Leaving behind her family in the United States, Jenny Vliek traveled halfway around the world to volunteer for three months at EHA’s Burrows Memorial Christian Hospital in Alipur, Assam.

While serving at BMCH, Jenny came to understand her calling to missions. She expressed her joy and appreciation in a letter later written to hospital staff. Jenny shared, “I will begin my studies this fall in Intercultural Ministries and Teaching English as a Second Language. As I sit here, I cannot help but think of all of you at BMCH. The Lord used my time at your hospital to deeply interest me in living my life in missions work for Christ, and it was only after staying there with you all that I felt a true calling to pursue missions at college. I want to thank all the hospital staff and students once again for being such Christ-like disciples and wonderful hosts. You all shine so brightly for Christ and show how to use your talents to glorify Him.”

Dr. Christopher Lasrado serves as chief medical officer at Chhatarpur Christian Hospital. Last September he was suddenly diagnosed with a brain tumor. The following account of his experience is in his own words, and captures his gratitude at the Lord’s strength and provision during this time. We trust you will be encouraged by this glimpse into the Lord’s work in one of EHA’s key leaders. 

“It was on a Sunday in the second week of September when my colleagues and I detected a significant gap in my memory of events in the last year. On consultation with Dr. Monica Chandy, I underwent a CT scan of my brain, which revealed a large non-cancerous brain tumor. Despite the size and position of the tumor, I had no headaches in the last several years and functioned normally, oblivious of this growth inside my head.

I was put on the fast track of the work-up for surgery. On reaching Chennai, I was picked up by colleagues and old classmates from St. John’s who helped me get to CMC Vellore at their expense. The surgery was scheduled for the 23rd of September; the surgeon, Dr. Ari Chacko, is the chief of Unit 2 Neurosurgery. The day of surgery and immediately prior to that saw a stream of friends and well-wishers visit, pray for me, and encourage me. The moment I was being moved to the operating room, a pastor who had come all the way from Mangalore (having heard of my illness) reached the hospital just in time to pray for me. He spent the rest of the day at the MUT (Missionaries Uphold Trust) rest house, fasting and praying through the surgery (the pastor is the father of a medical student whose medical studies in Mangalore are financially sponsored by Chhatarpur Christian Hospital).

When I had the opportunity to ask the pastor what made him come, he told me he had a very clear prompting from the Lord, telling him to “go and pray!” I was also amazed at how the Lord had worked out everything for my care. The people who were involved in the management of my illness were people I had met or spoken to several times over the years, or were indirectly known to me. I felt I was among family.

The surgery that was expected to last about 14 hours was done in 10 hours time. The surgeon managed to remove about 60% of the tumor. The remaining 40% was out of reach or too dangerous to touch, and has been left behind for radiotherapy. I’m convinced that the Lord has a very specific purpose for me vis-à-vis this illness. Never for a moment did I fear for my life or feel sorry for myself.

I had always felt like a shepherd/father to my staff and students. I love them dearly. What I did not realize was that they too loved me dearly. The brokenness that I saw on their faces when I broke the news to them, and the turn-out to say goodbye the night I was leaving Chhatarpur were both evidence of this love. I must have hugged over 200 weeping people that night. Many of them assured me that God would bring me back soon. Through the surgery and postoperative week, my staff and students fasted and prayed for my healing.

The postoperative course, to say the least, was uneventful. I had no neurological deficits or significant memory loss. I was walking in two day’s time. I was discharged after a week. I started leaving the house independently after two weeks, and at the end of the month I would walk 4 to 5 km at a stretch, in addition to doing physical fitness exercises.

My family was easily convinced that I was fit enough to return to Chhatarpur. I arrived at back at the hospital on a Sunday morning [the 26th of October], to a joyful welcome from staff and students. I started work on Monday. It was amazing the way my knowledge and skill has remained untouched by the surgery. I am discussing cases with my colleagues as before. At the time of writing this story I have already tried my hand at two surgeries and in a short while will work with another surgeon on some more surgeries.

Most of all I feel good to be back with my staff, students, and EHA family. I praise and thank the Lord for being my Good Shepherd through this dark valley. Only now has it dawned on me as to how dangerous and difficult the surgery was, and how miraculously unscathed I have come out of it. My gratitude goes out to my EHA family and all of the Lord’s people all over the world, who were praying and interceding for me through this difficult time.”

Yours in Christ,

Dr. Christopher Lasrado

by Christo Philip, former doctor at Duncan Hospital

People often ask us what a day at Duncan Hospital looks like. So I decided to write down all the events I could recall from one day at Duncan. Hopefully it will give readers a sense of the patients that come through the doors of Duncan each day and a glimpse into the lives of the staff that work at Duncan. Yesterday was a particularly challenging day, so the following is a glimpse from sunup to sundown…of course it does not include the 13 vaginal deliveries, the 5 c-sections, 1 breech delivery and 2 twins born courtesy of Dr. Dianna and Dr. Sharon. It also doesn’t include the 352 patients seen in the outpatient clinics by Dr. Vinod, Dr. Jeni, Dr. Chandan, Dr. Sunil, Dr. RK, Dr. Mini, and Dr. Mahitha.

3:30 am – called to see patient in ICU with a perforated duodenal ulcer who is now breathless. Placed on respirator because his breathing is bad.

4:00 am – while waiting to place chest tube in the first patient who has a pleural effusion (fluid in chest cavity), a 4-year-old child with hepatic encephalopathy (liver-related swelling in brain) in another ICU bed starts having seizures. Patient begins constant seizures and because of the poor prognosis (bilirubin of 32—normal is less than 10, INR high) due to total liver failure decide not to intubate. The child is given large amounts of midazolam and phenytoin to control seizures, and after 45 min the seizures stop. Also see another young boy (7) who has liver failure and ascites (fluid in abdomen). He also has hepatic encephalopathy (brain swelling due to liver problems). Question of whether he has a Kayser Fleischer ring suggestive of Wilson’s disease.

4:30 am – start placement of chest tube in ICU with Dr. Divya for large pleural effusion in the first patient. Start the procedure but find out we don’t have the right tools for a chest tube placement in the ICU. Nurses go to operating theater to find chest tube tray.

5:15 am – chest tube placed, 1.2 liters of fluid come out of the chest.

5:30 am – get morning report from ICU nurses on the adult patients in ICU.

7:00 am – the first child with a bilirubin of 32 and seizures dies.

7:30 am – patient with likely eclampsia who is a 20 y/o (20 year-old) first-time mother who was found unconscious by her family is brought in. Her baby at 38 weeks is already dead. Her blood pressure is 150/110 (normal is 120/80) and she has 4+ albumin (should be 0) in her urine. She is transferred to ICU because she has pulmonary edema due to eclampsia.

8:00 am – finish a couple of emails to visiting students and friends.

8:20 am – read a couple of Vivek’s (son) books with him along with a few poems for home schooling.

8:40 am – have breakfast with Melissa and the kids.

9:10 am – ICU rounds begin. A middle-aged woman with seizures who was admitted the previous night is transferred out of ICU. Family is elated by how much better she is. Patient with chest tube better but family very poor and unable to afford treatment—likely will need to give considerable charity.

9:45 am – called to see 4 surgical patients that need to all be cleared for surgery later in the day. 2 patients have hernias that will be repaired, 1 patient is a 16-week pregnant woman that has appendicitis. I warn them they could lose the baby because of the infection. There is also an anal fistula that is cleared for surgery.

10:30 am – back to ICU. Speak with family of pregnant patient with the intrauterine death and eclampsia. She has poor urine output and likely has rhabdomyolysis (decomposition of muscle) and is developing renal (kidney) failure. Attempting to increase her diuresis (urine flow). We pray with the family for her healing.

11:15 am – see one of our staff in private ward who has diabetes and vertigo. Discharge another patient from private ward who has heart failure and aortic regurgitation.

11:45 am – go to casualty to see patients with Dr. Meena. There is an elderly man with shortness of breath who has a left lower lobe pneumonia. There is a 30 y/o woman with extreme tachypnea, breathing at close to 40 breaths per minute (normal is 15). Lungs are clear with normal saturation, so likely due to severe acidosis (level of acidity in blood). Arterial blood gasses sent off. See another staff member who has been vomiting all morning.

12:00 pm – see patients in OPD with Dr. Divya. A patient with constant migraines needs a consultation. Another patient with diabetes needs her medications adjusted.

12:15 pm – run home for a quick snack.

12:40 pm – called to casualty to see one of our dentists who is sick. There are multiple sick patients in casualty that also need to be seen. 65 y/o man comes in gasping. His saturation is barely at 30% and the lungs sound horrible. Even not improving on oxygen. History of TB for several months. Family told there is nothing we can do except palliative care; diazepam given to ease his respiratory distress. Family decides to admit for comfort care. A few minutes later another 70 y/o woman comes in with cough she’s had for one week and severe breathlessness—some relative was prescribing her medications. Her saturation is about 40% and her lungs sound awful. X-ray shows bilateral TB involving the entire lungs. Told there is very little chance that the patient will survive but family wants everything done. Admitted to ICU on antibiotics but decision made to not intubate if she gets worse. Meanwhile, test on arterial blood gasses on 30 y/o woman comes back. pH is 7.04 and bicarbonate is so low it is unrecordable, creatinine comes back at 10. Outside ultrasound shows severe bilateral hydronephrosis (swelling in kidneys) of unknown cause. Family asked to take patient to Patna (7 hours away) for dialysis—they take time to decide. Given bicarbonate to help her with her acidosis. Also a 3-month-old comes in severely dehydrated. Given IV fluids and admitted to the pediatric ward.

1:50 pm – home for lunch.

2:40 pm – have Luke (son) read me a book for homeschooling.

2:50 pm – go back to casualty. Dr. Meena is getting ready to intubate a 24 y/o man who came in with florid secretions and likely organophosphate (pesticide) ingestion. We can’t get his heart rate up. Total of 12 mg of atropine given. Patient intubated, friends manually ventilate the patient until family can arrive. Craziness breaks loose in casualty. There are patients coming in left and right. 11 y/o comes in with vomiting and likely carpal spasm due to hyperventilation. First young man admitted to ICU on ventilator and started on atropine infusion—heart rate still continues to intermittently drop. 10-day-old baby comes in with neonatal sepsis due to pneumonia—admitted to nursery. As soon as first man with OP poisoning is transferred to ICU, another man comes in with severe hypertension and dizziness—given blood pressure medications and asked to come to outpatient clinic. 20 y/o man comes in with 8 days of abdominal swelling—his abdomen has significant ascites—differential diagnosis is liver failure vs TB abdomen. Another 55 y/o woman is brought in from six hours away in Nepal with left thigh swelling and unable to walk for 5 days. She has been in bed for the past five days because of the pain. Her leg is externally rotated and shortened—she has a left hip fracture.

4:30 pm – a 20 y/o G4P2 patient comes in—she is now 16 weeks pregnant and had come to our antenatal clinic the day before when Dr. Rama Krishna had picked up a loud murmur. ECHO was done by Dr. Joanna which showed an Ebstein anomaly (she was born with the tricuspid valve in the wrong location) along with rheumatic heart disease of her mitral valve. She comes to see me for a final consultation. Her husband is in Kashmir so I explain to her mother-in-law that the woman is very sick and will get sicker in her pregnancy and she needs to see a cardiologist and a high risk OB-GYN in Patna. Referral letter written for Patna, start her on penicillin injections to prevent further damage to her heart valve, and on lasix to control her heart failure. The family of the patient who was admitted for palliative care due to tuberculosis has a change of heart and asks for discharge so that he can die at home. Dr. Meena works on filling out the discharge summary so that they can take him home.

5:00 pm – Dr. Divya brings in two more patients from the outpatient department for me to see. The first is a 34 y/o man with continued cough even after 6 months of TB medications. His repeat chest xray shows continued active lesions. He likely has multi-drug resistant TB and is referred to Muzzafarpur for further testing. The second is a poor patient that likely has trench foot. His toes are all being eaten away by a fungal infection. His toes have been macerated and oozing pus for the past few months. He doesn’t have money for his medications so we write for charity to help him.

5:30 pm – 8-month-old girl is brought in for an upper respiratory infection, while getting history another 30 y/o man comes in with unclear history. His has wet lungs, his saturation is 70% and heart rate is in the 140s; he is gasping. We intubate him and give him atropine with which he improves somewhat. Family says he went out of the home last night and came in that morning altered. Unsure of cause but as soon as we put in the NG tube the characteristic smell of organophosphate comes out. As we are intubating him an 8 y/o boy who is hit by a motorcycle comes in with a large laceration of the face—father is freaking out—we tell him he has to wait until the intubation is done. The 30 y/o woman with the renal failure is taken home. Family cannot take her for dialysis tonight so they will take her home first and try in the morning—we tell them she will likely die in the next few days if she doesn’t get dialyzed. Dr. RK, Dr. Chandan, and Dr. Vinod come to help us in casualty after they are done with their outpatient clinic patients. They see the remaining patients in casualty to help Dr. Meena.

6:30 pm – I go back to ICU to check on the first patient we intubated earlier. He looks bad. His pH is 6.83, bicarbonate is unmeasurable. BP is 240/140 and he has a slow heart rate again. Increase the atropine, start on nitroglycerin drip—he has very little response on the ventilator so I talk to the family and explain he likely has a head bleed. Unusual to see such high BP with organophosphate poisoning but it happens occasionally. No ventilator available for the second intubated OP patient. Nurses work frantically to wash out and dry a ventilator circuit so that we can get him on the 3rd adult ventilator. We try the circuit but it is not working. Thankfully Dr. Vinod is able to take a baby with sepsis and apnea off the ventilator and thus we connect the new patient to that ventilator. Dr. Vinod and I discuss another patient intubated earlier in the day by him—a 7 y/o boy with pneumonia, pulmonary edema, and hypertension. Unsure as to the cause. Dr. RK fixes up the laceration on the 8 y/o boy’s face. Dr. Sunil has another surgical case—acute appendicitis in a young man. I go to the surgical ward to do a pre-anesthetic evaluation to clear him for surgery which will happen an hour later.

7:15 pm – I get home but ICU calls again because the young man with OP poisoning is very sick. His heart rate is in the 40s and now his BP is very low. We stop the nitroglycerin infusion and increase the atropine. Poor prognosis again explained to the family.

7:40 pm – I go back up to casualty with Dr. Emily to sign some prescriptions and see another patient that has had a reaction to a medication he received from an outside pharmacy.

7:50 pm – go to one of the nursing school staff’s home for their 13th wedding anniversary. Have dinner but am extremely tired so we leave early.

8:50 pm – a couple more calls from ICU and surgical ward about new patients. Another patient with necrotizing fascitis (dying tissue) has come in that needs to be cleared for surgery. Collapse into bed.

Special thanks to our wonderful casualty and ICU nurses who work tirelessly and without complaint. Without their hard work and dedication it would be impossible to care for so many sick and needy patients. With Pranoti, Nand Kishore, Suresh, Roseleen, Zing, Suman, Divan, Justina, and Sangmu.

It has been three years since I had my myocardial infarction (heart attack). My wife, Ann (an anesthesiologist), my two young daughters, and I had just returned from a 200 km road journey (on mountain roads) from Agartala (capital of Tripura) after a brief stopover at Ambassa, where we have a branch hospital. I was driving and tired.

We went straight to the hospital where I did a neonatal colostomy and a Caesarean section. The baby took time to come out of anesthesia, so I left Ann to extubate the child and went home. I parked the vehicle in the garage and walked home in the dark. When I reached the bottom of the stairs to my home (there is a steep climb of about 40 feet), I found it very difficult to take a step forward. I tried shouting for help but no sound came out. I managed to crawl up all the steps and reach home where I sat on the floor. I told Hannah, our eldest daughter, to call Ann. Ann thought that I was just tired. A little later, I vomited and started experiencing severe chest discomfort.

Ann and other doctors came home and lifted me down in a blanket and took me to the hospital. An ECG confirmed an acute anterior wall myocardial infarction (MI). We did not have streptokinase in stock. Ann sedated me and called my classmate, Ravikannan, at the Cachar Cancer Hospital in Silchar (120 kms away) and he brought the streptokinase. I had severe chest pain for a day. Ann managed me calmly (although she confesses to having some unease when she arranged the resuscitation tray with endotracheal tube at my bedside). In a few days, I was well enough to be wheeled around the hospital. All the staff, family, and friends prayed for my recovery and took good care of me. I did an echocardiography on myself and found a poorly contracting heart with an ejection fraction of about 35%—I could not believe that it was my heart! After about a week, one of the staff nurses had acute appendicitis and I managed to do the surgery from a wheelchair with the operating table lowered completely. Our obstetrician assisted me and closed the abdomen. I was then brought to the Christian Medical College at Vellore where I underwent angiography and stenting of my left anterior descending artery. I spent about a month at Vellore and Bangalore—there was no further change in my heart, and we returned back to Makunda.

My father and some other close relatives had coronary heart disease, and my father had died of an acute MI. Ann had taken me to a cardiologist a few months before my MI—all biochemical tests were normal and I was able to complete a full treadmill test without any signs of ischemia or discomfort. I had also started to exercise. I had no other risk factors (except family history). I was told (after my MI) that I had developed an acute coronary thrombosis.

After my return to Makunda, we found that I had to work as much as before my MI. There was no additional help, a lot of pending bills had accumulated, and workloads had increased. I started tentatively at first but was soon doing as much surgery, ultrasound, and other work as before. After an experience like this, every twinge in the chest is taken seriously (as you don’t want to have another one)! I avoided long surgeries, but sometimes I had no choice. There was a patient with tracheo-esophageal fistula who would have died if I had not operated. There was a patient undergoing laparoscopic cholecystectomy who developed a biliary leak and I had to do a hepaticoduodenostomy. Since I knew that there was no one else to take over, I just took deep breaths and completed these and other such surgeries one stitch at a time. When I was tired, I had a bed put in the hospital where I could lie down a time.

I was asked to walk 2 kms every day. I found this tiresome and took my daughters along. One day I noticed a tapping sound and found an unfamiliar woodpecker pecking on a dead bamboo stump. I photographed it and posted it on Flickr and it was identified as a relatively rare woodpecker (Stripe-breasted woodpecker—Dendrocopos atratus). I became very interested and started noticing all sorts of interesting birds and insects. I upgraded my equipment to a Nikon D300s with Sigma 150-500mm OS lens and also bought a 27″ iMac for editing the photographs. The home equipment budget was passed by Ann under the heading “Cardiac Rehabilitation Expenses!” I found that observing, photographing, and reporting the wildlife in the campus and surrounding areas was very relaxing and added new meaning to my walks.

I have been to cardiac reviews every year. I have not become any better (the ejection fraction is still around 35%) but I haven’t become any worse. I am able to do almost all the things I did before my MI. I cannot run or do anything which demands exertion. I am happy with my lot—it is God’s portion for me. We have to accept the whole package and cannot pick and choose the things that please us. It is also God’s way of telling us that He is sufficient and that in our weaknesses, we experience His strength. I have never questioned why I should experience this—in His infinite wisdom, God permitted it and that is enough. We need to trust God absolutely and in everything.

This experience has brought our family closer. We have realized the shortness and unpredictability of life. It also has made me look at everything with a greater heavenly perspective. We are citizens of the kingdom of heaven temporarily posted to this earth. We should not develop any deep roots here. The values of this world are temporary and not eternal. We should rather invest on those things that have eternal value—those things that find God’s approval. We should live for His approval—that the thoughts, plans and purposes of our hearts find His approval. This is our strength and that is sufficient.

Should my life be different? I think I should just go on being the person He wants me to be. I am not perfect but will become more and more like Him. Our physical bodies degenerate with the passage of time but spiritually we become stronger as we experience His faithfulness and learn to trust and obey Him. When I was young, I did not want to commit my life into the hands of my Lord and Saviour Jesus Christ. I felt that this would lead to a loss of control over my life and I wanted to enjoy life in the way I wanted. Later, when I made the commitment, I knew it would be for life—a vow had been made like the one at the time Ann and I married—I will seek your will and follow it all the days of my life (in sickness or in health).

Many people advise me to rest and relax. I find that doing the work that is pleasing in God’s sight brings the greatest rest and relaxation. Contentment and happiness are the rewards of obedience. Strength and health are given as the need arises. I spent several years after my undergraduate days spending time with young Christians, challenging them to find the same fulfillment that comes only by walking in God’s path, holding His hand. After joining the team at Makunda, this became difficult as work took a lot of time. I think that I may again be able to do this as more time becomes available. I find that even if I don’t physically travel to other places, I can still communicate with people over the internet. I look forward to whatever God has in store in the days to come. My ambition is to live a life pleasing to Him when on this world and to be welcomed back as a servant who has completed the task given to him when I go to be with God in heaven.