When Dr Yogesh told us that the hospital caters for around 1.5 million people, I didn’t quite believe him but what’s more amazing is how such a small team manages it.
Coming from a (relatively) well-resourced healthcare system to the unforgivingly hot and rural destination of Bilaspur certainly gave us a lot to ponder. I don’t think I’ll ever forget the scene of rolling into work, in the hospital jeep - to scores of people camping outside the hospital complex. Only then do you realise what real medicine and really being a doctor is about. When Dr Yogesh told us that the hospital caters for around 1.5 million people, I didn’t quite believe him but what’s more amazing is how such a small team manages it.
A lesson I learnt from the experience was how resource-conscious all the staff had to be - whether it be reusing clinical gloves or autoclaving instruments, or being very judicious in the choice of medical tests and investigations. It really showed the clinical skills of all the doctors, that they would correctly diagnose many conditions in the absence of certain tests. Indeed, when Sushil (basically the fixer of the whole place) showed us around the applied technology unit, I was honestly taken aback by the ingenuity of the whole operation. Spacer devices in the UK for respiratory conditions that cost an arm and a leg, had been replaced by a sealed metal tumbler. Simple, effective and cheap - we could certainly use a dose of that kind of lean thinking in the NHS.
JSS is not just a hospital, but an organisation dedicated to improving all aspects of the health of the rural poor. I certainly was surprised to see that a huge amount of time and effort was devoted to improving agricultural standards. Things that we take massively for granted in the EU Common Agricultural Policy-laden fields of England! The instruction given to farmers about how to improve crop yields, soil quality and grow foods that have greater nutritious value were an extremely simple but effective way of improving the health of the population. And considering just how many medical consultations I had seen, in which malnutrition was the usual cause of the problem - this was prevention in action.
​It is a small centre but busy nonetheless with patients sat out in the yard waiting their turn to be seen.
It’s a Saturday morning on the JSS campus and this morning we are driving out to visit the community centres where doctors hold their weekly clinics. From the Jeep’s rear seat, I peer out across the northern Chhattisgarhi farmlands – the pace of life is quieter compared to the bustle of Bilaspur and Ganiyari.
Patients come in with all sorts of maladies ranging from arthritis to old TB. A lady presents with a severe pain in her ear which has now led to tenderness around the jaw and mastoid. The team suspect an infection which has now progressed. The nurse and doctor help her into the adjoining room where she can lie down, set up an IV and await the ambulance to transfer her back to JSS.
Throughout the morning the patients calmly wait outside in the yard, some peering through the doorway to watch the doctors’ clinic, recognising each other and sharing jokes between themselves. There is a strong sense of community and a very welcoming atmosphere.
After a busy morning clinic, it’s time for lunch!