[Note: Against the backdrop of the Nurses' strike in Kerala in protest against abysmal pay in Church-run hospitals, here is an eye-opening report by Isaac Gomes, on Bel-Air Hospital, Panchgani, in Satara District, Maharashtra. What amazed him was the loving and caring service of all – the doctors, nurses, counsellors and the support staff. It is probably the only hospital / healthcare centre where under the seamless management of Father Tomy Karyilakulam and Sister Lourdu Mary Nagothu, one wakes up in the morning to soothing bhajans and everybody on the campus – patients, their family members/caregivers and the staff – shares the same food.
The Bel-Air College of Nursing, under the stewardship of Sister Lourdu Mary, is very well-designed with soothing interiors. What catches one's eye is the pristine hilly surrounding where peacocks strut. If there is a system of accreditation of nursing colleges as is done by the National Assessment and Accreditation Council (NAAC) to rate colleges in India, Bel-Air College of Nursing without an iota of doubt, will come out tops, because of its sparkling clean campus, well-equipped library, Smart Classroom, English Language Lab, Music room and above all, the faculty].
During the first fortnight of September 2017, I took a very close relative of mine and her son to Pune. She lost her very young husband in October 2016 and was going through acute depression and related illness. On reaching Pune we came to know of Panchgani, a hill station about 1293 meter (4242 feet) high in Satara District and about two and a half hours journey by car from Pune. Panchgani was founded by the ruling British, as a health resort and most of the visitors were there for their health. These were mainly from the affluent classes. Bel air in French literally means 'beautiful air'. It is used to name a place (often up a hill which catches fresh breezes or by the sea with gentle sea winds) that is considered to have pleasant, fresh and healthy air. We thought it was an ideal place to escape from the polluted city life and for recuperation. During sight-seeing, we came across Bel-Air Hospital. Then I recollected having read an article in the Herald Kolkata (dated 11th-18th August) on Sister Lourdu Mary Nagothu, Director Nursing of Bel-Air Hospital Panchgani and Principal of its College of Nursing, having been selected by the Association of Nurses in AIDS Care (ANAC), USA, to receive a prestigious global award this November, for pioneering the world’s first masters’ curriculum in treating patients with HIV/AIDS.
Since we were in Panchgani, we decided to follow St Thomas, and do a reality check for ourselves.
We made an appointment with Father Tomy and on reaching Bel-Air, Mr Jithin Jose Tom, the young and bubbly Administrator met us. He showed us around various departments and enlightened us in brief, on the history of Bel-Air.
HISTORY OF BEL-AIR
Bel-Air is a 44-acre campus donated by Sir Dorabjee Tata and founded by Dr. Rustomji Billimoria in 1912. It was designed to be a sanatorium for Tuberculosis (TB) patients who were rejected by the society due to the stigma associated with the disease. It was run as a private trust medical institution and was India's best TB sanatorium which patients considered their home. It saved thousands of people from death. Dr Billimoria's son Dr Bomi came to be known as one of the best thoracic surgeons in the country and was actively associated with Bel-Air. Unfortunately, tragedy struck and Dr. Bomi died young. Without a successor, Dr Rustomji Billimoria, decided in 1965 shortly before his death, to hand over the Sanatorium to Indian Red Cross Society.
Dr. Bomi Billimoria, one of India's best Thoracic surgeons regularly visited Panchgani to operate on patients at the Bel Air.
Bel-Air continued to flourish till the 1980s when the hospital saw a decline. According to Mrs Homai N. Modi, Honorary Secretary of Indian Red Cross Society, there were problems with labour, union problems, and hardly any funds. It was a place sinking at that time and by 1990 was on the verge of closure. It was then in 1993, Father Tomy who had gone to Panchgani as a tourist, chanced upon seeing Bel-Air. Father Tomy discerned the huge potential for the development of the 44-acre Bel-Air estate which was almost in ruins. One day while checking the records, Father Tomy came across a plaque named Dalkeith Estate of Sir Dorabji Trust. He met the trust president, Mr Rusi M. Lala, and offered to work for the turnaround of Bel-Air Hospital at one rupee per month. Mr Rusi Lala then asked Father Tomy how much money he needed. He requested for rupees five lakh and was handed a cheque for rupees twenty lakh! Since then there has been no looking back," says Father Tomy. He vividly recollected what Mr Rusi Lala told him: "You are created in Christ Jesus to do great deeds which God has predestined you to do. You are predestined by God to go to Panchgani to do this noble work of redeeming this hospital. I am created by God and pre-destined by Him to help you in this great work and that's why I am helping you." It was a point of transition for Father Tomy.
Bel-Air enhanced its scope in 1995 when it decided to take in AIDS/HIV patients. This was at a time when HIV positive people were practically ostracised and refused admission by hospitals and private institutions. The HIV virus reduces the strength of the patient’s immune system and an HIV infected person’s chances of developing active TB, is higher than in other affected patients, while an AIDS patient is susceptible to Active TB over a hundred times more. With rapid migration of workers to Mumbai, Bengaluru, Delhi, Pune and other cities, there is a likelihood of the number of HIV / AIDS patients increasing much more than at present and so will the TB afflicted.
Bel-Air's efforts to treat and reach out to a larger number of HIV/AIDS patients do not end at Bel-Air only. The dedication of its committed workers took them beyond the boundaries of Bel-Air to distant villages such as Wai, Jaoli, Mahabaleshwar, Khandala, Palkar, Koregaon, and Karad the different Talukas of Satara District. Their findings have brought to light the large number of HIV positive patients in these rural areas, who fearing social ostracisation, have preferred to live with the condition, and embrace slow death rather than avail treatment. Many HIV patients have landed at Bel-Air after having spent a lot of money on wrong medication/quacks.
In 2000, the National AIDS Control Organisation (NACO) sanctioned the first and biggest community care centre in the country. Enthused by the success of the programme and encouraged by President A.P.J. Abdul Kalam, Bel Air set up an Anti-Retroviral Treatment (ART) centre, the first in the NGO sector. Father Tomy was nominated chairperson of the technical resource group. To tackle stigma and discrimination, Bel Air has conducted several training programmes for doctors and healthcare professionals.
Bel-Air Hospital and Nursing College, Panchgani Director and lifeblood, Father Tomy Karyilakulam (Top photo – 4th from front row left) of Missionary Congregation of the Blessed Sacrament (MCBS) and Dr Aruna Rasal, Chief Medical Officer (Top photo – 5th left from front row) with Maharashtra Health Minister during his visit to the Hospital and the Nursing College. Photo 2 – Fr Tommy introduces the doctors to the Health Minister of Maharashtra.
Like a Phoenix Risen from the Ashes
As the need for resource grew, help came in the form of people who were touched by the healing hand of Bel-Air. A benefactor friend of Mrs Homai N. Modi, came to know that one of his relatives had been treated at Bel-Air. He was touched. Almost overnight, he made out a donation of one and a quarter crore rupees and with that funding revamp of Bel-Air started. The revamp gave way to expansion plan of the hospital with general medicine, orthopaedics, paediatrics, Gynaecology and Obstetrics, X-ray, ECG, CD-4 count test facility for HIV/AIDS patients, ,24-hour Emergency, other departments and various out-patient clinics. In the process, Bel-Air had opened its doors to the general public. With the visit of President APJ Abdul Kalam in 2003, Government took notice of the unique contribution being made by Bel-Air, particularly in the treatment and care of HIV/AIDS and TB patients who are socially rejected and spiritually ill with shattered dignity. This care is given through medication, yoga, prayer and bhajan and by understanding patients well through highly skilled counsellors who take care of the emotional, psychological and all other aspects of patients and help them come out of their trauma.
As Father Tomy put it, "We dreamt, we prayed, we believed and it started happening."
At Bel-Air, the emphasis is on removing the fears that many people have about HIV/AIDS and its treatment. Its approach is to be patient and holistic. Family members of the patients are also trained to provide care at home to the infected members and to prevent further infection.
PROVEN DEDICATION OF BEL-AIR MEDICAL TEAM
Bel-Air medical staff is always on duty 24 hours a day. Members of the Bel-Air staff are provided with quarters so that they live and work in Bel-Air. Many of the workers and drivers are HIV positive and are undergoing treatment. There is a fully-equipped kitchen which provides the same food for the patients and the staff.
There can be no greater proof of the unfailing dedication of the doctors and nurses at Bel-Air than the real life story of DR. VIJAYKUMAR RAJARAM NAIK, M.B.B.S., M.S. (SURG), D.M.A.S. (LAPRO), Consultant Laparoscopic Surgeon and G.I. Endoscopist, who was attached to the Civil Hospital Satara and Satara Diagnostic Centre but whose heart was with Bel-Air. Dr Vijaykumar Naik was a Life Member of World Association of Laparoscopic Surgeons and had several publications to his credit including a treatise on ROLE OF LAPAROSCOPY IN SURGICAL MANAGEMENT OF HIV PATIENTS.. He would take up operation of HIV patients which other surgeons won't touch. According to Dr Naik's wife Anjali, though her husband felt a pain in his chest, he brushed it aside and continued with an emergency operation of a patient at Bel-Air. Suddenly he fell down and breathed his last at the operation theatre. Anjali who was on duty at a nearby ward, could hardly hold back her tears while she recounted the heartbreaking December 2016 incident. In spite of the very tragic loss of her husband, Anjali carries on serving Bel-Air always with a smile. The same applies to Dr Aruna Rasal, Chief Medical Officer and her colleagues who without fail do their rounds on motorbikes to visit inmates everyday.
St Xavier's High School, Panchgani
To partly fund the hospital from its own resources, a state-of-the-art co-educational boarding school named St Xavier's High School, Panchgani was set up on the campus – a school meant to impart sound education to students from all over the country as well as subsidised education to children of staff members.
The facilities offered by the school are: Music (Instrumental & Vocal), Bands, Dance, Art, Physical Education, Sports & Games, Archery, Athletics, Swimming, Yoga, Horse Riding, Trekking, Drama, Debate and Camps & Educational Tours. There are three types of students: Day Scholars, Day Boarders and Boarders. Day Boarders and Boarders get well balanced, nutritious, and tasty vegetarian and non-vegetarian meals. There are separate kitchens to cook vegetarian and non-vegetarian food. In order to ensure that the students (especially boarders) are kept in the best of health, the institute has given the medical care responsibility to Bel-Air Hospital. The students get regular check-ups by a dentist, a paediatrician, and an orthopaedist, along with other health-related services. All boarders are also covered under a comprehensive medical scheme of the Bel-Air Hospital.
Bel-Air Hospital received The Times of India Healthcare Achievers Award 2014 in the category "Innovation in managing long term conditions." The award was presented to Mrs Homai Modi, Honorary Secretary Indian Red Cross Society and Father Tomy, Director of Bel-Air.
However, everything was not hunky-dory. With the help of Indian Red Cross Society, Father Tomy has had to fight local politicians and land sharks who wanted the 44 acres of prime land at Panchgani. But Father Tomy encounters Christ everyday (as Pope Francis urges all Christians) and continues relentlessly.
Bel-Air College of Nursing
Established in 2006, Bel-Air College of Nursing is affiliated to Maharashtra University of Health Sciences and approved by University Grants Commission. It offers 4-year B.Sc. in Nursing. The medium of instruction is strictly English. Students found chatting in vernacular have to undergo remedial measures like doing a given task by staying back in the college library or copying out a whole English newspaper. The underlying idea behind the strict regimen is to groom the candidates for top-notch national and international markets, including preparation for IELTS tests for those willing to go abroad. They are also not allowed to use their mobile phones. Needy students are given study loans from banks and various foundations. These are arranged by Father Tomy, Director of the nursing college, through his contacts with banks. Successful students land with good placements in Breach Candy, Mumbai and other leading hospitals and thus are able to repay their study loans (Course fee is Rs 1.25 Lakh per annum) in about two-three years' time. Graduates of Bel-Air College of Nursing are in great demand and easily find jobs.
The College also conducts a two-year course in Auxiliary Nurse Midwife (ANM), who will be grass-roots health service provider at village-level. This course is conducted, for free, in Marathi exclusively for girls from Maharashtra.
All the nursing students (including their teachers) have to stay in the college hostel. To keep themselves occupied and not to miss their cell phones, students take part in various creative, co-curricular activities including handicrafts and dress/costume-making for various cultural functions.
The student strength of the college is 250. It is the first nursing college in India which has a Nursing Education Program in collaboration with the University of Illinois-Chicago, USA.
Under Sister Lourdu Mary Nagothu, Principal, the College has made great strides. It is the first nursing college in Asia and probably the whole world, to have pioneered a Masters' Curriculum in HIV/AIDS. According to Ms Bincy Varghese, Nursing Superintendent of Bel-Air Hospital, Indian Nursing Council (INC) used to conduct a short term training course for nurses, on HIV/AIDS care. Father Tomy thought the short term course was not adequate and felt the need for a full-fledged curriculum on HIV/AIDS treatment. So Sister Lourdu Mary launched the Masters Course in December 2014. Ms Bincy is a product of the first batch with specialisation in HIV/AIDS care. Though the Maharasthra Government has sanctioned an intake of 20 students for the Masters' Course, the college admits only 8, as the curriculum is very exacting and each student requires a dedicated guide/professor.
According to Ms Bincy and also Counsellor Mrs Lida, women and children are the ones who suffer the most, without being responsible for their fate. Women are usually infected by their husbands who work as casual workers (or for instance truck drivers) out of their community. Many of these people migrate to big cities such as Mumbai, Pune, Karnataka and the borders of Andhra Pradesh where they get infected and bring the virus with them to their families.
Sister Lourdu Mary Nagothu of Society of Jesus Mary Joseph (JMJ), Director of Nursing at Bel-Air Hospital and Principal of its College of Nursing at Panchgani, a well-known hill station in Satara district of western India’s Maharashtra state, has been selected for being honoured with a prestigious global award for pioneering a study course in treating patients with HIV/AIDS. The Association of Nurses in AIDS Care (ANAC) decided to honour her for developing and implementing the world’s first masters’ curriculum in HIV/AIDS. She will receive the award at the conclusion of ANAC’s November 2-4 conference in Dallas, Texas in the United States.
The college is very well-designed with exquisite interiors. What catches one's eye easily is the pristine surrounding where peacocks strut and cool breeze blows. The sparkling clean campus with vitrified flooring, a well-stacked library, Smart Classroom where students interact with USA professors / experts through Skype, English Language Lab and Music room, to name a few, are standout features of the college. Each class-room is meticulously set up according to need. Sister Mary Lourdu keeps a very close eye even on minute details including the blooming of flowers in her garden. Because of her eye for details, she realised that it was necessary for each teacher to have a personal lap top. Immediately she swung into action by providing soft loans to her teachers to procure their own laptops.
Convocation (Graduation) Ceremony of B.Sc. Nursing students at Bel-Air College of Nursing, Panchgani.
SUGGESTED PREVENTIVE PRECAUTIONS
While Sister Lourdu was showing us around the Nursing College campus, I asked her whether in the light of her vast knowledge in the field Community Health and in HIV/AIDS, it is advisable to provide counselling on HIV/AIDS to intending couples during Marriage Counselling Courses conducted in various parishes. I also asked her whether she suggests blood test for couples, before their marriage, on Thalassemia and HIV/AIDS. She replied the suggestion was worth consideration to avoid post-marriage traumas. She also added many Catholic families were voluntarily undergoing Genetic Counselling, a process by which the patients or relatives at risk of an inherited disorder are advised of the consequences and nature of the disorder, the probability of developing or transmitting it, and the options open to them in management and family planning.
If a system of accreditation is introduced for hospitals and nursing colleges as is done by the National Assessment and Accreditation Council (NAAC) to rate colleges in India, Bel-Air Hospital and College of Nursing, Panchgani will without an iota of doubt, make many premier hospitals and nursing colleges of India blush. The reason? Both Bel-Air Hospital and its College of Nursing do not believe in resting on their laurels. For them the sky is the limit which makes both Father Tomy and Sister Lourdu believe in always raising the bar.