A water seeking Butterfly!

I often notice butterflies hovering around flowers in search of nectar in our garden. 

Yesterday, I noticed a butterfly moving between lime saplings in our garden. I wondered what it might be doing. 

Through the lens I could see its attempt to search for water droplets on the leaves. I noticed the water droplets drying up, with the butterfly receiving the water. 

This was was after a rain, when water drops were still on the leaves!

In the silence of nature, so much happens unnoticed, which tell us a lot about the cycle of life in nature!

The receiving and giving cycle is what sustains life around us. 

I felt fascinated by what the community Medicine department could do during a Measles epidemic at Nagpur,  when I was involved as an intern in the department in 1969. With several deaths of children in the community, families in three villages where we had weekly clinics were devastated. It was the time, when Measles vaccination was still not available for preventive immunisation. It was not included in the list of primary immunisation schedule of children in India. 

What was possible  was to isolate children with early symptoms of Measles in local schools and care for them till ten days after Measles. With this effort, the chain of spread was restricted and the  in two months, the incidence rate dropped from an epidemic level. As children were treated and observed in the school camps, many deaths could be prevented. For the next three months all children who had Measles in those three villages were weighed and examined weekly to observe their recovery path. Those who developed chest infections or were about to slip into Malnutrition could be taken care of. 

The professor of Community Medicine, Dr Natu who was earlier at B.J.Medical college, was trained by two professors at that department who were earlier clinicians, one a surgeon and another a physician. Both these professors moved into community medicine to create a preventive and early intervention profile for disease control and disease survillence of the population. 

I was absorbed by this philosophy of approach that I requested Prof Natu to help  me to study community Medicine at B.J.Medical College, Pune. After three months of joining, both of those professors who were eminent leaders of the discipline, left to take responsibilities in other leading institutions. The training programme became weak and least motivational. I continued to complete my diploma in public health but discontinued to go on to do the MD in that discipline. I was able to work at NM Wadia hospital along with Anna till she completed her sponsorship obligation, which was a fulfilling experience. 

It was a time I felt confused and disturbed about my choice of specialty for post graduation. I had a guilt lingering in my mind as I had qualified to study General Medicine or Paediatrics at Nagpur Medical College. I chose community Medicine against it.  

All those who studied in the government Medical Colleges in Maharashtra had an obligation to work in a government sector if called for two years. Accordingly I was called to serve as a District Medical Officer in Bhandara. As there was an option to work in a Medical college to teach, I opted to work at the Mahatma Gandhi Institute of Medical Science at Seagram in the department of community Medicine. The head of the department and the director of the   institution was Dr Sushila Nayyar, a former minister of health in the central government. She was also the personal physician of Mahatma Gandhi. 

During the time at the MGIMS I worked in Community Medicine. The hospital practice at that time in the college was that the physicians in the Community Medicine ran a general Out Patient service in the hospital and referred patients to the specialties as and when needed. That was a fulfilling experience. 

During another epidemic of Measles in the villages, I was actively involved in the delivery of services. I got associated with my class mate Dr Ullas Jajoo, to develop an insurance scheme for patients from the villages, by asking them to pay the annual premium with grains they produced from their field. The experiment worked and many could be covered through this scheme. 

 

Dr Nayyar who heard about my interest in community support initiatives called me one day and suggested that I worked in Paediatrics for a while to see if I could develop interest in Community Paediatrics. During the next three months I felt enthused by the experience of working with children that I applied for post graduate training in Paediatrics at Nagpur Medical College, for which I was selected in 1978.

When I met Dr Nayyar to thank her for leading me to take an interest in community Paediatrics, she suggested that I returned to MGIMS after three years to start a community Paediatric service in the communities around Seagram. 

By the time I finished my course, Dr Nayyar had retired on account of ageing. I continued working at Nagpur Medical College till in late 1980, Anna and I moved to the Christian Medical College, Vellore to work in the department of Child Health under Dr Malathi Jadhav, one of the two Paediatricians from the first batch of the post graduate trainees in India, at the Grant Medical College, Bombay. 

As I recall this span of 1975 to 1980, memories flood my mind with all the several significant things in my life. Anna and I got married in 1976; disappointment with training in community medicine at Pune; opportunity to meet and work with Dr Nayayr and  her nudging to lean towards Community Paediatrics: going to CMC Vellore in 1980 and suffering the loss of our daughter Susan at three months of her age in the same year, which led to turn our attention to be involved with Neuro-developmentally challenged children and the decision to leave CMC to start a Child Development Centre at Chennai in 1983! 

This period of five years was a season of receiving and giving which had  a significant impact in the later years of our life. 

Anna and I feel that we have arrived where we are, because we were given plenty and in abundance by people who cared. This experience of receiving enabled us to be in a giving role during the recent forty years through our association with children with Neuro-developmental needs. 

It was sighting the butterfly receiving its water drops from the leaves of a plant, which led me to my memory lane, to recall this short span of five years in our lives. 

Life is a story of receiving and going!

M.Ç.Mathew(text and photo)