A year long journey

Our journey of the last one year has been very satisfying and motivating.
A year long journey

kaul.upendra@gmail.com

Gauri Healthy Heart project is going to be one year old. This is an occasion of putting our cards together and introspect regarding the accomplishments and shortcomings.

A stray thought during a casual visit to Kupwara in September 2020 crystallized into an ambitious program of “No More Heart Attacks”. My friends Ajaz Rashid and Nasir Lone took me to North Kashmir, an area I had never been to in spite of being a Kashmiri born in district Pulwama in South Kashmir.

Seeing and meeting the very hospitable people of the district, struck me that the healthcare there needed an upliftment. Dr Zubair Saleem, an eminent Geriatrics physician, Priyadarshini and team from Research Department of Batra Hospital and some of my students practising Medicine and Cardiology, joined us in this mission.

We saw many cases of heart ailments caused by high blood pressure and diabetes and decided to do a camp in collaboration with the district health authorities on the World Heart Day (29th September). The aim was to see patients already on treatment for both these maladies referred by govt health centres.

To our surprise more than half of them were poorly controlled despite being on medicines. From Kupwara town we went to Machil a small town close to LOC with assistance from the local authorities and did a camp in the primary health centre of Dudi. It drains patients from several surrounding villages.

The observations were identical. Machil gets cut off from Kupwara during the long winters for at least 5 months and population has poor medical facilities. Seeing and documenting the problem is not enough. We deliberated amongst ourselves to device ways and means to provide medical help in terms of treatment. We thus thought of the feasibility of Telemedicine for this population.

A machine operated by a trained person. This machine is capable of measuring the blood pressure, getting an ECG, important basic blood tests and biomarkers to diagnose a heart attack and heart failure. The patient is connected to a remote clinician through internet who evaluates and prescribes treatment.

In case a specialist is needed the connection is diverted to a designated doctor for this. The drugs are available in the tele medicine machine compartments and are dispensed immediately. For very sick patients an ambulance with paramedics is available for shifting to the nearest hospital.

This experience led our team to go to different districts of the UT with the same aim. These one-day camps were held under strict COVID protocol in less developed areas of different districts. Krimshore and Ringzabal (Khan Sahab) in Badgam, Rajpora in Pulwama, Mir Bahri in the back waters of Dal Lake, Srinagar, the Leper colony, Bahrar, Srinagar, Banihal town in Ramban and Jagti migrant camp in Jammu.

We also ventured to visit Kakching near Imphal, Manipur in response to an invitation. The observations were the same as seen in other districts. Uncontrolled BP and diabetes and abnormal lipid profiles despite taking medicines. These problems are the harbingers of heart related issues especially myocardial infarctions.

Optimization of treatment remained our goal and we also delivered lectures on these subjects to district doctors. The message was to keep treatment simple and affordable. By this time, we made the “Gauri Healthy Heart Foundation” as our banner.

We took a decision to adopt the inmates of the Leper colony, Srinagar for providing free medical care in collaboration with our partner, Greater Kashmir Media. During these camps we observed the problems of elderly population who have many other additional co morbidities like joint problems, old strokes, issues of hearing and vision, chronic kidney disease, cancers etc. This made us to modify our methodology of the evaluation and formed Gauri Old Age Mission (GOAM) to look after the senior citizen differently with geriatric medicine as a component and adding specialists in our mission.

The rising incidence of substance use in the valley caught our attention and we held a one-day camp at the Institute of Mental Health and Neuro Sciences (IMHANS), Srinagar to understand the problem in collaboration with their senior staff. This was a young population with all the psycho social issues but very little diabetes and high BP.

Our efforts and the response to our appeals to good Samaritans started getting positive results. Indian Oil Corporation (IOC) decided to give us 2 Telemedicine units and ambulances for Machil, Kupwara and Jagti migrant township, Jammu.

Umeed Foundation, an NGO from Mumbai agreed to facilitate this donation which was a part of the corporate social responsibility (CSR) activity of the IOC. Mr Asad Pathan former Chairman and CEO of the IOC, guided and lead us to get this funding. The unit in Machil will become operational by the 29th of September (World Heart Day) this year and will be dedicated to the people of that area. The Jagti unit in Jammu is being put in collaboration with Helpline Humanity, an NGO helping the education and welfare of the people of this township of migrants from the valley in 1990’s. will also become operational soon thereafter. We have also donated both these sites a large number of books for various grades of students desirous of preparing for professional courses.

In order to facilitate proper cardiac evaluation for people of various districts we visited, our group decided to start the Gauri Heart Centre. The opening coincided with the registration of Gauri Kaul Foundation as an NGO, and the birth anniversary of my late mother Gauri on 10th April. This centre in the heart of Srinagar city, has all the top of line facilities for non-invasive cardiology, performing blood biochemistry including point of care Cardiac biomarkers for prompt diagnosis of heart attack and heart failure. The bio markers have now become a part of our district camps.

Our activities are soon spreading to needy areas of Maharashtra in association with the Umeed Foundation starting later this year . The aim is to replicate the facilities of Gauri Heart Centre there in Mumbra, district Thane, Maharashtra in due course.

We have also formed an Academics and Research Wing , Gauri Centre for Research which is being registered with the Drug Controller general of India. In order to take it further we approached the senior management of the Jawahar Lal Nehru (JLNM) Hospital, Rainawari, in order to foster a partnership. The response was good, a CME on “ COVID and Heart was organized was held under that banner. The MOU between the 2 organizations is underway.

We are engaged at present in developing a day care centre with facility of an OPD pertaining to all the major basic specialities in village Hawal, Pulwama. Several investigations like ECG, echocardiography, abdominal ultrasound and blood biochemistry will be available.

A pharmacy with cost effective medicines will also be maintained. Selected doctors from the district will be available there supported by periodic visits by us. This centre “Prasad Joo Khan Memorial Medical Centre” is named after a legendary personality of this village who lived there between 1908 -1965. The centre should become functional before the onset of winter in the valley this year.

Our journey of the last one year has been very satisfying and motivating. We hope to continue our mission and reach remote areas of all the districts in times to come and contribute towards better health.

Prof Upendra Kaul, Founder Director, Gauri Heart Foundation. Recipient of Padma Shri and Dr B C Roy Award

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