Tag Archives: Obeying a call to medical missions

Early Days at Makunda

12 May

Medical work at Makunda was restarted on 3rd March 1993 (after about 10 years of closure). Ann and me had arrived in Silchar several days earlier but our suitcase containing all certificates and money had been lost – we recovered it 3 days later when a passenger (who had taken it with him to Aizawl) returned it to Indian Airlines. Hospital staff had created local awareness and publicity and the OP consultation room had been cleaned. One patient (a girl with diarrhoea) was admitted but very few patients turned up. The first day’s collection was Rs. 20/-. Over the next few days, some people turned up asking for home visits and I went with them (pillion riding on their bikes) to see sick people at home.

 

The slow start changed quickly when a patient was brought in labor from a forest village – she had obstructed labor and was quickly referred to the Government Hospital in Karimganj for a Caesarean section. However, when we went to the ward on our night rounds she was still there – they could not take her to Karimganj. The uterus was now tense with a Bandl’s ring signifying impending rupture. We did not want her to stay at the hospital when we were not confident of treating her with the facilities available but the relatives said that if we sent them out of the hospital, they would take her home to die. The operation room was quickly searched – linen autoclaved many years ago was found (still in its wrappings), instruments were boiled and a Caesarean section done (with two nurses holding kerosene lanterns for light) under local anaesthesia – infiltration with xylocaine. Blood was scooped out of the wound and the final stitches put in. The baby was sick (died a few days later) but the mother was alive – I remember her name, Sumvankhup. The news quickly spread – major surgeries could be done at Makunda – and we started getting large numbers of patients. Soon the next LSCS was done, this time with a live healthy baby – her name was Hoia Chorei. Elective surgeries followed – all done without the help of electricity or running water! – only those that could be done under local or spinal anesthesia. We had a Schimmelbusch mask for open drop ether as well as ethyl chloride but after a few procedures, were not very keen to use this technique.

 

We quickly did a complete inventory of the hospital. Many of the equipment (including gensets) had been sold in the past years to pay salaries. We were left with one working blood pressure apparatus, a large amount of assorted surgical instruments and old suture material. The pharmacy contained a large amount of chaulmoogra oil as well as dapsone and some other drugs for the leprosy patients, there were many barrels of “Sanimaster” – universal disinfectant. There was an ancient Picker 15 mA X-ray machine and a Bovie “Spark-Gap” cautery machine as well as a drum dermatome. The laboratory had a colorimeter and a microscope. There was ‘electricity’ from the government – a few hours of electricity with voltage so low that only the red filament of the bulb could be seen. We had been in correspondence with Emmanuel Hospital Association (EHA) in New Delhi and had received Rs. 10,000/- to start off the work. I thought that this was to purchase something that could not be locally bought and had invested it in a BPL Cardiart 108 ECG machine (I was very interested in medicine and cardiology although I had trained as a surgeon). Now, it looked like a foolish decision – there was not even enough current to charge the batteries in the machine! I sent a long list of the equipment that was urgently needed at Makunda to EHA and received a reply several days later – Makunda was an independent society that had to rely on its own income. EHA could try to raise some funds but there were needs elsewhere too. We did receive small amounts but soon realized that we were on our own…

 

When we first arrived, the local staff held a welcome for us at the local Church with paper garlands and told us that we were an answer to their many years of prayer. The leader of the church pointed us out during his messages in Bengali with murmurs of assent from the congregation. However, after the first few weeks, we realized that their hopes were to first get benefits for themselves – gifts, jobs, even land. We disagreed – all the staff (including us) lived in difficult conditions but we had come primarily to serve the poor people of the area and making our lives better was not the priority. Soon he was pointing us out to tell God that we were not being very helpful – we had to stop going to church and spent Sundays at home, waiting for the days when more like-minded staff would join.

 

The staff at the hospital had been receiving their salaries for years without any work. Now they rebelled at the expectation of work. There were a few nurses and aides – one was nearly blind, another deaf, another handicapped, we did not know the local language – it was going to be difficult to change this situation.

 

A lot of time was spent with the 60 leprosy patients – many of them had been in the hospital for decades. We quickly put them on modern chemotherapy and the fit ones were given, “Released From Treatment” certificates allowing them to mingle with the outside population. Many did not want to go, fearful of stigma – we slowly convinced the able-bodied ones to leave. The staff quarters were far away from the leprosy wards and many of the leprosy caretakers were themselves leprosy patients. This was with good reason – in the past leprosy was incurable. Having been taught that it was just an ordinary bacterial disease curable with drugs, we did not worry about contagion – until some years later when I developed leprosy and then went through two years of chemotherapy, severe reactions and drug induced problems. It was a painful reminder that we are not immune and cannot afford to be careless.

 

Supplies soon ran out and we went to Silchar to buy more – we soon realized that dues were outstanding with most shops. All of them wanted cash and we spent hours going in and out of all the wholesale drug stores looking for the best bargains. I was the pharmacist and store-keeper and had to learn quickly to maintain the right amount of stock. We went once a month, on a Saturday evening, bought our medicines, spent time with Christian medical students at the Silchar Medical College, a night with one of the officers of the Baptist compound in Silchar and returned the next day. At Makunda, we were soon engulfed in legal and land problems which we did not understand. We did not know who was a dependable person and who was not. We did not understand why documents were worded in the manner that they were. It took many months of visits and talking with many different people before some clarity appeared and we could understand what was happening within this community. We could not understand how people could be so violent and hostile just to get land and property illegally – many criminal cases would be filed against us in the years to come in an attempt to get rid of us but we did not know it at that time – it is good that each day is revealed in its time!

 

Life at home was also a different experience. When we started work, Ann and me had been married for a little over a year. She had done her MBBS and I had completed my MS. We had a combined salary of Rs. 2000/- per month in Madurai and now at Makunda this had doubled! When we arrived, we were allotted the Doctor’s Bungalow – 3rd Bungalow – connected by ‘party-line’ intercom to the hospital and other Bungalows. There was a wood-burning stove in the back in a separate kitchen. We quickly invested in a kerosene stove. It took a long time to get a gas connection – only one cylinder would be given after waiting for many anxious hours at Karimganj. There was no electricity at home but we had kerosene lanterns and hand-fans. We hoped this would change quickly – it did, 14 years later! Water was carried to our homes at Re.1/- per bar of two 15 liter cans. This was muddy water from the fishery ponds, we allowed it to settle or used alum to clear it. The weather could be quite cold – we could not afford the warm blankets in the shops or it could be really hot and humid – we just prayed to God to turn on his ‘airconditioner’ – for the rains. There were cement tanks in all the toilets and as soon as the sound of rains was heard, both of us ran out to fill these tanks with buckets – clean water which was free! There were colorful birds and butterflies as well as tarantulas and snakes – Ann found a bamboo pit viper in our hall one night when we returned from hospital. Communication was difficult – the nearest phone was in Karimganj, 50 kms away on a really bad road (often blocked completely by floods). When we reached Karimganj and placed our ‘trunk’ call, it would often not go through and we would return without talking. Talking on the phone was not very encouraging – many friends and relatives thought that we were quite mad! Telegrams arrived many days after the incidents that they described. Many small inconveniences – but temporary and trivial compared to eternal life with God in heaven – we should learn to look at them from a heavenly perspective.

 

This is just a short glimpse of life 25 years ago. It was what we had expected when we signed up with God to go as medical missionaries. At the EHA (Emmanuel Hospital Association is an Association of many independent hospital running societies created in the 1970s to support several Christian mission hospitals which were teetering on the brink of closure following the departure of expatriate missionaries) office in Delhi (in October 1992), we had given a 30-year commitment to work at Makunda till retirement and we were planning to keep our promises.

 

The early life at Makunda was full of surprises – we looked forward to the future not knowing what it would bring. Would we be able to stay on? There were threats – could we be beaten up or even killed? It was also full of promise – God’s promise that He was with us. He had given us a vision of a great work that would transform communities in the future, only visible through God-given eyes of faith! Our human eyes could only see it as an impossible dream. We do not appreciate God’s presence until we are vulnerable and helpless. Our obedience was our duty, the results were His. He had promised to take us by our hands and lead us one day at a time. Most of the early days were not pleasant, they were difficult days, but we can testify that God was with us. The vision of a flourishing work would come true in the years to come – He simply wanted us to stay on and plod on, one day at a time, simply trusting Him. He would be the source of all wisdom, strength and encouragement. That vision has become reality in the following 25 years and God has allowed us to see it with our eyes. Great is His faithfulness…

References:

  1. https://the-sparrowsnest.net/2016/02/19/short-video-of-our-work-made-by-emmanuel-hospital-association/
  2. https://the-sparrowsnest.net/2017/09/13/obeying-a-call-to-medical-missions-a-testimony/

 

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Reflections on Medical Missions

14 Sep

With the background of my short testimony in the previous posts (1,2), let me reflect on some common queries regarding Medical Missions in the minds of Christian medical students and on ways forward:

 

  1. Who is a missionary? I found this definition from Wikipedia (3) quite comprehensive, “A missionary is a member of a religious group sent into an area to do evangelism or ministries of service, such as education, literacy, social justice, health care and economic development. The word “mission” originates from 1598 when the Jesuits sent members abroad, derived from the Latin missionem (nom. missio), meaning “act of sending” or mittere, meaning “to send”. The word was used in light of its biblical usage; in the Latin translation of the Bible, Christ uses the word when sending the disciples to preach in his name. The term is most commonly used for Christian missions, but can be used for any creed or ideology.” A Christian medical missionary would therefore be someone sent to provide health care on behalf of a Christian church or group and Christian medical missions would be the work done collectively by a group of such people.
  2. What are some of the characteristics of medical missionary work? I think that medical missionaries (like all other missionaries) need to be sent out to areas where they are relatively out of their comfort zone (vulnerable) and to help people who are poor and marginalized. They must excel in their professional work as well as serve in the Spirit of Christ, so that others may see Christ in and through their work. This would enable other Christian services to be offered through the activities of the mission compound.
  3. Does Medical Mission work have to be only in remote rural areas? Many of the present locations of mission hospitals in India were once rural – towns have developed around the mission compounds! However, after Indian independence, there has been a significant movement of people to urban areas and many live in slums. These people are also poor and marginalized – they do not have access to high quality medical care at affordable cost and this is an opportunity for mission hospitals in urban areas. Mission hospitals have great potential as they are among the few entities which focus on people whom nobody else is interested in.
  4. Are there opportunities for pioneering new Medical Mission work in India? Yes, Arunachal Pradesh is at present the only state in India without a Christian mission hospital. (Tripura too did not have one until we started a hospital there in 2005). There are large tracts of land in forgotten corners of our country where new hospitals are needed and can be started. However, due to local land and entry laws, it is not easy for outsiders.States such as Arunachal Pradesh, Mizoram and Nagaland require an Inner Line Permit – similar to a visa – for non-locals to enter and several states have restrictions on non-locals purchasing land). Similarly, great opportunities for transformation exist in other needy parts of the world where few want to go.
  5. Can Medical Mission work be done in hostile areas? When Makunda started the work in Tripura, Dhalai district was the most affected by militancy with murder and abduction being common and all public transportation possible only through armed convoys. However, the work at the hospital was never affected as it was seen as a humanitarian service to the poor. I had the privilege to visit Africa last year – mission hospitals are the only long-term health facilities that work well in conflict areas because of the commitment of staff. Other NGOs (like Red Cross and MSF) offer short-term medical support services. Warring groups usually do not target missionary services, recognising their humanitarian value and universal appeal.
  6. Is Medical Mission work a sacrifice? We are called to be ‘living sacrifices’ – meaning that we offer ourselves to a life of obedience to God. Medical mission work (especially in remote rural areas) is front-line work and not easy. However, in the light of the words of the Bible, I would say that the trials and difficulties are ‘temporary and trivial inconveniences’! We should not dwell on sacrifice as it makes people into ineffective self-styled martyrs! There is no sacrifice too great for a missionary – when we feel that we have been brought to life from death by the sacrifice of Jesus on the cross, we should be ready to die for Him. When we look at missionary history, many missionaries (often unheard and unsung) gave their lives so that the church may be built in remote areas all over the world – truly the present Christian church in these areas has been built on their sweat and blood. In comparison, the problems we face today in India are indeed trivial.
  7. Can Medical Mission work be professionally challenging? I have heard many people say that mission hospitals (especially remote rural ones) treat only diarrhea and ear discharge! When I completed my M.Ch in Pediatric Surgery at CMC Vellore, there were people who even asked why I wasted a M.Ch seat which could have been given to someone who was more likely to use it! I would like to say that I have seen and operated on some of the most professionally challenging conditions at Makunda. Since CT scans, nuclear scans and the services of other experts are often unavailable in these locations, missionary doctors need to innovate to be able to treat patients cost effectively with what is available.. I have operated on a teratoma in the right middle lobe of the lung (middle lobectomy with composite resection of two overlying ribs), ectopia cordis (unfortunately, this patient died), 35 kg ovarian tumor, retrograde jejunogastric intussusception, intra-abdominal cocoon (several cases) and so on. There have also been challenging medical as well as other specialties’ cases. All these years, I was the only full-time pediatric surgeon in the states of Mizoram, Tripura, Meghalaya, Manipur and southern Assam – so there are certainly a huge variety of patients who need treatment (and who cannot go elsewhere because they are poor), it is only logical to conclude that professionally, medical missionaries are in for exciting opportunities.
  8. Is it not difficult to be in a ‘vulnerable’ situation? Humanly speaking, it is. However, I would say that from a spiritual perspective, this is the greatest factor in favor of Medical Missions. Vulnerability is a blessing in disguise – how else will we see God at work? God specialises in helping us as we face circumstances beyond our control. Miracles do not happen when we are in control of situations. When all else fails and we totally depend on God, we see Him at work. It is an exciting experience to see God at work and see Him build up His kingdom and be partners in this great ministry.
  9. Is Medical Mission work drudgery with few opportunities to relax? When I was in school, I was interested in tennis, rifle shooting and rowing. In college, I cultivated an interest in electronics. However, many of these activities were not possible at Makunda. I discovered that nature observation and photography are excellent for relaxation. My observations in and around Makunda have been posted and published in many sites. (4,5) If someone is looking for the nearest mall to relax in, he may be disappointed but there are other (and maybe greater) opportunities to compensate.
  10. Can work focused on the poor be self-sustaining? When we re-started Makunda, we were told that it was impossible to work primarily for the poor on a self-sustaining basis and that all successful mission hospitals subsidise treatment of the poor by treating the rich at higher rates. However, we decided to be a hospital primarily for the poor with no special facilities for the rich as a part of our ‘pro-poor’ branding strategy. All patients wait in the same queues irrespective of their social class or wealth and the same general wards are used to admit them. Charges are low and charity is liberal – the hospital is flooded with patients and high capacity utilisation leads to high efficiency and lowered costs. God has blessed the work and we have been able to invest in new equipment and buildings, start a new school, the branch in Tripura and nursing school without major grants (the external funding received each year was less than 1 percent of income for many years). When we treat the poor who cannot afford to pay, God pays their bills – often in ways that money cannot buy – by giving us satisfaction, contentment and wealth in heaven.
  11. Why is there a high attrition rate in mission hospitals? Work in mission hospitals is not easy and not for every one. There is peer-pressure from families and friends. People look for comforts and sometimes are unable to adjust to life in mission hospitals. Many are short-term and do not want to stay on to solve local problems. There is a high attrition rate in Medical Mission work all over the world – maybe <10 per cent of new staff stay on long-term. However, most staff leave after tasting God at work and often say that the best years of their lives were at the mission hospital!
  12. Are many mission hospitals today ‘beyond redemption’? Sadly, many mission hospitals are ‘sick’. This is due to inability to adapt to rapid changes, poor governance and the absence of committed long-term staff at a leadership level. Being at the cutting edge of mission work, I am sure there would also be an element of spiritual warfare. However, no hospital is beyond redemption. Major changes may need to be done to resolve problems but all of them can be revived. If a completely shut hospital (like Makunda) with severe local problems can be revived to become a thriving community, there is hope for all the other sick ones too! God is able to do great things. He just needs a few volunteers willing to submit to Him.

 

What should be done to revive and revitalize Medical Missions?

 

  1. I feel that Medical Mission hospitals require a transition to effective and efficient governance mechanisms, without losing the vision of the founding fathers. They may need repositioning due to changing contexts – laws have changed and the world has changed. For this to happen, highly committed people should be willing to stay till they see change. It is a call to persevere – changes may take years to happen. Objective stock-taking exercises, strategic planning and an excellent system of accountability, transparency and integrity based ‘checks and balances’ is essential.
  2. The church should ‘own’ and support medical mission work. When I was young, I never went to church, thinking it was a waste of time! Parents and people at church disapproved. Later, when I started going to church, everyone was happy. However, when I felt God’s call to remote rural missions, many felt I was going too far, becoming extremist! If every church encouraged medical members of its congregation to give a year or two of their lives to missions, there would be more than enough people to run the hospitals.
  3. Many young doctors and specialists going to mission hospitals today do not have the training and experience to manage administrative (legal, financial and other) work. They need to have some exposure, as they are often required to take leadership roles. Some years ago, Makunda offered a mission-training programme of 2 years duration where doctors who are keen to work in long-term missions could work as apprentices and finally learn to manage a small hospital (our branch at Tripura) on their own.
  4. There is a lot of Christian work in medical colleges in India – EMFI and UESI as well as other groups. However, such work should lead to changed lives. We need people to experience the life-changing power of the Gospel and then take decisions that will take them to the best plans God has for them. Important attitudes need to be cultivated too. (6)
  5. Excellence in studies is important. Obscure facts learnt in medical college serve to be life-saving information(7). Students interested in a career in medical missions should ensure that every day in college is well-spent and no opportunity to study is lost.
  6. The choice of who one marries has a very strong effect on which medical missionary stays on in Medical Missions and which one does not. (8)
  7. When young Christian medical professionals talk of working abroad, the conversation is almost always about the developed world – the western nations, Australia and even the wealthy ones in the Middle East. Why don’t we look at the ones that need help instead – Myanmar, African and South American nations, small island nations – for those with a greater adventurous spirit, these opportunities beckon!
  8. There is a ’rut’ placed in time at the end of MBBS or other medical professional qualification. If nothing is done at this point, all graduates tend to follow the tracks left by their peers – corporate work, government work or private practice. So, for those considering Medical Missions, important steps need to be taken much prior to graduation – sensitizing parents, and exploring varied options.

 

I would like to invite every committed Christian medical professional to consider a life-long career in mission hospitals, or at least a few years of their life. We spend a lot of effort in investing our money so that it gains the greatest value over time. I think Medical Mission work gives a Christian medical professional the greatest value over time – an exciting and fulfilling life in this world and a great reward in heaven.

 

This post is updated and adapted from the chapter, “A privileged call to Medical Missions” published in the book, “Wings of Dawn” – used here with permission from the publisher, Evangelical Medical Fellowship of India. The book, which also contains chapters by several other authors is available in hard copy and Kindle versions on Amazon.

 

Bibliography:

 

  1. https://the-sparrowsnest.net/2017/09/13/obeying-a-call-to-medical-missions-a-testimony/
  2. https://the-sparrowsnest.net/2016/02/19/short-video-of-our-work-made-by-emmanuel-hospital-association/
  3. http://en.wikipedia.org/wiki/Missionary
  4. https://www.flickr.com/photos/ivijayanand/
  5. http://www.inaturalist.org/people/8853
  6. https://the-sparrowsnest.net/2014/04/28/attitudes-to-cultivate-for-the-aspiring-medical-missionary/
  7. https://the-sparrowsnest.net/2012/04/15/excellence-in-studies-for-an-aspiring-medical-missionary/
  8. https://the-sparrowsnest.net/2012/05/22/wisely-choosing-a-life-partner-for-an-aspiring-medical-missionary/

 

 

 

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Obeying a call to Medical Missions – a Testimony

13 Sep

In 1982, as a second year under-graduate medical student at the Kilpauk Medical College in Madras (1), I made a lifelong commitment to Jesus Christ. I started a Bible Study group in college and we discussed how to live the Christian life and make decisions that were approved in God’s sight. We heard many messages on the topic, “Finding God’s Will” but many of us were not able to get a clear convincing personal answer to this burning question. My query was answered one day when I was reading Jeremiah 29:11-13 (2) – I felt God telling me that I was not able to find His will for my life because I was not seeking with all my heart and that He was waiting to answer as soon as I realised that He had the best possible plans for my life. I also realised that I did not want to hand over my life totally into His hands; I wanted to retain control and this attitude was preventing me from seeing His plans for me. I felt God speaking to me and made a vow that I would obey Him and go where He wanted me to go and do what He wanted me to do with all my time, talents and treasure. It soon became clear to me that I should go where few others wanted to go, so that I could make a difference to people who had no access to good health care. Since the southern four states of India were well provisioned with healthcare, I had to go far away from home.

After my internship, I was not confident to run a remote hospital by myself and joined the Christian Fellowship Hospital (3) at Oddanchatram in 1987 and spent 3 wonderful years there, learning to become a more confident doctor. I also spent the 3 years (every Thursday) exploring villages in the hills of Pachalur (30 kilometers from Oddanchatram), doing medical work with some local missionaries and seeing God answering the simple prayers of poor people powerfully. For the next few years, I was involved in conducting the annual Medical Missionary Meets for medical college students of Tamil Nadu at Pachalur organised by the CF Hospital – I visited medical college fellowships in Tamil Nadu, wrote numerous letters to a large number of students and learnt many things about working with medical students.

I was married to Ann in 1991, during my Postgraduate Residency days in General Surgery at the Madurai Medical College (4) – we met over our common interest in medical missionary work. I had met Dr. Vinod Shah, a paediatric surgeon, then working with the Indian Evangelical Mission in Gujarat, at the Medical Missionary Meet at Pachalur in 1987. In 1989, I spent two months with him at the Chinchpada Christian Hospital in Dhule District of Maharashtra (he had just joined the hospital as its Medical Superintendent) – I spent time thinking about and discussing where God wanted me to go during my time at Chinchpada and shared with Dr. Vinod Shah a list of key points that I felt God was asking me to look for. Some of these key points were a remote rural area where no hospitals/doctors were present, a thickly populated area with great healthcare need, a large campus which could be developed over the years and the scope for working with medical students of the area. In 1992, when I was completing my MS in General Surgery, Dr. Vinod Shah, who had become the Medical Secretary of the Emmanuel Hospital Association (5), asked us to visit a mission hospital in Assam (bordering Mizoram and Tripura) that was closed for the past 10 years, called the Makunda Christian Leprosy and General Hospital (6,7) – he wrote me a letter saying that he was inspired to recommend this place to us as most of my ‘key points’ were fulfilled at this hospital. We visited the campus for a week in October 1992 and found a desolate place with broken buildings, no patients, no income and a violent group of people from the old church and staff of the campus who planned to steal the land and assets of the hospital for themselves. They told us that if we wanted to work peacefully in the hospital, we should join them. If not we would have to fight them and that they would make life difficult for us! We prayed for wisdom and guidance. God opened our eyes to the magnificent campus (at that time, 1000 acres of forested land), to the great need (we heard stories of many mothers who died as they were unable to cross flooded areas during childbirth to travel to faraway hospitals) and to the potential of working with young people in a new area where God was leading us, north-east India. We felt God assuring us that we were under His protection, He would take us by His hands and be the source of all the wisdom, strength and encouragement that we needed as we stepped into this new responsibility that He was giving us.

In 1993, we joined this hospital as its first doctors (after its years of closure) and have continued to serve there since then. Between 1997 and 1999, I did my M.Ch in Paediatric Surgery at the Christian Medical College (8) (CMC) at Vellore and between 1999 to 2000, I worked as a Lecturer in General Surgery in the same college (Ann, who had waited 7 years to do her Postgraduate studies, did her MD in Anaesthesia at CMC during the same 3-year period). During our stay at CMC, we were equipped with new skills and knowledge to expand the services we offered at Makunda – we started the only paediatric surgical centre for the states of Manipur, Mizoram, Tripura, Meghalaya and the southern half of Assam. When we initially joined the hospital, we were told by the leaders of Emmanuel Hospital Association in New Delhi (which took over the Board function of Makunda from the previous Baptist Mid-Missions Trustees India) that we had to make a long-term commitment to Makunda, as they would not be able to find anyone else willing to work there if we quit. We were also told that they were taking the risky decision to accept Makunda as a Member of the Association based on our willingness to stay long-term. When I asked, what they meant by ‘long-term’, we were told, ‘preferably retire from there’! We agreed and made a 30-year commitment to the hospital and started work on a 30-year strategic plan to rebuild the hospital. We thank God that He has enabled us to stay on till the present – we are in Year 25.

There were many battles to fight – we had no experience in administration, law or finance, there was no one on the campus who had the same vision, we did not know the language, there was no running water or electricity, no patients or money, we had to confront the so called ‘trade union’ members and a group of old leprosy patients who had joined them on a daily basis and the nearest phone was 50 kilometers away on a bad road! Makunda was considered a God-forsaken place – in those early days, if someone was posted to Makunda, the first question would be, “what wrong have I done?”!

In the past 24 years, God has blessed the work at Makunda. In 2016-17 (which was not a good year – due to three months of floods), the hospital saw 84,557 outpatients, admitted 11,017 inpatients, delivered 4886 mothers and performed 2194 major operations. A survey of northeast India showed that many remote rural areas (such as Arunachal Pradesh which is presently the only state in India without a Christian mission hospital) had low population density and could not support a hospital like Makunda. It was felt that nurse-missionaries could run healthcare services in such areas and a nursing school was started in 2006 – 25 students join every year and over 200 have passed out so far. A survey of local villages showed that poor tribal children had no scope of acquiring a good education and career, improving the social and economic status of their villages unless they had access to affordable English medium education as they were not comfortable and quickly dropped out of the locally available Bengali language schools (many tribal languages in northeast India use the English script – a testimony to the linguistic work done by Christian missionaries in the past). An English medium school, the Makunda Christian High School, was therefore started in 2004 and today there are nearly 1000 students studying up to class XII (Arts and Science) with 220 children in two hostels. It was also decided to start a new hospital in another state of northeast India to expand Makunda’s horizons, to serve as a training/experience centre for young staff interested in missions and learn how to start and run a new hospital – with a view of starting many more! A branch hospital was therefore started in the neighbouring state of Tripura, at Kamalacherra in the Dhalai District, in 2005 and it is providing service in one of the most needy parts of the state – it is the only Christian hospital in the state and at that time heavily infested with militants. An agriculture and fishery department looks after the large campus and in 2015, the “Makunda Nature Club” was started to document biodiversity, conserve wildlife and conduct research. A community college was started the same year. The hospital is focused on the poor and there are no facilities for the rich such as private rooms or private consultations. Yet, it has adequate income to meet the running expenses, able to offer charity liberally to the poor and still have enough for critical capital expenditure – a self-sustainable model focused on the poor with only 1-2% of income derived from external sources. Large numbers of poor people have found healing on the campus. During the day, more than 1000 staff and students work and learn on the campus. Spiritual work for patients, students, staff and for others outside the campus (villagers and college students) is carried out throughout the year. The medical work has therefore enabled the entire campus to thrive and this has been the story of successful Medical Missions all over the world. The hospital has partnered with the Government too – it has one of the best-run Private Public Partnerships with National Health Mission, Assam for maternal and child health care. It also provides a 6 month residency to doctors from Netherlands doing the MD (Global Health and Tropical Medicine) course from the Royal Dutch Tropical Institute, Amsterdam – enabling highly committed medical doctors from the Netherlands to acquire the skills and experience required to serve in even more needy parts of the world such as South Sudan and Ethiopia. I must acknowledge the selfless and joyful work put in by the staff in all departments who have gladly ‘walked the second mile’ – they have been the greatest strength of the hospital and all these developments would not have been possible without them. It has been a privilege to work with so many highly committed staff whom God has brought from many places.

Ann and me have faced many difficult situations (violence, health issues – I had a heart attack in 2008, court cases against us, to name a few) but count it all joy to be a part of God’s great work in this corner of the world. (9,10) We look forward to what God has in store for us in the years to come and our ambition is that we will continue to trust and obey Him and when our days in this world are over, be welcomed back to heaven as good and faithful servants who accomplished the work given to them.

This post is updated and adapted from the chapter, “A privileged call to Medical Missions” published in the book, “Wings of Dawn” – used here with permission from the publisher, Evangelical Medical Fellowship of India. The book, which also contains chapters by several other authors is available in hard copy and Kindle versions on Amazon.

Bibliography:

1. http://www.kmc.ac.in/kmc/
2. https://www.biblegateway.com/passage/?search=Jeremiah+29%3A11-13&version=NIV
3. https://www.cfhospital.org
4. http://www.mdmc.ac.in/mdmc/
5. https://www.eha-health.org
6. http://www.makunda.in
7. https://www.facebook.com/groups/380594120460/
8. http://cmcvelloremissions.org/
9. https://the-sparrowsnest.net/2011/11/01/an-encounter-with-a-myocardial-infarction/
10. https://the-sparrowsnest.net/2016/02/19/short-video-of-our-work-made-by-emmanuel-hospital-association/

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