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Bangalore: St John's gets essentiality certificate from govt for intake hike of 150 seats

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From Our Special Correspondent
Daijiworld Media Network - Bangalore

Bangalore, Sep 1: St John’s Medical College and Hospital, the only Catholic healthcare institution started and run by the Catholic Bishops’ Conference of India (CBCI), New Delhi, to emerge as the premier medical college in the country has crossed the first major hurdle in realising its ambition of increasing its intake of 60 MBBS seats to 150 by getting the all-important Essentiality Certificate from the State Government.

The college will be able to admit more students from the coming academic year if it able to get the approval from the Medical Council of India (MCI) within the next three to six months.

This was announced by Fr (Dr) Lawrence D’Souza, who handed over charge as Director of the St John’s National Academy of Health Sciences upon completing his extended term of six years and five months, to his successor Fr (Dr) Paul Parathazham.

Foundation stones for 2 new projects

The CBCI President blessed the foundation stones for the new hospital expansion project comprising construction of two six-storeyed buildigs of 2.5 lakh sqft with 720 common wards and 120 private rooms and the new laundry block.

The function to bid farewell to Fr Lawrence D’Souza, who will be completing 66 years in November next, and welcome the new Director, held under the chairmanship of the CBCI President, His Eminence Basilios Cardinal Cleemis Catholicos, Major Archbishop of Syro-Malankara Church, was preceded by a solemn mass with Cardinal Cleemis as the main celebrant at the St John’s Medical College Auditorium. Archbishop of Bangalore Dr Bernard Moras, Chairman of the Governing Council, Archbishop of Verapoly Archdiocse Dr Francis Kallarakal, Chairman of the Governing Board, the outgoing as well as the new Director, Associate Director Finance Fr Glen Mascarenhas, Assoiciate Director Fr Duming Dias and many other priests as the concelebrants at the Holy Eucharist.

Archbishop Dr Bernard Moras, in his homily during the mass, said St John’s institutions were known for adhering to the motto, "He shall live because of me," and said living life to its fullness and sacrificing in the service of others as Jesus Christ did were the hallmarks as well as the special ethos, care and love for the poor.

"Truly Committed Priest"

The CBCI President Cardinal Cleemis, in his farewell address to Fr Lawrence D’Souza lauded his contribution and service to the string of St John’s Institutions, which have grown to be a jewel in the crown of CBCI.

"A truly committed priest," described Cardinal Cleemis and said three of the most significant milestones in Fr Lawrence D’Souza’s stewardship were the successful hosting of the CBCI plenary session in the campus in 2012 and the year-long golden jubilee celebrations of the St John’s Medical College and the recently concluded silver jubilee celebrations of the nursing college.

"Fr Lawrence D’Souza has strived hard to enable the St John’s Medical College and Hospital and other institutions to grow in accordance with the motto in transparency and inclusive growth," said Cardinal Cleemis and wished him fruitful ministry in his future endeavours.

An emotional outgoing Fr Lawrence D’Souza, in his farewell address, said he was only an instrument and the entire credit for the achievements during his tenure of 6 years and 5 months should go to the team effort by all his associates, faculty, teaching and non-teaching staff as well as nurses and said he can only "sing the chorus of gratitude and praise for the blessings showered" on him.

"I don’t know what the future holds for me. But I know who holds my future," he said alluding to the blessings and graces of the almighty and said he was not interested in position or power but was always committed to the institution to discharge the responsibility thrust on him. "I may have been at times harsh and even rude. But all my decisions and actions were governed by the zeal to protect the interests of the institution and follow the motto, policies and vision," he said.

Going to Native Udupi Diocese

Adding a lighter tone and also answering many questions that might be lingering in all those who knew him, Fr Lawrence D’Souza said he did not know what will be his future. "I am not going back to Fr Muller’s Hospital in Mangalore, where he had served as Assistant Director and later as Director, nor to the Mangalore Diocese to which I belong," he said and disclosed that he would be returning to the newly formed Udupi Diocese, as his birthplace of Pangla near Udupi, was part of the new Diocese and that he would be free till May next year, when the new postings will be made.

He said he was happy that he was able to get the Essentiality Certificate from the State Government for increasing the intake to 150 seats without parting a single seat outside the prescribed admission norms before the completion of his term. The only "regret" he had was not doing much for improving the facilities and service in the hospital and hoped that his successor and his team would be able to devote more attention to the hospital and also in quickly getting the MCI approval to enable admissions from the ensuing academic year for the enhanced intake of 150 MBBS seats.

The new Director Fr Paul Parathazhan, who took charge of his new responsibility by symbolically accepting the plaque of the Academy from his predecessor, said the St John’s institutions have come a long way since its modest beginning. It is however time to pause and reflect on the values and ethos and reaffirm the commitment to follow the motto, he said.

"Miles to go, Promises to keep"

The college, hospital and other institutions in the words of poet Robert Frost, had "miles to go and promises to keep" to people, the unfortunate sick and all those languishing in the margins. It would be folly to grow complacent on the past glorious achievements and rest on laurels and even romanticise the past. "My primary responsibility is to continue to adhere to the core values and motto while ushering in change at all levels, especially improve the delivery of services and morale of the staff and the organisation while never losing site of the goal of achieving academic excellence. The rich legacy and visionary leadership of all the predecessors, especially the role model of Fr Lawrence D’Souza, must be continued, he said.

Fr Francis Kallarakal, Archbishop of Verapoly Diocese and St John’s National Academy of Health Sciences, said the St John’s institutions have earned name and fame due to its commitment and dedicated service of the poor and neglected sections of society.

Earlier, Cardinal Cleemis felicitated Fr Lawrence D’Souza and released a special volume, "St John’s bids adieu to a man with a vision…"compiled by Dr Pretesh Rohan Kiran of Community Health Department. A visual slide-show presented by Dr Tony Raj and narration by Dr Anil Abraham, with sectional tributes of love to the outgoing Director by Students union leaders Francis, Gerlin, Irene Machado, SrCelcy Mary, Dr Praveen Rodrigues and Dr K Sreenivasan were the other highlights of the function. Fr Pradeep Kumar Samad, Associate Director, explained the outline of the new porjects being undertaken by the Academy. Fr Glen Mascarenhas, Associate Director Finance, welcomed.

Fr Duming Dias, Associate Director, proposed a vote of thanks.Drs Arvind Kasthuri and Arpana Iyengar compered the entire programme.


Psychiatrist Remedies Lack of MH Care for Women in Rural India; Dr Geetha Jayaram

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Until recently, limited mental health care was available to women in several rural villages of southern India. Thanks to a U.S. psychiatrist, these women’s lives have improved considerably.

The women walk for hours over dusty roads and under the hot sun to a clinic in the village of Mugalur, some 30 miles outside of Bangalore, India. One of them has been beaten severely and abandoned by her husband and has been identified as having dysthymia. She struggles with thoughts of suicide. Another acted out violently against several members of her family and wandered the fields aimlessly with little concept of herself or others, showing evidence of psychosis. Yet another spent six hours a day washing herself and her clothes compulsively by hand and so would miss her school bus. Her washing rituals routinely disrupted her studies.

These women and hundreds more like them benefit from mental health services offered at no cost through the Maanasi Project.

Photo:of Geetha Jayaram, M.D.

Geetha Jayaram, M.D.

Psychiatrist Geetha Jayaram, M.D., established the project in 2002 (“maanasi” means “of sound mind” in Kannada, the local language) with funds raised through the Rotary Club of Howard West, Md., and the personal contributions of family, friends, and others. The funds are administrated by and supplemented through the Rotary Club of Midtown, Bangalore. Jayaram, a longtime Rotarian, is a faculty member in the Johns Hopkins University departments of Psychiatry and of Health Policy and Management and the Armstrong Institute of Patient Safety. Through a partnership with the departments of Psychiatry and Community Health at St. John’s Medical College in Bangalore, Jayaram launched the project, beginning with an assessment of the extent of the need for mental health services among the area’s women.

“India has a mere 4,500 psychiatrists,” Jayaram told Psychiatric News. “Yet it has a population of more than 1.2 billion people, so there is a huge shortage of psychiatric care. What we are doing is really just a drop in the bucket.”

The project began with a survey of 12,000 households in 25 villages regarding the prevalence of common mental disorders to determine the need for psychiatric care, said Jayaram, who supervises the project from abroad and during annual visits. To conduct the surveys, her team obtained permission of the “panchayat,” a local council with authority over villagers. The team consisted of four trained women caseworkers with a high school education who were fluent in the local languages and had good standing in the community.

Jayaram and her team established a psychiatric clinic that dovetailed with the primary care health clinic in Mugalur, which was already familiar to villagers. Women who screened positive for symptoms of mental illness with various standardized instruments translated into the local languages, including the Structured Clinical Interview for DSM-IV-TR, were encouraged to come to the clinic on Friday afternoons, when the psychiatrist sees patients.

The psychiatrist works with an internal medicine or family medicine clinician who assesses patients for symptoms of mental illness and refers them to the psychiatrist when necessary. “In this culture, many symptoms of mental illness are expressed somatically anyway, so it makes sense that they are examined by the internist first,” Jayaram said. The psychiatrist and primary care physicians are affiliated with St. John’s Medical College, and Jayaram supervises the care provided at the clinic.

Photo:of Maanasi Project caseworkers

Maanasi Project caseworkers (from left) Shantha, Usha, Anjum, and Gowramma traverse hundreds of miles on motorbikes to provide mental health services and medications to women in villages in southern India. Over the years, they have also helped educate many of the villagers about mental illness and treatment.

Since many of the women are agricultural workers and cannot afford to take a day off from working in the fields to make the trip to and from the clinic, caseworkers travel to the villages, Jayaram said. Each caseworker received a moped to traverse miles of unpaved roads between 187 villages where the women most at risk for relapse live. During home visits, caseworkers evaluate the women for symptoms; track patients’ behaviors, thoughts, and feelings; dispense medications with the community medicine physicians; and provide supportive therapy. Doctors and social workers may provide behavioral therapy onsite when indicated.

They also educate women and families at monthly women’s cooperatives about symptoms of mental illness and treatments that will help them. The clinic doctors, including Jayaram, also conduct home visits for patients who need specialized attention. The Maanasi clinic now serves approximately 1,600 patients. “Many have been successfully treated and are well,” said Jayaram, and the success of the venture has resulted in services being provided to women from 187 villages.

She recalled being asked to speak on an Indian TV program about the topic of depression. “As a result of that segment, the community medicine program at St. John’s Medical College was besieged with calls, emphasizing the great unmet need for depression treatment,” she noted.

The clinic continues to be a site for research and teaching, in addition to patient care.

The project was not always greeted enthusiastically at the start. Jayaram initially encountered resistance from villagers. For instance, a myth spread among villagers that antidepressant medications would lead to blindness, causing some of the women to resist the treatment. Members of the village mafia threatened some patients who had been encouraged to stop drinking as part of their treatment because they could no longer sell liquor at inflated prices, Jayaram said.

In addition, some women skipped clinic visits, telling caseworkers that they felt shame in accepting free medications.

In one unexpected obstacle, the caseworkers had to be convinced to wear protective helmets when riding their motorized bikes, “because they didn’t think the helmets went with Indian apparel,” Jayaram explained. “But I told them I didn’t want to lose them in an accident, and they complied.”

To educate women in the villages about mental health concerns, the caseworkers attend street festivals in the different villages and act in plays that portray the manifestation of different mental illnesses and how they may affect the villagers in everyday life. Over the years, the villagers have come to “embrace the caseworkers with love and respect,” Jayaram noted.

Jayaram and her husband, Jayaram Kumar, a fellow Rotarian, received an invitation to attend the 2013 forum of mhGAP (Mental Health Gap Action Program), a project of the World Health Organization (WHO) from Shekhar Saxena, M.D., director of the WHO Department of Mental Health and Substance Abuse. The goal of the forum was to discuss how to improve the delivery of mental health services in low-income countries around the world. Jayaram presented information about the Maanasi Project. “Dr. Saxena felt strongly that this was a project that could be replicated in other parts of the world,” Jayaram said.

Even certain areas in the United States, she remarked, could benefit from a model of integrated care like the one used by the clinic in Mugalur. “For so many of our low-income patients, care is fragmented. Someone with acute schizophrenia cannot negotiate the burden that we place on them and be expected to show up at five different appointments in five different places” for varying health care needs.

The Maanasi Project not only embodies the model of integrated care and collaboration between providers, Jayaram pointed out, it “applies transatlantic innovation to community psychiatry,” she said. ?

Dr KM Venkat Narayan et all article in JAIDS

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JAIDS Journal of Acquired Immune Deficiency Syndromes:

HIV and Noncommunicable Disease Comorbidities in the Era of Antiretroviral Therapy: A Vital Agenda for Research in Low- and Middle-Income Country Settings

Venkat Narayan, K.M. MD*; Miotti, Paolo G. MD; Anand, Nalini P. JD, MPH; Kline, Lydia Mann MPH, MS; Harmston, Christine MHSC; Gulakowski, Roman III BBA; Vermund, Sten H. MD, PhD§


Abstract: In this special 2014 issue of JAIDS, international investigator teams review a host of noncommunicable diseases (NCDs) that are often reported among people living and aging with HIV in sub-Saharan Africa. With the longer lifespans that antiretroviral therapy programs have made possible, NCDs are occurring due to a mix of chronic immune activation, medication side effects, coinfections, and the aging process itself. Cancer; cardiovascular and pulmonary diseases; metabolic, body, and bone disorders; gastrointestinal, hepatic, and nutritional aspects; mental, neurological, and substance use disorders; and renal and genitourinary diseases are discussed. Cost-effectiveness, key research methods, and issues of special importance in Asia, Latin America, and the Caribbean are also addressed. In this introduction, we present some of the challenges and opportunities for addressing HIV and NCD comorbidities in low- and middle-income countries, and preview the research agenda that emerges from the articles that follow.

To read the full article copy and paste the link on to your browser


Dr Vasanth Rao and his family conduct a medical camp in his village

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On 9.8.14 a rural medical camp was organised in my village Shantapur India by my family with no involvement of sponsors or NGOs.My sister (nurse) , an auxiliary nurse,myself   and non-medical people as support staff were present. My sister brought disposable needles and syringes, stethoscope and BP apparatus. I bought paracetamol, antimalarial, anti-inflammatory tabs, skin ointment and, injections and ORS.
The previous night, the village Kothwal announced by his drum that there will be a free medical camp.The news spread to the neighboring villages as well. The village Sarpanch opened the camp with lighting of the Deepam. He allowed the gram panchayat office to conduct the camp. I was alone and I have not done any general practice  for some time. Needless to say I  was bit apprehensive. My brother was doing the registration of the patients.  The response would be so positive which really surprised me.With a 15 minute break, I saw patients from 11-7pm. The sewing machine board was my consulting table.

There was no cot, electricity or fan . As daylight went down I had to refuse to see a few patients which sad to say caused some village folks to be disappointed..The patients were from various disciplines; pediatrics-geriatrics medicine and surgery. I really can’t imagine I was able to last the whole day in the hot weather. I with help of others saw close to 300 patients.. Most of them were treated and some required referral service to other towns and others I  made referrals for them to go to Hyderabad. I really thank God for giving me opportunity to care for these people and  I am astounded with my ability to remember medicine from my rural service(1989-91).

The Sarpanch has asked us to conduct  this camp on regular basis. I really think Johnites who do rural service and those still serving are legends. . I would urge anyone at anytime to do this kind of work as the community needs our help. If any specialists interested would like to join me to conduct camp next year, please let me know. Many patients require a good listening ear,  some a sincere examination and some need  good advice and medication. This doesn’t cost you much.I left the village with great professional satisfaction. My sister visits the village but I am also thinking of a follow up visit soon.


Vasanth Rao 1982 Anesthesiologist Australia

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