A humbling dedication - the return

THREE YEARS following my first visit to the Duncan Hospital, in Raxaul, North India – to experience “real medicine” in a very poor and destitute part of the world – I decided it was the right time to return and see what progress has been made.

On this trip I travelled with consultant surgeon Mr Ian Hutchinson, an MDDUS member and friend who was also making a return visit. In addition we were accompanied by three of his colleagues, two consultant paediatricians from Airedale and a FY2 trainee who was of Indian origin and, importantly, spoke Hindi fluently. The final member of the group was an engineer.

Following my previous excursion much has happened. In particular an extremely generous charitable donation of over £500,000 had been gifted to the Duncan Hospital by another MDDUS member from Stirling. It really is amazing the generosity of the Scottish people – one of whom, of course, had started the hospital in 1930 in the first place. This money was used to complete the new Mother and Child Building at the hospital which had come to a complete halt due to a significant decrease in charitable donations from the wealthier west. The global recession has more to answer for than just depressed high-street sales!

Small islands of change

We flew to the New Delhi airport which was an extremely impressive modern building of considerable size – no doubt upgraded for the Commonwealth Games held in Delhi in 2010. However, the rest of the journey by train to Bihar soon brought things into proper perspective! Rural India was as deprived, poor and dirty as I remembered it. Nothing had changed. I could see no improvements in the lives lived by the poor in Bihar. It was like going back in time.

The recently completed new Duncan Hospital building, however, was extremely modern and impressive – a definite improvement over the muchloved, but no longer fit-for-purpose, old building.

Unfortunately in some ways, we soon began to realise again what “real medicine” actually is. The building was great, some of the equipment was modern and up to western standards but there was a major problem – namely lack of staff. For example, the paediatric/neonatal unit treated over 45 babies in any one day with two to three deaths, many of which could have been prevented had the child been brought to the hospital sooner. There was only one paediatrician in the hospital on duty 24/7, 365 days a year. Dedication or what?

Greatest resource – people

This dedication reminded us all that at the end of the day “real medicine” is delivered by caring, trained and experienced members of the medical, nursing and ancillary staff, all of whom are essential in providing quality of care that saves lives and limbs. No matter how wonderful a modern building might be it is the people delivering the service that count.

The efforts of our two paediatricians and indeed the FY2 doctor in helping the indigenous staff over the relatively short period of our visit was amazing to watch. “When the going gets tough – the tough get going” and we saw that for ourselves as these doctors rolled up their sleeves and got on with the job at hand. It was also a privilege to take much needed equipment and even ordinary pens for distribution at the hospital. In addition, a kind donor had made available very high quality theatre gowns and sheets for use by the surgical team at the Duncan. Again, all this was much appreciated.

Nowhere in this life is perfection found – and so it also proves in Bihar. In recent years the improved standards at the Duncan Hospital had attracted government support for initiatives to help the lives of those under the poverty line. One way forward was to offer a “payment” card so that the poorest would not have to pay for maternity services or any necessary medication. Outside the hospital are a number of stalls selling medication to anyone at a reduced price, though it is difficult to know if the medications being sold are genuine or otherwise. The stall-holders were very unhappy over the new payment card, fearing that their business would be adversely affected by patients no longer needing their “services”.

Hospital management staff at the Duncan had to seek assistance from the local police to prevent a possible riot over the issue. However, they remained resolute in their commitment to assist the poor in an honourable and legal fashion. It’s not easy being in hospital management – anywhere!

Humbling sites

Our journey back was supplemented by visits to such wonderful sites as the Taj Mahal, the Red Fort, India Gate and the Parliament of India. All worth seeing. Nothing, however, could match the joy of observing new-born babies being saved by the skill and dedication of the staff at the Duncan. Who knows what even one of these lives saved will achieve in the future? “We can only leave that to God”, as they would say at the Duncan.

You will not be surprised to read that all the doctors on the trip were keen to return to the Duncan in the near future to see what else they could contribute to that deprived part of the world. They also would be doing their best to encourage others to consider how they too could help. If you would like to know more please feel free to get in touch with me at MDDUS.

I now understand what the saying “you can take the boy out of the Duncan, but you can’t take the Duncan out of the boy” means. How true, how true.

Mr Riaz Mohammed is a senior medical adviser at MDDUS