A presentation on the fundamental concepts of Mass Gathering Medicine in the context of the Kumbh Mela was recently given to students of a premier Science Education Institution in Pune (no guesses).
The students were very receptive in their attention and the questions were indeed thought provoking. The future of Science and the Country seems to be in safe hands with these young people , given their interest and curiosity.
If you would like to have a look at the detailed presentation, given elsewhere as a Webinar for the World Association of Disaster Medicine, with a target audience of Public Health and Disaster Medicine Professionals, just click on….. (its about an hour long)
After this tremendous opportunity to lead a Study team from the Armed Forces Medical College Pune, India, to evaluate the preparedness status of the Kumbh Mela , first at Allahabad, India in 2013 and then at Nashik, India in 2015, a comprehensive, layered module on Mass Gathering Medicine, with an extensive interactive component including table top exercises, was developed and rolled out for Undergraduate and Post graduate students of the AFMC, as also for MPH students of the University.
I am indeed grateful to my then HOD, Dr Mahen and the overall Head of the Medical Services, Dr Joshi, to have afforded me the opportunity to witness and study at close quarters the spectacular spectacle of thronging humanity.
As an aside, I did not bathe in the waters during the Kumbh Mela, maybe in the mistaken belief that I had no sins to wash away, or maybe I was sceptical in my faith about the quality of the water.
The above link will (hopefully) lead you to an article written by Col Tommy Verghese, Retd, giving the background story of the “Monsoor” football tournament conducted every year at AFMC (you guessed right, in the monsoons)! This article was published in an earlier iteration of Dhanvantari (that annual College magazine which no student ever reads through, other than to glance at the cartoons !).
The new Monsoor Cup being presented to the College administration
It is with undeniable pride, with a lump in my throat, with a tear lurking at the corner of my eye, with overwhelming emotion , I state , in all due humility, it is my privilege to aver that I am from the same batch of the Armed Forces Medical College (the Z Batch) as Capt Devashish Sharma, KC.
On 10 Dec 1994 Capt Devashish Sharma was serving as the Regimental Medical Officer, 26th Battalion the Punjab Regiment of the Indian Army.
During a cordon & search operation in Dangarpur village (J&K), he shot a fleeing militant and himself sustained bullet injuries. Despite being wounded; he continued to render effective medical care to the other wounded soldiers and evacuated them to the hospital, prioritizing them ahead of himself in the time honoured tradition of Officers of the Indian Armed Forces and succumbed to his injuries in the process, making the supreme sacrifice for the Nation..
In recognition of his exceptional bravery in face of the enemy and unsurpassable devotion to duty, he was awarded the KIRTI CHAKRA (the second highest peacetime gallantry award of India), posthumously on 26 Jan 1995.
He remains the first AMC officer and the first alumnus of the Armed Forces Medical College, Pune, India to receive this award.
In his memory, and combining the love of students of AFMC for Football in the midst of the monsoons, and the pre-MS Word autocorrect era of the late 1980s, when the Monsoor Cup came into existence, Z Batch has been conducting the informal ‘nothing official about it’, “Z Batch Devashish Sharma Memorial Mansoor Cup” every year in July – August since 2013. The more rain the better…. who can resist the slush and the slipping and sliding….
The inter Batch Futsal Tournament with a sparkling rolling trophy at stake and a cash prize for the winning team is conducted every year within the hallowed precincts of the Boys Hostel . Every year , one Batch has etched their name on the trophy! Who will it be this time in 2018, in the immediate aftermath of the World Cup?
This here is a photo from one of the past editions of the tournament.
This post was published earlier in the magazine released annually by the Organizers of the AFMC Illuminati Society during their 2017 jamboree. Please visit https://www.illuminatiafmc2018.com/ to check out what a great job our young students are doing nowadays.
The article in its original avatar , was intended to serve as a motivator for young medical students attending Illuminati at the Armed Forces Medical College , Pune, India
(Col MP Cariappa, an alumnus of AFMC, has been a doctor and a Public Health Specialist, for the past 26 years and has seen active duty with Airborne and Special Forces)
So without much more ado, lets begin….
The simplest approach for the young medical student or for that matter anyone, to learn about something unknown or unfamiliar today, may be just to check it out on Wikipedia, or you could read this brief summary, not long enough to slip beyond the edges of your attention span though!
The term military medicine has a number of potential connotations. In the present context, it means the science and art of the practice of medicine within the milieu of an Armed Forces, by provision of comprehensive health care, which is preventive, promotive and curative, for all ranks of the Armed Forces and their dependents, across diverse deployment paradigms. Simply put, Military Medicine is medicine practiced in the military setting, dealing with the peculiarities of military service, and the ills and ailments that can only confront a military.
While presently there may be no academic degree for Military Medicine as yet, the raison d etre for doctors in the military, irrespective of their level of medical qualifications, to be wearing a uniform and to receive basic combat training, is that that a military is the last answer that a country has to external aggression and internal strife. In such situations, doctors have to stand by the side of the fighting forces and support them right at the battlefront. With today’s scourge of terrorism rising its Hydra head, the spectre of combat is omnipresent, and the enemy is all around. Doctors cannot be found wanting in training or response in case of an assault by an enemy that knows no rules.
The planning and practice of the management of mass battlefield casualties and the logistical and administrative considerations of establishing and operating combat support hospitals involves military medical hierarchies, peopled by medical professionals with administrative and military exposure. The delivery of healthcare for military personnel and their dependents in non-deployed (peacetime) settings usually consists of a medical system paralleling all the medical specialties and sub-specialties that exist in the civilian sector.
Military medical personnel apart from their routine duties in providing comprehensive health care to deployed military personnel, often engage in humanitarian work and are “protected persons” under international humanitarian law in accordance with the Geneva Conventions, which established legally binding rules guaranteeing neutrality and protection for wounded soldiers, medical personnel in armed conflict. Under international humanitarian law, military medical personnel may not be attacked and not be taken as prisoners of war; hospitals and other medical facilities and ambulances, may not be attacked either. It is common knowledge that the Red cross is the protective sign recognised under international humanitarian law, and is used by military medical personnel and facilities for this purpose. Attacking military medical personnel, patients in their care, or medical facilities or ambulances, is a war crime. Likewise, misusing these protective signs to mask military operations is a war crime of perfidy. Military medical personnel may be armed, for the purpose of self defence or the defence of patients.
However, with the advent of the modern day ‘couldn’t care less’ terrorist, there are no rules that are applicable in the paradigm of asymmetric warfare. Doctors beware! Hospitals are soft targets, and hence in the military, all personnel are always on the alert and there are contingency plans and quick response teams available on all bases. Ask yourself, when cornered by a terrorist, would a doctor plead for his life on grounds of being merely a doctor, akin to a vegetarian asking a carnivorous predator, to spare his life, being a vegetarian!
Young doctors in the Indian Army routinely provide frontline combat medical support to soldiers in the thick of battle , triaging casualties, providing expert first aid, combat Basic Life Support and Pre hospital trauma care, while arranging for casualty evacuation by road or by air. This medical support is provided in all terrains, in all climatic conditions, from Siachen Glacier to Andaman Nicobar, from the Thar Desert to the jungles of the North East. Young doctors are there with our soldiers, up front where the action is, armed with a gun (for self defence) and brimming with confidence, with a back pack of essential medical supplies, and a prayer in their hearts. These young doctors slither from helicopters, they jump from aeroplanes, they trek through the mountains, they crawl through the jungles.
In support of the brave soldiers of the Indian Army, it is our young doctors from AFMC and other medical colleges of the country who are there with them, as their first line of medical support and succour. It is these devoted medical professionals, whose selfless dedication it is , that saves lives! Through rain or sunshine, through storms or gunfights, through good times and in tough times……
Just have a quick look- see at one of our dashing young doctors…. Maj Ritesh Goel, a paratrooper doctor, doing what he does, with elan….
Do you have it in you, to practice Military Medicine?
For those young doctors (well, you have to be less than 45 years of age (or whatever is the latest rule )), please visit http://www.amcsscentry.gov.in/ (active only when there are vacancies available)
Timeless Reflections is the title of a Coffee Table Book that was released in 2012 and was the brainchild of Lt Gen Ramdas, the then DGMS (Army).
I had the privilege of being associated with the compilation and development of this project till its final form….. Timeless Reflections. Many a story can be told about the ups and downs in how this book journeyed ….
However, it is to the credit of the leadership skills of Gen Ramdas (an alumnus of AFMC) that this book did eventually get published , and well, here it is for you to have a look at.
There must be some sound business sense at play if Jeff Bezos and Warren Buffet decide on appointing Dr Atul Gawande to promote health and wellness……
When will the common man (whose voice is eventually heard, when loud enough) , and then the corporate sector (lets leave the Govt out of this one), realise that health is in our hands, and that prevention indeed is often better than cure.
The very essence of Public Health practice is to strike at the grassroots and to promote wellness….. curative medicine is always there as a fail safe….
Awareness is key to success in any walk of life! More so when it pertains to such an important aspect of life i.e health and wellness!
The hospital system is essentially a sickness care system…. the need of the modern times, caught up by the double whammy of Lifestyle Diseases and Communicable Diseases (in the developing world), , the need of the times is to transform into a holistic wellness and health promotion centre for the community being served.
There is a strong case in point for experienced Public Health Specialists with medical backgrounds to be integrated into the hospital based health care system to work with staff and patients alike, for health and wellness promotion.