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Eight Years of Elevating and Holistic Healthcare

By Mr. Y Arvind

On January 19, 2009, the Sri Sathya Sai Institute of Higher Medical Sciences, Whitefield, celebrates its 8th anniversary; another fulfilling year in the calendar of the Sai Health Care Mission. Times change, people alter, but the will of God remains eternal. Many are called but few are chosen, is an oft repeated aphorism.

When opportunity meets energy, the result is a revolution. Bhagavan Sri Sathya Sai Baba has set in motion a revolution founded on the most fundamental need of every being – Love. Swami’s Hospitals are the physical representation of “Love in Action”. No wonder they are referred to as ‘Temples of Healing’.

With its four specialties of Cardiology, Cardiothoracic surgery, Neurology and Neuro surgery, the SSSIHMS, Whitefield, has steadily been healing hearts and minds - physically, emotionally and spiritually - and returning them to society as productive men and women. The guidelines that Swami has given form the bastions that hold up this edifice of healing:

With time, the SSSIHMS, Whitefield, has evolved to meet demands from various fronts: Clinical, Academic and Technological. In addition to this, fresh initiatives have also been taken to provide more amenities at the staff residential campus.

I. The Clinical Dimension:
Exploring New Frontiers of Cardiac Sciences and Setting Challenging Targets in Neuro Sciences

On the clinical front, a special mention must be made of the Department of Cardiology which has surpassed itself in performing a variety of cases and has added to its repertoire the cutting edge procedure of Device Closure. This is a new technique where holes in the heart are closed using artificial devices in the Catheterisation Lab, instead of doing an open heart surgery.

	Cross section of a healthy heart (left); with a septal defect (right)

A little explanation will make this clearer. The heart has four chambers, two atria on top and two ventricles at the bottom.

The right side of the heart pumps impure blood to the lungs, which return pure blood to the left side of the heart, which in turn pumps the pure blood to the rest of the body.

There are four valves that control the unidirectional flow of the blood; from the left – the mitral, the aortic, the pulmonary and the tricuspid.

Anything out of the ordinary with the walls between the chambers or these valves, leads to a cardiac problem. “A hole in the heart” causes pure and impure blood to mix leading to various other complications.

Earlier, these holes could be closed only through open heart surgery, where the sternum (breast bone) was cut in half, the chest opened up and the surgery done on Cardiopulmonary bypass using a heart lung machine. This, of course, meant that the patient was scarred for life and post operative complications always hung like the Sword of Damocles. Young women and girls in their teens were the worst affected since the scar on their body was always a cause of concern for them.

In Device Closure technique, a small collapsed synthetic wire-meshed device is threaded onto a catheter and through standard catheterisation procedure is manoeuvred into the hole and released. The device pops open and expands into a disc that effectively blocks the opening, and restores normal blood flow. It has the same result as a full fledged operation, but without the pain, scarring or intensive care unit observation – all this at the same price. The benefit is enormous, particularly because the patient can return to normal life and activity within two days of the procedure with no after effects.

The vascular device in threaded into the hole...		...guided by catheterisation...		...the device expands to block the hole and the catheter is removed

The workshop on Device Closure conducted by SSSIHMS, Whitefield on November 13, 2008 had Dr. Hieu from Vietnam National Heart Center demonstrating the procedure. Dr. Dash, Head of the Department, Cardiology, SSSIHMS, Whitefield was guided by Dr. Hieu, and together over 8 cases were addressed in one day.

Other participants from SSSIHMS, Whitefield included Dr. Barooah, Dr. Amit Garg and DNB (Diploma of National Board) residents. Dr. Ravi Narayan from Manipal Heart Institute, Dr. Deepak from Vydehi Institute of Medical Sciences and Research Center, and Dr. Keshav Murthy from BGS Apollo also participated in this workshop.

The Department of Neurosciences, not to be out done, has performed more than 49 aneurysm clippings (surgical procedure to treat a balloon-like bulge or weakening of an artery wall) in the brain along with a host of other surgeries including spinal surgery and brain tumour excision. This department has upped its ante of increasing the number of surgeries, and as a unit, has achieved the set targets. There are new frontiers now being envisaged.

II. The Academic Dimension:
The Sri Sathya Sai Institute of Allied Health Sciences, Aids Scores of Students

With the inauguration of the Sri Sathya Sai Institute of Allied Health Sciences, the SSSIHMS added another feather to its cap. Already recognised by the Diploma of National Board, the Hospital has a full fledged DNB program in Cardiology, CTVS, Neurosurgery, Anaesthesia and Radiology. Now, the Hospital has further increased its academic ambit by offering undergraduate paramedical training programmes. The SSSIAHS offers seven courses – B.Sc. (nursing), B.Sc. (Radiology), B.Sc.(Anaesthesia Technology), B.Sc. (Cardiac Care Technology), B.Sc. (Imaging Technology), B.Sc. (Medical Lab Technology), B.Sc. (Perfusion Technology). All the courses are offered totally free of charge. The students are provided accommodation on campus and are selected through an entrance examination. The program is affiliated with the Rajiv Gandhi University of Health Sciences.

The first batch of fortunate students who are being trained for free at the Sri Sathya Sai Institute of Allied Health Sciences

The first batch has 57 students with a compulsory science background hailing from various parts of the country. They are taught the Sai system of education and educare, and are made aware of the value of the opportunity provided to them. For instance, an undergraduate nursing training programme in a commercial institution costs Rs. 4,00,000 (US $8300). The students of SSSIAHS get it at absolutely no cost to them.

The academic curriculum is designed to give the students the best of both worlds, and there is no paring of resources when it comes to delivering quality education. A fully equipped library, laboratory facilities, computer lab, and avenues for various extra-curricular activities provide the students all they need to mould themselves into fully productive members of society. Their classrooms are equipped with technological aids including LCD projectors, networked computers, and the new kid on the block – Moodle (more about it later). In SSSIAHS, it is called LMS (Learning Management System).

III. The Technological Dimension:
eHIS and Telemedicine – Demonstrating the Direction to the Future

On the Technological front, the institute conducts academic research focusing on preventive healthcare, low-cost substitutes for medical implants, and clinical markers for early disease detection to name a few. Inspired by the noble mission of the Hospital, many professionals of eminence from various domains and geographical locations visit the institute and contribute their expertise.

The Hospital has moved over to a superior electronic database management system called the eHIS, short for, Enterprise Hospital Information System, set up by IBA Health, a leading provider of medical software solutions. The DMS (Database Management System) is a multidimensional tool that is being customised to suit the needs of the Hospital with able support from the managers of the Hospital’s Information System department working in tandem with the representatives of IBA Health. Efforts are now on to have a complete software solution including the Human Resource Management, Asset Management as well as Payroll modules.

The Information System Department		The hub of Telemedicine

The Department of Telemedicine that started just 18 months ago has already helped over a thousand patients, both cardiac and neurological at the Barrackpore nodal center in West Bengal. Tele-consultation for cardiac sciences started less than four months ago, and over 90 patients have benefited from this new service. Efforts are now underway to open a second nodal point in Orissa that has the second largest concentration of patients visiting the Hospital.

IV. The Academics-cum-Technology Dimension:
“eGuru” Takes off to Train the Eager and Inspired

Technology offers tremendous opportunities to impart interactive, enriching and collaborative learning experience for the students, and a Learning Management System (LMS) is the best tool to harness its potential. The institute deployed an LMS in October 2008 using the popular open source Moodles under the banner "eGuru" to impart, administer and manage the various academic programmes and courses it offers.

eGURU offers self-paced, interactive and object-oriented training to its students. The trainers of education are very adaptive to such technologies and advancements which give LMS an edge in acceptance and usage. The institute plans to extend the scope of LMS to enhance staff skills, job-oriented training, and shape it into a knowledge portal.

One can use the LMS to: access course materials (such as lecture slides and assignment sheets), view announcements (that will be posted throughout the semester and will contain important information about the subject, such as reminders about an upcoming assignment due date) and perform online tasks (such as submitting an assignment).

The course outline, lecture notes, assignments, and other learning resources will all be made available through the LMS. In addition, one will also have access to online tools such as feedback quizzes, interactive courseware, and audio recordings of lectures.

The advantages of e-learning are many, such as: Flexibility – anytime and anywhere; Self-paced – students can learn at their own pace; Knowledge Management and Electronic Performance Support; increasing the self-responsibility of the students; and so on.

V. The Spiritual Dimension:
Direct Guidance from the Divine - Swami’s Visit to the Hospital

While all these developments have been taking shape in the Hospital in recent months, the One who actually shaped and gifted this marvel of healing to this world, and continues to inspire the employees in so many different ways, Bhagavan Sri Sathya Sai Baba, blessed the Hospital again with His personal visit on June 7, 2008. On this occasion, He inaugurated the “Sai Veda Venkatarama Health and Fitness Center” in the residential campus of the SSSIHMS.

	The Sai Veda Venkatrama Health and Fitness Center

The fitness centre was the concretization of the words spoken by Swami on His visit to the Hospital on January 26, 2002.

On that day Swami had blessed the staff of the Hospital with His divine message in which He said, “In due course, this Hospital will have a General Hospital, and a school for children. In the evenings, the tired teachers and doctors will have a play ground to relax and play tennis. I will arrange for all these amenities.”

The SSSIHMS Whitefield now has the Sri Sathya Sai General Hospital, Whitefield associated with it, the Health and Fitness centre has a tennis court, a basket ball court, an indoor shuttle court, a fully loaded gymnasium and an indoor games area; a crèche for the children of the staff is also part of the fitness centre complex.

After inaugurating the campus, Swami blessed the Hospital and surprised all the staff with His munificence by dining with them in the huge atrium of the main building. He then blessed all those present with His Divine message in which He highlighted man’s weakness for wealth and the loss of health in pursuit of the same. Here is an extract of that timeless discourse:

	“The world today…is dependent on money. Whichever party or department you may see… it is all money, money, and money… For the sake of money, everything else is discarded. One destroys one's health for money. Health is very important. It is the greatest wealth. With good health one can achieve many things. Therefore, Hospitals are very much necessary to be healthy. Amongst you, some consider themselves doctors and others as students. No! In my opinion, all are students. Even doctors, need to study, learn and know many new things. So, they too have to study throughout their lives. Doctors and everyone else too… should learn new techniques… And find treatment for new diseases. Giving medicine alone is not enough. More investigation has to be done to ascertain if the dosage is sufficient and know more about the nature of the disease. The personality of the patient as well as the cause of the malady has to be thoroughly understood; at times, the diseases are genetic, at other times, from friends and associations, or through unforeseen circumstances. Diseases come and go…The cure is not as important as preventing the infection. This is very important in youth. All powers are imbued in youth energy. God, the almighty, the All-knowing One, is in man. And in man, there are thoughts, mind, intellect, awareness…and ego. Diseases arise because of all these. Even the food we eat… gives rise to many diseases. Therefore, investigate the food you eat… is it Satwic, Rajasic or Tamasic? First and foremost, examine the food. Satwic (sublime) thoughts arise from Satwic food, and Satwic actions arise from Satwic thoughts. So, based on food… diseases progress. First, partake Satwic food. Alcohol and non-vegetarian diets bring with them many diseases. There is no medicine for these diseases. If we eat proper Satwic food…good health is assured. So, eat Satwic food… but in moderation. Excess eating leads to indigestion. Just because it is tasty, do not overeat. But children today do not think on these lines. They consume immediately whatever is offered. One has to investigate to know if the food is Satwic, Rajasic or Tamasic. Therefore, the mind is the cause for bondage or liberation. In fact, it is the cause of everything. Mind is the primary source of both health and happiness. If the mind is steady… one has good thoughts. Good thoughts lead to good action. And good action in turn gives rise to happiness and health. So, we have to be careful of what we eat. Without health, the body is of no use. It cannot do any work. So take care of your health. For children too, in whatever they may learn and play, everything should be in moderation (mitamu) and hitamu, that is, for goodness and good will. The world needs both of these. Today in politics, there is no moderation. We find excesses in all forms. More importantly, there is no goodness or good will. With moderation and goodwill, one earns respect from society. To provide strength and support, and reform society… we must enter society, and give them appropriate advice. Not mere advice, but demonstrate to them through our actions. When we do so, society will reform. Therefore, if society has to improve, it is possible only through our efforts. If society and country have to progress, first you should evolve. When you transform for the better…you can then help society. Understand this concept. You consider the body very important… not the body, the sheaths covering the body are important. Mind, intellect, awareness and ego… are the four coats covering the body. First and foremost, the coat of buddhi (intellect) must be removed from the Atma. Why do you wear a coat? It is to protect from external environment. First, remove the coat of Tamas (dullness and inactivity). Abandon the vest of Rajas (unwarranted aggression and passion) and discard the shirt of ego. What remains is the body. This mind, intellect and awareness are meant to facilitate the function of the body. Without these, the body is an empty balloon. Once the body is empty, neither sin nor merit will touch it. Neither praise nor blame; or rewards nor ignominy will have any effect on it. The body is then liberated. Therefore, eat in moderation. Do not eat in excess and make your stomach look like a “question mark”. When you feed the patients in the Hospital, speak to them peacefully. Have a cheerful “smiling face”. When we explain to them calmly, they will develop good feelings and follow the right path. Therefore, students too should be careful. In particular, if students are well, the Hospital will be fine. They must follow doctor’s advice, respect their words and learn from them.”

After this, Swami blessed the staff with group photographs and then left for Brindavan. The very next day He returned to Prasanthi Nilayam.

Bhagavan with some of the medical staff during His visit to SSSIHMS, Whitefield, on June 7, 2008

VI. The Inspiring Dimension:
The Beacon of Blissful Healthcare for the Twenty-first Century and Beyond

“Hi Arvind, this is Lakshmikanth from Stockholm, remember me?” When one receives a call that begins like this at 10.30 in the night, it is a natural reaction to say ‘wrong number’, but when the caller has used your name you begin to think twice. Well, in this case, it turned out to be genuine. The call was from the Karolinska Institute, Stockholm, Sweden.

Some of the alumni of the Sri Sathya Sai University are doing their academic research there, and Lakshmikanth was one of them. He and his co-researcher, Mr. Pettr Brodin, M.D., an immunologist, were working together on the same project and had been to Australia to attend a conference. They had to stop over in India, and when one is touched by God, one cannot but run to him at the first chance. Therefore both of them visited Prasanthi Nilayam and had Swami’s darshan. And after this, Bangalore being just a three hour drive away, they decided to see His Hospital.

Apparently, life is indeed a series of appointments. It is a matter of semantics whether we call these moments appointments or circumstances or coincidences or miracles. To paraphrase Albert Einstein, one can live life only in two ways, as though nothing is a miracle, or everything is a miracle. I must confess, I don’t believe in coincidences. As Swami says, everything happens for a reason.

Pettr and Kanth, as they wanted themselves to be called, drove in from Prasanthi Nilayam in the afternoon just in time for lunch. Over lunch we swapped tales of our experiences working in Hospitals and I was surprised to find Pettr, a European, relishing proper Indian fare, down to eating without a spoon and fork. I asked him about this, and he grinned and gave a distinctive answer “Looks like the amino acids on my finger tips are adding a new taste to my lunch”. One can’t argue with such an answer. Anyway, after their lunch we set out on a tour of the Hospital.

He Came, He Saw and Was Conquered

We started with the main atrium that soared up 488 feet with its massive six layered crystal chandelier, surrounded by four acres of space. Though Pettr kept a straight face, one could see he was impressed. We went over to the wards, and Pettr whispered in the deafening silence of the preoperative cardiac ward, “Is this a ward?” It was enough to tell me that he was moved. Being a doctor, he had seen many hospitals.

But he later confessed, “This is different. I’ve never been to a place like this before.” Then, with the permission of the Chairman of the Cardiac Sciences, the three of us entered the cardiac theatres. Again Pettr’s silence told me much more than words can assay. Not many can put into words their feelings when they see Operation Theatres, and Cath-labs half the size of shuttle courts, wards the length of football fields, with roofs soaring up to 25 feet, balconies larger than an average sized parking lot, and an atrium that fills them with awe and reverence.

A multi faceted overview of some of the visual highlights of the SSSIHMS Bangalore

It was when I took him over to the patient counselling area that his façade melted a bit. The patient counselling department at SSSIHMS was the brainchild of Mr. and Mrs. Umesh Rao, who are long time followers of Bhagawan Sri Sathya Sai Baba. In their recent visit overseas, they had been to Karolinska University, and had presented the concept of emotional counselling with the onus on psychosomatic relationship to some of the senior staff over there.

Their response had been overwhelmingly in favour of the idea, and they agreed that what they were just beginning to accept with scientific validation was already being practiced at the SSSIHMS for the past 8 years, and the underlying concept had been expounded by Bhagawan Baba decades ago, “Treat the disease and not merely the patient”.

Pettr was from the same Institution and was in the audience when the couple had made their presentation. He saw what was propounded in reality – if seeing is believing, he saw and believed.

There are many more like Pettr who come with questions and return with none of them unanswered. For actions speak louder than words. Ask and you shall be given, knock and the door shall be opened is what the Bible says. We are taught again and yet again that we have to take the first step. But we rarely heed the words.

Probably that was the reason for the great artist Michelangelo painting the magnificent fresco of God reaching down from the heaven every sinew of his arm stretched fingers pointed…reaching out to man…but man lies on the earth, his arm raised in limp response, his fingers lifeless and without spirit. God does not have to descend on earth to prove He exists. He exists in the good man who helps his fellowman.

But when God does descend on earth and sets an example, He lights up fiery beacons that do not hide their glow, but speak through silent action, putting smiles on the faces of those stricken by sorrow and defeated by life. It is time to do what we have to do. The words of Robert Frost should always reverberate in our minds…