LadakhHeart-News - September 2006 -07
The ground floor of the hospital is completed and for the time being it is open for the public as a DAY CARE CENTRE with following staff and facilities – two doctors, a pharmacist, a laboratory technician, clerk and a watch man. X-rays, ECG, laboratory to carry out all the basic test and dispensary.
The ground floor of the hospital is completed and for the time being it is open for the public as a DAY CARE CENTRE with following staff and facilities – two doctors, a pharmacist, a laboratory technician, clerk and a watch man. X-rays, ECG, laboratory to carry out all the basic test and dispensary.
T. Motup Lab. Tech.
Dr. Yangzom
Dr. Norbu Tsering
The main aim of Ladakh Heart Foundation is to come up with the need of a state of the art on diagnostic facilities, Operation theater and intensive care unit in the hospital for the benefit of Ladakh populace who cannot afford treatment outside Ladakh. Due to lack of equipment and other resources, we couldn't make the hospital functional for the indoor patient. First floor of the building will be completed next year. If possible we are looking forward to make it functional for the indoor patient also by 2008.
Fayaz X-ray Tech.
Hospital equipment is very costly. If you would like to sponsor, kindly, contact Lama Thupsten Chogyal, President, Ladakh Heart Foundation.
Mr. Rigzin Namgyal Watchman
Mr. Tashi Dorjay Pharmacist
Rinchen Dolma Office Secretary
Sherab Dolma Receptionist
*
Inauguration of the hospital was supposed to be done by H. H. The Dalai Lama, but unfortunately, he was unable to come due to his tight schedule. Thus, The DAY CARE CENTRE was inaugurated by eminent Cardio-thoracic surgeon Prof. Sampath Kumar of All India Institute of Medical Science, New Delhi on 8th September 2007. The occasion was graced by Prof. Mishra, Ven Lama Lobsang, Dr. Dolma CMO and members of L.H.F.
Inauguration by Prof. Sampath Kumar
President, LHF welcoming Prof. Sampath Kumar
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Prof. Sampath Kumar and team have operated five cardiac cases, supported by L.H.F. and examine 200 follow-up cases from 4th – 8th September 2007 at S.N.M. Hospital, Leh. If the patient has to go to Delhi per patient they have to spend more than Rs. 100,000 to get operation. For a follow up patient has to visit Delhi once a year. The team's coming to Ladakh has thus benefited many people.
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Foundation stone of Henley Medical Aid centre laid by Mr Tsering Dorjay, Chief Executive Councillor, Leh on 24th of August 07.
The Foundation stone of Henley Medical Aid Centre sponsored by Association Christophe Viard was laid by Mr. Tsering Dorjay, Chief Executive Councelor, Leh on 24th August 2007. It was graced by the Executive Councillor Health, Henley Councillor, CMO Dr. Dolma and more than 100 local people. They are very happy and appreciated the project. The foundation of the building is already done and next year the whole building will be completed.
We are thankful to Miss Stanzin who introduced us to Christophe Viard Association.
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The link road to hospital has already started with the help of Ladakh Autonomous Hill Development Council.
Government making link road connection to LHF
Patient visit for medical check up
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We are thankful to Mr. Rigzin Jora, Minister of Power to provide funds to drill the underground water supply.
We are also thankful to the head of the Singaporean Chen Xian temple who are sponsoring the salary of our lady doctor.
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Ladakh Heart Foundation Leh was organized
World Heart Day 30-9-2007
11 am at Ladakh Heart Foundation
Hospital & Research Centre, Dambuchan, Agling
The Chief Guest Sh. Tsering Dorjay, Chief Executive Councilor, LAHDC, Sh. Dorjay Mutup, Executive Councilor Health, Dr. Phuntsok Tsering, Deputy CMO, Dr. Norphel, BMO, Students from various schools and local people participated.
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Research Project
Dr. T. Norbu Presentation at Japan (International Conference)
28th October 2006 – Ven. Thupsten Chogyal and Dr. Norbu were invited to Tokyo, Japan for the International conference to present their research paper. There they met Prof. Harvard renowned Scientist of Harvard University, USA and discussed about the research collaboration with Ladakh Heart Foundation in the near future.
We are grateful to Prof. Kuniaki Otsuka of Japan for inviting us for the international conference. We published many research papers with him (Tokyo Women's Medical University)
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Lama T. Chogyal, President and members of LHF are grateful to all the people who supported – morally, financially and physically so far. We hope you will continue the support.
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Thank you Les Amis de Ladakh Heart Foundation support group and Mr. Vincent Schmid, Mujin Sounim for supporting, we hope you will continue to support in the future.
*
You can download a table of expenditure (in .rtf format) by clicking here
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Previous newsletters:
May 2002 - August 2003
The past year has been a very busy one for the Ladakh Heart Foundation. We have been continuing and extending our activities all over Ladakh, trying to prevent and cure all forms of heart disease, while also concerning ourselves with the general health of the local population, Our efforts can be broken down into four main areas-
- Primary preventative medicine, mainly in the form of lectures and seminars
- Village clinics in out-lying regions
- The maintenance of a register of all patients in the region, and the continued monitoring of their conditions
- Surgery and diagnostic clinics
In the meantime, the LHF has been working hard to press ahead on the construction of the new hospital. What follows is a little more detail on the advances that have been made.
Lecture Programmes
The lectures are all given by Dr. Norboo, and are designed to educate Ladakh about the ten impending diseases of the new millennium. These are:
- Hypertension
- High cholesterol
- Smoking
- Obesity, leading to diabetes
- Diet (prevention of cardiovascular disease and cancer)
- Heart Attack
- Sexually transmitted disease, HIV and AIDS
- Environmental and occupational health disease
- Accident prevention
- Mental health
As Ladakh rapidly develops and changes economically and culturally, it is vital that the population understands and can make steps to address these new issues- hypertension is exceptionally common due to the salty diet and local butter tea, and Ladakh has the lowest age of onset of stomach cancer in the world. The information is tailored for the cultural background in which it is to be received.
Dr. Norboo and other members of the Foundation travel to the villages with the generator and projection equipment of the Ladakh Heart Foundation, where lectures are given in halls, schools, and even outdoor areas at night. The attendance, and attention, at lectures is always high, and the information is always very well received. Whenever possible, the lectures are also given before any clinics, so that diagnoses, blood pressure measurements, and lifestyle advice is better understood. The feedback and questions from villagers is always positive, and lectures often stimulate many more questions. Over the past year, around 6400 children, adults, teacher, and health professionals have heard these lectures.
A list of campaigns can be found at the end of the newsletter.
International Seminars
In November 2002, Dr. Norboo and Lama Chogyal were invited by the Tokyo Woman Medical University to give a series of presentations upon aspects of high altitude disease, at the 3rd International Symposium on Chronobiology.
Village Clinics
Over the course of the past year, approximately 750 patients have been seen in village clinics, as part of the out-reach programme. We have been able to dispense free medicines for a very wide variety of ailments, and feel that a large impact can be made on each individual's quality of life, through schemes such as these. The clinics are always very popular.
Patient Register
The maintenance of the patient register is an on-going project. At present we are maintaining a database of 127 patients suffering from Rheumatic Heart Disease, which is important both for the monitoring of the condition of these individuals, and as a resource for research into the condition.
Fortunately, over the past year there have been only three new cases of rheumatic heart disease, and this is a reduction that we have tried to assist through the provision of free Penidure (Benzopenicillin) injections at hospitals, clinics and village centres for those with symptoms that are suggestive of a streptococcal throat infection. These injections were kindly donated by Casa del Tibet. Though this steady reduction in cases is welcome, we are aiming for a total eradication of new cases over the next few years, through continuing increased awareness, and the availability of suitable medicines.
We also maintain registers of patients with other conditions, monitoring 82 individuals with Congenital Heart Disease, 22 individuals with serious Arrhythmias, and 20 cases of Coronary Artery Disease.
We are also in the process of developing further registers, allowing us to help those with neurological problems, such as those that follow a stroke, as we feel that this is intrinsically linked with heart disease, and therefore the aims of the Foundation.
Construction Site
The construction site is progressing steadily. From merely foundations this time last year, we have added the whole of the ground floor, constructed a well 170m deep to provide a reliable and clean water supply, and now have a connection to electricity and telephone. The army also gave a loan of a bulldozer, allowing the leveling of the rest of the site, while the forest department has pledged to plant approximately 1000 trees around the hospital.
We hope to complete the shell of the building by the end of the summer season, in one and a half months time, but this is very much dependent upon the resources available to us.
Nine volunteers from Singapore, including two nuns, came to assist in the building of the site, and also in the clinics, earlier this year.
Heart Surgery
Over the past year, we have financially assisted 15 patients in the costs of their surgery at the All India Institute of Medical Studies (AIIMS) in Delhi. Lama Chogyal and Lama Lobzang have flown to Delhi to help with the admission of some of these patients. We continue to maintain a close relationship with the AIIMS Cardiology department, which ensures that patients are admitted immediately, without paying to stay in Delhi while on the waiting list. This is aided to a great degree by the clinics given each year by Professor Kumar (cardiovascular surgeon) and Dr. Mishra (cardiologist) from AIIMS at the government hospital in Leh, whose expenses are paid by the Ladakh Heart Foundation. Over the course of a few days, difficult diagnoses can be made, surgical need can be assessed, and surgical follow-up can be ensured- hundreds of patients are seen, removing the need of a costly journey to Delhi for many of them. Patients who do travel to Delhi pay only for supplies used in the operation, particularly the cost of the valve, while the services of the doctors and nurses and the hospital bed are free. Over the past ten years, many of the patients who have had to travel to Delhi have got to know Tsering Norboo Rafta, who has helped them with all the difficulties that Delhi can throw at a visitor. He is now working as a councillor representing the Nemo region in the Ladakh Autonomous Hill Development Council, and his services over the past decade have been indispensable.
Some of the patients require blood transfusions during surgery, and this is very kindly donated by some of the Ladakhi students, monks, and other Ladakhi residents in Delhi. The Ladakh Buddhist Vihara in Delhi also often supplies accommodation in Delhi at little or no cost.
This year, for the first time, Professor Kumar also performed six closures of a congenital heart disease condition known as a Patent Ductus Arteriosus. This initiative has not only saved the patients approximately Rs600,000 ($12,000) combined, but has also allowed the training of surgeons in Leh to perform the procedure in the future. All the patients, aged between 2yr and 12yr, are recovering well. This venture has been a great success, and next year it is hoped that mitral valvotomies (a procedure that can be of enormous benefit to sufferers of rheumatic heart disease) will be performed.
Other Projects
We are currently sponsoring the up bringing of four siblings who were all born blind. They are members of a Muslim family of five children from the remote village of Igoo, whose village leader contacted the Lama Chogyal about their troubles. The three daughters now attend a school for the blind in Delhi, while the son has remained in Ladakh, with help to cope with his disability. This is only possible through the donations from Singaporean groups and two ladies from the Muslim Women Alliance.
Four wheelchairs and other handicap aids have been donated at the Dalai Lama's request to children at the Tibetan Exiles' Handicap Centre in Deharadun.
The Ladakh Heart Foundation has also helped co-ordinate donations from Singaporean groups to nine nunneries and a school in Ladakh, and to four patients with suspected chronic mountain sickness, from the high altitude Tso Moriri region of Ladakh.
A support group has been set up in Geneva,
"Les Amis de Ladakh Heart Foundation"
1B Clos de Ladakh Fonderie,
CP 1272,
1227 Carouge,
Geneva, Switzerland
This group has kindly donated a vehicle, which has been vital for both the everyday running and the far-flung activities of the Foundation.
Campaigns
02/05/02 - Location: Ladakh Buddhist Association,
Leh.
Series of lectures, attended around 1000 lamas and nuns, by Dr Norboo in co-operation with government health department. Topics covered included: hypertension, diabetes, obesity, diet, and stomach cancer.
18/05/02 - Location: Skurbuchan village.
Lecture attended by most of village population, on "ten impending diseases of the new millenium" (TIDNM).
31/05/02 - Location: SOS Tibetan Children's Village School, Choglamsar.
Lecture on all aspects of tobacco to entire school (around 800).
05/06/02 - Location: SSB military headquarters, Leh.
Lecture for 200 army officers and rank personnel on STDs, HIV and AIDS.
08/06/02 - Location: Sumur, Nubra.
Lecture for 150 students and villagers on TIDNM.
09/06/02 - Location: Tongstet, Nubra.
Village clinic with free medicines followed by lecture on TIDNM.
10/06/02 - Location: Diskit, Nubra.
Lecture for 250 students on TIDNM.
Evening lecture for 40 adults on TIDNM.
15/06/02 - Location: Lamdon Model Secondary School, Leh.
Debate on anti-tobacco campaign followed by tobacco lecture with all pupils (around 300).
24/06/02 - Location: Chief Medical Officer's Office, Leh.
Education programme on TIDNM for the 5 Block Medical Officers and 13 other medical officers. 5 training packs distributed.
09/12/02 - Ladakh Ecological Group Hall, Leh.
Lecture to 30 Muslim women on lifestyle-related diseases.
16/12/02 - Ladakh Ecological Group Training Centre, Leh.
Lecture on environmental and occupational health problems to 25 teachers.
Jan 2003 - Location: District Institution of Education and Training, Leh.
2 Lectures for 250 teachers each on the theme of TIDNM.
Feb 2003- Location: District Institution of Education and Training, Leh.
A further 4 lectures were requested and delivered each for 250 teachers.
27/02/03 - Location: Sonam Norboo Memorial Hospital, Leh.
Lecture for 80 paramedical trainees on a theme of TIDNM.
Education on blood pressure measurement, record keeping and body mass index calculation.
03/03/03 - Location: CMO's Office, Leh.
Lecture to 20 multi-purpose workers on TIDNM.
29/03/03 - Location: Auditorium Hall, Leh.
Lecture to members of Women's' Alliance and paramedical staff on TIDNM.
03/04/03 - Location: Government High School, Nimo
Lecture to villagers and students on tobacco and TIDNM.
07/04/03 - Location: SOS TCV School, Choglamsar.
Lecture to 800 students on TIDNM.
15/04/03 - Location: Shara village.
Lecture to 300 villagers on TIDNM followed by clinic attended by 40 patients with free medicines.
21/04/03 - Location: Bema village.
Epidemiological study on 148 subjects, blood sampled for sugar and serum cholesterol. 2 found to have impaired glucose tolerance.
22 - 24/04/03- Location: Dha, Sanjak, Dartsik, Garkon village.
Village clinics for over 230 patients in total with free medicines.
12/05/03 - Location: Islamia Public School, Leh.
Lecture to 50 students and all teachers on tobacco.
14/05/03 - Location: Islamia Public School, Leh.
Lecture to 50 students on STDs, HIV and AIDS and aspects of TIDNM.
21/05/03 - Location: Government Higher Secondary School, Leh.
Donation of "No-Smoking" sign by Ladakh Heart Foundation followed by lecture on tobacco.
19/06/03 - Location: Chokhang Lecture Hall, Leh.
Lecture to 50 students on tobacco and alcohol.
15 - 17/06/03- Location: Korzok, Tsomoriri.
Village clinic for 80 patients with free medicines.
23 - 24/08/03- Location: Gya, Rumtse villages.
Lecture for 150 villagers on hypertension and stomach cancer followed by clinic for 210 patients (in association with army medical corps).
30/08/03 - Location: Girl’s Middle School, Leh
Lecture for 100 pupils and teachers on tobacco
9/09/03 - Location: Middle School, Saboo
Lecture for 80 teachers and pupils on TIDNM
September 2003 - August 2004
The past year has been another very busy one for the Ladakh Heart Foundation (LHF). We have been continuing and extending our activities over Ladakh, trying to prevent and cure all forms of heart disease, while also concerning ourselves with the general health of the local population, which explain the creation, this year, of the Ladakh Institute of Prevention (LIP), dedicated to environmental, occupation, life style related and high altitude diseases. The activities of this newly born institute, with Lama Chogyal as its executive director, are presented in a separated newsletter. Our efforts (Ladakh Heart Foundation) can be broken down into five main areas:
- Primary preventative medicine, including primary prevention of acute rheumatic fever, as in the past years. Lectures and seminars were the main means of communication to impart health education.
- Village clinics in out-lying regions.
- The maintenance of a register of all patients in the region, and the continued monitoring of their conditions.
- Surgery and diagnostic clinics.
- Contributing, in a humble way, to the health care facilities provided by the government by initiating innovative projects, but always with the final objective of creating an environment conducive to make those projects acceptable to the government and the population, which also applies to LIP activities.
In context of the last point, we are delighted to highlight that two of our initiatives are now well accepted both by the government as well as the population. The first one consists in the local government (L.A.H.D.C.) agreeing to bear the expenses incurred on the cardiothoracic surgery (P.D.A. and Mitral Valvotomy) being conducted by Professor Sanpath Kumar, Cardiovascular Surgeon, in the local government owned hospital (S.N.M. Hospital). The initiative and the expenses involved were initially the responsibility of LHF and the Venerable Lama Lobsang, Hon'ble member of Sheduled Tribe Government of India.
Secondly, our primary prevention program against acute rheumatic fever, involving Benzathine Penicillin prophylaxis in children of age 5 to 15 suffering from streptococcal throat infection, is now well accepted by the patients and the medical profession in Ladakh. LHF initiated this program and still bears the expenses. The good outcome of this preventive program has resulted in acceptance by all parties concerned. We look forward to hand it over permanently to the government in near future.
In the meantime, LHF is also proud to announce that the construction of the new hospital has progressed considerably over the last year, as well as the guesthouse attached to it. What follows is a little more detail on the advances that have been made and we include some photos, as well.
Lecture Programs
The lectures are all given by Dr. Norboo, and are designed to educate Ladakh about the ten impending diseases of the new millenium. These are:
- Hypertension
- High cholesterol
- Smoking
- Obesity, leading to diabetes
- Diet (prevention of cardiovascular disease and cancer)
- Heart Attack
- Sexually transmitted disease, HIV and AIDS
- Environmental and occupational health disease
- Accident prevention
- Mental health
As Ladakh rapidly develops and changes economically and culturally, it is vital that the population understands and can make steps to address these new issues; hypertension is exceptionally common due to the local butter tea, and Ladakh has the lowest age of onset of stomach cancer in the world. The information is tailored for the cultural background in which it is to be received.
Dr. Norboo and other members of the Foundation travel to the villages with the generator and projection equipment of the Ladakh Heart Foundation, where lectures are given in halls, schools, and even outdoor areas at night. The attendance, and attention, at lectures is always high, and the information is always very well received. Whenever possible, the lectures are also given before any clinics, so that diagnoses, blood pressure measurements, and lifestyle advice is better understood. The feedback and questions from villagers is always positive, and lectures often stimulate many more questions. Over the past year, around 6400 children, adults, teacher, and health professionals have heard these lectures.
A list of campaigns can be found at the back of the newsletter. Please note that most of these lectures will now be organised under the supervision of the Ladakh Institute of Prevention.
International Seminars
In November 2003, Lama Chogyal was invited by the Tokyo Woman Medical University at the 4th International Symposium on Chronobiology.
Lama Chogyal was also invited to participate in a half hour radio program broadcasted on BBS Radio, in South Korea. Lama Chogyal then had the unique opportunity to present most of the LHF activities in Ladakh, addressing a broad auditory, which gave good results as the Koreans did respond in a very positive way, including some very helpful donations.
Village Clinics and Health Camps
Over the course of the past year, approximately 700 patients have been seen in village clinics, as part of the out-reach programme. We have been able to dispense free medicines for a very wide variety of ailments, and feel that a large impact can be made on each individual's quality of life, through schemes such as these. The clinics are always very popular.
Lecture given by Dr. Norboo, Physician
Clinic Photo
Patient Register
The maintenance of the patient register is an on-going project. At present we are maintaining a database of 135 patients suffering from Rheumatic Heart Disease, which is important both for the monitoring of the condition of these individuals, and as a resource for research into the condition.
Fortunately, over the past two years there have been only three new cases of rheumatic heart disease (only three over the past year), and this is a reduction that we have tried to achieve through the provision of free Penidure (Benzopenicillin) injections at hospitals, clinics and village centres for those with symptoms that are suggestive of a streptococcal throat infection. Though this steady reduction in cases is welcome, we are aiming for a total eradication of new cases over the next few years, through continuing increased awareness and education, and the availability of suitable medicines.
We also maintain registers of patients with other conditions, monitoring 84 individuals with Congenital Heart Disease, 22 individuals with serious Arrhythmia, and 23 cases of Coronary Artery Disease, as well as 4 individuals now registered under the new database about neurological cases, such as those that follow a stroke, as we feel that this is intrinsically linked with heart disease, and therefore the aims of the Foundation.
Construction Site
Plan for the Heart Foundation site
The construction site is progressing steadily. From merely the first floor this time last year, we have added the whole of the second floor, constructed a well 170m deep to provide a reliable and clean water supply, and now have a connection to electricity and telephone. The army also gave a loan of a bulldozer, allowing the leveling of the rest of the site, while the forest department already concretized its pledge to plant approximately 1000 trees around the hospital.
Another good news is that the construction of the guesthouse is progressing as well, most of the first floor being almost completed at this time. This guesthouse is very important to us, as it is going to facilitate most of invited specialists and medical volunteer’s accommodation.
Ramp of the hospital
Second floor under construction
Guest house nearly complete
We hope to complete most of the main building by the end of the summer season, in one and a half months time, but this is very much dependent upon the resources accessible to us, considering that most of the material costs increased considerably in the last months.
Planted by Govt. forest Department this year
The Ladakh Heart Foundation also wants to inform its members and donators about the list of requirements for the registration of the LHF Hospital under section 4 of the J&K State Nursing home and Clinical Establishment Registration and Licensing (Act. 1963). The required parameters are the following:
1. Official name of the establishment with specifications about the owners and management
2. Documents about land allotted and building design
3. Specifications concerning full time resident doctors and their certificates
4. Specifications about paramedical and nursing staff, and their certificates
5. Arrangements regarding blood transfusion processes
6. Investigation facilities
7. Full list of medical equipment, Surgery Theater included
8. Resuscitation and life saving related equipment
9. Specifications about ambulances
10. Biomedical waste disposal
11. Arrangements in case of electricity breakdowns
Any help regarding those requirements will be welcomed and highly appreciated, particularly regarding numbers 6, 7, 8, 9, 10 and 11.
Heart Surgery
Surgery by Dr. Sampath Kumar
Echo diagnosis by Dr. Mishra
Over the past years, we have financially assisted many patients in the costs of their surgery at the All India Institute of Medical Studies (AIIMS) in Delhi. Lama Chogyal and Lama Lobzang used to fly to Delhi to help with the admission of some of these patients. We continue to maintain a close relationship with the AIIMS Cardiology department, which ensures that the few patients we still send down are admitted immediately, without paying to stay in Delhi while on the waiting list. However, over the past year, LHF has tried to put more emphasis on the clinics given each year by Professor Kumar (cardiovascular surgeon) and Dr. Mishra (cardiologist) from AIIMS at the government hospital in Leh (SNM Hospital), whose expenses is paid by the Ladakh Heart Foundation. Over the course of a few days, difficult diagnoses can be made, surgical need can be assessed, and surgical follow-up can be ensured- hundreds of patients are seen, removing the need of a costly journey to Delhi for many of them, which explains our interest for those clinics. Regarding those patients who still have to travel to Delhi, they have to pay only for supplies used in the operation, particularly the cost of the valve, while the services of the doctors and nurses and the hospital bed are free.
Some of the patients require blood transfusions during surgery, and this is very kindly donated by some of the Ladakhi students, monks, and other Ladakhi residents in Delhi. The Ladakh Buddhist Vihara in Delhi also often supplies accommodation in Delhi at little or no cost.
After last year successful attempts to perform Patent Ductus Arteriosus closures, which saved the patients a lot of expenses and allowed the training of surgeons in Leh to perform the same procedure, Professor Kumar performed patent Ductus Arteriosus surgery on a similar number of patients in SNM Hospital on 17th & 18th of August 2004. A young married woman, mother of 3 month old baby suffering from left atrial myxoma was taken down to AIIMS New Delhi and was operated free of cost at the AIIMS New Delhi by Prof. Sampath Kumar. The timely diagnosis and prompt surgical treatment certainly saved this young woman's life. Otherwise she was certain to die in few months.
Campaign
02/05/02
Location: Ladakh Buddhist Association, Leh.
Series of lectures, attended by around 1000 lamas and nuns, by Dr Norboo in co-operation
with government health department. Topics covered included: hypertension, diabetes,
obesity, diet, and stomach cancer.
17/04/04
Location: Lamdon Higher Secondary School, Leh.
Health awareness program, lecture given by Dr. Norboo and attended by nearly
300 students. Topics covered : Introduction to series of Lectures on Health
and environment in future.
26/4/04
Girls Higher Secondary School Leh, Introductory lecture on series of talks to be given in schools on Health and environment principal, the staff and students participated.
15/5/04
Mahabodhi High School Choglamsar: A lecture on prevention of air - pollution - tobacco smoking - passive smoking - environmental and occupational air pollution. 150 students and teachers participated in a lively discussion following the talk.
22/05/04
Location: Moravian Mission School, Leh. (Forenoon)
Health awareness program, lecture and slide presentation given by Dr. Norboo
and attended by nearly 100 students. Topics covered: prevention or air pollution
in home, workplace, institutions and open environment (dust pneumoconiosis
prevalence), tobacco history, constituents and prevalence of smoking, nicotine
addiction, withdrawal syndrome, short and long term effects of tobacco, cessation
program, counciling, passive smoking, tobacco advertisement and other strategies
of tobacco companies.
29/5/04
Islamia school Leh - Health awareness programme on clean air and prevention of air pollution. About 100 students participated. Dr. Norboo Lecture was followed by lively discussion by Students and teachers.
6/7/04
A well planned health check up cum high altitude resident physical appearance study cum treatment clinic and health education drive was conducted on 6th and 7th July, at Hanley. 200 subjects were studied in detail. The findings finally analysed will be beneficial for planning remedies for common health problems of this area.
This area has been experiencing water and food borne disease in epidemic form - this time we investigated into this epidemic - Entero - haemorrhagic E-coli infection. Samples of drinking water from different sources were taken for bacterial and mineral content analysis. Health education was mainly devoted to hygiene of food, food handlers and surroundings.
25-29/8/04
Under the joint supervision of Dr. Otsuka Kuniaki professor Tokyo women university and Venble T. Chogyal and Dr. T. Norboo consultant Physician LHF & LIP; a detailed health check up of senior citizens of age group 50 and above, young men and women between 20-49 was held on the above mentioned four days. After registration a detailed questionnaire regarding life style, sleep pattern, depression and view on health. Height, weight, measurement for BMI, Blood pressure measurement in sitting, supine and standing position twice each time; were done. Then the senior citizens were carried through series of cognitive function and joint and spine mobility tests like up and go test - functional reach test - button score and kohs test, SpO2 and Heart rate and time estimation test. Finally all of them under went ECG and Pulse Wave Velocity (PWV) and Ankle Brachial Index test (ABI) for finding the status of Aortic stiffness.
Check up by Dr. Otsuka Kuniaki PWV for measuring aortic stiffness
These battery of tests done on 230 subjects in four days was the first of its kind in Ladakh organised by L H F and LIP through kind courtesy of Dr. Otsuka Kuniaki and his dedicated team is an important milestone in preventive medicine. This data will be analysed and the observation will be utilized to educate the people in prevention and promotion of health of the population.
This will now on be a continuous activity of L H F and LIP.
Newsletter
August 2004 - September 2005
Julay! and welcome to 2005 Ladakh Heart Foundation (LHF) newsletter. Things have really taken off this year with the construction of the hospital well under way, visitors from Julay Ladakh (Japan), various village clinics and 5 heart operations carried out in S.N.M. Hospitals, Leh by the Doctors from AIIMS (New Delhi). The Healthy Heart Programme was launched in early June05 and also Japanese sponsors funded 2 operations for a 6-month-old Tibetan girl and an 18-year-old Ladakhi girl, earlier this year in Delhi, which were both successful (pictured below).
Jigmet Ladol
Ngawang Thupten
Lecture Programs
Dr. Norboo continues to run his popular lectures on topical subjects (such as hypertension, heart attack, diet, etc.) to the local communities and schools.
Village Clinics and Health Camps
This year’s village clinics have been conducted in the areas of Thatsang Kuru, Sumdo and Nang and have all been a great success. Many other clinics were also carried out in 2004. A list of these clinics can be found at the end of this newsletter.
Also, more clinics are planned before the end of summer in the Chomda Sacta villages. These will be large scale clinics run over a 3 day period, examining up to possibly 500 local residents.
Lions club, LIP and LHF Leh camp......................
Tundup Paljor (before surgery)
Dr Norboo & Dr Diskit in Sumdo
Tundup Paljor, pictured above was diagnosed with PDA at the SOS school clinic in Sumdo, Chantung. He was brought to Leh within weeks of the clinic for heart surgery.
Patient Register
Rheumatic heart disease 143 total, congenital heart disease 93 total
Due to health education numbers of rheumatic heart disease have been reduced.
Exit programme, government taken over distribution of Benzathine penicillin, syringes and distilled water for primary prevention of acute rheumatic fever and secondary prophylaxis of rheumatic heart disease. We are extremely pleased by the outcome of this project and the acceptance of the programme by the government.
Construction Site (to date)
- Ground floor plastering is finished
- Roof is half completed
- Electric wire ducting has been installed in the ground floor
- Guest house is finished
- Trees are becoming established turning the desert landscape to greenery
- Government have agreed to tarmac the hospital drive (due to be completed by the end of summer 2005)
- Lend building stuff
- Cardish from Indus Hotel for loan of roof supports
- Sharma from Leh for supports
- Tibetan community for their voluntary help in laying the foundations
- Free lunch from Saboo village womens volunteers for all workers, they will repeat
- Thundup and Sarma helping with the electrical fittings
- Wangyal Tsering phunchok spituk engineering /design
-
As the Dalai Lama is the patron on the LHF, a request will be made to him, asking if he will open the hospital next year if he visits Ladakh. All friends, sponsors and connected parties of the LHF will receive further information and personal invites on confirmation.
Heart Surgery
Here is the list of the PDA and MS patients operated on by Professor Sampath Kumar at SNM Hospital Leh in July 2005-08-13
No. |
Name |
Age |
Sex |
1 |
Tashi Angmo |
31 |
F |
2 |
Tashi Lamo |
38 |
F |
3 |
Skitzom |
58 |
F |
4 |
Tundup Paljor |
5 |
M |
5 |
Stanzin Chorol |
20 |
F |
Other Projects
This summer saw the start of the Healthy Heart Programme, (with photos) designed to bring awareness to the importance of looking after your heart. The repeating 4-week programme involved local people attending 2 yoga classes per week that included asana (postures), Pranayama (breath control) and relaxation techniques. An educational talk was also given at each class on various aspects of healthy living (diet and healthy eating, relaxation, cessation of smoking etc.)
In 2004 – 2005 we had a great number of volunteers, both locally and from as far a field as Australia and Japan. Here’s what some of them had to say about LHF
“We arrived in Ladakh at the beginning of June to come and volunteer for the Ladakh Heart Foundation. Since we arrived we have been involved in lots of different & interesting projects from participating in village clinics/camps, to running yoga classes to designing health promotional presentations. The 3 months we’ve spent working here in Ladakh have been some of the most rewarding and enjoyable times we’ve ever had in India.......id highly recommend it!”
Over the course of the next year we hope to be beginning to raise money for the equipping of the new hospital, especially for the previously stated registration requirements. The new hospital should one day include a fully functional operating theatre, and all necessary diagnostic equipment, such as an echocardiography machine, treadmill and X-ray. We will have more information next year.
Last winter we made an application for government funding to pay for hospital equipment such as lab instruments, heart lung machine, sterilisers etc.
We are currently applying for the registration of the hospital with the directorate of health services, Kashmir.
Mention Dr Norboo new appointment
Indian research application
Campaigns
Health Camps 2004 – 2005 |
||
Place |
Date |
Total Patients |
Ladakh Old Citizen |
25.07.04 |
180 |
Ladakh Young Citizen |
28.08.04 |
204 |
Upper Karzoo |
10.10.04 |
39 |
Chuchot Gongma |
11.10.04 |
47 |
Marchelang |
24.10.04 |
68 |
Shenam |
31.10.04 |
36 |
Lower Karzoo |
01.11.04 |
33 |
Sumdo |
09.07.05 |
12 |
Thatsang Kuru |
10.07.05 |
90 |
Nang |
07.08.05 |
44 |
Rheumatic Heart Disease 144
Congenital Heart Disease 93
Acute Rheumatic Fever 9
Coronary Artery Disease 22
YOGA SESSION
LIP and LHF introduced Yoga sessions in the LIP office lobby. Three batches of participants; each batch comprising of 6 to 8 participants underwent well-planned yoga initiations and training. Mr. Simon and Mrs. Emma Simon, very experienced yoga teacher and experienced nurse supervise respectively were kind enough to conduct the yoga sessions voluntarily and painstakingly. Each batch attended eight sessions of yoga classes on Monday and Thursday’s between 5 to 6.30pm for 4weeks. The Yoga classes were followed by brief talks and discussions on topics like yoga and heart: nutrition and health, importance of exercise, basic first aid etc.
Mr. Cam and Mrs. Sarah took over the responsibility of yoga sessions from middle of September to October for the third batch of 8 participants Mrs. Sarla Chewang the president of LIP also participated for the full course of yoga session with the third batch. LIP & LHF plans to motivate our office staff member Miss Sherap Dolma to develop this skill as a trainer. She has been attending 24 session of yoga this season. Inactivity, a big risk factor for cardio-vascular disease, diabetes, obesity and related health problems is afflicting the Ladakhi society in a big way. Propagation of yoga in the younger generation by LIP & LHF is one of the many ways of letting the society shed off the habit of inactivity. Next year, we plan to develop yoga programmes for middle aged and hypertensive subjects quite appropriate for their health conditions.
PREVENTION OF STROKE AND DEMENTIA
LIP & LHF are grateful to Professor Otsuka Kuniaki of women’s hospital, university of Tokyo and Fukuda Denshi Company to let us utilize their instrument (PWV) (to determine aortic stiffness and the ECG machine. We utilized this opportunity to do well-planned study in the rural and urban community with questionnaire on life style, sleep pattern, psychiatric ailments followed by physical examination and cognitive function tests and battery of other investigations which includes height and weight measurement (BMI) SaO2, B.P, Pulse wave velocity, ECG, fasting blood sugar and hemoglobin estimation. Though the study was meant for senior citizens; the communities desire made us to include men and women aged 40years and above. These studies were preceded by health education explaining to them in particular the relevance of the study. On the completion of study, each subject was exammed by the physician and appropriate treatment and advice were given free on spot. The relevant findings of the investigations recorded on their health cards.
The population covered in the urban sector included Shanam, Kazoo, Murche and a portion of main town. In the rural set up – the study included areas as far as Thakungkuru, Sumdo, Karzok in Changthang; Tongtot, Taksha and surrounding villages in Nubra and Sakti.
The study being very detailed in nature, help of dedicated, trained and motivated volunteers is very crucial to make this programme successful. LIP and LHF very gratefully acknowledges the invaluable help of following volunteers: Dr Diskit, Dr Tundup, Dr Norbu Angchuk; Dr Stanzin Choeing; Dr Pame, Dr Farhana, Dr Rinchen Angmo; Dr Qadar Pasha; Dr Iqbal, Mr. Mohd Iqbal; Mr. Motup; Mr. Stobdan; Miss Dolley, Mr. Thubstan; Mr Dorje Angchuk, Mrs. Rinche Angmo; Mr.Tsering Sonam, Miss Yeshi Angmo, Miss Sumi, Mr.Rigzin and Angdus stok, staff members of PHC Sakti Panamik Tongstot Staksha, Mr Wangchuk Noney; House father and house mother and children of lions club children hostel; SOS hospital staff Mr Thubstan (the excellent camp cook) and not forgetting Miss Sherap Dolma and Ms Rinchen Dolma for producing the questionnaire forms well in time.
This type of epidemiological studies cum health education cum health clinics though very useful for health of the individual as well as health of the community producing enormous information for future health planning as well as promotion of health and prevention of diseases; however each big camp costing on an average Rs 20,000/-(Rupees twenty thousand) for the NGO organizing it may affect the enthusiasm unless government; NGO’s and individual support groups joins in this noble venture.
List of places where camps held 2004 – 2005
Health Camps 2004 – 2005 |
||
Place |
Date |
Total Patients |
Ladakh Old Citizen |
25.07.04 |
180 |
Ladakh Young Citizen |
28.08.04 |
204 |
Upper Karzoo |
10.10.04 |
39 |
Chuchot Gongma |
11.10.04 |
47 |
Marchelang |
24.10.04 |
68 |
Shenam |
31.10.04 |
36 |
Lower Karzoo |
01.11.04 |
33 |
Sumdo |
09.07.05 |
12 |
Thatsang Kuru |
10.07.05 |
90 |
Nang |
07.08.05 |
44 |
Sabu |
01.09.05 |
25 |
Tongstot (Nubra) |
17.09.05 to 18.09.05 |
87 |
Taksha (Nubra) |
19.09.05 |
78 |
Sakti |
25.09.05 to 26.09.05 |
130 |
Total no. of patients=1073 |
||
List of the publication during 2005
(1) K.Otsuka, T.Norboo, Y.Otsuka, H.Higuchi, M.Hayajiri, C.Narushima, Y.Sato, T.Tsugoshi
S.Murakami, T.Wada, M.Ishine, K.Okumiya, K.Matsubayashi, S.Yano, T.Chogyal, D.
Angchuk, K.Ichihara, G.Cornelissen, F. Halberg. Chronoecological health watch of arterial
stiffness and neuro-cardio-pulmonary function in elderly community at high-altitude (3524
m), compared with Japanese town. Biomedicine and Pharmacotherapy 59(2005) S58-S67
(2) K.Otsuka, T.Norboo, Y.Otsuka, H.Higuchi, M.Hayajiri, C.Narushima, Y.Sato, T.Tsugoshi
S.Murakami, T.Wada, M.Ishine, K.Okumiya, K.Matsubayashi, S.Yano, T.Chogyal, D.
Angchuk, K.Ichihara, G.Cornelissen, F. Halberg. Effect of aging on blood pressure in Leh,
Ladakh, a high-altitude (3524 m) community, by comparison with a Japanese town.
Biomedicine and Pharmacotherapy 59(2005) S58-S67
Scientific paper presentations by Dr T. Norboo and Dr T. Lhadol of LIP &LHF during the year 2005
January 8 to 10 2005
Dr. T. Norboo consultant LHF and secretary LIP was invited to attend International Workshop on emerging trends in High Altitude Physiology and medicine organized by Defence Institute of Physiology and Allied science, DRDO ministry of defence in Delhi.
From 8-10 January
Dr Norboo read a paper on medical problems of high altitude natives, chaired a session and was on the panel discussion.
January 11,2005
Dr. T. Norboo consultant LHF and secretary LIP was invited to deliver a lecture on “Chronic Mountain Sickness” in the institute of Genomic and allied science New Delhi.
Dr. S. Lakiri USA was the other speaker. This special lecture session was organised by Institute of Genomic and allied science to pay tribute to late Professor Paintal the renowned Physiologist and high altitude researcher. Scientists of the institute, the Director and the faculty members and clinicians from Patel Chest Institute attended the special session.
Dr T. Norboo and Dr Tsering Lhadol of LIP were on the panel of Ladakh Autonomous Hill Development Council for preparing the manuscript for vision document – Ladakh 2020. They were mainly responsible for interacting with different sections of the society to develop “Health and Environment policy for Ladakh-2020”.
They remained involved in the process for major portion of 2004. The draft
document was presented to the council of ministers and Bureaucrats of J&K
state in 2nd week of may 2005 and Prime minister of India Dr Manmohn Singh
released the final document during his Leh visit.
The role of LIP as a cornerstone in Ladakh environment and health policy was thoroughly discussed, emphasized and documented in the policy.
May 1 to 2/ 2005
Women alliance of Ladakh (WAL) Ladakh health and environment organization (LEHO) and Ladakh ecological development group under the aegis of Ladakh Voluntary network funded by LAHDC organised two day seminar on May 1 to 2; 2005 on “Sustainable management of Garbage in Leh town through peoples” participation, professionals and civil society”.
Dr. Norboo of LIP was asked to present a paper on the topic” Impact of growing number of tourists arrivals on the health of public and environment of Leh township in particular”.
The Chairman LAHDC and the executive councillors participated in the deliberation on both days. Apart from other issues discussed; Dr. Norboo could highlight the role LIP can play in improving the health and environment of the Ladakh. The Chairman LAHDC suggested that LIP should take up the issue of “drinking water” particularly its safety aspect. The issue of course is on the top of the objectives of LIP.
June 23 to 26; 2005
Dr. T. Norboo consultant LIP and LHF conducted the visit of MS Bella Shah Sr.Dy. Director General of Indian council for medical research to various health institutes: Stockholders for medical research. SNM Hospital: 153 GH; Mahabodhi Charitable Hospital and LIP and LHF.
Her visit to Leh is the result of the decision taken after panel discussion in January DIPAS organised conference in Delhi to extend research facilities in civilian sector. She advised LIP and LHF to get accreditation from DST and than apply for project funds.
For LIP: her visit has been fruitful and hopefully a beginning of an association of collaborative study: we need to discuss the issue in depth-plane things and write projects before the end of this year to follow up with concerned authorities for sanction.
July 13 to 14: 2005
Dr. T. Norboo and Dr. T. Lhadol of LIP were invited to attend and present papers in the workshop cum seminar “High altitude health related issues and high altitude medicine” held jointly by DIPAS and 153 GH. Dr. T. Norboo was on the panel discussion of experts where the army commandant as users of health related recommendations participated. The high point for LIP was the appreciation by Dr. S. Silwamurthy the chief controller of DRDO of our contribution and their willingness to work with us in collaboration and extending their support.
Newsletter November 2005-August 2006
Heading into completion of the building construction, scheduled 2006 ending, the president, Ladakh Heart Foundation (LHF) Ven’ble T.Chogyal and Prof. Sampath Kumar, senior cardio-thoracic surgeon, All India Institute of medical science (AIIMS), New Delhi were fortunate in getting an appointment with His holiness the Dalai Lama at Dharamsala, Himachal Pradesh, India. Prof.Sampath briefed about the far sighted objectives of LHF to his holiness and presented a CD of himself and his colleague performing cardiac surgery at Leh. He sum up with the heart surgeries carried out at Leh on the poor Ladakhi during the past three years and also about the aims of caring out major heart surgeries at Leh itself once the complete infrastructure is available at LHF hospital complex. His Holiness expressed his willingness to motivate possible donors and immediately request his secretary to start correspondence to this effect is earnest, Very soon we received blessings from His Holiness in the form of a letter of recommendation to philanthropist around the globe to support LHF along with Rs. 20,00,000/-(twenty lakh rupee) as donation from HH The Dalai Lama’s trust. The motivation was so effective that within a short period we received $1,00,000/-from Mrs. Fusako Okawa, Japan as donation for which we gratefully acknowledge with deep appreciation.
September 1st to 15th is the Ladakh festival time, when people from all walks of life gather to present their cultural programme. To make this occasion more productive, Ladakh Volunteer Network (LVN) came forward to organized an exhibition in Leh, with our awareness drive motive about the NGO’s activity and their objectives. On that occasion we invited Chairman of LAHDC, and the DC of Ladakh and other well-known person. They went through the posters one by one and asking question and after all that, chairman of LAHDC and DC gave a little speech on our work, and they were very impressed and appreciated a lot and said to keep it up. The chairman of LAHDC wrote a little note in our suggestion book (I am highly impressed by the hard work LHF is putting up in fighting with heart diseases in Ladakh) and also Mr. Manoj Dwivedi DC/CEO recorded. (I am impressed, keep it up)
DC filling up the suggestion book
Chairman of LAHDC filling up the suggestion book
Ven’ble T. Chosgyal interviewed by media
We have been continuing and extending our activities all over Ladakh, trying to prevent and cure all forms of heart disease, while also concerning ourselves with the general health of the local population, Our efforts can be broken down into four main areas-
- Primary preventative medicine, mainly in the form of lectures and seminars
- Village clinics in out-lying regions
- The maintenance of a register of all patients in the region, and the continued monitoring of their conditions
- Surgery and diagnostic clinics
Lecture Programs
Dr. Norboo continues to run his popular lectures on relevant subjects (such as hypertension, heart attack, tobacco cessation, diet, etc.) to the local communities and schools.
Patient Register
Updated data of rheumatic and congenital heart disease revealed
Rheumatic heart disease to be145 and congenital heart disease to be 101.
Due to health education, numbers of patients suffering from rheumatic heart disease have been reduced. Only one new case of acute rheumatic fever has been reported this year.
Exit programme. As department of health has accepted the programme of primary prevention and has taken over distribution of Benzathine penicillin, syringes and distilled water for primary prevention of acute rheumatic fever and secondary prophylaxis of rheumatic heart disease. We are extremely pleased by the outcome of this project and the acceptance of the programme by the government. To avoid duplicacy we decided to make our exit from this programme, while continuing to keep vigil on this programme.
Heart Surgery:
Operated heart patients supported by L.H.F
Before surgery
After surgery
After surgery
Baby Pema Khando with her parent
Other project:
Health Post Project in Hanley
Place
This is the place where we propose to construct the Health Post Project in Hanley
Mr. Christian Jacquir, STEP Global coordinator and four members of French Christophe Viared association; donor group of this project visited Ladakh. As they could not visit proposed site of Health Post Project at Hanley. Dr. T. Norboo made a presentation to the group on behalf of LHF in Hotel Omasela. Sh. Dorjee Motup Hon’ble executive councilor of Health LAHDC; Mr. Nawang Norboo Hon’ble councilor Hanley; Dr. Dolma Tsering Chief medical officer Leh Ladakh and Miss Stanzin Dolkar of ILO were present.
Dr. T. Norboo explained the genesis of the special request for this particular Health Post Project. Hanley being a swamp area is a sanitation nightmare causing water and food borne diseases amongst the population, lack of hygiene sense and potable drinking water needs to be addressed through a community health post project doing promotive, preventive and curative medicine simultaneously. Hanley is the most populated village in this remote part of Ladakh with cluster of village surrounding it making it suitable for micro-insurance programme at a later date. Sh. Dorjee Motup Hon’ble executive councilor and ven’ble Chogyal thanked Mr. Christian and members of French association who seemed impressed by the proposed Project.
*
Donation
Switzerland Les Amis de Ladakh Heart Foundation, donated cement, marble, tile and labour cost amounting to Rs.4,46,130/- for our new hospital construction.
Mrs. Vinod K. Wazir donated Rs. 25,000/- (Twenty five Thousand only) for our new hospital construction.
Mr. Nawang Rigzin Jora Hon’ble Minister of Power J & K Government, who sanctioned Rs 1,50,000/-(one lakh fifty thousand) for our new hospital.
Miss Gladys Thacher from USA, donated colour paint cost amounting to $400 for our new hospital construction.
Thanks Gigi and Lella donated Euro 1550/-(one thousand five hundred fifty) for our new hospital construction.
Construction Site (to date)
Hospital almost under completion
Government’s sanctioned road for LHF
currently under construction
The LHF Hospital construction will be completed by this summer end and the dream that we dreamt appears to be realized due to the continues supporters like you. The most essential things now are hospital equipments and those equipments are too costly.
January 26,2006
A memorable day, when one of the vice president of LIP and an important member of LHF Dr. Tsering Lhadol, the Gynecologist’s name appeared in the distinguished groups list of the president of India (Govt. of India) of national awarded for the highest order for their distinguished service to the society. She was awarded with Padma Shri, one of the most prestigious award of the country: whole Ladakh including the members of our society rejoiced over the news and congratulated her for the honour conferred on her by the president of India.
If you would like to sponsor any individual part of the operation of the foundation, such as a Village Clinics, the Hospital requirements or the Rheumatic Heart Disease injections, please contact Lama Chogyal at the Foundation.
June 23; 2006
Lecture on Prevention of disabilities in Ladakh
Venue: CMO’s office, Leh
Participants: - Pharmacists of khalse
block NIRLAC & district health services had jointly organized a programme “Basic training in management of disabilities for health workers” pharmacists around twenty from khalse block were the participants. Dr T. Norboo of LIP & LHF
was asked to speak on prevention of disabilities on this day
from 2 – 4 pm.
Started with definition of developmental disabilities.
As usual, we start such programmes in the community with realization that it become successful only when we start with programmes which the community feels important & therefore NIRLAC perhaps very rightly started with data collection and management of disabilities. Prevention as usual took a backburner.
People are not concerned with disability problems unless some one they love become disabled. These families are then the leaders of such initiation & the disabled are the real force. (NIRLAC is no exception; is the best example) next group of concerned people should be the health workers of all level who has to tackle these problems in his/her practice. Physically challenged is a better description then disabled.
What is important is to critically analyze the NIRLAC data as to which of the disabilities are the commonest; what age group? Which sex? Which region? & What is so different in the distribution of disability problem in Ladakh compared to other districts of India? Such analysis can give us vital clue about the predominant causes and naturally help plan preventive measures so that our future generations are not afflicted with disability problems.
Socio-economic conditions has big role to play in prevalence of disability problems: poverty, illiteracy, undernutriton, lack of sanitation, lack of basic health and rehabilitation programmes; examples – premature babies- lack or trained ANM’s to conduct proper delivery-prolonged obstructed labours – lack of immunization – accounting for increased prevalence of cerebral palsy – post-polio – paralysis lack or iodine in water supply leading to cretinism, mentally retarded babies etc.
Therefore multipronged health and environment and rural and urban development are very crucial to prevent disability problems.
Immunization particularly pulse polio programmes are crucial in prevention of disability: Proper storing of vaccines – transport of vaccines & ensuring 100% coverage & AVOIDING INJECTIONS are very important issues that health care workers need to keep in mind. It has been reported that 2million cases of paralysis due to Poliomyelitis are caused by giving injections to these patients during this illness.
Avoid medicine during pregnancy – avoid X-ray radiation during pregnancy – points which need awareness in all; health care workers in particular.
Rural Ladakh needs special attention to improve their nutritional status. Protective food available through fresh vegetables, fresh fruits, are not available throughout the year in places like Changthang, Zanskar etc. deep green, deep yellow vegetables & meat rich sources of vitamin A should be made available if blindness as one of the disability is to be prevented.
Skeletal & dental fluorosis (Chushul, Man Merak, area) iodine deficiency disorders in Nubra regions needs attention to prevent skeletal, dental & mental retardation disabilities.
Unorganized small industrial units like Saw machines – automobile – cement & flour factories etc. needs utmost safety measures to prevent disabilities causing for example Amputation of limbs etc.
Planning to prevent automobile; road accidents are urgently needed to prevent preventable disabilities.
Adulterated alcohol sale; adulterated edible oil sale; use of pesticides, insecticides in farms etc needs special attention to prevent disabilities like vision lose etc.
Awareness about Ear, nose and throat care is important to avoid preventable deafness. Pharmacist should know that inappropriate unnecessary injection of Aminoglycosids like Streptomycin, Gentamycin etc can cause deafness.
Preventative Intervention:
Before the establishment of the Ladakh Heart Foundation in 1997, there was a high prevalence of Acquired Rheumatic Fever in Ladakh. The reason for this is that during the extremely cold winter months (which can drop to below 30), local families spend most of their time together in the traditional kitchen. This close proximity to each other exposes young children to cross infection with streptococcal throat infections, which may develop into Acquired Rheumatic Fever, and possibly Rheumatic Heart Disease with severe consequences later in life.
In response to this problem the Ladakh Heart Foundation, in association with the Lions Club Leh and the District Health Services, initiated the “primary prevention of ARF” scheme. This entails any child aged between five and fifteen with possible streptococcal throat infection, receiving a single shot of Benzathene Penicillin after a proper sensitivity test, so that the infection doesn’t develop into ARF. Thanks to this scheme the instance of Acquired Rheumatic Fever, Acute Rheumatic Fever and Rheumatic Heart Disease has dropped since 1997.
Leh world anti-smoking day:
On May 31st 1998 the Ladakh Heart Foundation in collaboration with the Ladakh Health Department organized an anti smoking march. Children from local private and government schools marched in procession through Leh, carrying banners warning people of the dangers involved in smoking and asking them to give up. The procession began from Lah Chowk Leh and was flagged off by the Deputy Commissioner of Leh, Mr R.K. Goyal. The Deputy Commissioner himself also appealed to people to stop smoking as it is one of the major causes of heart disease and cancer. The event was reported on in the Daily Excelsior newspaper the next day.
Extending health care to some of the more remote villages:
The LHF runs a series of medical camps when they travel to some of the more remote villages of Ladakh, with local doctors and sometimes foreign volunteer doctors. On these camps, the Foundation carries out general health checks such as measuring blood pressure as well more specific health checks such as ECG readings and monitoring people’s breathing capacities. The doctors working in association with the Heart Foundation are able to diagnose many new cases of heart disease on these camps. Another purpose of the medical camps is to educate local people about the symptoms and possible preventative measures associated with heart disease. The Ladakh Heart Foundation doctors also give talks teaching the locals about the risks associated with poor diet, obesity, smoking and excessive alcohol consumption and the effects such habits may have on their cardiovascular system. These medical camps provide a very important service by taking health care and education to villagers and nomads who would otherwise have very limited health facilities, if any. Thanks to the time and effort put in by local doctors, foreign doctors and other members of the Heart Foundation, a total 20 medical and educational camps have taken place in the past years. As a result of all these camps over 2000 people have been examined. The Heart Foundation at present has 66 registered cases of Congenital Heart Disease, 14 cases of Acquired Rheumatic Fever patients, 14 cases of Coronary Heart Disease and 108 cases of Rheumatic Heart Disease; the Heart Foundation keeps detailed case histories of all these patients. As a result of it’s medical camps the Heart Foundation is able to run checks on its current patients, and to diagnoses new cases of heart disease thus helping local people further.
Details of the medical camps running between October 1997 and July 2000
Visit from AIIMS doctor from New Delhi:
In August 1998 the Ladakh Heart Foundation invited Dr Sampath Kumar, a senior cardio-thoracic surgeon from AIIMS, New Delhi. At this time the LHF had 85 rheumatic heart disease patients, each patient with a detailed case history for periodic check up, referral management, financial and rehabilitation purposes. Dr Sampath Kumar examined all these patients, here in Leh so they didn’t have to travel to Delhi, and advised appropriate management. He strongly recommended the Foundation aquifer a state of the art Colour Doppler Imaging system to facilitate the diagnostic capability of local physicians. This would be a big step forward for the Heart Foundation, as the local diagnosis of our patients would curtail the costs of visits to Delhi for initial diagnosis and subsequent follow ups if required. Following this advice the Heart Foundation is currently trying to get hold of such a machine.
Plans for the future:
The costs for cardio-thoracic surgery are prohibitively expensive for the majority of the Heart Foundation’s patients. The cost of surgery required to treat rheumatic heart disease ranges from Rs. 91,500 for one valve to Rs. 142,000 for two valve surgery. Congenital heart disease is also in high prevalence in Ladakh. The average cost of surgery to treat Congenital Heart Disease is Rs. 45,000. These prices are exclusive of costly travel expenses and accommodation charges for the patient and attendant in Delhi. When possible the LHF is committed to help raise money for it’s poorer patients so that they can afford the surgery they require. In 1998 the Foundation was able to donate Rs. 85,000 each to two very poor Rheumatic Heart Disease patients in need of two valve surgery, to contribute to the cost of their treatment. Some of this money was acquired from the donations of local people through “16 Friends”, a Ladakhi organisation which the Heart Foundation had spoken to in order to get them to persuade local people to donate money to help these patients. Another welfare organisation based in Leh, the Otzer Tsogspa Skyanos Gogsum Association, organised a concert, the proceeds of which, over Rs. 40,000, were donated to the LHF so that these patients may be helped. The Heart Foundation tries to contribute to the surgery of other patients, the amount they receive depends on their condition and their financial situation. The Ladakh Heart Foundation is currently raising money to build it’s own diagnostic centre in Leh, land for this project has been kindly donated to us by the J&K government and the Ladakh Autonomous Hill Development Council. The centre is to have a diagnostic wing, an operating theatre and a conference hall which will be used for preventative health seminars and training of local health workers which is an essential part of the Foundation’s work. This centre will allow patients not requiring open heart surgery (such as Congenital Heart Disease patients), to be operated on in Leh, thus curtailing their costs greatly. More invasive surgery, such as that required for people suffering from Rheumatic Heart Disease, will still have to be carried out in Delhi as the procedure requires a lot of sophisticated equipment which the Heart Foundation does not have. However as a result of the Foundations scheme to prevent acquired rheumatic fever by giving children shots of Penicillin, the instance of rheumatic heart disease and subsequently the number of patients requiring treatment for this condition are falling. Once the diagnostic centre is built, cardio-thoracic surgeons from AIIMS in New Delhi have pledged to visit the Heart Foundation for one week every year to operate on patients in Leh voluntarily.
The Ladakh Heart Foundation was founded in 1997 by Ven Thubstan Chogyal. He was ordained in 1977 at the age of seven. Chogyal studied at Drebung Loseling College in South India and spent seven years at the Tantric College of HH the Dalai Lama at Namgyal Monastery. After three years in South Korea, where he learnt Korean, he spent seven months studying English in Oxford. Now he has decided to dedicate his life to finding solutions to the problems facing his people.
Contact Details
Ladakh Heart Foundation Hospital and Research Centre
Agling Dambuchen
P.O. Box 150
Leh, Pin. 194101 -
Ladakh
India
Tel.: (91) 01982 253291
(91) 01982 255888
Email: ladakhheartfoundation@yahoo.co.in and cthupstan@yahoo.com