0)1634 - 831 661
Email: doctor48@gmail.com

Treasurer: David Gardiner
Address: ‘Trees’, Whitepost Lane, Culverstone, Meopham, Kent DA13 0TW, UK


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KHT Annual Report 2008-2009

The news from Dr Vimala Charles, director of the Kanyakumari Health Trust, is most encouraging. Instead of the hoped for 2 new wards each, for the Mary Jenkins Hospice and the Castricum Hospital, the builder managed to provide 3 additional wards for the Hospice and 5 additional wards for the Castricum Hospital... far more than we had hoped. This is a great bonus for the work being done here.

Work with the survivors of the 2004 tsunami continues regularly, as does the work in the mountain villages. Patients in the poorer parts of Nagercoil are increasing continually.

Hospice Care

The following examples illustrate the work of the terminal care hospice:

Mrs Y had radiation of the cervix followed by a subtotal hysterectomy 8 months later. In the 9th month she came to Nagercoil with abdominal distension and colonic obstruction. The treatment given was a palliative transverse colostomy, Fentaryl pack, intravenous fluids & Parental Injection. This kept her comfortable until she died in her sleep under sedation. Her sons and daughter were relieved that she had been kept pain free.

Mrs S, aged 65, came for an out patients check up. She had a lump in the breast. We took a mammogram and suggested a mastectomy. She underwent surgery and the report was non-Hodgkins Lymphoma. She started chemotherapy and radiation at R.C.C. Trivandrum. But her condition didn’t respond to the treatment. 6 months later she developed painful multiple ulcerating nodules all over her body. She came to the Hospice for pain relief and palliative care. Analgesics, sedatives & I.V. fluids were the only possible treatment. Her husband was aware of the inevitable. Though educated she didn't accept the facts. We were able to keep her comfortable for 2 weeks and she died peacefully.

Mr X had had a case of pulmonary tuberculosis 3 years previously. He came with dyspnoea and a cough. X-rays showed a mass in the lungs. He was not willing to undergo further investigations. He'd been a heavy smoker till one week before admission. Bronchodilaters, cortisone, I.V. fluids, and O2 therapy all helped him a little. Antibiotics were administered and he was comfortable 24 hours after starting the treatment. Though clinically he looked better, his condition deteriorated. The spiritual support given by one of our Trustees helped him to meet his end peacefully.

Training

The medical training we give not only supplies our own personnel needs but enables the spread of primary heath care and palliative care in the wider area. This is now partly government funded, and partly financed through IPM.

In 2008/9 we had 30 candidates (24 women and 6 men) for the paramedical, nursing assistant, X-ray technician and laboratory technician courses. These are supervised by the Manonmaniam Sundaranar University. All candidates passed the examinations and all are now employed... 4 nursing assistants and 1 lab technician by ourselves. The current intake has 4 X-ray technicians and 20 nursing assistant trainees.

Media Coverage

The work of KHT, and Dr Vimala Charles, has been featured on television in Trivandrum, the nearest large city. This encourages others to take primary health care further a field.