Lip News
Neonatology services by Dr Tomoko Tsugoshi and Dr Norboo
20th November 2011 From 22nd August – 31st Aug 2011 Dr Tomoko, an experienced qualified neonatologist from Japan, assisted by Dr Norboo assessed new borns (1-24 month old) in terms of their growth and development. Mothers were given information and advice on breast feeding and weaning methods. The local medical staffs were provided with information & advice with practical demonstrations on correct procedures to weigh babies and measure their height accurately to help assess the growth and development of babies. They were also provided with advice to consider expected milestones and a detailed examination to help detect any congenital or acquired abnormality. Dr Tomoko & Dr Norboo help clarify traditional myths about baby feeding and weaning practices by answering questions from mothers and local medical staff. Similar services were provided at Solar colony, Tibetan children village Choglamsar, Spituk and Phey village during the same period. Few children were diagnosed with congenital abnormalities and were appropriately referred to the local paediatricians for regular follow-up. The data of these young children will be analysed after the services are extended to rest of the villages of Ladakh. The expected results from results should help District Health Services in planning child health care services in Ladakh.
Preventative Healthcare at an Altitude of 4000-4900m – Changthang - Ladakh
20th November 2011 As part of LIPs strategy for Innovative Rural Healthcare Reform for the Ladakh region a number of preventative educational healthcare camps were organised in the remote villages of Sumdo, Thasangkaru, Korzok, Rina Rubsho and Kharnak Changthang. Communities in these villages are inhabitants of one of the highest plateaus of the world. The inhospitable high altitude environment, severe cold climate, intense solar and ionizing radiation, low humidity, non-availability of fresh vegetables and fresh fruits in this region makes the population vulnerable to various micro-nutrient deficiencies. LIP carried out a complete health check-up of the adult population in these five high altitude villages, which otherwise is not available to the population. The medical examinations include, measurement of Body Mass Index (BMI), waist circumference, SpO2, Blood pressure, ECG, Cardio-vascular index (CAVI), Haemoglobin, Blood sugar, lipid profile, HBsAg, Questionnaire for tobacco smoking, alcohol, diet, physical activity, GERD, Diabetes, hypertension, stroke and modified Rose questionnaire for ischemic heart disease, PHQ 2 and PHQ9 for depression, MMSE, BCRS, and ADL for cognitive function, and up-and go and functional reach test for physical functional ability test. These medical examinations were also carried to 27 senior citizens at Solar Colony, Choglamsar a village on the outskirts of Leh town. This is the area affected by the flash flood of August 2010. Through these camps the team were able to screen, diagnose and offer appropriate treatment, including counselling for senior citizens, at Solar Colony. Patients suffering from major depression, hypertension, and diabetes were enlisted with the medical centre run by the government health services to ensure regular follow up by psychiatrist and physicians to ensure drug compliance and life style measures.
Construction of LIP Laboratory
9th April 2011 We are pleased to announce that construction has begun for LIP’s Laboratory. It is one of the greatest achievements for LIP and indeed for the whole of Ladakh. The first phase of Laboratory with five rooms will be completed by October 2011. When functional the Laboratory will be first of its kind in Ladakh to help monitor air and water pollution, including facilitate testing of water samples and noise pollution. However, it is a slow process and funding support will be much appreciated as it will be sometime before Laboratory will be fully functional. Nevertheless, the Laboratory will hugely benefit the Public Health of Ladakh region for generations to come.
LIPs New Commitment for the Year 2011
10th February 2011 It is another New Year – and yet again our commitment to facilitate the health and wellbeing of communities in Ladakh continues and key focus.
Elderly (senior citizen) population in the villages: ascertaining those with chronic non-communicable diseases, digestive disease and cancer. This will be carried out by supporting existing mainstream healthcare centres - with regular health checkups and - by supplying medicines Furthermore LIP will make the programme successful by - mobilising and facilitating self-help groups and volunteers from the villages for community health education, promotion and creating better awareness
Systematic registration within village healthcare centres of those suffering from chronic Non-communicable diseases, degenerative diseases and cancer. Health promotion
(1) For senior citizens in the villages. LIP will enlist all elderly people in the villages with chronic Non-communicable diseases, degenerative diseases and cancer. Support health care centres to ensure regular check up and continuous supply of medicines. Mobilize self help groups and volunteers in the village to organise physio-therapy and health awareness sessions. Mobilize public opinion amongst youth in town about the declining social and health status of the senior citizens in the village and seek their support. (2) Have a registry in the village health care centre of all those suffering from chronic Non-communicable diseases, degenerative diseases and cancer. It has been generally observed that many villagers suffer from hypertension, diabetes, chronic liver disease, yet they are unaware of the disease, and the need for regular treatment and life style modification. LIP commits itself to create awareness amongst the rural community of dangerous consequences of this silent epidemic and work hard to ensure regular check up and treatment for these conditions. We have initiated such a programme in Dhomkar village.
(3) VCD of a documentary film on Healthy life style in Ladakhi language and booklet on Healthy life style will be provided by LIP for every village community centre. Villagers gather at community health centres quite often for village meetings. The materials will be of helpful for them to understand the health issues.
Ladakh Institute of Prevention (LIP) Extends Integrated Healthcare Programme to Flash Flood Affected Villages in Ladakh
Over 300 lives lost and several villages destroyed when cloudburst caught people by surprise in the middle of the night on 5th August 2010. This was the worst ever flash flood witnessed in eco-fragile Ladakh, even today the cataclysmic incident haunts Ladakhis and many survivors suffer from post-traumatic stress disorders. The dreadful thunder and lightning, the dirty black clouds preceding the cloudburst affected Leh town and several villages (Sabu, fiyang, Taru, Nimo, Basgo,Igoo,Skurbuchan, Gya miru, Tyakshi turtuk,and Skyu Marka) and swept away everything in its path leaving families homeless, trees uprooted, hospitals flooded and making many of farm lands uncultivable years to come. Rescue operation was a collective effort, local authority with the support of Army, ITBP, local volunteers all put a collective and brave effort, which was swift and even tourists, both national and international rendered their support. Most vulnerable were those who defied the old wisdom and had their houses built in the flood prone areas. Immediate attention was given to restore the Hospital services and to provide shelter to the homeless survivors. Aids started coming in from Government, Philanthropic institutions, corporate sectors, Civil Society, individuals, communities and international organisations. Medical aid camps were provided by the Government health services, Red Cross society and by many NGO’s.
Ladakh intstitute of Prevention (LIP) promptly collaborated with the Ladakh Heart Foundation (LHF) and Government medical aid camps. This was immediately followed by LIP’s more integrated and systemic health survey complemented by treatment camps in the flood affected villages. In addition to the immediate basic clinical examination and treatment (dressing, medicines) to help people cope with the trauma counselling was provided and ascertain the level depression validated questionnaire on depression screening (PHQ-2, PHQ-9) was used. Cognitive function test questionnaire (MMSE, GDS, ADL. (for senior citizens) we used. Communities also has the opportunity to health awareness sessions. LIP has prepared a booklet on healthy lifestyle and a documentary film on this subject which we intend to distribute free of cost and will revisit all these areas and those already not covered in spring when the weather in conducive for everybody.
Dr Keith Percy Ball, doctor and campaigner, born December 8 1915; died January 10 2008
As a consultant at the Middlesex Hospital in the postwar years, Keith Ball became increasingly concerned about the damaging effects of tobacco on his
patients, not widely understood at that time. As the evidence showing the
alarming extent of the problem accrued, he combined with like-minded people
to raise awareness about the magnitude of the harm tobacco was doing,
enlisting the help of MPs of all persuasions as well as ministers - though
the might of the tobacco industry ensured that some of them did not retain
their ministerial positions for long.
The fight was a vigorous one on many fronts but he and his colleagues managed to get the seemingly immobile Royal College of Physicians to take a position and then to produce in 1962 what was hailed as a highly influential keynote report on Smoking and Health.
This report in turn led to the foundation of Action on Smoking and Health: he became its first honorary secretary and he remained intimately involved with it for the rest of his life. ASH campaigned relentlessly for measures, including legislation, to curb the deleterious effects of tobacco, campaigns which culminated most recently in the ban on smoking in public places.
Keith Ball was born in 1915 and graduated from the Middlesex Hospital Medical School in 1938. He held house appointments there before becoming a medical registrar at Stoke Mandeville Hospital. War was looming ominously, but having been rejected for military service on medical grounds, he became senior registrar in Medicine at the Middlesex Hospital where he remained through the Blitz.
In 1944, restless to help to rebuild a shattered Europe, he volunteered to join the recently established United Nations Relief and Rehabilitation Authority. His experiences in working with this organisation to provide medical and other help for people who had been displaced in forced labour camps, concentration camps and those who were refugees, imprinted indelibly on him the social sources of disease.
On returning to Britain, he was appointed in due course a consultant physician to the Central Middlesex Hospital, where he was to remain for the rest of his professional life. Many medical luminaries were working there including Dr (later Sir) Francis Avery Jones and Dr (later Professor Sir) Richard Doll. He was influenced and greatly supported by Dr Horace Joules. It was an exciting time with the inception of National Health Service and all the potential that this brought with it. He built up a department not only with a strong interest in clinical care but also with an interest in research into heart and lung disease.
He attracted many young doctors for training as well as a continuing stream of medical students from the Middlesex Hospital Medical School. He was the sub-dean for the medical school, a responsibility he took seriously, taking a personal interest in everyone who worked for him, particularly junior doctors from abroad who came to Britain for training. Aware of the problems they faced in getting training both in their own countries as well as here in the UK, he made it a responsibility to encourage and support them. Many became lifelong friends.
As a cardiologist, he was aware of the role of smoking in the inexorable rise in coronary heart disease and other vascular disease. At a time when cardiologists were more concerned with other forms of heart disease, he took what was then the unpopular path of proselytising for the need for coronary prevention. Once again he harnessed the Royal College of Physicians and the British Cardiac Society to jointly produce another highly influential report, now recognised as the starting point for coronary prevention in the UK.
Nowadays it is strange to learn that the British Heart Foundation was initially reluctant to become involved in coronary prevention, but Ball eventually persuaded the BHF to join in. He and his friends founded the Coronary Prevention Group to focus the efforts of many diverse organisations on the common task of prevention, thereby raising greatly awareness of the extent of the problem and what could be done about it. Later much of this work was absorbed by the National Heart Forum, of which Ball was an ardent supporter. These organisations extended their influence to fruitful collaborations elsewhere in the EU.
When he reached 60, Ball retired from clinical work, becoming an academic in public health and community medicine. This gave him an opportunity to forge increasing links overseas. He travelled to many countries in Africa, Asia and the Middle East where he was able to encourage doctors working in those countries to engage in the prevention of diseases at that time more prevalent in the affluent nations. He developed a particular affection for Ladakh - an Indian community high in the mountains in a disputed territory adjacent to Pakistan and China. Immense social changes were going on in this isolated, pastoral community as a result of it becoming the epicentre for a military stand-off - and also as it opened up to Western tourism. With his friends working there, Ball identified the importance of starting preventive measures and developed with them the means to do so.
Dust storms in China and Central Asia, arising because a combination of industrialisation and climatic change, and causing pulmonary silicosis and modulating tuberculosis, proved an unexpected problem. Again, Ball drew international attention to the issue as well as seeking local measures to counter it. His efforts, both intellectual and material, were central to the foundation of the Ladakh Institute of Prevention where, once again, he brought together people with seemingly disparate interests united in a common aim.
As a child Ball had a rascally sense of humour which never really left him. In his career he had frequent heated battles, which he often won, but he was always chivalrous about his opponents, however misguided he may have found their views. It gave him great satisfaction see the ban on smoking in public places, to know that the increase in coronary heart disease had been stemmed, and to learn of the efforts in developing nations to curb the growth of diseases of Western, industrialised nations.
Ball is survived by his wife, Francesca, and three daughters; a son predeceased him.
This Obitury is published in THE TIMES, London - February 8th 2008, and written by Brian J Kirby