Medical Google of RID 3232

From L: RID 3232 Covid Task Force chairman P Sathish, DGN Dr N Nandakumar, IPDG G Chandramohan, DG S Muthupalaniappan, district community services chair Dr V Sriram and disease prevention and treatment chair Dr Vasudha Rajasekar.
From L: RID 3232 Covid Task Force chairman P Sathish, DGN Dr N Nandakumar, IPDG G Chandramohan, DG S Muthupalaniappan, district community services chair Dr V Sriram and disease prevention and treatment chair Dr Vasudha Rajasekar.

All of us have seen pictures of ambulances queueing up outside hospitals during the second wave of the Covid pandemic. We were all under tremendous pressure to find hospital beds with oxygen, and even ventilators. A former Rotarian called to say he was waiting outside the GH in ­Chennai. ‘There is a queue of ambulances, my son-in-law is sick and his oxygen saturation level is only 80’,” recalls RID 3232 DGN and eminent maxillofacial surgeon Dr N Nandakumar.

By this time, thanks to the initiative of IPDG G Chandramohan during his year to bring the doctors in his Rotary district together in a group, to help Rotarians with their healthcare needs, RID 3232 had a robust group of 193 healthcare professionals, including 165 doctors. The “doctors’ group”, which Dr V Sriram, community services chair for the district, refers to as Medical Google — as it has not only specialists and super specialists, but also professionals from hospital management, the pharma industry and medical equipment manufacturers, was further strengthened by DG S Muthupalaniappan, as he saw the pandemic taking a firm grip over the country.

This group has been helping each other by sharing knowledge and helping to acquire the right equipment at the right price.
S Muthupalaniappan, District Governor

On getting the SOS, Dr Nandakumar immediately reached out to the doctors’ group, saying “we need a hospital bed urgently. DRFC M Ambalavanan responded saying there is a bed available in MMRV Hospital, and we immediately shifted him there. He had left Rotary but I was still in touch with him. The son-in-law got treatment, recovered and was discharged.”

A fallout of this help was that the grateful man has returned to Rotary, “saying that thanks to help from Rotary, my son-in-law is alive today.”

 

A great gesture

There are so many such cases. DG Muthu relates two interesting anecdotes. Dr S Suresh, a member of this doctors’ group, and secretary of the Voluntary Health Services (VHS), a flagship hospital in ­Chennai which caters to the middle and lower classes, which Rotary has been helping upgrade for decades now, shared with him a heartrending tale. A Rotarian from Thiruvannamalai lost one of his parents in the pandemic and his ­Covid-positive wife ­admitted in a hospital, was very sick and was brought to VHS in a very critical condition. “They tried their best but couldn’t save her. The couple had two young daughters. The bill came to ₹3.8 lakh, and the relatives were trying to raise  the money, “but because she had left behind two young daughters, Dr Suresh decided not to collect any money from the family. Such wonderful gestures have happened during this pandemic.”

The DG related one more incident from VHS. Dr Sriram, the community services chief, had referred a patient, and his family had expected a huge bill, but got a small one and they insisted on paying ₹30,000 above that bill. Dr Suresh called to complain that they are not vacating the bed because they want to pay more!”

A line up of Covid patients in ambulances waiting to be hospitalised.
A line up of Covid patients in ambulances waiting to be hospitalised.

Thanking the doctors’ group, he added: “This group of doctors has rendered remarkable service to save so many people’s lives. There are instances when I have passed on a request at 10 pm, and this group has worked till 3 am to do the needful. District 3232 would not have handled this pandemic so well without their help. Hats off to Dr Sriram, Dr Nandakumar and Dr Vasudha Rajasekar, the district disease prevention and treatment chair, for working tirelessly.”

 

Genesis

Giving details of the genesis of this group, IPDG Chandramohan said that in March 2020, when the coronavirus hit and a lockdown was announced, “everybody was at sea, we had no knowledge of this virus and even doctors were not totally aware what it really meant. I thought even for ordinary ailments like flu, malaria, typhoid etc, the district’s 5,000-odd Rotarians (20,000 with their families) need medical consultation. And RID 3232 has so many wonderful doctors, a doctors’ group to provide general healthcare was started. Then the pandemic hit us.”

What began as a 60-member group has now expanded to 193, including 165 doctors; the rest being from allied healthcare fields. As the pandemic worsened, the group helped with consultation, advise and hospitalisation.

The government reached out to us Rotarians, because they saw the work we had done in the first wave.
Dr Vasudha Rajasekar, Chair, District Disease Prevention and Treatment

DG Muthu added that this group has also been helping each other “by sharing knowledge, helping to acquire the right equipment at the right price. They have many brainstorming sessions which I attend, even though often what they discuss is like Greek and Latin to me. Their involvement and application of knowledge is exemplary.”

He added that RID 3232 has donated to the Chennai Corporation 15 mobile vans for vaccinating visually challenged, differently abled and senior citizens. Four vans have been donated to visit traffic signal points and check policemen on duty for vital parameters, to ensure their good health. “All this has been done with the guidance and leadership of Dr Sriram. Eminent doctors with whom an appointment is often difficult, are available for consultation to Rotarians thanks to this group. Other districts should also emulate our example,” the DG added.

 

Enormous demand for beds    

Dr Sriram, an ENT surgeon who is now more into healthcare management, and runs his own clinic in Chennai, said that during the month of May, as the second Covid wave hit India, “there was an enormous demand for hospital beds, lack of oxygen supply and medicines like Remdesivir.  For a month, we were getting from early morning to late night, desperate calls pleading for a hospital bed. Money was no criterion, people just wanted to see their dear ones get some medical treatment.”

It was decided to get oxygen concentrators (OC); “we’ve started mobilising 100 OCs and have tied up with a partner for 100 more, which we will be lending free of cost. There are several patients who get discharged from hospitals but still need O2 support at home, and for such people OCs are a big help.”

On the funding, Dr Sriram says, “While 100 OCs were donated by ­Portea, the online doctor’s consultation app, the other 100 were procured with the funds raised by RCs Vadapalani, Chennai Temple Towers, Chennai ­Central and my own club RC Madras West.”

 

The long dance for a bed

Vasudha Rajasekar, an anaesthetist and trained health management expert, said in the last couple of weeks the pressure had reduced (May-end). “But it was sheer madness while it lasted.” Confessing that she sleeps late and wakes up late, she said one morning she got a call at 5.45 am from “Rtn Suryanarayan Rao, from RC Madras Central. He said, ‘one of my staff members is going from hospital to hospital in an ambulance, not able to find a bed, and her saturation is down to 82.  She is only in her ’40s and she is going to die’.”

The patient couldn’t afford a “posh hospital, and the only place I could think of immediately was the Government Hospital of Thoracic Medicine in Tambaram.” Last year, her club (RC Chennai Temple Towers) had done a ₹1.25 crore ICU project for them. She called the hospital superintendent Dr Sridhar, who said it would be done. The additional medical superintendent was also roped in. “But from then to 9.45 am, I got a call every 10 minutes, saying ‘nobody is there’, ‘we went to the Covid ward, nobody is attending to us’ etc. So I called Dr Sridhar again and said please do something, I can’t take this stress anymore.”

She added that Dr Sridhar had to directly call the ward and “I could hear this normally patient man, tell the sister in an agitated tone: ‘Admit that patient now, take a picture and send it to me, so I can share it with Dr Vasudha.’ It took four hours to finally get her on the bed. She got discharged after a week and is doing very well.”

There are so many such cases and Dr Nandakumar says that despite working for long hours late into the night, pooling resources, compiling lists and giving referrals depending on the condition of the patient, whether he needed a bed with oxygen, or an ICU bed with ventilator, sometimes their help comes too late. “Most of the calls came from Rotarians asking for help for their families or friends. I think 90 per cent of the time we were successful in finding suitable beds in time.”

He says that what really helped this group to render effective and timely help was “that we already had a doctors’ group in place as the pandemic hit us. In January 2020 itself we knew something bad was going to hit us. Thankfully the district leadership is well connected to this group and DG Chandramohan asked me to prepare a list of all Rotary doctors and get them into the group.”

With so many seniors being in the group, “from RC Madras to the juniormost club, the “younger doctors were reluctant saying we won’t fit into this group, but I said we have to do this during Covid times, and many came on board. Some didn’t, but they still help when we ask.”

The group realised the need to connect very swiftly with equipment manufacturers, suppliers, doctors and hospitals, “right from the government to the private sector and in all aspects of the healthcare industry. We worked particularly closely with the government because we know that anything largescale can be handled only by the government.”

Luckily the group has some Rotarians very well “connected with the government and at the drop of a hat we can reach the seniormost people in government in doing a project or programme,” he adds.

Dr Vasudha adds that apart from helping out with Covid cases, right from its inception this group also refers Rotarians to the right specialists. “When we get a call, we refer patients for cardio, neuro, ortho, gynaec and other cases. This ensures that not only do the Rotarians get effective treatment, Rotarian doctors too get an adequate number of cases and some professional benefit through this networking.”

 

Early vaccination

P Sathish, a past president of RC Madras North, who owns a pharma company, is the chairman of the Covid Task Force for RID 3232 in the current year. “And everybody who got vaccinated early in the district, owes it to him; he took them to KMC, and all the PDGs in the district got vaccinated well before anyone was looking seriously at vaccination. We pushed them, they said why are you pushing us, and we said you as leaders ought to set an example. So, everybody from RIDE Venky and Vinita got vaccinated as well as my wife Dr Sumedha, who is also a member of RC Chennai Temple Towers as Vinita,” says Dr Nandakumar.

He added, “he also helped in the procurement of critically required medicines and organised the supply of the much-wanted Remdesivir within a week.”

Quips Dr Sriram: “I told you, this group is a medical google… anything you require, from an ICU/oxygen bed to medicines, you will get a solution quickly.”

Sathish explains how at the peak of the second wave, “when ambulances were waiting in long queues at hospitals… and the patient would spend a whole night hooked to oxygen supply, in an ambulance outside a hospital, we moved fast to create additional beds with oxygen.” He started a dialogue with the president of CREDAI (Confederation of Real Estate Developers Association of India), Tamil Nadu, Suresh Krishna, a past president of his club, “and they promised to sponsor the beds. We quickly called TN health secretary J Radhakrishnan and told him we want to help with additional beds.”

Within a short period, the entire state government administration started rolling, with “all the required departments such as health, PWD, and entire hospital management team of KMC doing whatever was required and within one week we had set up 250 beds; 50 ICU beds and 200 with oxygen supply.”

Next on his radar were another 250 beds in Omandurar, Annanagar Peripheral and Saidapet, all government hospitals. A total number of 500 beds were created in 10 days. It worked so fast as CREDAI was involved and they know the system,” smiles Sathish. Next, beds were added in Madurai, Salem and Coimbatore.

He adds: “I’d like to add that there was never any paucity of funds for whatever we wanted to do in terms of creating beds, additional oxygen supply or other equipment because the money that came in was unbelievable. Indians living overseas, after seeing pictures of desperation from India, were just pouring money into the country. And so many clubs individually have done global grants to help in Covid relief work.”

There was also CSR money; “Dr Vasudha’s club did a ₹1.25 crore project to create 40 ICU beds for VHS, thanks to a partnership with the ­Cognizant Foundation.”

Secret behind their success

Dr Nandakumar says that if ­Chennai and Tamil Nadu never really went into a crisis in oxygen supply, it is thanks to the TNMSC (Tamil Nadu Medical Services ­Corporation) MD P Umanath. “Thanks to his planning and action, we had access to an adequate supply of oxygen. Another thing which helped is Tamil Nadu’s robust healthcare delivery system, which helped our doctors’ group to be effective.”  Almost every hospital, be it government or private, or non-profit, has a Rotarian doctor in it, he adds.

His goal, he admits, was to put at least one representative from each hospital in the doctors’ WhatsApp group, and say: ‘Hey, we don’t do this in normal times, but these are extraordinary times and your help will make a huge difference in getting vital information in getting beds.”

Dr Vasudha adds that even though RID 3232 created a large number of beds, “the TN ­government itself had already added 15,000 Covid beds. What they didn’t have was the infrastructure, oxygen cylinders, concentrators, nurses, PPEs, etc.”

She recalls that there was a time during the second wave when ­Stanley Hospital, one of the biggest government hospitals in ­Chennai, ran short of drugs. “This, not because they didn’t have money, but because the stocks weren’t coming in. They reached out to us Rotarians, because they saw the work we had done in the first wave. We had classmates and friends in all government hospitals and they would ask our help to see if private suppliers had drugs which we could buy and give them. This included even the most common drugs such as blood thinners to prevent blood clots.”

Adds Dr Sriram, “Oxygen concentrators were needed in many places and DG Muthu asked my club to ensure people requiring oxygen support at home after discharge got the OCs.”

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