Octogenarian Dr Jonathan Fine who dared to go where even Indians did not dare #RIP

 He sent the  mail from Bilaspur District, Chhattisgarh, India after hisarrival

The work of JSS in a remote region of India. JSS serves the rural poor from 1,500 villages.  This is the most remarkable health service that I have ever witnessed. Everything that JSS has accomplished is doable by others.  Direct superb services are provided, but equally, research and advocacy for the systemic changes required, to bring these benefits to all the rural poor of India who number over 500 million.  I will be reporting in greater detail later.

Here are a few photos! These seven from Jan 19th when I visited the most remote of the forest clinics (sub-centers).  Although some patients came from close-by villages, others walked for several hours to get to the clinic, often with serious injuries, in pain, or weakened by severe anemia (prevalent), tuberculosis or malaria.

Photo #1 Lunch with the village dais – village midwives – attending a two-day training.  We are eating a nutritious vegetarian meal off leaves gathered in the forest. A treat for them, this is probably the only well-rounded meal these women will have until they return in a month’s time.

Photo #2 – Dr. Yogesh Jain with mother and little boy. The child suffered an infection of his finger resulting in a contracture.  He will soon go with his mother to the JSS main campus that has two operating pavilions to correct the defect.  If the family cannot afford even a small fee, the surgery and all attendant costs are waived.

Photo #3 – Dr. Ramani with a pregnant village woman patient discovered to be hypertensive. All patients have their BP measures each visit. Hard to believe, many women patients in this remote area suffer from severe hypertension.  No one is yet sure why but they all receive the same effective medicines we do at home only at a tiny fraction of the price we pay.  Pregnant patients are treated aggressively for even mild elevations of blood pressure.

Drs. Yogesh and Ramani visit this remote forest sub-center every Tuesday. It’s a long day. This particular day, Dr. Ramani stayed overnight for the two-day, monthly in-service training of the dais.  As it’s very cold at night in the forest, she told me that the blankets available were not sufficient.  None of these village people have woolen clothes. They only survive this time of year by building fires inside their homes for the night – suffering the consequences of smoke inhalation.

Photo #4 – Photo of dais raising hands when asked if they’d like to learn to ride bicycles. Every hand went up. There were 45 present, usually 100% attendance.  Many walked two to three hours to get to the sub-center that morning with the same trek the following day to get back home. I am going to try and raise funds to get them bicycles!  They are all volunteers. Each delivers one or two children each month.

Photo # 5 – A five year old with acute glomerulonephritis.

She will probably be spared permanent kidney damage after a course of antibiotics and a diuretic. Dr. Jain, one of the founders of JSS, is finishing his tenth year of this work.  He and his colleagues are all superbly trained clinicians and public health specialists and staff three sub-centers in remote regions of central Chhattisgarh.  I am spending three weeks with them now, taking on collaborative projects with them and intend to return in July for a few months of active work under their direction.  We want to document the life-stories of these village people and bring to the world’s attention how neglected they have been.  Millions like them in India have no such good fortune as what the JSS physicians and staff of 140 provide.  This work is not a  drop-in-the bucket. Jain and colleagues have developed low-cost technologies – like a solar refrigerator at this outpost that keeps vaccines at constant temperature even in the brutally hot months – provide low cost treatments, doing research that hopefully will spread throughout India and beyond to help others.  When I get home, I also plan to help them recruit all kinds of volunteer health workers to come for three months or more as volunteers.  They are short-staffed in every category – administration, diagnostic laboratory specialists, pharmacists, trainers, nurses, physicians and surgeons.

Photo #6 Dr. Yogesh Jain with two patients.  Six weeks ago, the older lady, a dais, was gored by a bison while chasing a monkey away and suffered a broken wrist, severe internal injuries and a broken wrist. She was gored right up to the splenic capsule. A young American, a fellow activist with the Assocation for India’s Development, had donated $5,000 for a small bus two years ago that doubles as an ambulance.  If it were not for this remote clinic, the bus, and a marvelous surgeon at JSS in the village of Ganiyari, this woman probably would not have made it.  Look at her six weeks later!

Photo #7 Several of the dais, who gathered firewood, trying to get warm in the early evening after a long day of training.  They will be sleeping in the cold this night, finish the training tomorrow and then take the long walk back to their villages.

and then this followed

ERRATA

I sent this e-mail out last evening about midnight here in Chhattisgarh.  There are a few errors to be corrected.

 

!. The Title “Photos” was meant to read “Deeper and Deeper”.  Why?  Because the report is from the furthest clinical and public health outpost of JSS into the forests of the Bilaspur District and the miracle called JSS goes deep not only into remote regions but to sound the depths for the root causes of illness and its profound consequences.

 

2. The photos of this single day are from the JSS sub-center in the midst of a Wild Life Preserve.  Ironically, the villagers you see here are planned to be evicted soon by the powers that be in New Delhi.  That fight is just getting underway.

 

3. The village midwife described in Photo #6 who was gored by a bison suffered, as reported, a deep abdominal wound, but also a hemarthrosis of the knee, a wrist fracture and several broken ribs.

 

All of my informal reports will need subsequent edits and, presumably corrections, where I have “rushed to print”.  Hopefully, the general gist will be dead on.

 

4. I am for the first time now forwarding a “field report” e-mail to the AID Health Cell and to AID Boston’s lists.  I will follow up with other earlier emails and a few subsequent ones as well.  Feedback is always welcome, friendly or critical.