CMC Year book 2013

Contents Foreword .....................................................................

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On solid Rock we stand ................................................

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Vision Statement ..........................................................

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CMC's Story: Dr. Ida S. Scudder ...................................

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Clinical Services Dr. Ida B. Scudder ...........................................

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Services .........................................................

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Research Dr. T. Jacob John ............................................

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Research Activities..........................................

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Education Dr. Sheila M. Pereira........................................

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Programmes...................................................

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Spirituality Rev. A.C. Oommen..........................................

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Dr. K.G. Koshi .................................................

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Programmes...................................................

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Our Director, Dr. Sunil Chandy for his constant encouragement.

Archives ......................................................................

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Photography means 'writing with light' and Drs. Wesley Rajaleelan and Georgie Mathew have done just that with their evocative images.

Milestones ....................................................................

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Supporting CMC’s Work ...............................................

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M/s Sasika’s Image for printing.

Friends of Vellore...........................................................

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Our families, for their loving support.

Contact Information.......................................................

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With grateful thanks to: Dr. Pippa Deodhar, Mr. M. Saravanan and Mrs. Mary Anslum for their tireless, cheerful and meticulous work in preparing this Year Book and its Supplement.

And God, the source of our inspiration.

Outreach

All rights reserved © CMC Vellore, Promotion and PTP Office

Foreword

I

t is said that the average lifespan of an institution’s vision is about forty years. Thereafter, it tends to drift in response to generational and cultural shifts that evolve over time. The Christian Medical College, Vellore has withstood this expected change over a hundred and thirteen years, adhering to the letter and spirit of the original vision of ‘…………….seeking to be a witness… in the spirit of Christ’.

Through a century of its existence, CMC Vellore has been more than a medical college or a hospital. It has been a beacon of hope, a place of total healing and a way of life for thousands of people who have walked the corridors of this great institution as patients, students, staff and visitors.

This yearly supplement holds within its pages enormous amount of information that would be difficult to assimilate at first glance. But between the lines, we hope the reader would be able to capture the spirit behind the voluminous work of our institution. The unique work ethic of CMC, inculcated during the training years which later finds expression in the demanding schedules of patient care, education and research, is what is responsible for this output.

CMC continues to grow rapidly on all fronts. The burgeoning patient load reflects the growing need of reliable healthcare in India. Our clinicians carry this burden valiantly, without compromising on quality in patient care. The student numbers have increased and our teaching faculty have stretched their time and talent to cope with the increased demand. The increase in postgraduate seats has been a big blessing in that it has translated into better doctor-patient ratio and clinical care. We thank God for this.

CMC has been invited to partner with many health initiatives of the Government of India. The community oriented teaching of medical students in CMC is being replicated nationwide as a sustainable model suited to the healthcare needs of our country. This year, two of our graduate Alumni

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have been honoured with Padma Shri by the President of India. CMC is proud to have been part of their formative years and their contributions to science. We are equally proud of the other faculty and alumni spread across the country bringing hope to millions in the field of healthcare.

Research in CMC has grown by leaps and bounds. From clinical to population based to cutting edge basic research, CMC is involved in all. I am grateful to the large team of basic and clinical researchers in various departments whose work and publications add value to our institution, nationally and internationally.

As I flip through the pages of this year book, I can only thank God for His grace. I am grateful to the large number of faculty and support staff, students and postgraduates who provide the man-power for the day-to-day running of services. There are a large number of Alumni, Council members and Friends of Vellore who contribute to this institution by their goodwill and prayer-support. I am thankful to God for them. My sincere thanks to Dr. Abraham Peedicayil and his editorial team for their meticulous work in bringing out this publication.

As we surge ahead with the new challenges facing us, as we respond to changes around us, my prayer is that we will remain conscious that God is at work through us. The content of this book is ample testimony to our Founder’s dream, that in and through all the work we do in CMC we continue to ‘…..build the kingdom of God.’

Dr. Sunil Chandy Director

The verdant view from the College Chapel 3

On solid Rock we stand

T

he Christian Medical College was born in response to

aspects of CMC's endeavours in education, health care

community are legendary. He was able to convey the

a calling and a realization that there was a great need.

delivery, research, outreach and spirituality are presented

universality of Christ in very practical terms to both students and faculty.

Ida Scudder, the founder made a considered choice

with examples from the lives of real people who strived for

to leave the comforts of her homeland and serve the people

high standards and served with integrity and

of India. Her favourite hymn, 'Be thou my vision' embodied all

professionalism. These stalwarts worked with passion and

that was true and dear to her and gave her strength to

faith in their respective areas, reflecting the love of God in

persevere in her mission. The institution has continued to

their actions. They were very clear that institutional needs

train men and women in the 'spirit of Christ', not to be

trumped their own dreams and aspirations.

ministered unto but to minister.

Departments of Radio-diagnosis as well as Radiation

strives to stay true to its core values of professionalism,

Therapy. She was willing to work where there was a need and

justice, truth, holistic healing and concern for the

obtained appropriate training to start these new

marginalised. CMC is a scientific and spiritual community

departments.

that derives its meaning from service to patients who flock to Vellore from all over India and neighbouring countries.

children, especially poliomyelitis, and played a great role in influencing policy decisions in the country.

and daily routine. However, people's expectations are changing. They want efficient and compassionate service

researcher. With her humour and candour she was a role

Dr. K.G. Koshi played an important role in the formative years of the Community Health department. He carried out

The Year Book aims to showcase what CMC, Vellore stands

Editor

model and guiding light to several batches of students.

and they are willing to pay for it. Although times have

for and practices. The reason CMC has withstood the ravages

Dr. Abraham Peedicayil

Dr. Sheila Pereira was an exceptional clinician, teacher and

changed, the lives and examples of the giants of yesteryears show us how to keep our foundations intact.

changing with the times, the values that the institution upholds are timeless.

Dr. T.Jacob John was a passionate researcher with a very keen

Patients come to CMC because they trust that they will be uppermost. They are willing to travel from far corners of the

provided a rock solid foundation for the institution to grow.

CMC is a community serving patients and students. Although

and incisive mind. He focussed on infectious diseases in

given an honest opinion and that their interests will be kept land and spend several days - even weeks - from their home

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Dr. Ida B. Scudder, the niece of our founder, established the

CMC has grown tremendously over the last few decades, but

The sincerity, diligence and faithfulness of these visionaries

Dr. Ida's wishes of taking health care to the people and thereby gained the trust and confidence of the villages in Kaniyambadi block.

of time is its bedrock of foundational values: ministering to

Rev. A.C. Oommen was a great thinker and communicator.

the people of this country in the spirit of Christ. The various

His contributions to the spiritual nurture of the CMC

'On Christ, the solid Rock we stand, All other ground is sinking sand.’

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Vision Statement

T

he Christian Medical College, Vellore seeks to be a

In the delivery of health care, CMC provides a culture of

witness to the healing ministry of Christ, through

caring while pursuing its commitment to professional

excellence in education, service and research.

excellence.

The Objective

CMC is committed to innovation and the adoption of new,

The objective of the Christian Medical College, Vellore is the

appropriate, cost-effective, caring technology.

establishment, maintenance and development of a Christian Medical College and Hospitals in India, where men and women shall receive an education of the highest grade in the art and science of medicine, nursing, or one or other of the

CMC reaffirms its commitment to the promotion of health and wholeness in individuals and communities and its special concern for the disabled, disadvantaged, marginalized and vulnerable.

related professions, to equip them in the spirit of Christ for service in the relief of suffering and in the promotion of health.

CMC looks for support and participation in its programmes in education, service, outreach and research, from friends and like-minded agencies in India and abroad, in a true spirit of

Mission Statement

partnership.

The primary concern of the Christian Medical College, Vellore is to develop through education and training, compassionate, professionally excellent, ethically sound individuals who will go out as servant-leaders of health

In its role as a living witness in the healing ministry of Christ, CMC seeks to work in partnership both with the Church in India and the universal Church, and their institutions.

teams and healing communities. Their service may be in promotive, preventive, curative, rehabilitative or palliative aspects of health care, in education or in research.

In the area of research, CMC strives to understand God's purposes and designs, fostering a spirit of enquiry, commitment to truth and high ethical standards. Research may be aimed at gaining knowledge of the fundamental basis of health and disease, at improving interventions or in optimizing the use of resources.

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The historic Mary Taber Schell Arch 7

CMC's Story

S

trangely, Christian Medical College, Vellore owes its beginnings to a societal stricture that Ida Sophia Scudder found completely unacceptable.

As a third generation of the first family of missionaries to India and other parts of Asia, Ida was steeped in the tradition of mission work. But this was an ancestry which, for most of her youth, she did not wish to claim. Her earliest memories of India were of the terrible famine of the 1880s, and the ensuing hunger and destitution. Life in America eased those nightmares, and as a young girl, she knew-or thought she knew- what she wanted from life.

In 1890, while on a trip to India to meet her parents, three men begged her to help their wives in the throes of difficult labour. And no, they were emphatic, her father, Dr John Scudder, would not do. It had to be only a woman doctor. The three women died and the tragedy of that night consumed Ida's very soul- it demanded more than helpless shrugs. Her answer redefined her life.

Ida went back to America and trained in medicine in Philadelphia and Cornell. It was 1900 when she returned to India to join her father's practice in Vellore. India might have been the brightest jewel in the British Raj, but for most Indians, life was a miserable circle of poverty, illness, famine, plagues and drought; for women it was an even more circumscribed existence. She started with a one bed clinic that soon grew to the 40-bed Mary Taber Schell Hospital. As the numbers increased, Ida was suffused with the sheer enormity of her task. Even her 'roadsides', which treated so many in remote hamlets and villages, did not seem to make a difference.

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What frustrated and distressed her most were the prevailing social tenets that denied women almost everything, particularly a space and an identity. Ida contented with it with an empowering initiative- educating women. It did not matter where they were; what mattered was that they should not remain where they were, and educating them was her second epiphany.

So, despite the lack of trained staff and resources, Ida started training programmes for women in nursing (1909), and later, much to the surprise of the Presidency government, the licentiate programme in medicine (1918). The growing years of consolidation and development nurtured Ida's vision, as the Hospital expanded to its present site (1928) and the Medical School found a home in a beautiful campus (1932).

Probably Ida's biggest challenge was upgrading the Medical School to a Medical College as per the Government's directive in the 1940s. Those were the most trying years of her life, as she grappled with several possibilities- an end to her dream because of a paucity of every kind of resource or a paradigm expansion to include men students. After much thought and prayer, Ida realised she did not answer God's call to make a point, but to make a difference, a difference to the India of tomorrow, and opening the college to men students was doing just that. As she drew a wider circle, it was not just students, men and women, who came to CMC, but staff from all over India and the world, who made Ida's tryst their own.

The news of permanent affiliation to the University of Madras in 1950 was the apogee of her life.

CMC today is a vibrant, busy institution, rated as one of India's finest, a pioneer of several clinical specialities, at the forefront of research relevant to the needs of the country, with coveted educational courses, and award winning outreach programmes that meaningfully engage with communities. CMC continues to redefine the health contours in India in the midst of the challenges of change, and strives

to balance the best that technology has to offer with the provision of inclusive, accessible healthcare.

But there is something more to CMC than accolades and ratings. Why else would patients - over a million annually from India and abroad - flock to Vellore? Why else would it find mention in a work of fiction? Amitav Ghosh, one of contemporary India's finest novelist, writes of a doctor 'from that prestigious medical college of Vellore' working in a small hospital on an island in the Sunderbans (The Hungry Tide).

Clearly, CMC is more than just an idea or a mere dot on the map.

The story that probably best illumines the essence of CMC is that of the first patient Ida was called upon to treat. For several weeks, patients had pointedly ignored her and asked for her father. So when a young man came, asking her to treat his sick mother at home, Ida jumped at the opportunity.

What she found was not a sick old woman, but a dying old woman, past any ministrations of medicine and cure - not a patient you want when you are trying to make an impression.

Ida could have walked away from this adverse publicity of failure. But this is what our good founder did: Ida had the woman moved from the dark, dank, airless room to a shady part of the open verandah; she moistened the parched lips with drops of water, and used her own handkerchief to bathe the old woman. As she gently tended the woman, Ida could feel the fright ease and calm return. She did what she could to make the last hours- usually an agony- comfortable and peaceful. It would have been a sight that would have moved the Great Physician Himself.

It is this legacy that is the continuing narrative of CMC's story.

A legacy that imbues hundreds of graduates, for whom being a medical professional is not a vocation, but an identity and calling:'Not to be ministered unto but to minister'.

Silver Gate (1923) 9

Clinical Services Dr. Ida Belle Scudder

W

hat's in a name?' Shakespeare famously asked.

But the niece and aunt shared more than just a name - the rich tapestry of their lives had threads of a common vision and the shared synergy of a higher calling.

‘

Ida B., as she was called, was born to Cora and Lew Scudder in 1900, prophetically perhaps, the year her aunt established a one bed clinic in Vellore. Her father, like so many others in his family, trained for the ministry in India, but poor health precluded him from going there. Instead, he served as a missionary to the Winnebago Indians in Nebraska. Ida B's was a happy, content childhood, as she later recalled - they lacked much materially, but then lacked nothing at all.

A story from her childhood was always in the recesses of her mind: as an infant, she was gravely ill with pericarditis. The doctor came, gave her some medicine and left, expecting a dead baby by the morning. Her parents did the only thing they knew: they prayed. 'You were spared for a reason', her father later told her. Ida B. made that reason her life.

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crowds of patients- Ida B. had hardly time to orient herself, when she was handed charge of the Department of Eye, Ear, Nose and Throat. That was the first of many times Ida B. was called upon to 'hold the fort'. She did it for Anatomy, Medicine, Paediatrics, Obstetrics and Gynaecology, pitching in where ever there was a need. In the initial years, she was beset by an avalanche of doubts, of being a 'Jill-of-all-trades', but in time she learnt to view these as opportunities to learn and gain experience. Her first love was Paediatrics, but the growing hospital and medical school desperately needed a Radiologist. Ida B. agreed to fill that role.

radioactive substances. It was the treatment planning that took the most time, for the complex mathematical calculations, involving doses of radiation, had to be done by hand, a far cry from the computerized treatment planning systems of today. True to her calling, Ida B. never forgot the human side of her work. Her concern for patients on therapy led her to support the building of the Annex, where patients could stay during the course of their treatment. Despite a punishing schedule, Ida B. additionally went on the Friday Roadsides, welcoming the fifteen hour day as a refreshing respite.

In the 1930s and 1940s, radiology, through the common link of radiation, embraced today's specialities of Radiodiagnosis and Radiotherapy. Thus, during her extended furlough between 1936 and 1939, Ida B. trained in both. In New York, she trained under such eminent Radiologists and Medical Physicists as Drs. William Meyer, Edith Quimby, Ira Kaplan and Reva Rosh. To ensure her training would be recognized in India, she then went to London and Cambridge, obtaining the LRCP, MRCP and Diplomas in Radio-diagnosis and Radiotherapy.

With the arrival of Dr. Donald Patterson in 1951, Radiology formally divided into Radio-diagnosis and Radiotherapy, and Ida B. took charge of the latter. It gave her the time to concentrate on building the Department of Radiotherapy, and the space to focus on her patients and their care. Ida B. started the Radiotherapy Technician's course (1951), the Diploma in Radiotherapy (1954), the R Ward (1957), in addition to acquiring several important equipment such as the 250 kV deep therapy and 150 kV superficial therapy units, Cobalt 60, Theratron 60 etc, paving the way for today's modern Radiotherapy Department that proudly bears her name.

Ida B. returned to Vellore in 1939, and for the next twelve years singlehandedly ran both Radio-diagnosis and Radiotherapy. Her patient load was tremendous, to say the least. There was the growing demand for Radio-diagnosis from emerging specialities like Neurosurgery and Cardiothoracic Surgery. Given the vagaries of instruments and equipment, Ida B. found herself creatively improvising with locally made materials. The challenge was with techniques that involved a rapid succession of readings:

As a young woman, her formative years were spent at the Northfield Seminary - her aunt's alma mater as well - and later Mount Holyoke College. She joined the Women's Medical College of Philadelphia in 1926, and thrived in the rigorous academic atmosphere of the world's first medical school for women. Ida B. had the distinction of securing the highest marks in the National Medical Boards in 1928. She completed her internship at the Albany Medical College, making light of the fact that she was the only woman intern in the hospital. In 1930, she began her residency in Paediatrics in New Haven, spending some time in Yale as well. But five months into her residency, she was urgently called to Vellore.

'We'd say 'ready, go!-One!' and the person doing that would jerk the film out, and it would slide down a board with a blanket on it, so that it wouldn't bend. And we'd decide we wanted to take a film at one, at three, at five, at seven seconds. Someone would count, so that everyone was synchronized - very difficult to get the person pulling and the person pushing going at the same time'.

It was May 1931 when Ida B. arrived in India. The heat of the hottest month, the chatter of an unknown language, the

Such improvisations were necessary in Radiotherapy as well, where she had to design special sinks and safes for the

At the institutional level, Ida B. 'held the fort' on several fronts: Medical Superintendent, Registrar, Acting Vice Principal and Acting Director. She remained a support and strength to her aunt, especially during the difficult years of upgradation of the medical school and the debate on coeducation. In a letter home, Aunt Ida proudly wrote, 'Ida B. is one grand girl…so clever and capable and loving and she is looked up to by all.'

As the last missionary of the Scudder family in India, Ida B. stood at a vantage point of historical change - in CMC, in India, in the practice of Medicine and the position of women.

Comparisons to her aunt were inevitable, but Ida B. remained true to herself.

Ida B. passed away on July 4, 1995 and was laid to rest next to her parents in Valley Forge, Philadelphia.

Dr Ida B. positioning a patient for treatment with the Cobalt 60 Unit.

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Blood Borne Virus Screening

Automated Nucleic Acid Extractor

Ultra Performance Liquid Chromotography Machine

12

Automated Lab Haematology Analyzers

EGFR Amplification: Glioblastoma

Rotavirus

Inductively Coupled Plasma - Mass Spectrometer

Digital Subtraction Angiography Room 13

Reproductive Medicine Unit Lab

Stereotactic Surgery

Surgical ICU

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Hearing Aid Clinic

Trans cranial doppler study (Neurology)

Well Baby Clinic

Vascular Surgery

Radiation Therapy Treatment Planning System

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Support Services

Accounts

Chittoor OPD Pharmacy Manufacturing

CHIPS - Servers

Voice Clinic

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Medical Records

Laundry

Oncology Pharmacy

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Research Dr. T. Jacob John and the Pulse Polio Story

R

ukhsar Khatoor is a four year old girl from Howrah in West Bengal. In January 2011, Rukhsar was the last case of polio in India. In the two years since then, the WHO has officially removed India from the list of polioendemic countries. India's tumultuous battle against polio is a fascinating public health story, given the immense odds faced-cultural, political, economic, geographic and physical.

It is a story that holds out hope for so many other preventable childhood diseases. And at the forefront of the fight against this ruthlessly paralyzing and sometimes fatal disease have been the Department of Clinical Virology and Dr. T.Jacob John.

But we digress to the ending. Let us start at the beginning.

It was 1966 in the busy Child Health OPD. Dr. T.Jacob John (or Dr. TJJ, as he is known), a Paediatrician-Virologist, was examining a little girl who exhibited the symptoms of polio.

'Not possible', a disturbed Dr. TJJ thought, because she had had the three routine doses of polio drops - her immunization card showed the exact dates of her having received the drops. Dr.TJJ collected her stool samples and took them to the lab. Sure enough, they grew the polio Type 3 virus. His curiosity piqued, he began accumulating similar cases - in significant numbers - of children acquiring polio despite the 3 doses of polio drops. It was not that polio was an uncommon disease in India - until as late as the 1980s, an average of some 500 to 1000 children suffered polio paralysis every day. But it was widely believed that three doses of the Oral Polio Vaccine (OPV) offered complete protection against all three types of the polio virus. Clearly not, as Dr. TJJ began questioning and researching…… three doses were not enough.

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The following year, India's first Diagnostic Virology Laboratory was set up in CMC, building on the groundbreaking work done by Dr. Ruth Meyers and others.

Dr. TJJ began his research into the polio puzzle through a WHO funded study on the standard potency of OPV and the response in children, the first of its kind anywhere in the world. The results were shocking - the response rates were abysmal, especially for polio Type 1. Projecting ahead, research established that as many as ten doses were required to reach the level which Developed Countries had reached with the third dose. Ten doses? Would people respect a vaccine that needed ten doses to prove its effectiveness?

In order to test the efficacy of additional doses, the Department of Clinical Virology and Dr. TJJ partnered with the local Vellore branch of the Rotary International.

Extensive field work had put the monthly average of polio cases in Vellore town at 4.2. The plan was to 'pulse' Vellore town: three pulses of OPV drops to all under-five children.

The campaign began in October 1981 with vaccine donated

by Save the Children, UK. The result - for the first nine months of 1982, no cases were reported in Vellore town, and only 5 cases in the following three months. Again towards the end of 1982, Vellore was pulsed and nine months of 1983 revealed no cases. The simplicity and success of this programme caught the attention of the Rotary International President, Clem Renouf, who visited Vellore. He took this concept and developed the idea of a global polio vaccination programme called Pulse Polio.

In 1988, the WHO launched its polio eradication programme, arguably its most ambitious and expensive public health project, aimed at achieving eradication of polio by 2000. The Government of India established the National Pulse Polio Initiative in 1995-96, expanding on the early Vellore experiment of giving polio in pulses to all under-five children.

By October 1999, Type 2 was eradicated. In the endemic regions of Western Uttar Pradesh and Central Bihar, as many as 9-10 pulse immunisation campaigns were carried out annually between 2004 and 2012. The monovalent and bivalent OPV, again a product of research from the

Department of Clinical Virology, helped reduce immunity gaps. Focussed attention to the nearly 4 to 8 million migrant population helped turn the tide - no Type 3 detected in 2011 and no Type 1 beyond January 2011.

India may have successfully stopped the transmission of polio, but risks remain: of complacency; of importation of polio from neighbouring countries, and that of the vaccine virus itself mutating, causing vaccine associated paralytic polio (VAPP), for which IPV (inactivated poliovirus vaccine) is the logical solution. A current project of the Departments of Virology, Community Health and Wellcome Research Lab, sponsored by the Bill and Melinda Gates Foundation, is the IPV OPV mucosal immunity study, in which the short term waning of gut mucosal immunity among children immunized with oral poliovirus vaccine (OPV) will be studied to determine if an additional dose of oral or inactivated poliovirus vaccine can boost mucosal immunity.

Strengthening mucosal immunity would be important for polio eradication.

Technically, the absence of polio for 3 years in the face of sustained high quality surveillance is necessary for global acceptance of elimination, and India looks forward to that momentous day in January 2014.In this long-drawn, complex battle against polio, vital inputs from Clinical Virology helped break the stranglehold of polio in India- each dose adding to the response rate, more doses implying better response rates, giving polio in pulses and the superiority of monovalent and bivalent OPV as compared to the trivalent OPV. The polio story underlines the seminal research that the Department of Clinical Virology has done and is doing in measles, HIV, Hepatitis B and C and HPV. At its simplest, the polio story reflects the 'spirit of enquiry' of the institution: of going beyond the headlines to the tragedy that polio was, asking specific questions and meticulously seeking answers relevant to the nation and the context of the people we serve.

And, yes, Rukhsar has since recovered.

Dr. Jonas Salk, Dr. T. Jacob John and Dr. LBM Joseph 19

Research

A

n expansive range of research takes place in CMCfrom basic science to clinical and translational. The st ro n g c l i n i ca l b a s e a s s o c i ate d w i t h a comprehensive tertiary care referral centre, excellent laboratory facilities and vibrant community programmes have helped enhance research output in CMC. Faculty are given opportunities to train overseas, which enables them to bring back expertise and form valuable networks and associations. Research in CMC is oriented towards seeking relevant, and often innovative, solutions to problems specific to the Indian context and its socio-economic milieu. The results and outcomes remain valid for India as well as other countries of the Developing World.

A number of departments have initiated translational research, for example, the Departments of Clinical Genetics, Endocrinology, Gastrointestinal Sciences, Haematology, Nephrology, Paediatric Orthopaedics and Rheumatology.

The studies include evaluation of cellular and immune response in a range of diseases and conditions. An interesting instance is a collaborative study lead by the Department of Physical Medicine and Rehabilitation in examining spinal cord regeneration using stem cell transplantation.

In clinical research, both observational and interventional, major areas of interest include Hepatitis B and C, HIV, TB, astroviruses, influenza, maternal morbidity, schizophrenia, Parkinson’s disease, depression screening and HIV, enteric infections, clubfoot brace, spinal spondyloarthopathies and immune responses to enteric and viral pathogens. A Phase III clinical trial for an Indian made low cost Rotavirus Vaccine has resulted in an affordable vaccine for a childhood disease that kills an estimated one lakh children every year in India.

CMC has also played a pivotal role in enhancing capacity

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through the creation of models of surveillance networks in India, thus influencing national policy. Departments such as Endocrinology, Medical Oncology, Radiation Oncology and Pulmonary Medicine continue to extend their involvement in clinical trials. Basic science departments such as Physiology and Biochemistry are expanding their research portfolios and collaborating with clinical departments on projects that seek to understand why and how inflammatory processes and toxins affect gut, renal and cardiac functions.

Taking research a step further is the Department of Bioengineering which is pioneering several biomedical projects in collaboration with the Departments of Neurosciences, Physiology, Medicine and PMR. Sensor based monitoring of home based therapy for stroke rehabilitation and instrumentation for long term monitoring for cardiovascular and neuromuscular signals have the potential to change conventional rehabilitation therapy A number of departments and facilities within the institution promote research through the provision of specialized training, resources and research opportunities. These include the Epidemiological Resource Centre, the Clinical Epidemiology Unit, the Department of Biostatistics, the Basic Sciences Laboratory and the Field Research Unit. In addition, the South Asian Cochrane Network and Centre promotes evidence informed healthcare, an important example being the change in the National Malaria Policy with the Primaquine Review. The Infectious Diseases Research and Training Centre, has, for the last decade, promoted research and education in infectious diseases. The Centre for Stem Cell Research, supported by the Department of Biotechnology, has pioneered translational research with stem cells.

Research in CMC is funded by all major national and international funding agencies, a recognition of CMC’s place in the vanguard of medical research. These include, among others, the Departments of Science and Technology and the

Biotechnology, the Indian Council for Medical Research, the Serum Institute of India, the Department for International Development, the WHO, the Australian Research Council, the British Heart Foundation, the National Institutes of Health, the Centers for Disease Control and the Bill and Melinda Gates Foundation. Research collaborations with several universities in India and abroad - IIT Madras, the NCBS Bangalore, Oxford University, Karolinska Institute - to name a few, have provided opportunities for scientific and medical research.

CMC has been certified as a ‘Centre of Excellence’ in clinical research by the Clinical Development Services Agency (CDSA), an extramural unit of the Translational Health Science and Technology Institute, an Autonomous Institute of the Department of Biotechnology, Government of India.

This certification has been awarded after a detailed inspection of various departments and will facilitate collaborations with other leading institutions of clinical research. During 2012-13, a total of 622 new proposals, including 351 institutional funded and 126 externally funded projects were cleared by the Institutional Review Board (IRB).The Research Digest, published bi-annually, contains the titles and abstracts of publications from the institution in peer reviewed journals. The Annual Research Day is an opportunity for staff and students to highlight the research activities of their Departments and shows the breadth and depth of ongoing research in our institution. As a continuing process of strengthening research practice in CMC, the Research Office regularly conducts Workshops on Research Ethics and Good Clinical Practice Guidelines for faculty.

Clinical Genetics

Design of wheelchair control (Bioengineering)

Central Electron Microscope

Sensorized glove (Bioengineering)

GMP facility

EGFR Exon 19 mutation (del E746-A750)

Our mandate envisages the inculcation of a ‘spirit of enquiry, commitment to truth and high ethical standards.’ It is a mandate CMC hopes to continue to follow as we promote an understanding of health and disease.

Molecular Pathology

Human Induced Pluripotent Stem Cells GMP facility

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Education Dr. Sheila M. Pereira

D

r. Sheila Pereira was born on June 16, 1927 in Chittoor (Andhra Pradesh). Her father, Mr. Robert Pereira, MBE was a District Board Engineer with the then Madras Presidency and was based in Chittoor and Coimbatore. As a young girl, Dr. Sheila aspired to be a journalist and a writer; it was her mother, Mrs. Edith S. Pereira, a teacher, who encouraged her to take up medicine, a decision she never regretted. Dr. Sheila was a brilliant student, both at school and later at the Stanley Medical College, from where she completed her undergraduate medical studies. Her outstanding academic performances at all levels won her innumerable awards, medals and honours. She was one of the first students of Dr. S.T. Achar, a pioneer paediatrician of South India.

Dr. Sheila joined CMC in 1954 as a registrar under Dr. JKG Webb. Except for a brief stint in the UK to complete her MRCP, CMC Vellore remained her calling until her retirement in 1987. In her career as a paediatrician spanning over four decades, Dr. Sheila constantly gave of herself- to young children under her care, to her colleagues with her support and goodwill, and above all to her students, whom she constantly taught, mentored and motivated.

Dr. Sheila did pioneering and seminal work on Kyasanur Forest Disease (KFD) and protein energy malnutrition. Her research on nutrition continues to influence the way severe malnutrition is treated. Her principal work on Vitamin A won her international acclaim and a prominent place in the International Vitamin A Consultative Committee. She was a member of the International Nutrition Society and a WHO consultant for international nutrition research. Her love for writing underscored the prolific scribe she was of scientific

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articles, WHO technical reports, chapters and booklets- and, not surprisingly, story books for children. Dr. Sheila played a critical role in the institution as Additional Medical Superintendent during the turbulent years of the 1970s.

It was as a consummate teacher that Dr. Sheila came into her own. She was an astute and incisive clinician, passing on to a whole generation of students the art and science of paediatric medicine and then some more. Her clinical acumen was astounding, yet she combined her erudition with humaneness, warmth, humour and a sparkling wit.

As Dr. Bobby Cherayil, alumnus of the MBBS batch of 1973 and currently Associate Professor of Paediatrics at Harvard Medical School recalls: 'What I remember most clearly about Dr. Sheila is her no-nonsense approach to looking after sick children. The guiding principle of clinical management that she passed on to us was to diagnose and treat as efficiently as possible, a principle that was based on careful history taking, a thorough physical examination, laboratory investigations confined to the absolute essentials, and therapy that was tailored to the medical and financial needs of the patient. For those who did not have her years of experience, applying those tenets sometimes required an act of faith. How many of us, for instance, could have complete confidence in a diagnosis of post-streptococcal glomerulonephritis that was supported by a mere urinalysis? Yet, that was the only test that we were allowed to do when a child presented with acute onset of periorbital edema and hypertension. And the only treatment prescribed was careful monitoring of fluid balance and blood pressure. Fortunately, faith was rewarded in most cases and the patient could be sent home with little fuss and a bill that the family could hope to pay without selling their livestock.

Dr. Sheila's attitude to the training of future pediatricians was also minimalist in nature. Her case discussions were practical and down to earth: the galloping of hooves always meant horses and clinical zebras were given short shrift. Her emphasis was on doing rather than talking. She put this idea

into practice by allowing her registrars a good deal of latitude in the management of patients so that they had the opportunity to learn from their mistakes. She made sure that you did learn, of course, by hauling you over the coals in no uncertain terms if you blundered. But she was also generous with her praise when the occasion called for it. It was never fulsome (perhaps she feared that we would get swollenheaded), but a brief pat on the back from her went a long way.

After 2 or 3 years under her tutelage, you could be sure of having the skills and the confidence to deal with almost any problem that you might face in a paediatric emergency room.'

Similar thoughts are echoed by Dr. Thomas Cherian, alumnus of the MBBS batch of 1970 and currently WHO Coordinator on EPI - 'Laboratory investigations were to be done and interpreted only to confirm, and not instead of diagnoses.

With Dr. Sheila, every investigation, even checking Haemoglobin concentration, had to be justified with an explanation as to how the result would influence the course of treatment. This was not merely a cost-cutting exercise, but one that forced you to think more carefully about every test you did and how you would use the result. In an era when history taking and clinical examination are being rapidly replaced by a dependency on technology, this lesson still stays with me, and I am sure with others who trained under Dr. Sheila.'

Even after she had retired, her students went back to her for advice, guidance and just to be blessed by her dynamic and inspirational presence. Dr. Sheila passed away on December 22, 2012, leaving many bereft, yet richer for having known her. 'She was instrumental in shaping me' was and is an oftrepeated sentiment expressed by many of her students. It is probably the highest form of tribute to a teacher of Dr. Sheila's stature and resonates with the 'guru-shishya' educational tradition that CMC values even today.

Dr. Sheila would have approved !

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Medical Education

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he Women's Medical School in Vellore was started in 1918 to address the overwhelming health needs of the country especially those of women living on the fringes of society. In 1942, the School was upgraded to a College and five years later the College opened its gates to men students.

The beautiful and verdant campus that houses the medical college promotes a vibrant community life where there is much interaction between students and faculty in both academic and other activities like sports, cultural events and religious activities. Some of the excellent facilities made available to the students include libraries, with large numbers of printed and online books, journals, and computer laboratories with online access to teaching material through the e-learning portal. In addition, there is an advanced simulation laboratory to complement the clinical training delivered by a large number of dedicated faculty.

The over 2000-bed hospital with advanced technology in all broad and advanced specialities provides the base for training students at a tertiary level of health care. Training in primary and secondary health care is provided by smaller hospitals in three peripheral campuses of CMC serving different patient populations. Students learn holistic medicine - how to integrate basic sciences with clinical subjects, communication skills, ethics, leadership and management skills through innovative techniques and by observing their teachers. Research, both basic and clinical, is encouraged, with ample opportunity to participate in projects run by various departments. The network of secondary mission and church hospitals across India, where students are committed to serve for two years after their course, adds a different dimension to their

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Allied Health Sciences training. The students mature into young doctors, who continue to uphold the traditions of their college and find innovative and appropriate solutions to contemporary problems.

In 2012, in yet another important transition, the number of undergraduate seats increased from 60 to 100. The Postgraduate student intake also increased, with the addition of many new courses such as Geriatric Medicine, Transfusion Medicine and Immunohaematology, Endocrinology, Hepatology, Endocrine Surgery and Vascular Surgery. This has helped enhance the contribution of CMC towards providing well trained health personnel to meet the increasing needs of our country.

As the Christian Medical College reaches the threshold of completing a century of high quality medical training, we can proudly affirm our motto 'not to be served but to serve.’

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raining in allied health began as early as 1903 when Dr. Ida enrolled local women to assist her. Such informal in-service training programmes were gradually upgraded to certificate, diploma and degree courses. Since 2011, there has been a significant increase in the number and range of allied health courses, reflecting the increasing diversification and specialization of medicine.

They encompass the earliest courses in Medical Records, Occupational Therapy, Physiotherapy, Radiology and Radiotherapy, to newer ones in Critical Care, Urology Technology, Emergency Medicine, Nuclear Medicine, Perfusion Technology, Applied Molecular Genetics Methods and Cytogenetics. Courses on Health Management, Hospital Administration, Dietetics, Pharmacy, and Hospital Equipment Maintenance complement the diagnostic and therapeutic aspects of allied health disciplines in CMC, Vellore. Courses in Chaplaincy and Pastoral Counselling are in keeping with the ethos and the mandate of the institution and provide holistic care to the patients. Training in all these courses takes place through structured lectures and comprehensive practical sessions. Many of these courses, particularly the Laboratory based courses, involve the use of sophisticated equipment.

Currently there are eighteen bachelors programmes affiliated to the Tamil Nadu Dr. M.G.R. Medical University, seven diploma and seventeen postgraduate diploma programmes. All these courses aim to train competent and professional allied health personnel to make a vital difference in the quality of care of patients.

Distance Education

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stablished in 2004, the Department of Distance Education aims to train practicing doctors in proper diagnostic approaches to medical problems and strengthen the healthcare delivery systems in India and other developing countries. Courses offered include Allergy and Asthma, Diabetes Management, Hypertension and the Postgraduate Diploma in Family Medicine. The latter course began in 2007 as a one-year Fellowship Programme and was upgraded to a Postgraduate diploma in 2010. It is open to recent MBBS graduates working in secondary hospitals, and aims to equip them with skills and expertise as multicompetent family physicians to engage with secondary level health situations. It is now affiliated to the Tamil Nadu Dr. MGR Medical University as the innovative M.Med in Family Medicine.

The one-year distance Supplementary Education targets medical students in their clinical years, introducing them to integrated learning and practical experience at the nearest Mission Hospital. A Community Lay-leaders Health Training programme trains NGO workers based in remote parts of the country.

The programme uses a variety of pedagogic methods such as interactive problem based modules, video lectures, videoconferencing and contact classes. A multi-media project and a Primary Care Research Desk have been established. The e-learning platform is being launched this year. Three centres in Africa will be set up in collaboration with the University of Edinburgh, Scotland. The Distance Education Unit also trains future and potential faculty for the Unit through a series of Faculty Development Workshops.

Nursing Education

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ursing education has traversed an extraordinary journey since its formal beginnings in 1909.

Securing students for the school of nursing in those early days was an uphill task. Dr. Ida went personally to mission schools and canvassed for applicants. With the support of several pioneers and slogans such as 'Not somehow but triumphantly', India's first degree course (1946), postgraduate courses (1969) and doctoral programmes (1994) have been important milestones in the history of the College of Nursing.

Since 2011, there has been an increase in the number of students admitted to both the degree (100 students) and Post Basic nursing (50 students) courses. The new campus at Kagithapattarai marked the start of another century of innovative and quality education for nurses in India. The campus continues to grow and flourish- recent developments include the on-going construction of the Student Nurses' Hostel.

Today, the College of Nursing is widely recognized as a trend setter for nursing education in India, particularly with its strong emphasis on education, practice and research, and on preventive and promotive health through a variety of clinical specialities. The curriculum, with its strong theoretical foundations, emphasis on the scientific principles of patient care and practical experience, is designed towards the goals of improving patient care, preventing disease and promoting health.

Students are closely mentored by the faculty through a variety of initiatives.

The Departments of Continuing Nursing Education and Community Health Nursing provide excellent opportunities for research, training and outreach work.

The College has been designated a WHO Collaborating Centre for Nursing and Midwifery Development since 2004, and this collaboration has recently been extended up to 2015. The College has also been identified as one of the five National Nodal Centres for strengthening preservice education in ANM schools, support for which is provided by JHPIEGO, USAID. Mission hospital nursing is strengthened in partnership with the Nurses League of the Christian Medical Association of India.

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Nursing practical training

E-learning Class Room

Speech Therapy

School of Optometry

Graduation 2012

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Spirituality Rev. A.C. Oommen

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MC Vellore is fortunate to have had, at various points in her history, perceptive individuals who have helped to interpret the organisation to itself, enabling the staff, students and patients to envision the Divine in our midst. Rev. A.C. Oommen (fondly known as Achen), who served CMC for seventeen years as Dean of Chaplaincy, was one such individual.

After completing his undergraduate studies from UC College, Alwaye, he joined Sadhu Mathaichen, a Christian Sanyasi, in his work at the Manganam Ashram, looking after street children. In 1947, he joined Serampore College, near Kolkata, for his BD. A few months into his theology course, the country was plunged into the abyss of communal violence following Partition. In response to a call for help from Gandhiji, he quit college and joined a group of Christian youth to work in the relief camps in Delhi and Ambala. Later, he returned to Serampore and completed his course with distinction.

The Archbishop of Uganda, Leslie Brown, then requested Achen, and his wife, Amini, to come as missionary teachers to Uganda, to work on reconciliation and race relations. They agreed, and went to Uganda for seven years. He was ordained there, in the Namirembe Cathedral, Kampala.They returned to Kerala at the request of the Church, to help with trouble between different caste groups. He worked as a Parish priest in the remote parish of Kattampackal village, where he also campaigned for land reforms, started agricultural cooperatives and fought against alcoholism.

In 1964, he was invited to CMC by Dr. Jacob Chandy and Rev. A. S. Savarirayan to be the Dean of the Chaplaincy

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Department, where he put to good use all his previous experiences: in working among the poor and displaced during the freedom struggle and later in Kerala, in being a teacher and pastor for the deeply spiritual African people, and having grown up in the rich Eastern tradition of the Indian Christian church. His deep involvement with patients and their families here gave him new insights into the theology of suffering and healing, which he expounded in Vellore, CMAI, Tubingen, Canterbury and beyond. He believed in the quiet, absolute faith in a God who loves, and the consistent acting out of this faith in our daily lives, building a caring community.

He was, and continues to be, a warm, sensitive friend and counsellor to many students, leading them in Bible studies, lending a guiding hand through spiritual crises and a shoulder to lean on during heart aches (& breaks) of student life. He encouraged students to encounter and learn from the lives of ordinary people through retreats, physical labour and work camps, thus enabling them to experience a vibrant, living relationship with God. He was a kind pastor for the staff and his ability to interpret health, healing and suffering in the daily context, reminded them that the God they encountered during Holy Communion in Church was equally present in the ward and should be encountered among the sick and dying and their families. For the patients and their relatives, he was a Chaplain, constantly available and reminding all of us that suffering is a mystery, not a punishment, and can be borne with the insight that God is present in our suffering. He saw healing as not only as a restoration to wholeness but also to the purpose for which God had created that person.

He characteristically thought and communicated in 'three points': for example: 1. Our lives are not our own; we belong to God. So CMC is not merely a human organisation but belongs to God, and therefore we need have no fear.

2. What God asks of us is obedience, and therefore, following our Master on the Road less travelled is the most critical individual and corporate task.

3. God is faithful and we experience his faithfulness all the time and strive to witness this in our lives together.

During early seventies, a renowned management expert, who was then on the faculty of IIM-Ahmedabad, was requested to evaluate the finances and organisational structure of CMC. He did a detailed study and was quite astounded that CMC's was giving away so much as charity. He suggested that if CMC continued to function in this way, it would become bankrupt and cease to exist in 5 years time.

The senior staff members of CMC were quite disturbed on hearing this prognosis from the young expert. Achen stood up and respectfully announced that the expert must be quite right, because he had studied the organisation in great depth before coming to this conclusion. However, he had forgotten to add five words to his verdict “If CMC continues to function in the present manner, giving away more money than it is earning, then it will shut down in five years, if there is no God.” This incident, which occurred over three decades ago, demonstrates how Achen Oommen was able to consistently unveil the Divine and reveal the true strength and source of healing in CMC. It is in this tradition that spirituality undergirds CMC. The fourteen chapels and quiet spaces are open places of worship, comfort and solace for people from diverse faith backgrounds. Retreats, community worship services and music are some of the ways that we in CMC renew ourselves to be holistic partners in the healing ministry of Christ.

Chapel at the Mary Verghese Rehabilitation Institute 29

Outreach Dr.K.G. Koshi

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r. K.G. Koshi was born in 1914 in Kottayam, Kerala.

Even though his father was a lawyer, he chose to do medicine and joined the Madras Medical College in 1931. Dr. Koshi then joined the Army for a short service commission. He served in Iran for four years during the Second World War and was later posted to Poona (today's Pune). When his commission was coming to an end, Dr. Koshi chanced upon an advertisement for doctors in CMC Vellore.

He came to CMC in 1947 and was interviewed by the then Director, Dr. Robert Cochrane. Dr. Koshi planned to be a physician and hence was appointed Medical Assistant in the Department of Medicine. He worked with Dr. Kamla Vytilingam, an alumnus of the LMP (licentiate medical practitioner) batch of 1919 and a pioneer of the Department of Medicine and later of Cardiology.

The late 1940s were transition years for India and for CMC as well. The institution was facing the herculean task of upgrading the medical school to a college with a bachelor's programme. With the increase in the number of students, and the college opening its doors to men students as well, the expansion and upgradation brought with it urgent requirements of buildings, infrastructure and qualified staff for a number of new departments. One of the Departments that needed staff was the Department of Hygiene, as Community Health was then known. Dr. Koshi was asked to fill in this lacuna, and without a second thought, he dropped his plans of training as a physician and stepped up to be counted.

To train in this area, Dr. Koshi went in 1950 to the School of Public Health and Hygiene, Liverpool, U.K., where he obtained the Diplomas in Public Health and in Tropical

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Medicine and Hygiene. A year and a half later, Dr. Koshi returned to Vellore and took over as the Head of the Department of Hygiene. He set about establishing the community work in the rural area around Bagayam.

Reaching out and taking medical care to people- 'roadsides'was one of Dr. Ida's earliest initiatives of bringing about change. Organised community work began in CMC in 1948 when Dr. Robert Cochrane established the Kavanur Rural Health Centre (today's RUHSA). The urban health work in Thottapalayam was started at about the same time, and Miss. K. Norris, a Public Health Nurse, was the dynamic spirit behind these two programmes.

Dr. Koshi was joined in 1952 by Dr. Leroy Allen, a public health specialist who had previously worked in Burma (today's Myanmar). In 1953, the Department of Hygiene was renamed and reorganised as the Department of Preventive and Social Medicine, with the aim of establishing comprehensive integrated health services and rural field training centres. Other staff who contributed immensely during these early years included Dr. Pauline King, who lived and worked in the villages, and the first social workers - Mr. Anthony Palocaren, Miss. Sosa Kuruvilla and Miss. Saroj Devavarum- who were instrumental in carrying out field surveys and home visits. By October 1956, health subcentres were established in the villages of Pennathur, Kannyambadi and Edayanzathu. Right from the beginning, the emphasis was on providing promotive, preventive and curative care as an integrated service.

By the mid-1950s, changing medical education requirements called for rural hospital postings for interns. With the aid of the Rockefeller Foundation, a field area was developed for training interns, medical and nursing students in public health. The area covered villages in the Kanniyambadi Community Development Block. Nutrition and health studies, sponsored by the William Waterman Foundation and headed by Dr. Hanumantha Rao were conducted in the area. In 1957, the Rural Health Centre (today's CHAD), with 12 beds and an outpatient facility was opened. It provided

medical services for patients referred from the village sub-centres.

By then, Dr. Sojibai Samson and Dr. V. Benjamin, as well as Dr. PSS Sundar Rao, a pioneer in Biostatistics, had joined the Department. Thus, Dr. Koshi led a team of doctors, nurses, social workers, statisticians and health educators to establish links with the community and build up a service and teaching programme of high quality. They focused on nutrition, common communicable diseases, and mother and child care and health education. In all this, the emphasis was to bring about an improvement in the health and well being of individuals and communities. To quote the former Director, Dr. John Webb: 'Within the framework of orthodox medical education, our emphasis on preventive and social medicine, later rightly renamed community health, has been far greater and more effective than almost any other college in India.'

Dr. Koshi maintained the tradition of 'roadsides', and accompanied Dr. Ida B. Scudder on her Friday Roadsides and looked after the Leprosy patients. At a wider level, Dr. Koshi was Principal (1970-71) and Director (1971-74), in addition to being Registrar (1956-66), Vice Principal (1961-70) and Deputy Director - positions of responsibility that he carried out with distinction and integrity. He was Warden of the Men's Hostel for nearly fourteen years, and students remember him as a kind, gentle and helpful person. He was a fine, passionate teacher, who made the field of Public Health come alive. His wife, Mrs. Susie Koshi played her own part in CMC's Outreach services as Superintendent of the New Life Centre, a rehabilitation home started by Dr. Paul Brand for young men cured of leprosy. To these men, starting life afresh from the fringes of society, Mrs. Koshi was simply 'akka'.

Mrs. Koshi was also in-charge of the Big Bungalow from 1962-1974 and helped start the College Hill Nursery School in 1954.

Dr. Koshi will be remembered for giving direction to the fledgling Department of Community Health. And like the unsung hero in so many stories, he encouraged, nurtured and shaped a generation of students as people and professionals.

A busy day in CHAD OPD 31

College of Nursing Community Health (CONCH)

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ommunity nursing in CMC has evolved from the early days of the ‘roadsides’ to the Kavanur Health Centre (1948), the Community Nursing Department (1961) and finally CONCH (1987). Today, CONCH covers a population of over 63,000 persons in 21 villages and a semi-urban population of 23,000 persons. Home visits constitute the main basis of the programme. The four thrust areas of CONCH are Education, Service, Training and Research.

Community health postings are a vital part of the nursing curriculum, wherein students are exposed to a variety of health and development issues. Exchange students from USA, Denmark, Sweden and Nepal have also benefitted from the CONCH experience. A number of innovative means are used to spread health awareness about a variety of health issues- these include NSS Camps, puppet shows, film shows, health exhibitions and health screening camps. Maternal and child health programmes, geriatric clubs, awareness about such health threats as dengue and obesity, as well as holistic approaches to dealing with psychiatry and its related problems form part of CONCH. The programme also works closely with the local and district administration as well as with non-governmental agencies and self-help groups to implement Government health projects, like the DOTS of the National Tuberculosis Control Programme, and to train health personnel.

Community Health and Development (CHAD)

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he 130 - bed CHAD hospital of the Department of Community Health provides primary and secondary health care to the rural, tribal and semi-urban areas around Bagayam. In addition, community health programmes involve a range of preventive, promotive and social initiatives, including leadership and training in community development projects.

Teaching involves comprehensive, practice oriented undergraduate and postgraduate community health courses, epidemiology and public health. The Community Health Department has pioneered highly successful teaching programmes to sensitize students to the needs of the community, to equip them to study these needs, and identify cost-effective and appropriate ways of dealing with them.

The Community Orientation programme, initiated in 1974, has often been described by students as a life changing experience. The Community Health Training Centre and the Epidemiology Resource Centre offer short courses in epidemiology, research methodology, nutrition, health economics and public health.

Within its scope and situation, CHAD offers excellent opportunities for research. Current research includes studies on severe acute malnutrition, trial of vero cell rabies vaccine, the aetiology of neonatal infection in South Asia, comprehensive health and community development in Jawadhi and Kalrayan Hills, testing and evaluating the safety and efficacy of oral rotavirus vaccine, oral cholera vaccine and coronary heart disease and its risk factors among urban and rural residents. Many of these involve collaborations with other departments of CMC as well as centres across India, and as such have the potential to influence national policy.

Low Cost Effective Care Unit (LCECU)

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stablished in 1983, LCECU and the Ida Scudder Urban Health Centre serve the health needs of the urban poor in Vellore city. While CMC underwrites most of the costs of the Unit through many subsidies, several strategies help keep costs low: family physicians, who manage most patients; patient retained medical records; appropriate usage of laboratory investigations; usage of generic medicines, and home based care where needed. The Unit has an excellent referral system with consultants in the Main Hospital, which helps facilitate high-cost, tertiary care for the few patients who require it.

On an average, 200 patients are seen daily in LCECU. An example of patient-centered care is the Diabetic Group clinic which brings together patients for education, peer interaction and comprehensive care. Community outreach activities include Life Skills Programme for youth; home visits and follow-up of patients in the community for medical care or social assessments; community based clinics; school education in government and government-aided middle schools; and medico-social work. This year, Occupational Therapy has been added to the services available in LCECU. Teaching of medical, allied health and postgraduate students is an integral part of LCECU. Current research from LCECU includes enteric infections, malnutrition and effects on cognition, management of severe acute malnutrition and newer typhoid vaccines.

Rural Unit for Health and Social Affairs (RUHSA)

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rom its early beginnings in 1948 as the Kavanur Rural Health Centre, RUHSA is an innovative model of socioeconomic development, with the promotion of health as a means to development. Medical services are provided through the 70-bed secondary care health centre in the KV Kuppam Block and many peripheral health centres.

A successful outreach activity has been the cervical cancer screening programme, a joint collaboration with several organizations, including Cancer Council, Australia, the University of Sydney, Weill Cornell Medical College, USA and CMC, Vellore. With its innovative theme of 'educate, screen and treat', it has successfully integrated cancer screening with the existing public health outreach programme. Several cervix cancer screening and management training workshops have been held.

Five elderly day care centres add to the quality of life of nearly hundred poor elderly persons in the Block, while the mental health initiative helps maximize the independence of mentally and physically challenged persons. Occupational therapists assess their training needs, plan training schedules and make home visits. The Community College offers vocational and other educational programmes to empower rural youth. RUHSA trains different levels of healthcare professionals; currently it is training 1,300 Rural Health Assistants from Chattisgarh, a state with some of the lowest health indicators, in primary health care. Two HIV cohort studies, supported by NIH and ICMR and the Vellore Aberdeen Nutrition Exchange are examples of the fertile ground that RUHSA offers for research.

The Department of Community Health was honoured with the WHO Award for Excellence in Primary Healthcare at the India Healthcare Awards 2012 by ICICI Lombard and CNBC TV 18.

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33

Outreach Clinic in Jawadhi Hills 34

Prosthetic Lab

Occupational Therapy

Meditation Space, Psychiatry

Cervix Cancer Screening Education, RUHSA

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Peer counselling, Rehabilitation Institute

Nursing Outreach - RUHSA

Elderly care, CONCH

Home visit, Rehabilitation Institute

Home visit, CONCH

Developmental Peadiatrics

School Outreach, LCECU

Community College (RUHSA)

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From the Archives

Dr. Ida Scudder and nurses (1905)

Hospital Chapel with construction work in the background 38

Dr. Ida Scudder and Pharmacy staff (1950)

Dr. Ida Scudder’s 87th birthday celebrations

Dr. Ida Scudder and medical students (1957)

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Early Days....

Dr. John Carman and Mrs. Indira Gandhi (1958)

Corner stone of Scudder Auditorium (1964)

Clinical Pathology (1956)

Lamp lighting

Chattram

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Sir Alexander Fleming and Dr. Ruth Myers (1953)

Mental Health Centre

Open Heart Surgery (1961)

Ms. Monica Hopkins and Occupational therapy

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Inauguration of Schell Hospital (1902) 42

Invitation to the Opening of the Medical School (1932) 43

Milestones 1900 1902 1903 1906 1909 1918 1924 1932 1942 1945 1946 1947 1948

1950 1951 1953 1954 1956 1957 1961 1962 1963 1965 1966

1967 1968

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Single Bed Dispensary Schell Hospital for Women and Children (40 Beds) Training Course for compounders First "Roadside" Dispensary Nursing School - Diploma Course Medical School for Women - LMP Course Hospital on present site in Thottapalayam (267 beds) Medical School moved to College Hill Campus Medical College-MBBS Degree Course Laboratory Technician Training Course College of Nursing - Degree Course - India's first College of Nursing First batch of men medical students First reconstructive surgery on leprosy patients in the world First Neurological Sciences Department in South Asia First Eye camp Medical Postgraduate Courses - MD and MS New Life Centre (Leprosy Rehabilitation) Men's Hostel Radiographer Training Course Mental Health Centre Rural Health Centre, Bagayam Pharmacy Diploma Course First Successful Open Heart Surgery in India First Middle-ear Microsurgery in India Medical Records and Physiotherapy Courses College of Nursing building Fleming Memorial Research Laboratory in Virology First Rehabilitation Institute in India Williams Research Building Scudder Auditorium Student Nurses Hostel Occupational Therapy and Hospital Administration courses

1969 1970 1971 1972 1974 1975 1976 1977

1978

1981 1982 1983 1984 1985 1986

1987 1990 1991 1992

1993 1994 1995

College of Nursing - Postgraduate Degree Courses Nephrology Department First Kidney Transplant in India Carman Block Engineering Services building New Operation Theatre complex Community Orientation Programme for medical students Artificial Kidney Laboratory Rural Unit for Health and Social Affairs (RUHSA) First external quality assurance programme for 59 Indian laboratories Betatron ICMR Centre for Advanced Research in Virology Nambikkai Nilayam - Institute for children with special needs New Ophthalmic Hospital in the Schell Campus Degree programmes in Occupational Therapy, Physiotherapy and Medical Record Science Low Cost Effective Care Unit (LCECU) Continuing Medical Education Department Epidemiology Resource Centre National AIDS Reference and Surveillance Centre India's first Bone Marrow Transplant Whole Body C.T. Scan M.Sc. in Biostatistics College of Nursing Community Health Programme (CONCH) Infant Open Heart Surgery 1000th Live Donor Kidney Transplant Dr. Ida B. Scudder Radiation Therapy Block ASHA Education Block 10,000th Open Heart Surgery Nuclear Medicine Department Dorothy Joske Hostel for AHS men students Linear Accelerator Diploma in Clinical Pastoral Counselling First Rehab Mela Magnetic Resonance Imaging Reproductive Medicine Unit Endocrinology Department

1996

1997

1998

1999 2000

2001 2002 2003

2004

First carotid bifurcation stenting procedure in India First trans-septal carotid stenting procedure in the world First trans-jugular mitral valvuloplasty procedure in the world Distance Education Unit-Family Medicine Programme Child and Adolescent Psychiatry Unit Developmental Paediatrics Unit P.G. Diploma in Clinical Pharmacy First In-Vitro Fertilisation / Gamete Intra Fallopian Transfer Babies ABC Block Staff Quarters Working Women's Hostel First Bone Marrow Transplant in a six month old baby First whole body irradiation for a bone marrow transplant patient.

Paediatric ICU First Intra cytoplasmic sperm injection baby First Liver Transplantation Centenary Year Ida S. Scudder Centenary Center for Women and Children Sullage Treatment Plant 2000th Live Donor Kidney Transplant PACS system for Radiology Medical Oncology Unit Cytogenetics Laboratory Vellore Bombay Artificial Limb Bioengineering Department National Citizens' Award India's Best Employer Award Speciality Oriented Department of Surgery Palliative Care Unit Fellowship in HIV Medicine Paediatric Casualty H1 grading by Investment Information and Credit Rating Agency CON designated WHO Collaborating Centre for

Nursing and Midwifery Development Annual Winter Symposium started Outreach Clinics in Vellore Town Rheumatology Unit Medical Genetics Unit Telemedicine South Asian Cochrane Network 2005 First Live Donor Liver Transplant Department of Continuing Nursing Education First Surgical Ventricular Restoration (SVR) Infectious Diseases Training and Research Centre (IDTRC) New Fitch Hostel for AHS women students 2006 CHRIS card for patients PG Diploma in Family Medicine (Distance Education Course) 2007 MMM Award for excellence in healthcare Gurukuljyoti Award Basic Sciences Laboratory Centre for Stem Cell Research Pneumatic Conveyor System Modale Hostel for International Students 'A' Block of Private Wards Fellowship in Secondary Hospital Medicine 2008 Alumni House Anti Retroviral Therapy Centre Balavihar Creche 'A' Block ICU International Living Award from LeBonheur Healthcare, USA New Medical ICU HDU complex Department of Geriatric Medicine 2009 Centenary Celebrations, College of Nursing Centenary Building, New College of Nursing Campus Diamond Jubilee of Neurological Sciences First Endovascular Repair of Aortic Aneurysm using Three Chimney Grafts First Successful ABO Incompatible Renal Transplant in India

One Thousand Bone Marrow Transplants New Bioengineering Block New O5 and O6 Wards Interventional Pulmonary Service Cardiac Electrophysiology Unit Department of Hospital Management Studies and Training LUTS Clinic 2010

Social Responsibility Award Foundation Stone, Chittoor Campus PET Scanner Field Research Facility GFATM Award to CON Florence Taylor Memorial Library (CON) Medical Education Unit recognised as Regional Centre

2011

School of Optometry Central Electron Microscope OPD Services, Chittoor Campus E-learning Classroom Diamond Jubilee-Department of Medicine and Division of Surgery Advanced Medical Simulation Laboratory

2012

Computer Disaster Recovery Grant from ASHA, USAID Medical Physics Education and Research Block Foundation Stone, Student Nurses' Hostel, Kagithapattarai Campus Dedication of the Paul Brand Building Dedication of the Chittoor Campus Chapel Sewage Treatment Plant, Kagithapattarai Campus.

Signboard near College Hill 45

Supporting CMC's Work

O

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Friends of CMC Vellore

ne year old Sumiya’s misery was cut short by pure

a 30km radius of Vellore City and areas covered by RUHSA,

means to cope with the financial implications of a serious

chance. Her family arrived in CMC from West

CHAD, CONCH and LCECU. The fund invests all the donations

illness. Many CMC staff are committed to the PTP cause

Bengal because her elder sister, Suriya needed

received and uses the interest to help patients who need

through monthly deductions from their salaries. CMC

surgery for a rare condition called Achalasia Cardia. While in

complex and expensive treatment and high-tech

absorbs all the administrative support for this fund, so that

CMC, the Paediatric Surgeons discovered that Sumiya was

interventions like heart surgery, but can ill-afford it. Grants

the entire amount goes directly to helping poor patients.

CMC gratefully welcomes any donations. Donors may

suffering from the same condition as well. For the parents, it

up to a maximum of Rs. two lakhs are allotted from this

was a shock, as they had just enough money to pay for their

Fund. Applicants are carefully screened by means of a house

older child’s treatment. A grant from the Development Office

specify the kind of patients- gender, age group, disease or

visit, their need and the ability to continue with ongoing

clinical unit- they would like the money to be used for. The

Emergency Fund made Sumiya’s surgery possible as well. The

care. This fund also supports the costs of unexpected

parents returned to their village in West Bengal with two

demand for grants has been increasing steadily over the

complications for poor patients from any part of India. Poor

years, and we are indebted to our many donors and well-

healthy children.

patients who require expensive antibiotics for sepsis after

wishers who have been generous in their support of our

Devagi and her family live in Vellore, and they get by on

chemotherapy or for ICU admission and ventilation after a

work in CMC. Cheques and bank drafts should be made out

practically nothing. Devagi had an uneventful confinement

surgical procedure can avail financial support up to

to ‘CMC Vellore Association’ payable at Vellore. Donations

and regular antenatal checkups at CHAD. A day after her son

Rs. 50,000.

are eligible for tax relief under Section 80G of the

was born, his blood sugars plummeted and he had seizures. A

The Development Office Emergency Fund helps poor

Income Tax Act.

diagnosis of inherited error of metabolism, hypoglycemia,

patients who need expensive and specialized hospital care.

leucopenia and sepsis called for expensive medication and

The Fund has flexible criteria and enables clinicians to

prolonged treatment. Thanks to the PTP programme and the

proceed with surgery or medical treatment immediately.

Child Health special fund, the family was spared a crushing

Outpatients are also given assistance to buy costly

debt that ill health imposes on so many in India.

antibiotics, chemotherapy drugs or for radiation. The

CMC’s mandate spells out the institution’s special concern

Development Office also raises funds for CMC’s capital

for the disadvantaged, marginalised and the deprived. CMC

needs and for scholarships for students from economically

is often the only hope for families like Sumiya’s and Devagi’s.

disadvantaged backgrounds.

Clinical Units try to write off costs of tests and all general

The Person to Person Fund (PTP) gives small grants to

beds are subsidized. There are also special funds, thanks to

patients needing treatment in any of the general wards. The

the generosity of well-wishers, friends and many former

extremely poor are given priority. Reports are sent back to

grateful patients.

the donors, so that there is a personal touch to the donation.

The Centenary Endowment Fund was established during the

In 2012-13, a total of 3,222 persons benefitted from the PTP

centenary year in 2000 and is specifically for residents within

programme- most of these beneficiaries were those with no

Australia Prof. Ian Olver Australian Board of CMC FOV 354/298-304, Sussex Street, Sydney New South Wales, Australia 2000 Email ian.olver@cancer.org.au United Kingdom and Ireland Mr. Richard Smith Flempton Hall, Bury Road Flempton Bury St Edmunds Suffolk IP28 6EG, Great Britain Tel: 01284 728453 Fax: 0871 2439240 Email: friendsofvellore@gmail.com www.friendsofvellore.org Germany Dr. Peter Albrecht Eythstrasse 2 74613 Ohringen, Germany Tel: 07941 / 61958 Email: peteroehr@gmx.de Sweden Dr. Sven Andreasson Stockholm Centre for Psychiatric Research and Education Karolinska University Hospital R5:01 171 76 Stockholm, Sweden Tel: +46 8 5661 3582 +46 76 8443582 Email: sven.andreasson@sll.se

Contact Information Canada Mr. Douglas Virgin Vellore-Ludhiana Committee 23 Farmview Cres.

Toronto ON M2J IG5 Canada Tel: 416-921-2301 Fax: 416-494-7403 Email: vel-lud@sympatico.ca

Address Christian Medical College Ida Scudder Road Vellore - 632 004 Tamil Nadu, India Telephone 0091 416 228 1000 0091 416 228 2500 0091 416 228 extn 0091 416 307 0000 0091 416 307 2500 0091 416 307 extn

United States of America Ms. Katherine D. Guenther Vellore C.M.C. Foundation Inc. 475, Riverside Drive, Rm. 725 New York, N.Y. 10115 Tel: 212-870-2640 Fax: 212-870-2173 Email: foundation@vellorecmc.org www.vellorecmc.org India Mr. Hugh Skeil Development Office Christian Medical College Vellore 632 004 Tamil Nadu, India Tel: 91-416-2283509 Fax: 91-416-2232035 Email: dev.office@cmcvellore.ac.in

Fax 0091 416 2232035 0091 416 2232054 Email hospital education directorate development office overseas visitors and volunteers research Websites christian medical college education

msoffice@cmcvellore.ac.in princi@cmcvellore.ac.in directorate@cmcvellore.ac.in dev.office@cmcvellore.ac.in dir.evo@cmcvellore.ac.in research@cmcvellore.ac.in

http://home.cmcvellore.ac.in http://www.cmch-vellore.edu/main.asp http://home.cmcvellore.ac.in/ admissions/admin.htm

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