In 1982, as a second year under-graduate medical student at the Kilpauk Medical College in Madras (1), I made a lifelong commitment to Jesus Christ. I started a Bible Study group in college and we discussed how to live the Christian life and make decisions that were approved in God’s sight. We heard many messages on the topic, “Finding God’s Will” but many of us were not able to get a clear convincing personal answer to this burning question. My query was answered one day when I was reading Jeremiah 29:11-13 (2) – I felt God telling me that I was not able to find His will for my life because I was not seeking with all my heart and that He was waiting to answer as soon as I realised that He had the best possible plans for my life. I also realised that I did not want to hand over my life totally into His hands; I wanted to retain control and this attitude was preventing me from seeing His plans for me. I felt God speaking to me and made a vow that I would obey Him and go where He wanted me to go and do what He wanted me to do with all my time, talents and treasure. It soon became clear to me that I should go where few others wanted to go, so that I could make a difference to people who had no access to good health care. Since the southern four states of India were well provisioned with healthcare, I had to go far away from home.
After my internship, I was not confident to run a remote hospital by myself and joined the Christian Fellowship Hospital (3) at Oddanchatram in 1987 and spent 3 wonderful years there, learning to become a more confident doctor. I also spent the 3 years (every Thursday) exploring villages in the hills of Pachalur (30 kilometers from Oddanchatram), doing medical work with some local missionaries and seeing God answering the simple prayers of poor people powerfully. For the next few years, I was involved in conducting the annual Medical Missionary Meets for medical college students of Tamil Nadu at Pachalur organised by the CF Hospital – I visited medical college fellowships in Tamil Nadu, wrote numerous letters to a large number of students and learnt many things about working with medical students.
I was married to Ann in 1991, during my Postgraduate Residency days in General Surgery at the Madurai Medical College (4) – we met over our common interest in medical missionary work. I had met Dr. Vinod Shah, a paediatric surgeon, then working with the Indian Evangelical Mission in Gujarat, at the Medical Missionary Meet at Pachalur in 1987. In 1989, I spent two months with him at the Chinchpada Christian Hospital in Dhule District of Maharashtra (he had just joined the hospital as its Medical Superintendent) – I spent time thinking about and discussing where God wanted me to go during my time at Chinchpada and shared with Dr. Vinod Shah a list of key points that I felt God was asking me to look for. Some of these key points were a remote rural area where no hospitals/doctors were present, a thickly populated area with great healthcare need, a large campus which could be developed over the years and the scope for working with medical students of the area. In 1992, when I was completing my MS in General Surgery, Dr. Vinod Shah, who had become the Medical Secretary of the Emmanuel Hospital Association (5), asked us to visit a mission hospital in Assam (bordering Mizoram and Tripura) that was closed for the past 10 years, called the Makunda Christian Leprosy and General Hospital (6,7) – he wrote me a letter saying that he was inspired to recommend this place to us as most of my ‘key points’ were fulfilled at this hospital. We visited the campus for a week in October 1992 and found a desolate place with broken buildings, no patients, no income and a violent group of people from the old church and staff of the campus who planned to steal the land and assets of the hospital for themselves. They told us that if we wanted to work peacefully in the hospital, we should join them. If not we would have to fight them and that they would make life difficult for us! We prayed for wisdom and guidance. God opened our eyes to the magnificent campus (at that time, 1000 acres of forested land), to the great need (we heard stories of many mothers who died as they were unable to cross flooded areas during childbirth to travel to faraway hospitals) and to the potential of working with young people in a new area where God was leading us, north-east India. We felt God assuring us that we were under His protection, He would take us by His hands and be the source of all the wisdom, strength and encouragement that we needed as we stepped into this new responsibility that He was giving us.
In 1993, we joined this hospital as its first doctors (after its years of closure) and have continued to serve there since then. Between 1997 and 1999, I did my M.Ch in Paediatric Surgery at the Christian Medical College (8) (CMC) at Vellore and between 1999 to 2000, I worked as a Lecturer in General Surgery in the same college (Ann, who had waited 7 years to do her Postgraduate studies, did her MD in Anaesthesia at CMC during the same 3-year period). During our stay at CMC, we were equipped with new skills and knowledge to expand the services we offered at Makunda – we started the only paediatric surgical centre for the states of Manipur, Mizoram, Tripura, Meghalaya and the southern half of Assam. When we initially joined the hospital, we were told by the leaders of Emmanuel Hospital Association in New Delhi (which took over the Board function of Makunda from the previous Baptist Mid-Missions Trustees India) that we had to make a long-term commitment to Makunda, as they would not be able to find anyone else willing to work there if we quit. We were also told that they were taking the risky decision to accept Makunda as a Member of the Association based on our willingness to stay long-term. When I asked, what they meant by ‘long-term’, we were told, ‘preferably retire from there’! We agreed and made a 30-year commitment to the hospital and started work on a 30-year strategic plan to rebuild the hospital. We thank God that He has enabled us to stay on till the present – we are in Year 25.
There were many battles to fight – we had no experience in administration, law or finance, there was no one on the campus who had the same vision, we did not know the language, there was no running water or electricity, no patients or money, we had to confront the so called ‘trade union’ members and a group of old leprosy patients who had joined them on a daily basis and the nearest phone was 50 kilometers away on a bad road! Makunda was considered a God-forsaken place – in those early days, if someone was posted to Makunda, the first question would be, “what wrong have I done?”!
In the past 24 years, God has blessed the work at Makunda. In 2016-17 (which was not a good year – due to three months of floods), the hospital saw 84,557 outpatients, admitted 11,017 inpatients, delivered 4886 mothers and performed 2194 major operations. A survey of northeast India showed that many remote rural areas (such as Arunachal Pradesh which is presently the only state in India without a Christian mission hospital) had low population density and could not support a hospital like Makunda. It was felt that nurse-missionaries could run healthcare services in such areas and a nursing school was started in 2006 – 25 students join every year and over 200 have passed out so far. A survey of local villages showed that poor tribal children had no scope of acquiring a good education and career, improving the social and economic status of their villages unless they had access to affordable English medium education as they were not comfortable and quickly dropped out of the locally available Bengali language schools (many tribal languages in northeast India use the English script – a testimony to the linguistic work done by Christian missionaries in the past). An English medium school, the Makunda Christian High School, was therefore started in 2004 and today there are nearly 1000 students studying up to class XII (Arts and Science) with 220 children in two hostels. It was also decided to start a new hospital in another state of northeast India to expand Makunda’s horizons, to serve as a training/experience centre for young staff interested in missions and learn how to start and run a new hospital – with a view of starting many more! A branch hospital was therefore started in the neighbouring state of Tripura, at Kamalacherra in the Dhalai District, in 2005 and it is providing service in one of the most needy parts of the state – it is the only Christian hospital in the state and at that time heavily infested with militants. An agriculture and fishery department looks after the large campus and in 2015, the “Makunda Nature Club” was started to document biodiversity, conserve wildlife and conduct research. A community college was started the same year. The hospital is focused on the poor and there are no facilities for the rich such as private rooms or private consultations. Yet, it has adequate income to meet the running expenses, able to offer charity liberally to the poor and still have enough for critical capital expenditure – a self-sustainable model focused on the poor with only 1-2% of income derived from external sources. Large numbers of poor people have found healing on the campus. During the day, more than 1000 staff and students work and learn on the campus. Spiritual work for patients, students, staff and for others outside the campus (villagers and college students) is carried out throughout the year. The medical work has therefore enabled the entire campus to thrive and this has been the story of successful Medical Missions all over the world. The hospital has partnered with the Government too – it has one of the best-run Private Public Partnerships with National Health Mission, Assam for maternal and child health care. It also provides a 6 month residency to doctors from Netherlands doing the MD (Global Health and Tropical Medicine) course from the Royal Dutch Tropical Institute, Amsterdam – enabling highly committed medical doctors from the Netherlands to acquire the skills and experience required to serve in even more needy parts of the world such as South Sudan and Ethiopia. I must acknowledge the selfless and joyful work put in by the staff in all departments who have gladly ‘walked the second mile’ – they have been the greatest strength of the hospital and all these developments would not have been possible without them. It has been a privilege to work with so many highly committed staff whom God has brought from many places.
Ann and me have faced many difficult situations (violence, health issues – I had a heart attack in 2008, court cases against us, to name a few) but count it all joy to be a part of God’s great work in this corner of the world. (9,10) We look forward to what God has in store for us in the years to come and our ambition is that we will continue to trust and obey Him and when our days in this world are over, be welcomed back to heaven as good and faithful servants who accomplished the work given to them.
Dr. Vijay Anand Ismavel
Makunda Christian Leprosy and General Hospital.
This post is updated and adapted from the chapter, “A privileged call to Medical Missions” published in the book, “Wings of Dawn” – used here with permission from the author Dr. Vijay Anand Ismavel. The book, which also contains chapters by several other authors is available in hard copy and Kindle versions on Amazon.