An Overview and Update
The Ear Nose Throat Department at Karigiri Hospital was begun in 1998 with the E N T specialist, Dr. Daniel K Mani joining the staff; prior to that, periodic visits of E N T specialists from C M C Vellore .E N T Department helped provide Outpatient treatment of common E N T ailments of Leprosy patients and take on collaborative studies on leprosy affectations of the nose.
Over this past decade the E N T department has steadily posted growth in the numbers of patients seen at OPD and in the IP admission and surgeries done. Overall, the ENT Department has complemented and has been encouragingly supported by, other clinical, non clinical and peculiarly leprosy service departments as well, of Karigiri.
Out Patient Clinic:
From the beginning, regular daily O P Clinic was conducted at OPD; it is now held on all weekdays except Wednesdays at the main Karigiri Hospital; on Wednesdays ENT OP clinic is conducted at Gudiyatham. Non leprosy patients hailing from in and around the rural and semi urban population of Karigiri, Katpadi and Vellore form the bulk of OP clientele; however in keeping with the ethos and focus of the institution, service to leprosy patients (who come from nearby and faraway places see (k)ing Karigiri as their one home and hope) is given priority ,in an atmosphere of total acceptance and integration with others. This has considerably helped increase acceptance and reduce stigma of leprosy.
The number of OP registrations has shown steady increase presently reaching ~ 120 patients in a week.
In Patient Service:
Being equipped to treat ENT conditions at primary and secondary level of care, the ENT department started to do Otolaryngological surgeries from May 1999 when the services of General Anaesthesia were inaugurated at Karigiri. The number of IP admissions and surgeries has increased year by year although sometimes fluctuating. On an average of 175 patients are admitted to undergo operations like Tonsillectomy, Adenoidectomy, and Nasal Septal surgeries - like Septoplasty, Polypectomy - and Ear Microsurgeries - Myringoplasty. Those in need of tertiary care or specialized surgery are referred to CMC Vellore with whom there is a good rapport.
Rotary Matching Grant - Year 2000:
The receipt of a Rotary International Matching Grant in the year 2000-2001 helped purchase, among other equipment for the hospital, the following ENT equipments - an Operating Microscope, Impedance and Pure Tone Audiometry and Diagnostic Rigid Endoscopy scopes- that has enhanced and enlarged the scope and quality of service provided to the patients.
Collaboration within and outside Hospital:
In collaboration with Community Department regular outreach activities through the years ENT camps at Villages and Schools in the vicinity are conducted, which have helped popularize the availability (at affordable cost) of ENT Medicare at Karigiri.
Since 1999, Volunteers in MedicaI Mission (VIMM– USA) have visited Karigiri and conducted free rural health camps every alternate year in an attempt to share their Christian love in action; these have been enormously welcomed by the local rural population and enhanced the popularity and made aware of the variety of Medical Services available at Karigiri.
Other Voluntary service organizations like Compassion India (for their children inmates) and Rotary Clubs too, extend help to conduct free ENT camps for general public and for school students
Special WHO Project for provision of free Hearing Aids (for ~ 400 needy eligible hearing impaired people) was a recent successfully concluded activity of our Community Health Department in which screening and assessment to qualify for susceptible suspected population at risk was done through ENT department. Those who needed surgery for correctable conditions could undergo treatment at Karigiri and at CMC Vellore.
Training and Research:
In an atmosphere of high importance given to teaching and training that has always been the hall mark of Karigiri, a comprehensive understanding of leprosy includes, the part ENT plays in leprosy; the ENT specialist facilitates learning about ‘the role of ENT in Leprosy’ for long term and short term course students through a short module.
He is also involved in teaching basic ENT paramedical care and advice to the nursing students relevant to their curriculum as per CMAI syllabus.
Working in collaboration with Community Health Department especially for the INDO US Nasal Study and the WHO Hearing Aid Project (which was done also in collaboration with CMC Vellore), ENT has helped with research activities of the hospital. Asian Leprosy Congress at Agra 2000 saw a poster presentation on the rare EWAN’s SYNDROME in a leprosy patient.
Present and Future:
The ENT departmental activities have become a part of the comprehensive and complete package of care Leprosy patients now receive at Karigiri; it caters too, to other non leprosy patients who increasingly form the bulk of clientele and generate income for the hospital to a very large degree.
There is much scope for further development of ENT in Karigiri as newer modalities of treatment such as through FESS for nasal diseases. These facilities, which are now the norm in urban and even rural ENT practice, need to be acquired so as to strengthen and expand the quality of ENT care.
Collaboration with nearby tertiary care centre, CMC Vellore, can and will be taken up for research avenues, even as there already exists good rapport with CMC for referring difficult or terminal care patients.