India
MCAI worked with medical staff in the Ahmedabad VS Hospital to improve facilities, from early 2001 to 2006
Earthquake
MCAI responded to the 2001 earthquake by sending emergency medical equipment, supplies and drugs to VS Hopsital in Ahmedabad- the largest city affected by the earthquake.
Post earthquake
MCAI stayed on in Ahmedabad after the earthquake and continued to work with local paediatricians to improve facilities for children. Wards which were falling into extreme disrepair were refurbished to reduce cross infection. Wards treating children with malaria, polio and typhoid, amongst other things, continued to struggle with inadequate equipment and insufficient drugs. MCAI refurbished two wards and provided equipment.
Dr John Bridson, Chairman of MCAI said, 'The hospital is a tertiary referral centre for the sickest children from other parts of Gujarat. In some ways this makes its problems even worse. Parents travel with hope yet there is little here for them'.
A local doctor told MCAI, 'We have a big list of patients with diphtheria etc who are transported here without oxygen. Children arrive gasping, in immediate need of resuscitation and ventilation support, sometimes after journeys of 6 - 8 hours, and we cannot help them. We need better resuscitation facilities, monitoring equipment and a special intensive care unit. This could make a lot of difference'.
High dependency care in India
Dr Kathy Pearl, MCAI’s Honorary Country Director for India visited Ahmedabad Hospital in 2003 and identified the urgent need for improved care for critically ill children. She returned with plans to provide a high dependency ward for children.
The 4 bedded High Dependency Unit (HDU) was successfully set up in 2004- 2005. The equipment we provided included 2 multi chanel monitors, infusion & syringe pumps, pulse oximeters and ventilators. The provision of HDU facilities for children has raised the profile of children’s services within Ahmedabad Hospital. Our work with the hospital management has to some extent been instrumental in gaining a shift in attitude and an acceptance of the rights of children to appropriate dedicated facilities. Both the University and hospital management have been supportive and creative in providing additional training to doctors in high dependency and short term intensive care techniques. Paediatric medical staff feel that they have good opportunities to maximise the benefit of the HDU. Nursing staff would profit from more training opportunities, but a core group of them have achieved very useful competencies in an area of work previously unfamiliar to them.
Because the standard of care for critically ill children has improved substantially this has a knock on effect on those children cared for within the general wards. It is the impression of the senior consultants on the unit that serious illness and deterioration in children are now being recognised much earlier, and even if they are not actually admitted to the HDU the experience and expertise that medical and nursing staff have gained is benefitting the child. Admissions to HDU have been for system failure such as respiratory failure, shock, severe dehydration, liver failure, kidney failure and loss of consciousness. Many illnesses are infective in origin.