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Rhythm 6 : Beat 2

From the President

www.atmaus.org

Dear ATMA members:

It has been six months since I took over the presidency of our ATMA. A lot of water has gone under the bridge. I along with the members of the executive committee and the

Board (which is the controlling and over seer of all activities of ATMA) are working diligently to improve ATMA to achieve its goals.

Enacted new policies regarding the Charitable Foundation (CF) and Communication : http://atmaus.org/ATMA/ATMAUSabtus.aspx

Set Guidelines for the Project Review Committee (PRC) http://atmaus.org/ATMA/charity_atma.aspx

Our best achievement this year has been the creation of our redesigned ATMA website: www.atmaus.org. The credit goes to Dr. Nazeera Dawood and her team. Please visit the web-site and familiarize with ATMA events and happenings.

Secured a website advertisement sponsor and in the process of getting many more. If you would like to advertise on our website, contact us.

Creation of our three new chapter websites :

Greater Washington www.atmagw.org

North Carolina www.atmauscarolinas.org

Chicago Tristate www.atmachicagotristate.org

Chapter Appreciable Events:

Health fair event of the Greater Washington Chapter http://atmagw.org/ATMA/chaptergw/atmagwevents.aspx

Georgia chapter’s first chapter initiated newsletter : http://atmaus-ga.org/index_files/Page1316.htm

Initiation of Volunteer ATMA Program (VAP) : This program would encourage our members and their youngsters to

participate in the various PRC approved projects. http://atmaus.org/ATMA/youngphysician.aspx

Published an issue of the “PULSE” which all of you might have received and enjoyed, thanks to Dr. Selvakumar and his editorial team. He and his team should be congratulated in bringing this 2nd issue of the “PULSE”. I would like to encourage all our members to write medical articles for our “Journal of ATMA”- ‘JATMA’, which is to be published in the

next few months. http://atmaus.org/ATMA/PDF/PULSE_ATMA_Dec_2009.pdf

Membership drive/Creation of ATMA brochure :Mailing of this brochure to the non-members of ATMA (almost 2000) is in process.

Annual convention 2010 will be held in Chicago. Dr. Francis Xavier Roche, being the convention chair along with his dedicated team members

have been working feverishly to make it a grand event. It will be held in Chicago from August 12 - 15, 2010. I encourage all our members to participate in this convention which will be delightful and informative (C.M.E.). This will be an attraction that we will all enjoy and socialize with our friends and colleagues. The convention is also our main Fund Raising event, the proceeds from the conventions minus the operating expenses is transferred to our CF. ATMA CF funds our PRC approved charitable projects. http://atmaus.org/ATMA/atma2010covention.aspx

I am always available for your questions and if you require any help, please reach me at nsithian@yahoo.com. Wishing you all the very best in the rest of the Year. Hope to meet each and every one of you at the Chicago convention. Thank you again for supporting ATMA.

Sincerely, Nedunchezian Sithian M.D, F.A.C.S.

President-ATMA nsithian@yahoo.com

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a)Gloves a)Nebulizersb)Suturematerial b)Disposable anddressings. syringesandneedles.c)Autoscopesand c)Cardiorespiratory disposables &pulseoxymeters.d)Electronic d)Oneortwoolder thermometers childweight&

heightmachine.e)Multivitamin e)InfantDoppler tabletsand BloodPressure syrups apparatus.f)VitaminA f)Subscriptionfor capsules pediatricmagazines.

Dear ATMA friends,PCMC started functioning in full speed since the inauguration on October 2009. It is because of your generous support that we were able to launch this ambitious project and serve the children in the Pallavaram area. Children are the future of any nation and the entire world, but the neglected majority.

Statistics:India has 40% of its population younger than 18 years of age and is still losing a quarter of its children from birth to 5 years of age mostly by neonatal and infant mortality, from preventable illnesses like unmonitored and unavailable safe deliveries, and preventable childhood illnesses like diarrhea, respiratory infections and malnutrition.

Figures on PCMC:v Pallavaram Children’s Medical center

(PCMC) was constructed at a total expense of Rs.1.4 Crores (approximately $ 310,000). This does not include the value of the land which is estimated to be around 3 crores (approximately $ 600,000). The total value of the property is currently around Rs. 5 crores.

v Nearly One Crore Rupees of the building funds were donated by the original trustees including Dr & Mrs. Athi Narayan, the Bharathi Nagar Health center Trust and several corporate and individual donors in India through the help of Mr. M. Gopalakrishnan the former Chairman of Indian Bank who also tirelessly oversaw the construction with the help of Mr. Somasundaram, the secretary and founder of Bharathi Nagar Health Center Trust.

v ATMA was generous in donating $ 93,500 through the following major sources.

ATMAgreaterWashington $5000+Chapter: 11000= $16,000

Dr.RajanfromFlorida $15,000

Dr.FrancisXavierRoche(throughTristateChapter) $6,000

GeorgiaChapterofATMA(ALAMmeeting) $8,500

GeorgiaChapterofATMAAnnualConvention $45,000

TexasChapter $3,000

Total $93,500 (Apprx) Rs40Lakhs)

v $ 49,500 of ATMA’s donation went into the building of PCMC and the balance went into furnishings and equipments and early operational expenses.

v Current running of the hospital operations are being funded by donations from the Trustees and other donations through TNF

Facts on PCMC:v PCMC is a Non- Profit entity although it

will strive to break even and make a small profit for expansion and to subsidize more care for poor patients.

v None of the Trustees of PCMC or their relatives has any controlling interest or will derive any income from its operations.

v None of the Trustees derive any income for their time and efforts in the operation of PCMC including any out of pocket expenses.

v All of PCMC’s operations will be audited by a qualified auditor and the tax returns will be filed as per the existing Indian law.

Mission & Vision:v PCMC will serve every child in the

service area without regard to the ability to pay or the cast or religion of birth of the individual.

v PCMC will employ people from the local market without regard to their cast or religion or whom they know ( Infact 90 % of the 29 employees walk to work from their homes )

v PCMC will concentrate its efforts on our original statement (PEEPS) Prevention, Education, Emergency, Primary care and Secondary Care.

Recent Visitors:Drs. Pandiyan, Geetha Pandiyan & Bagyalakshmi Arumugham- TXDr. Sambandam Baskaran - MD. Dr.Tamilarasi Kannan - NCDr. Palanisamy Sundaram NJDr.VG Dev - TN Ashref Hashim from—ILL.

Volunteers:Dr. Balu Subramanian MD FAAP, a veteran pediatrician from the Pittsburg area is currently volunteering at PCMC. He started in late February and will serve as a volunteer until the first week of April. He sees patients two evenings a week, educates the nurses and the pediatric residents .

Visit PCMC:- If you are in Chennai, visit PCMC. If you need a ride or guide call PCMC while you are in Chennai. PCMC: 2266-1192 Dr. Parvathi Home: 2448-5345 Cell: 94445-31517.

Report:v PCMC has seen over 3200 patients since

the short time it has been in operation. (Please see Charts ) Recently we have added an Ambulance to the facility donated by Mr. Muruga Dass of Atlanta, GA and two Nelcore Pulse Oxymeters donated by Emory Johns Creek Hospital . We have 24/7 in-house physicians at this time although we had considerable difficulty in the beginning. Believe it or not Pediatricians are very difficult to get in Chennai area and the salary levels run well above Rs. 45,000 a month.

Future Activities:v There will be a Pediatric seminar in

Chennai jointly arranged by PCMC, Mehta Children’s Hospital and Child Trust Hospital on the 7th – 9th of January 2011. The seminar will be lead by PCMC with Collaboration from Emory University. Efforts are under way to choose topics and speakers and an agreement with Emory and its pediatric faculty. CME credit will be available thru Emory for those participating physicians from the US

Future Direction:v We envision opening similar centers in

other parts of Tamil Nadu & extending our services to women and children

v We have instituted a Pediatric Residency Program which is currently not approved by any Indian agency. We hope to get approval in the future, but believe strongly this work and training experience will help those who want to come to the US seeking Pediatric Residencies

How ATMAite can help:v Volunteer your time and expertise. We

are eager to have General pediatricians and pediatric emergency medicine specialists to volunteer with hands on care and education. Get involved in educational and advisory roles. We are eager to have sub specialists in pediatric ID, Cardiology, allergy, pulmonology, neurology and developmental, neonatology and pediatric intensive care.

v Donate small items to the Hospital. We are looking for durable equipments and supplies. (Table )

Athi Narayan MD, President – ATMA 2008-2009Member of the board of Trustees PCMC Trust and Bharathi Nagar Health Center Trust

For Questions:- Dr. Athi Narayan: Home: 770- 475-1924. Cell: 248-212-3148 Work : 678-474-7500, E- Mail drnarayan@aol.com

Dr. Arumugham: Home: 972-788-9440, Cell: 469-713-9715. E- Mail arumughap@yahoo.com

AN UPDATE ON PALLAVARAM CHILDREN’S MEDICAL CENTER (PCMC)

v Although we are not asking for any cash donation at this time you may choose to buy health insurance to one or many poor children at Rs. 600 ($ 15) per child per year.

THANK YOU:Once again thank you ATMA! Without the support of all of you, PCMC would not have come into being and with your continued support we can serve as many children as your heart desires!!

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What about VaP?ATMA is glad to announce the initiation of Volunteer ATMA Program (VAP). Volunteering has been the backbone of

ATMA ever since its foundation. ATMA members are already making a difference in our own small way here as well as back home. We need not need to reiterate the satisfaction that is attained by volunteering. Volunteers in ATMA

have always worked for the cause of improving the health of the underprivileged. So WHAT, WHY and WHEN is VAP? VAP goes a step further in giving an opportunity for the volunteers irrespective of their age to volunteer in ATMA Project Review Committee (PRC) approved projects. It can be us, our daughters/sons/ grandkids who visit back home and want to spend some time offering their expertise or learn new skills in any of the organizations that ATMA has already recognized.

Frequently asked Questions:How does VAP identify the potential volunteers?There is a VAP application form available on the website that can be downloaded by interested volunteers. The applicants can fill out the form and scan and email to atmaus@yahoo.com . ATMA will carefully screen and evaluate the volunteer applicants. Once the applicants are approved to VAP, they will be referred to the organization of their interest.

What are the benefits for VAP volunteers? Not to mention all the benefits that volunteering brings in, VAP volunteers get to volunteer in an organization that they like. VAP volunteers get to learn new skills and also offer their expertise to the ATMA PRC approved projects. In addition a letter of reference will be provided by the ATMA president as well as the ATMA approved projects director.

Does ATMA pay VAP volunteers?No, As ATMA is a non-for profit, there is no funds separately allocated to this program. We will try to secure some funds for this program in the future. But the PRC approved member organization may be able to provide a subsidized cost for food and lodging.

Does ATMA pay for travel costs?At this time ATMA has not separately allocated funds for VAP. So at this time ATMA will not be able to pay for travel or accommodation. ATMA might be able to secure funds for travel, food or lodging for VAP volunteers in the future.

Who will benefit the most from VAP?ATMA members themselves, who visit TamilNadu for a vacation or who stay for few months. ATMA members’ kids or grandkids who have wanted to serve the underserved or who wish to gain experience from working in PRC approved projects. VAP volunteers do not have to be ATMA members as the application for VAP is open to members as well as non-members. The people who will benefit the most are the underserved, rural community or the organization itself where the VAP volunteers will serve.

Is there a time limit for VAP?There is no time limit for being a VAP volunteer. It can be anywhere from one day to one year or more. Even 10 minutes spent at these organizations offering your expertise is a volunteering in itself. But reasonably a VAP volunteer is expected to be volunteering for a minimum of one month.

Is there an age limit for VAP?No, absolutely not. Even if you are a ten year old or eighty year old, VAP is ready to accept you as a volunteer.

Do I need any particular skill sets for VAP?As volunteers are always appreciated and ATMA does support health care projects, any skills related to health care is a plus. Even if you are a good typist, a good communicator, or a people person, the PRC projects can use your help with or without these skills.

Once I get accepted to VAP, what happens?Once you are accepted, you will be referred to the organization that you are interested in volunteering. Then you would have to sign an agreement form with ATMA and then be ready to make your travel plans.

Promotors of VAP :

Nedunchezian Sithian, MD,FACSnsithian@yahoocom

Nazeera Dawood, MBBS, MPH, CCRCnazeera@ymail.com

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Stool Sample I asked a patient that he should bring a stool sample for testing.The patient brought me this:

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Chettinad University Medical College

Chettinad University Medical College is a constituent of Chettinad University. The mission of the Hospital is to provide, ‘Health care for all.’ The mission of the University is to ‘Educate, Enlighten, Empower.’ The Chettinad University

Medical College combines these two great ideals and provides, ‘Health care for all,’ and Educates, Enlightens and Empowers the medical and paramedical students.

Chettinad University is an integral part of the Chettinad Health City, a pioneering concept that strategically combines the best of education, research and health care delivery and provides a synergy across the entire health care spectrum. With its ultra modern infra structure and highly qualified and experienced faculty, Chettinad University offers an environment ideal for learning and growth.

Chettinad University Medical College was founded by the Chettinad Academy of Research and Education (CARE), the philanthropic wing of ‘The House of Chettinad.’ The House of Chettinad is a household name in India and in particular Tamil Nadu. They have been pioneers in Education, Banking and a myriad of other activities.

The Medical College Hospital offers free consultation for all and free treatment for many patients and highly subsidized treatment for the others. The current hospital bed strength is 750 and is likely to be increased in the near future. There is also a super speciality hospital attached to the college which has several centres of excellence like the Department of Reproductive Medicine and Institute of Cardio vascular disease.

The medical college offers a 4 and ½ year undergraduate Medical course followed by one year of internship as per the norms of Medical Council of India. The students are taught by didactic lectures, practical sessions,

- Dr. Natarajan Pandiyan, Chennai

Professor K. Bhasker Rao In the recent passing away of Prof K Bhasker Rao in USA, the nation has lost one of its most outstanding Obstetricians and Gynecologists. A man who had as his life’s mission, ‘to reduce the maternal mortality and morbidity in third world countries,’ worked incessantly to achieve this objective. He was a teacher par excellence, a great organizer and the architect of the Obstetric & Gynecological Society of Southern India in its present form. He served the World Health Organization, Federation of Obstetric & Gynecological Societies of India, Institute of Obstetrics & Gynecology, Madurai Erskine Hospital, Vijaya Hospital & Andhra Mahila Sabha Hospital.

His passion for teaching was phenomenal and his passing away has left numerous grieving students all over the world. He was a great administrator and showed clearly that one could be soft but yet firm. He will be missed dearly by his students , who are the present practicing Gynaecologists in Tamil Nadu, India & abroad.

Prof K Bhasker Rao was 89 when he passed away.

I was most fortunate to be trained under his guidance during my undergraduate & post graduate studies in Obstetrics & Gynaecology.

Dr. N.Pandiyan, Chennai.

A Legend passed away.

model/mannequin based teaching and clinical training. The college is located at the Chettinad Health City, an eco friendly green campus on the Rajiv Gandhi Salai in Kelambakkam, Kanchipuram district, away from the pollution of Chennai city.

There is a huge central library, besides departmental libraries. The campus is Wi Fi enabled and allows easy access to Internet. A virtual library helps earlier and easier access to journals. The staff and students have comfortable accommodation on campus. The campus is self contained with Food Court, Gymnasium, Play ground and a Salon and a magnificent state of the art auditorium.

Chettinad University Medical college aims to educate, enlighten and empower the students to heal the sick, nurture the passion to care, propagate the commitment to serve and promote the zeal to excel in all their endeavours.

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population of 1.2 billion people, India just isn’t producing enough physicians, and needs to liberalize medical education to meet the future demands. Surely, all of these developments indicate a pattern that augurs

well for the future of higher education in India, but what about basic education? Even here, there have been several encouraging and revolutionary developments. India has taken primary school enrollment very seriously, and its Sarva Shiksha Abhiyan (SSA) is the largest ongoing “education for all” program in the world. Between 2003 and 2009, the number of children enrolled in elementary education in India has increased by 57 million. India currently has a total of 192 million children in elementary education and this cohort will – within 10-15 years – benefit from the expanding higher education development. Just last week, the World Bank announced two projects totaling USD 1.05 billion

for India to expand the reach of primary education and to improve the quality of engineering education. The 86th amendment of the Indian Constitution passed in 2002 has mandated education as a fundamental right for all children. India is also addressing its rural person-power needs with bold and creative strategies. For example, the Medical Council of India recently released a plan for an alternative model of medical education involving a four year Bachelor degree in rural healthcare. (See BMJ, 9 February 2010). Not only will this create employment for rural India, but will also enable the development of relatively low-cost rural healthcare infrastructure for the significant proportion of Indians living in rural areas. There clearly is major momentum in India to take the formidable education challenges head on and to aggressively solve the problems with pragmatism and without the baggage of ideology. Replicating its success in the area of information technology, new India seems to have decided to leapfrog directly into the knowledge economy, skipping the industrial revolution of factories and assembly lines.If India’s bold initiatives in education succeed, the world’s largest democracy can also emerge as the world’s largest knowledge and technology society within a generation. One gets the feeling that India has its mind set on that goal.

K.M. Venkat Narayan is Ruth and O.C. Hubert Professor of Global Health and Professor of Epidemiology and Medicine at Emory University Atlanta. He is a product of three continents, having lived and worked in India, United Arab Emirates, United Kingdom, and United States of America.

Posted in :

Venkat Narayan, BMJ Group blogs 22 Mar, 10 | by julietwalker

http://blogs.bmj.com/bmj/category/ venkat-narayan/

Oozing With Confidence New India Takes on Education ChallengesK. M. VENKAT NARAYAN, MD, MSC, MBA

In general, past trends may help to reliably predict the future of simple systems. Not so with complex dynamic systems, which are hard to predict, and when it comes to complexity and dynamism,

new India is hard to beat, and therefore, hard to predict.In one of my earlier blogs (1 March, 2010), I asked whether and how India might meet the gigantic challenges of educating its very large young population (nearly 50% of India’s population is under 25 years of age) – often touted as India’s “demographic dividend” for economic growth.I am going to boldly predict that India will meet her education challenges very substantially, if not completely, within the next two decades. Why do I think so? The one way to make “predictions” about complex systems is by observing patterns (and, of course, in India, they have astrologers too!!). In the recent few weeks, there have been a number of revolutionary developments concerning India’s education sector, which together make a pattern and tell a story. The Indian Cabinet approved a plan to allow foreign universities to set up campuses in the country. This still has to be ratified by the Parliament and there are several hurdles ahead before it is fait accompli. But for a country that has for six decades held on to Gandhian ideas of self sufficiency and to the Nehruvian model of “License Raj”, this is a revolutionary and pragmatic move. As the education Minister, Kapil Sibal, put it “In the next 10 years, you are going to have more than 40 million children going to college, an extra 40 million. So you have to create infrastructure for them”. With a current graduate enrollment rate (GER) of 7%, India needs massive infrastructure and investment in higher education to reach developed country rates of 25-30%. The National Knowledge Commission of India had estimated that the country will need 1500 universities compared to about 350 now to meet this GER target, and this simply cannot happen without wisely and cautiously opening the education market. Indeed, not only is India opening the market to foreign universities, there are also signs of some highly successful Indian entrepreneurs getting into higher education. Notably, the State of Karnataka has passed the “Azim Premji University Bill 2010”, which will enable the founder of India’s IT giant, Wipro, to start the first private university in the state. In the same week that this foreign universities plan was approved by the Cabinet, the Medical Council of India (MCI) approved of a plan to allow private companies to open medical colleges. This means that large, high-quality hospital chains – such as Fortis Healthcare, Apollo Hospitals, and Max Healthcare – with deep pockets, market knowledge, and grand ambitions can get into medical education. While this move on the part of MCI is bound to raise noisy controversy in cacophonous India, this too is a revolutionary move of profound future significance. For a

Our own Venkat Narayan, the recipient of ATMA’ Lifetime Achievement Award in 2009 is providing his perspectives (in blogs) in the British Medical Journal on how India is poised to tackle challenges in education both primary and higher. Interesting and illuminating reading!

Abdul Jabbar Atlanta, GA

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ATMA’s Support Goes

Global

Chicago/Tri-state Chapter

Report -April 1, 2010

ATMA’s Support Goes

GlobalHari Prabhakar

Looking back at 5 years of progress at the Sickle Cell Center in Gudalur, the support of ATMA comes to mind as one of the most important factors in the success of the program. I can still remember

sitting in Dr. Mathuram Santosham’s office at the Johns Hopkins School of Public Health in 2004, as he told me about Dr. Jay Gopal’s work in establishing the American Tamil Medical Association. At first, I was hesitant to contact Dr. Gopal about our project, but the interest, warmth, and support that I received from an initial query to Dr. Gopal ultimately set the stage for a long-lasting and continuing collaboration between ATMA and the sickle cell program.

ATMA members have a lot to be proud about through their support of the Sickle Cell Center. In the past 5 years, full-fledged screening, treatment, and education programs have been developed throughout the Gudalur and Pandalur Taluk’s. Over 8500 individuals have been screened, and around 200 adivasi and non-adivasi patients are receiving treatment for this debilitating disease and global public health issue. In the past, sickle cell disease has been given very little attention in India, despite there being at least 1-2 million sickle cell patients throughout the country. Through ATMA’s support, the Sickle Cell Center has been recognized by the Tamil Nadu Health Systems Project as a pioneering program in comprehensive care provision for rural and underserved sickle cell patients.

What ATMA members may not immediately realize, however, is that their support of the program has had global implications, particularly in the United States, for managing the disease. Developing a sustainable, community-based, and comprehensive model of sickle cell care has placed us in a position to explore avenues for cross-implementation of our model to other affected areas both in India and throughout the world. In fact, thanks to the lessons that we have learned in the process of developing the Center, we have been able to create a number of manuals and primers on improving the quality of care for sickle cell patients in the United States and internationally. These materials have been distributed to public and private agencies including the Agency for Healthcare Research and Quality and the Sickle Cell Disease Association of America. Furthermore, we have created an action plan and clinical guidebook for the Indian Health Service to provide better care to Native American sickle cell patients, much of which is based on the work done in Gudalur. We look forward to continue working with public and private agencies to improve the quality and accessibility of care for sickle cell disease, and had it not been for ATMA’s support, we probably would not have been in a position to do so.

Without a doubt, ATMA should be proud that it has played a crucial role in bettering the lives of underserved sickle cell patients both in India and in the United States. This fits well within the mission of an organization whose members are dedicated to providing care to patients in both the oldest and largest democracies of the world.

Thank you, ATMA.

Our Convention Committee members are busy with the planning for the upcoming Convention in August aiming to make it the biggest & best one ever.

Our Committee met on March 21st and had member input and updated the various sub-committees and their activities. The Chairperson for the committees have been chosen: Dr. Narmadha Kuppuswami for CME, Dr. Vasantha Naidu for Reception & Registration, Dr. Bhanu Rangachari for the Food committee & Entertainment committee, Mrs. Viji Palani for the Spousal program, Dr. Kris Rangachari for Souvenir, etc. We have prepared the Registration form & Fee schedule for ATMA members and also ITMA members.

CME topics & speakers have been chosen. We are encouraging them to bring their sponsor in their fields. We are approaching various companies for Educational grants. Great entertainment programs have been arranged for all nights. We are adding and modifying the agenda every day for the various areas of the convention. We have chosen our local Charity to donate to -Jane Addams’ Hull House.

Our committee will be active and will be meeting often to make the event as a memorable one.

Dr. F.X. Roche Governor/Convention Chair

Dr. Priya Ramesh Dr. Ram S. Prasad Secretary Treasurer

Chicago/Tri-state Chapter 2010:

Dr.Ram Prasad-Treasurer, Dr. F.X.Roche- Governor & Convention Chair & Dr. Priya Ramesh- Secretary

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V.Selvakumar, MD., FACG.,

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E D I T O R I A L B O A R D

Editor-in-chief: V.Selvakumar, M.D.,F.A.C.G Omaha, NE. gutkumar@gmail.com 402-963-0505

Editors: MehalaiArivoli, MD mehaarivolimd@gmail.com NazeeraDawood, MBBS,MPH,CCRC Nazeera@Ymail.Com NedunchezianSithian MD,FACS nsithian@yahoo.com,

Articles NeededWe solicit articles for the upcoming next Pulse issue and for the Souvenir for the convention. For details for the Souvenir, visit www.atmachicagotristate.org.

We are still planning to Publish Journal of ATMA/ JATMA. However, the response for scientific article so far is not enough to successfully bring the next issue. We know there is enough academic and scientific talent across the nation. We also need abstracts of any of their published articles in the past few years. Please send them to :

gutkumar@gmail.com

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H ow many of you thought that implementing a health care prevention / intervention program in rural Tamil Nadu was as easy as 1, 2, 3. Well, of course you would say it is not that easy. But why so? Let us take a charitable hospital in a rural setting where the majority of patients that the hospital

serves are from in and around the rural community. The biggest hurdle that we can cross in implementing a health care program is convincing the hospital administrators, staff, faculty and service workers to get to agree to implement the program.

I would like to tell you from my experience of implementing such a program called “Prevention of Parent to Child Transmission of HIV” (PPTCT) at the Gandhigram - Kasturba Hospital (KH) in Dindigul district. This program was implemented Tamil Nadu State AIDS Control Society (TANSACS) to reduce the number of newborns with HIV (estimated 32,628 children infected with HIV through parents in India every year). It was funded by UNICEF. The implementation of PPTCT at KH would involve:

v Counseling and testing all the antenatal mothers getting care from KH for HIV

v Tracking of antenatal mothers identified as HIV positive and

v Administration of Nevirapine for the mother-baby pair at the time of delivery at KH

KH&PPTCT: When it was announced at KH that such a program was going to be implemented, there was this tenseness in the air all around. I was the Program manager for the PPTCT, also working as a junior medical officer then. There were whispers heard all over at KH. As I was the new kid on the block, the administrators would try to portray a grim picture for KH if PPTCT was implemented. They would say to me KH would be called an ‘AIDS hospital’, you would be called ‘AIDS doctor’ and KH would close down. It was not only the administrators that were tensed; the nursing staffs were worried as well for their well being if patients with HIV were delivered routinely.I would listen to all their concerns and would tell them to be strong and asked them to attend the in-house training for the PPTCT program.

In-House Training : Being in charge of the in-house training, I felt I had that huge responsibility of convincing the 250+ staff that KH would be incomplete without PPTCT. I designed the curriculum for training according to the nature of the work performed by trainees. It was conducted for a day each for administrators, nursing staff, doctors, health workers, Arokya Sevikas, and finally the service workers, which lasted a total of six days. The curriculum for the day would be talking about history of HIV/AIDS, modes of transmission, signs & symptoms, diagnosis, treatment, prevention, interactive role play games & what is your role in the PPTCT program. Most of the participants felt they had gained more knowledge during this training. They also expressed that they were not exhausted by the end of the day because of the interactive activities. I remember few of them in tears during roll play games and would say “only now do we feel what they (Mothers who are HIV positive) feel.” As KH is a close knit community, news spreads like wild fire. So I had to make sure that the curriculum stressed on maintaining patient confidentiality.

“On the third day of the in-house training, I got bad news that my grandpa passed away. I was heart broken but could not show any emotions as I did not want the training to be disrupted. I used the lunch break to go see my grandpa in Dindigul one last time and was back to continue the in-house training for the rest of the afternoon. Till this day, no one at KH knows why I went missing during the lunch break and the loss that I suffered.

TheDayAfter: It is usually hard to bring a behavioral change in a group of people but this training proved that there was a positive change in attitude of some of the staffs towards patients living with HIV. Almost 40% of staff who were reluctant to start this program was fully convinced in implementing the program after the in house training. Most of the staffs also mentioned that if they were provided with the universal work precautionary materials they did not have any hesitancy in treating HIV positive patients.

CountdowntoPPTCTImplementation:If I had thought that the gloomy days were over. Oh Boy, Was I wrong? Only few more days left to the PPTCT implementation and there was disruption, disengagement and rumble from few of the staff. I was exhausted and was not in a state to start from the beginning

all over. I was furious and wondered what part of the in-house training didn’t they get it. I had had it and there was nothing left for me than cry and hand over the resignation letter to Dr.Kausalya Devi, Managing Trustee of KH. She refused to accept the resignation and wrote back: “This is just a simple

example of practical difficulties in a new work. If your education (MBBS & MPH) does not give you the confidence to manage the work that you have undertaken now, shame on you dear. Any new work with only few involved is likely to create problems like this. You should face it, deal with it in the right way, find solutions , explain to them, gain their confidence, share with your work and

bring you good name”. Dr.Kausalya Devi’s letter gave me all my energy back and I was back in action. I felt all the obstacles hanging in front of me could be conquered.

TheBigDay&MeasurementofSuccess: The PPTCT implementation day at last came on a sunny day. I could not have been prouder of the KH staff and their adaptation to change. One month after the implementation of the PPTCT, some of the data that we had was astonishing:- We had almost screened and tested almost 95% (515/ 550) of the antenatal mothers who came to KH for check up that month. Almost 45% of the pregnant mothers who were counseled did not know anything about HIV/AIDS. Apart from having a counselor, I would personally sit with patients and listen to them in a

group or individually and counsel them on family planning, birth spacing etc.

What?NametheBaby: I also would provide my cell number to the mothers who were tested HIV positive so that they could reach me at any time with their concerns. Delivery was conducted for a HIV positive mother during the first month of implementation with no hesitations from the doctors or the staff. The same lady came back after a month with the cutest living being in her hand and said I had to name her baby starting with Ka, Ke or Ku. I was taken

aback as I had never named anyone before . So I got to name the product of our first PPTCT program baby as Keshini and she was confirmed HIV negative eighteen months after her birth.

PPTCTSustainability:Six months in to the implementation of PPTCT, there was no problem sustaining it. The program was serving its purpose of screening the antenatal mothers for HIV as well as creating an awareness to keep them negative in the future as well. TANSACS was delighted to see the KH report on the In-house training & implementation of PPTCT at KH, that they called it a role model and circulated the in-house training report to all the 65 PPTCT centers in TamilNadu.

This implementation happened five years back and if you ask the staff at KH about PPTCT program today, they will say “What, Oh you mean Dr. Nazeera’s program” According to my experience, implementing a program in the rural hospital in TamilNadu involves dedication, patience, consideration, inclusion, empathy, education, commitment and the most important thing a gentle personal touch. Finally, I would like to thank Dr.Kausalya Devi, Dr.Manonmanie, Dr.Indru Tupulur, Counselor Vimala, Lab Tech Mr.George, TANSACS officer Dr.Kuganantham and of course the KH staff for giving me the opportunity and believing in me for the successful implementation of PPTCT at KH.

Now you may ask how, when and what happens once the antenatal mother at KH is told that she is HIV positive.

That in itself is another long story that you do not want to read now. Probably next time...

Meendum Anubhavam Thodaruma?

Nazeera

Reference:

1. UNGASS Country Progress Report 2008 India http://data.unaids.org/pub/Report/2008/india_2008_country_progress_report_en.pdf

2. TANSACS, December 2007

Whatever you do will be insignificant, but it is very important that you do it.

- Mahatma Gandhi

Nazeera Dawood MBBS, MPH,CCRC

Implementing a Health Care Program in Rural Tamil Nadu

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March 13, 2010, 7am, A cold rainy and gloomy morning in Maryland, the ATMA-GW doctors and volunteers left their homes to care for the refugees of

Bhutan living in Baltimore.The Bhutan refugees are the newest refugees, immigrated within the last 2 years. There are 70,000 of them in US and 700 of them live in Baltimore. They are considered to be the most under-served in the area were they live in Baltimore. Though, they are in the process of getting their medical assistance from the state, many of them were yet to see a doctor and did not have any health care. Since ATMA’s one of the missions is to provide health care for the needy, when the Bhutanese community requested, the GW chapter ceased the opportunity to conduct the health camp.

The health camp was held in Greater Baltimore Temple Auditorium. None of the refugees had cars or access to public transportation; they had to be picked up by volunteers in 10 cars and had to make 2 shifts to bring about 60 of them. After a formal registration, the volunteer physicians’ conducted the health camp with utmost dedication, care and compassion. Every individual was evaluated with the following: Weight, Height, BMI, Vital signs including BP measurement, Review of History forms, Physical exam, limited to GE, HEENT, Dental, CVS, RS, and GI. Two of the phlebotomists helped in blood drawing for: CBC, CMP and cholesterol (Courtesy of Union Memorial Hospital, Baltimore). Counseling was given on: Nutrition, Tobacco use, education on breast, colon and prostate cancer. This is in addition to counseling on their specific problems. At the end, a referral was given to every person for a follow-up to a free clinic located closer to their residential areas.

Thanks to all the following physicians for volunteering their time and efforts in making this health camp a success: Dr. Jeyanthi Sirithara, Dr. Sankari Sivasailam, Dr. M. Vasanthakumar, Dr. Unni Sivaraman, Dr. Raj Manickam, Dr. Devika Ananthakrishnan, Dr. Geetha Raja, Dr. Rama Shankar, Dr. Deepak Baskaran, Dr. Sam Baskaran, Dr. Sri Sirithara and Dr. Jay J. Gopal. Also, thanks to non-physician volunteers, without whom this health camp would not have happened.

This is the first of this kind of health camp we have done since the inception of ATMA. This camp has created precedence for future health camps. The next health camp is planned for uninsured elderly Indians living in greater Washington area, summer of this year.

“Makkal Sevai Mahesan Sevai”

Greater Washington GeorgiaATMA GA 2010 Kick Off Meeting was held on Feb 6 2010. Dr.Balu

Mani stressed on getting more members to the GA chapter and during his term, his goal is to increase the membership atleast by 50%. For this

all of us have to actively be involved in spreading the word about ATMA and its activities.

Website, Yahoo groups email list & Newsletter: Dr.Nazeera talked about the launch of the website on Oct 09, and the update of the website. For now, we are looking for advertisers to place ad banners on our website. She also encouraged members to communicate in the Ga chapter yahoo groups email list. The ATMA GA newsletter will be published thrice a year to involve the GA chapter members. It will go a step further in asking for members profile to be published. There was a consensus however that the ATMA GA yahoo group email list is not only to talk about medicine, and can be of any interesting topics, news articles, jokes, announcements that all the members can enjoy.

Financial Data: Gayathri Indrakrishnan gave an idea of the money that came out from the convention and the money that had been spent on projects and the amount that is left in our GA chapter account. Chapter membership per 2009 submitted last year:- $1535 Available cash balance for operations:- $2206 Budgets will be prepared once the projects are planned. A detailed report of the financial data will be presented on the next GA chapter General Body Meeting.

ATMA-GA projects/ Fund raising event

Dr.Balu and Dr.Indran further talked about ATMA-GA projects and fundraising events. They reiterated the fact about ATMA’s visibility to the community esp. the Tamil community. For this to be achieved, ATMA-GA should atleast conduct a health screening fair not on a large scale but in a small scale to start with. One suggested idea by Dr.Indran was during a cultural get together event organized by Greater Atlanta Tamil Sangam (GATS), ATMA-GA can set up a booth and the attendees can approach the personnel at the booth if they have any medical question answered, an ATMA physician present at that particular event might be able to help with answering those health related questions. For more community involvement of ATMA-GA, ATMA members who consent to volunteer helping the community by answering their health related question put forth through the website. The general consensus from this meeting was to avoid unnecessary hassles and get the chapter energized to achieve the goals of the GA chapter help ATMA develop and serve the underserved.

Thank You Note : Finally Dr.Balu thanked the group and the new members for their presence and for their active participation. Since our kick off meeting, 2 new members have joined ATMA. ATMA GA chapter is also planning to have a health fair in collaboration with Greater Atlanta Tamil Sangam on May 9th (Mother’s day).

Balu S.Mani, MD, MBA Governor

Nazeera Dawood, MBBS, MPH,CCRC Gayathri Indrakrishnan, CPA,MBA Secretary Treasurer

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The Convention Committee is working hard to give you all a grand experience.WWe need your help and support to make the Chicago convention the best and most memorable ATMA Convention. Please encourage your friends to become members and attend this great social gathering to make plans for the betterment of of the poor & underserved in our homeland.

ATMA’s 6th ANNUAL CONVENTIONAugust 12th-15th, 2010

Looking Forward to See You All :

Dr. Francis X. Roche, Convention Chair, Chicago/ Tri-State Governor

Dr. Nedunchezian SithianPresident, ATMA

Dr. P.ChockalingamChairman, ATMA

Dances to the Rhythms of Rahman by Internationally acclaimed dance troop of

Mrs. Hema Rajagopalan

To Become a Member, To Register Online or To print the form & for information:

visit : www.atmaus.orgChicago Tristate : www.atmachicagotristate.org

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American Tamil Medical AssociationTax ID: 20-2245175

6th Annual Convention, August 12-15, 2010Hilton Chicago/Indian Lakes Resort, 250 West Schick Road, Bloomingdale, IL 60108

http://www.hiltonindianlakes.com Phone:- 630-529-0200

ATMA 6th Annual Convention Registration FormName: ________________________________________________________________ Member: [ ] [ ] (Last) (First) (Yes) (No)

Mailing Address: ________________________________________________________________________

City: __________________________State:_______ZIP:_____________Phone:______________________

Medical School: __________________________________Email:________________________________

Specialty of Practice: _____________________________________________________________________

Spouse_______________________________________________________________________________ (First) (Last)

Children attending with names & ages:1._______________________________________ 3._________________________________________2._______________________________________ 4._________________________________________

Registration includes : 8 hrs of CME, Reception, 2 breakfasts, 2 lunches, 3 dinners & all Entertainment How many # Veg: [ ] # Non-Veg: [ ]For more information: Visit www.atmaus.org

Registration Fee Schedule*Patron Donor Details Amount Physician +Physician Spouse $ 1500 (Includes: CME, meals for 2 people & 1 hotel room for 3 nights (12,13 & 14 or 13,14 &15) $Physician + Non-Physician Spouse $ 1250 (Includes: CME, meals for 2 people & 1 hotel room for 3 nights ( 12,13 & 14 or 13,14 &15 ) $Allied Professional +Spouse $ 1000 (Includes CME if applicable, meals for 2 people & 1 hotel room for 3 nights( 12,13 & 14 or 13,14 &15 ) $

Member Non-Member After July 11th AmountPhysician $470 $520 Add $50 $Physician Spouse/Associate Member $345 $395 Add $50 $Non-Physician Spouse/ $170 $220 Add $50 $ Child > 15 years $170 $220 Add $50 $Child < 15 years Free Free Guest $300 $300 Add $50 $ Retired MD/+Retired MD Spouse $320/520 $370/570 Add $50 $ Medical Student/ Resident/Fellow $190 $240 Add $50 $One day attendee Friday $100 Saturday $125 Add $25 for non-members $

Total Registration Fee $

Online Registration: http://www.mydonations.com/atmaus/?e Last date for Online Registration is August 11, 2010

Make check payable to: ATMA- Chicago/Tristate Chapter Mail to: Dr. Ram S. Prasad 1730 Timberwood Ln, MUNSTER, IN 46321

Hotel Information & Reservation:-Hilton Chicago/Indian Lakes Resort, 250 West Schick Road,

Bloomingdale, IL 60108 Phone:- 1-800-334-3417http://www.hiltonindianlakes.comATMA Special Rate :- $ 105 / night

Discount Code- ATM

Your Registration fee may be Tax deductible - Please consult your accountant. *The registration fee does not cover hotel accommodation except for Patron donors.

To become a member of ATMA, please visit http://www.mydonations.com/atmaus/?m Complete your online registration and pay your membership dues.

Cancellation Policy: Before June 30, 2010 - full refund, less $90 administrative fee. July 1 - July 31st, 2010 - 25% refund. After July 31st 2010 - no refund

Dr.Nedunchezian Sithian MD Dr. F.X. Roche Dr. Priya Ramesh Dr. Ram S. Prasad President Chicago/ Tri-State Governor Secretary Treasurer nsithian@Yahoo.com franxer@gmail.com priyarameshmd@gmail.com ramspras@yahoo.com 718-667-3630 219-864-1233 847-657-7413 219-922-3682

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Rhythm 6 : Beat 2

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வளர்க ஆத்மா

ேமகைல அறிெவாளிThis issue of Pulse was Sponsored by

Chicago / Tri-state Chapter of ATMA, ,

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A patient was asked to bring “Stool Sample”The patient brought me this

Selvakumar

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