Christian Hospital Taxila, Pakistan

ANNUAL REPORT OF

CHRISTIAN HOSPITAL AT, TAXILA

(From January 1st 1972 to December 31st 1972)

Year 1972 had been a very turbulent one in the history of this hospital. There were two thefts in the hospital's pharmacy with considerable loss of costly medicines and for the first time in fifty years the medical superintendent was taken to court by one of its ex-members of staff. However inspite of these shortcomings the hospital continues to serve the people just as zealously as it had done in the past. We have continued to enjoy the confidence of the people and this had been shown very clearly by an increase of over ten thousand patients over last year. I just hope that this increase will rather decrease since it will become humanly impossible to serve all the patients with present facilities of staff and buildings. The delicate balance of the number of staff to cater to the number of patients coupled with very hard work, will be broken by any increase in the number of patients and then any increase in staff or buildings will only increase the amount that patient has to pay for the services in this hospital and thus the basic aim to serve the poor with minimum expense will be completely defeated. It is my hope that we in Taxila do not get involved in this vicious circle which will increase the cost of medical care. I am grateful to my doctor colleagues for their hard work which is one big factor in handling the volume of work that is done in Taxila. Especially to Dr. P. Lall and Dr. N.E. Christy for their hard work done for eye patients. Over forty five thousand patients in outpatients and little over eight thousand Cataract operations were done by them. I am also grateful to Dr. E. Umer Khitab and Dr. Mussarat for sharing general work with me which comprises about 46 % of the whole work done in this hospital.

I am also grateful to Dr. E. Umer Khitab and Dr. Mussarat for sharing general work with me which comprises about 46 % of the whole work done in this hospital. I am also grateful to my other staff of nurses, ward aids, dispensers, clerks and others whose hard work make it possible for us to be able to handle 82 thousand patients last year. I will be failing in duty if I do not make a special mention of the real hard and long working hours that our operation room staff put in every year. Last year something like 514 extra working hours were put in by them to get all the surgical work done. All the staff need encouragement and blessings of all people interested in the medical work done in Taxila.
Twenty sixth August 1972 marked the end of first fifty years of service of this hospital. A public meeting was arranged for Saturday the 26th of August. Over 1200 guests came for the function. Mr. Sidney Sobers the American Charge d' Affaires was amongst the distinguished guests. On Sunday the 27th Rev. R.E. Noble arranged a special service in the hospital. About 800 people attended the Thanksgiving Service. British Ambassador was present amongst our distinguished guests.

Future needs of the hospital are very much in our thoughts, and with this in mind Dr. Christy and myself decided to go ahead with planning of a new Out-Patients building capable of handling volume of work done each day. Our old building was built to handle about 10,000 patients a year and as such is totally inadequate to handle the present volume of work. Almost 200 % increase in covered space has been accomplished during the past few years but there is
just no way we can ensure smooth flow of patients from the time they come to the hospital. With lot of statistical data of patient load Zor engineers have been working with us to design such a building, capable of holding over 80 thousand patients. Believe me it is not easy task but we have accomplised a design which we believe will serve our purpose. Blue prints are almost complete and now only awaits the interests of some one to finance the project. We estimate it to cost about rupees 10,00,000 (or $ 90,000 U.S.) We sincerely hope that soon we will be able to find someone to finance this project.

We have also plans to build twenty private rooms to replace the old ones built forty years ago. This project will cost about $ 15,OOOfor the whole thing. There is need to build some more staff quarters. Foundation are already laid out and now each quarter will cost about $ 1,000, we need twelve of them.
I will be failing in my duty if I do not thank many friends of Taxila who have contributed in many way towards the efficient running of this institution. I must also make special mention of Interchurch Medical Assistance, Inc., in NeW York and Medical Assistance Program, Inc., in Illinois who have given their services very efficiently and very liberally.
In the 'New Society' or 'New Order' proposed by our new government Christian services in medical field will have to make far reaching adjustments so as to mold itself in such a way so that it can identify itself with the new ideals of the present government and also be able to continue to be identified itself as Christian. It is a great challenge to see that our Christian Service is not lost in the ideals of socialisim. This situation calls for great moral, physical and
mental adjustment with the changing circumstances. My only hope is that God will give us strength so that we will be able to bend, mold with the circumstances and yet not break under the stress and strain of the circumstances. Prayers of every Christian is needed to sustain us through this difficult time.
Lastly, about 150 people will receive this report and they also have been receiving material from Taxila in the past. I would request that please write to me soon so that we may bring our list uptodate and thus we will be able to keep you in touch with events and progress in Taxila.

Dr Ernest Lall.
Medical Superintendent.

DETAIL OF SURGICAL WORK DONE IN TAXILA

IN YEAR 1972 (JANUARY TO DECEMBER)

Ophthalmic SurgeryGeneral Surgical Procedure
Intracapsular Extraction 8,075Secondary Suturing 3
Capsultomy 31 Trauma()gun shot 1
Linear Extraction 115 Small Intestinal Obstruction 21
Capsulectomy 1 Sigmoid Volvulus 2
Spontaneous Delivery 3 Colostomy 1
Combined With Cyclodialysis 23 Gastrojejunostomy 1
Posterior Puch Sclerotoy 3 Appendectomy 6
Sub Total 8,256 Appendecular abscess 1
Iris inclusions 303 Cholecystectomy 3
Peri[heral iridectomy11 Cholecystotomy 1
Cyclodialysis 10 Cholecystojejunostomy 1
Schie Operation 22 Repair Injuinal Hernia (Direct and Indrect) 81
Sub Total346 Repair Bubonocele2
Optical Iridectomy23 Epigastric Hernia1
Iridotomy21 Repair vnetral Hernia4
Evscerations26 Excision Hydrocele8
Enucleations23 Excision Thyroid Nodule 2
Excentrations3 Excision Thyroid Cyst 3
Exploration Orbit4 Thyroidectomy2
Muscel Operations12 Delivery (Normal)68
Carcenoma Cornea6 Delivery (Forceps) 21
Cornea and Conjectival Cyst4 Delivery (Breech) 9
Corneal Laceration repair9 Caesaian section11
Conjectival Flaps10 Retained Placenta 2
Air Injections24 D & C 79
Foreign Body in A.C2 D & C and Insufflation9
Foreign Body in Eye24 Repair V.V. Fistula 2
Iris Prolapse Repair216 Hystrectomy (Total) 6
Needing39 Hystrectomy (sub-total) 17
Secondary Suturing26 Myomectomy 2
Plastic Repair of Trichiasis315 Ovarian Cyst 23
Electrolysis28 Repair Cystocele 10
Ptregium837 Repair rectocele 5
Summer Skill Operations264 Cervical Polypectomy 2
Tarsorraphy4 Tonsillectomy 53
Chalazian35 Polypectomy21
E.D.T.A1 Plypectomy ear 2
Iodine Cautery14 Excision Hypertrophic Turbinate2
Sac Probings287 D & S7
Suture Removal4 Haemorrhoidectomy55
Mucous Membrane Graft2 Excision Prolapse Rectum1
Alcohol Injection50 Fistulectomy27
Lid Scrapping2 Excision Rectal Polyp2
Total10,817 Amputations (Foot, leg and Hand)59
General Surgical ProceduresOpen Reduction 23
Laporotomy expliratory, carcenoma and etc.20 Bone plating5
T.B. Abdomen11 Close Rduction50
Exploration Knee1 Excision Knee meniscii4
Excision coccyx1 Excision tongue tie15
Scequestrectomy2 Excision lipomas20
Club foot correction7 Excision ganglion wrist3
Tenotomy for club foot4 Biopsy neck glands15
Hemimandebulectomy2 Tooth extractions250
Mastoidectomy6 Paracentesis chest9
Repair cut tendon2 Paracentesis abdomen20
P.O.P.300 Aspiration abscess32
Wedging plaster4 Rectal bougies4
Lower jaw wiring2 Total Major operations959
Bladder stone30 Total minor operations 2,057
Exploration bladder1 Total 3,016
Kidney exploration1 X-rays taken 2,072
Nephrostomy1 Refractions 2,034
Nephrolithotomy1 Anesthesia
Nephrectomy3 Spinal 132
Prostetectomy54 Open drop ether 648
Repair hypospadias2 Pentathal 155
Orchidectomy2 N20 and Oxygen 42
Vasectomy6 Control intubation 45
Circumcision56 Total 1,200
Orchiplexy3 Laboratory work:
External urethrotomy1 Biochesistry 194
Cystoscopy10 Blood Kahn 53
Excision uretheral stone3 Urine- examination 8,570
Retrograde1 Other lab tests 10,973
Bougies260 Blood transfusions678
Excision meningocele9 Blood grouping 1,356
Sympathectomy (lumbar)7 Total 21,824
Spinal tapping15 Out patients record:
Skin grafting55 New eye patients 35,586
Tube graft2 Old eye patients 9,712
Repair cleft lip9 Total45,298
Rhinoplasty (Indian method)4 New General patients 22,495
Plastic bat ears1 Old General patients 15,137
Contracture lysis6 Total 37,632
Z & V Yplasty5 Grand total 82,920
Excision keloids3 Inpatients 12,330
Excision small tumours127 Percentage of bed occupancy 2.58
Incision quincy3 Excision Ca lover lid2
Excision in growing toe nails24 Debridoment10
Varicose vein ligation4 Dr. Miss Umer Khitab
Suturing lacerations228 Dr. Miss Mussarat Alam
Excision glands22 Dr. Ernest Lall
Currettage sinus bone28 Dr. Ernest Lall
Currettage sinus55 Dr. Mrs. Pramila Lall
Manipulations shoulders etc59 Dr. N.E. Christy
Abscess I & D332 GUEST DOCTORS:
H.C. Injections30 Dr. Wayne H. Parris
Removal foreign bodies30 Dr. Mark Lazarous
Sigmoidoscopy4
Excision small cysts54
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