“Hospital Travels to the Patient” cried the front page lead story in The Telegraph and the travel, hospital indeed did, on the 22nd & 23rd of May, 2009 to the interiors of the hills of Uttarakhand, to Dena Hospital in Dinapani, Almora to perform three land mark open heart surgeries. Similar stories bespeckled the journalistic landscape, both print and electronic, of Uttarakhand & rest of the country. This was the first time, open heart surgeries had been performed in the hills of Uttarakhand. Mrs.Meena Devi and Mr.Hemant Singh Tolia underwent open heart surgeries for a hole in the heart (Birth Defect) and Ms.Sonia, a teenage girl underwent valve replacement surgery for a leaking heart valve.

It all began almost five years back, when National Heart Institute under its ‘Corporate Social Responsibility’ and the‘Community Outreach Programmes’ organized a free heart check up camp for people from the remote areas of the Kumaon region. The camp was well received and seven patients from the camp underwent free open heart surgeries at the National Heart Institute in Delhi. However it was soon realized that there was a total upheaval of the entire family when any member had to come to Delhi for their treatment and therefore efforts were initiated towards providing these services at the door step level.

Ms.Mukti Datta, Chairperson of the Jan Jagaran Samiti which runs the Dena Hospital, took a keen interest and in consultation with the Government of Uttarakhand and with technical know how from National Heart Institute, a road map was drawn of providing all encompassing cardiac care for the people of the Kumaon region. Under the plan preventive aspects of heart care were given prime importance and towards that end, services were designed for the provision of preventive cardiac care at the village level; secondary cardiac care, that is medical management of simple cardiac ailments at Dena Hospital and tertiary cardiac care, that is open heart surgeries and advanced management of cardiac ailments including angiographies and angioplasties at Base Hospital, Almora. The then Hon’ble Chief Minister of Uttarakhand, Gen.B.C. Khanduri himself led from the front and initially showed keen interest in the whole project and every decision used to be taken with alacrity and with his direct involvement. A Memorandum of Understanding was drawn between the Govt. of Uttarakhand, Jan Jagaran Samiti, Almora and National Heart Institute, New Delhi and all nitty gritties, both legal and financial, were sorted out and respective departmental clearances taken.

It was a wonderful and well thought of project in which local talent from the hills was identified and they were to come down to National Heart Institute, in Delhi for varying periods of time for training. During this phase of training of roughly 3-5 years, National Heart Institute was to provide tertiary care services at Base Hospital, Almora by regular visits with the aim of transferring the complete knowledge and expertise to the local talent, which would then carry on with the cardiac programme. The then Hon’ble Health Minister, & the present Hon’ble Chief Minister Mr.Ramesh Pokhriyal Nikunj, during his public rally speech in Almora during Dusshera declared this project and announced that Hon’ble Chief Minister will inaugurate it formally on the New Year’s day. The Chief Minister did visit Almora in the 1st week of January, 2009 but to the ulterior surprise of all the stake holders and the general public, announced that this project was not feasible as it was not safe to do open heart surgeries in the peripheral areas. This was a blatantly wrong statement and the unofficial version of people in position of consequence, who would not like to be identified, was that this was the age old and traditional rivalry between the Garhwal and the Kumaon regions for the ‘one man upmanship’!

However, the official version was the safety concerns of performing open heart surgeries. It is with this aim of demonstrating to the government and to the political and bureaucratic bosses, National Heart Institute, Jan Jagaran Samiti and Dena Hospital took upon themselves to show case that it is feasible to do complex heart surgeries in these far flung areas. After reccee visit by a team of nurses and doctors from National Heart Institute, led by Dr.Arvind Prakash, Chief Anaesthetist, National Heart Institute and Sister Bindu, Sister in-charge of surgical services, basic infrastructure was developed at Dena Hospital and the surgeries were planned for the 4th week of May 2009. All equipments including heart lung machine, heating cooling systems, ventilators, monitors, blood banking equipments, biochemistry equipments, instruments and specialized gadgetories were all carefully packed and transported to Almora from Delhi in trucks. A team of 18 personnels including cardiac surgeons, cardiac anaesthetists, cardiologists, operation theatre scrub nurses, intensive care nurses, blood bank technical staff, biomedical engineers, manifold technician (those responsible for maintaining gas supplies), Perfusionist (technician who runs the heart lung machine), laboratory technicians etc. embarked by road on a 400 kms long 10 hours journey. A make shift operation theatre was commissioned and then sterilized. An intensive care unit was created in a near by room. Protocols & processes were gone through & rehearsed & dry runs carried out with military precision a number of times to prepare for an uneventful day Zero.

On the designated day, two open heart surgeries of hole in the heart were conducted and egged on by their grand success, another complex open heart surgery of replacement of mitral valve was performed on the day two. All surgeries went off with clinical precision and the patients were discharged from the hospital within five days and are progressing extremely well and are back to full gainful employment.

This act of defiance was entirely to prove the age old adage, ‘where there is a will, there is a way’. Having shown the government that reasons given out by them are totally wrong, we now leave it to the conscience of all the stake holders, including the senior officials and the bureaucrats of the Government of Uttarakhand and their political masters, to decide if they would like to serve the people of their own state in right earnest.

Its indeed a matter of great shame that the entire state of Uttarakhand does not have a single open heart surgery programme in the government sector (while Delhi has more than 35 cardiac centers running active open heart programmes). The cost involved in setting up these programmes is also not prohibitive as we had given the complete costing to the government and it was around Rs.10 crores for the initial set up. It was also demonstrated that the government was currently spending a huge sum of money, sending its beneficiaries to outside the state and within that cost itself, the running expenditure for the programme could have been met with the added advantage of convenience to the patients. I only hope the inner soul of the people in authority will wake them from their slumber, shake their conscience and stir them in to action of providing at least the basic medical facilities to its beneficiaries.

National Heart Institute on its part is always willing and keen to join in any such venture that is socially relevant. It is this ethos which the current management has inherited and carried on, from our founders, specially Late Mr.Ashok Jain and the entire family of the Bennett, Coleman & Co. Ltd and our mentor Dr.S. Padmavati. It is with this mind & heart set that, National Heart Institute is running the highly successful and much acclaimed Rotary ‘Gift of Life Programme’, the ‘Vyadhi Nidhi Programme’, ‘Winning Heart Programme’ and ‘Free Pacemaker’ programmes for the financially impoverished section of the society. We have now provided advanced cardiac care including free open heart surgeries to over 200 patients under these programmes - a crowning glory in which the entire staff, faculty and management of National Heart Institute take pride. ….. Indeed a Feather in our Cap !