Ram Kairam MD
524 Pelham Manor Road
Pelham Manor, N.Y. 10803

February 10th, 2006

I have some good news to report. Many of you will recall that prior to the last Alumni meeting (during the TANA convention in Detroit) I made an appeal to raise funds to improve the deplorable conditions at the AMC Men's and Women's hostels. Many of you were enthusiastic about getting involved in such a project rather than the usual alumni projects such as building auditoriums and improving ICUs etc.
As promised I went Visakhapatnam twice during my visit to AP from Dec 2nd to the 23rd.
I first visited Drs Pedaveerraju, Head of GI and his assistant Dr Murali Krishna. They gave me a tour of the newly added facilities created by AMCANA funds- A PG library/reading room in Bhava Nagar Ward and a much Larger A/C Reading room in the AMC Library (through a gift from Dr. Jogi Pattisapu, and his wife Dr. Annapurna (AMC -1977 batch) which was equipped with 10 desktop PCs, all with high speed internet access. Almost all of these stations and the 4 PCs in our earlier funded AMCANA Electronic Access Library were in use. I was given an account of the Library Fund Account, down to the last rupee. So far the contributions from us amounted to Rs. 620,000 and I was very satisfied with the disbursements.
The following day I visited the Men's Hostel and what I saw sickened me. The facility deteriorated beyond your imagination, the rooms and the corridors were sad looking, the bath rooms were in despicable conditions (there were stray dogs IN the bath rooms), the 'new block' had been closed down, the mess hall was empty (no food has been available for sometime now) and the 'gardens' where we used to see some evergreens (Crotons) and Hibiscus were dilapidated. Of the 206 rooms only 102 were occupied! I spoke to a group of ten students who told me that they have to go down the hill to eat and they have not been able to get much of a response from the administration. They had even gone to represent themselves to the Visakhapatnam District Collector! Apparently the mess was closed down because of lack of running capital. The stipends arrive in quarterly disbursements and the children do not have enough cash to pay the monthly bill, in advance. They walked me to the back of the
building, the play ground, which was in pitiful condition. I am sure many of you already heard that the 'Ebden' tournament had already died.
I then went to the Women's hostel and saw similar conditions. I spoke to a couple of young ladies and was told of similar situations in the bath rooms, except for no stray dogs inside. The dogs were only at the entrance. The conditions in the dining room were unsanitary and there were several baskets of clothes, not far from the area where food was being served. Apparently there are no laundry facilities. So, the girls leave the dirty clothes to be picked up and washed. I went out into the awful looking courtyard only to find several clotheslines with drying clothes. There was no place for the students to sit down or to read. I could not easily figure out the nature food being served.
The next day I went to see the Superintendent of KGH, who happens to be M Ganeswara Rao, my own class mate. He himself was under inspection by Dr. I.V.Rao, the Additional Director for Medical Education- AP (you will remember him as Venkatesh, cricket star and the younger brother of Ramjee and Mrithyunjaya Rao). I was able to address the issue of the hostels. He was very receptive but of course the situation did not permit a separate discussion. He asked me to come along on his inspection of the new operating theatres, through the OPD building ending up with visiting the Casualty Department. I was impressed with his attention to detail and the apparent power of his position. He suggested that I come to see him in his office in Hyderabad.
I then went back to see Muarli Krishna and Peda Veerraju to gain more insights into the administrative and funding situations. The Principal was unavailable. Although these two kind and eager gentlemen were enthusiastic for the near future (apparently some large funds were commissioned for new construction in the KGH complex), I did not recognize any plans for improving the conditions under which the under graduate lives in AMC/KGH. Muralikrishna pointed out that in addition to the unfortunate situation in the hostels, there was no comfort station at all for the students, in KGH, especially for the women. Don't get me started on the awful plight of the AMC students' canteen, next to Rajendra Prasad ward. I attempted to take pictures and the owner/franchisee shooed me off.
I returned to Hyderabad and two days later Ramakrishna Sastry Varanasi (1963 batch) arranged for me to see Venkatesh in his office. I was able to discuss at length our mission for improving the conditions for the undergraduate. The following were on the table:
*Creation of a Cloak Room in KGH with lavatory facilities for Men and Women
*Organizing a new canteen and dining facilities adjacent to the Cloak Room
*Renovation of the entrance lobby of the Women's Hostel, adding a reading room (with internet access), Laundromat and improving toilet facilities.
*Reopening of the dining facilities in the Men's Hostel and fixing the bath rooms and toilets
He asked that I write a formal proposal/request and send to him through the office of the AMC principal. I discussed the various mechanisms for depositing and disbursing our donated funds i.e., AMC principal's Office, KGH Trust, Visakhapatnam Health Care Trust and our existing mechanism through the good offices of Dr Peda Veerraju. He suggested that the last option as the most expeditious and the least bureaucratic. I left here very hopeful.
The following day, Sudhakar Varanasi arranged for me to meet the officers of EMRI-Emergency Management and Research Institute
(http://www.emri.in/emri_aboutus.html , http://www.hindu.com/2006/01/28/stories/2006012812120400.htm), Mr. Venkat Changavalli, CEO and Mr. Anil Jampala, COO. As you can see from the attached info found at the links, this organization made enormous progress in a short time. By staying independent and yet fully endorsed by the current state govt this organization made great strides in decreasing response time and substantially reducing deaths. Their motto- 'your safety is a right' was very refreshing. I am sure that you all have been hearing about the escalating fatalities for road accidents in AP cities and the almost primitive state of the Casualty Departments, especially in KGH. I realized the great potential in Visakhapatnam for our cause of aligning with and contributing to a worthy project which may not become mired in bureaucracy and inaction. I promised them that I will bring to the attention of our members the possibility of establishing a new department of
Emergency Medicine, the first ever, in AMC/KGH
I returned to Vizag to attend the annual meeting of the Indian Neurological Society during which I was asked to give a lecture. I chose to speak of 'Autism Treatments- An Evidence Based Medicine approach 'which was well received, I think. Several senior neurology professors were in attendance and I exhorted them to create formal Child Neurology training programs and to pay attention to EBM. My attendance was acknowledged in the newspapers and one of my classmates came to hear me speak after having read the notices! During this meeting, Dr S. Balaparameswara Rao was honored for life time contributions to Neurosurgery and for the founding of the department of Neurosurgery in AP. On behalf of AMCANA I announced a gift of $ 5,000 for the development of a Neurosurgery Departmental Library and $ 1,000 to defray the cost of the meeting itself (this was made possible through a restricted donation). In attendance also was Dr.Jogi Pattisapu. He had brought along speakers form the
US and underwrote some of the cost of this meeting.
I then went to visit Mr. Praveen Prakash IAS, the district collector of Visakhapatnam. It was a difficult meeting to begin and he lectured me about the glory and heritage of India and why the administration is not looking for hand outs. My patience paid off as he listened to the issue of the AMC Men's Hostel conditions and the lack of food services. I also told him that I will be representing to our group to recommend the purchase of an ambulance to add to the EMRI fleet. He was appreciative of my interest in helping to develop Emergency Medicine services in AMC/KGH and countered with an instantaneous order to disburse Rs 2,00,000 to jump start the kitchen. This was exciting.
I met with Dr. Raghurama Rao, professor and head of the department of Dermatology the next morning. He is interested in HIV-AIDS research and we explored the possibility of extending treatment research from my own unit in NY. The immediate obstacle of course is lack of facilities to perform Virology work, DNA-PCR and poor follow up rates. During the meeting with Dr. Murali Krishna (GI Dept) the previous night I understood that there was little research infrastructure such as IRB, Consents, and cohort follow-ups. I told Dr Raghurama Rao that I will disseminate his interests.
Murali Krishna then accompanied me to visit Prof. Narayana Rao (1965 batch), current AMC principal. He acknowledged the fiscal situation regarding AMC Men's hostel mess and the lack of the running capital. I authorized the disbursement of an additional Rs 2,00,000 in addition to the same amount commissioned by the District Collector. He agreed to put in a formal request for the improvement of the Hostels and forward it to I.V.Rao.
I had to leave shortly after, but overall I felt optimistic that AMCANA may after all accomplish a few things from now on. Sonty Sriram is on his way to Viskahapatnam during the later part of this month and I encouraged him to see the EMRI facilities in Hyderabad. Upon my return I spoke to Dr Sridhar Chilimuri (1977 batch), chairman of the Department of Medicine in my hospital. He in fact had some very interesting suggestions: He pointed out that by making the PG training programs in Andhra Pradesh copy the US residency program curricula one would immediately double the work force- The PGs currently work less than 40 hours per week in KGH. He also liked the idea of developing a department of Emergency Medicine in AMC. I then recruited Dr John Coffey, department chair of EM in our hospital to visit India in the coming summer. John had spent time in India while working in the Peace Corps in Nepal. He will go to Hyderabad to consult with EMRI on EMT training, Quality
Assurance, Performance Improvement, Incident Reporting, equipping and staffing the ER, protocol development and help train the staff on JCAHO style reviews and tracer studies. He will spend time in Visakhapatnam also, if we make progress with the birth of an EM department. I briefed Sriram to pursue these topics during his visit there and visit EMRI offices
I am recommending that we make the following disbursement to the AMC Library fund # 11786 ( supervised by Dr Pedaveerraju);

AMC Men's Hostel Kitchen	Rs 2,00,000
Indian Neurology Society Meeting	Rs. 45,000
Neurosurgical Library	Rs. 2,15,000
EMRI/AMC-BLS Ambulance	Rs 13,00,000
Total	Rs. 17,60,000

At 44Rs= $ 1 $ 40,930
That should leave a balance of approximately $ 10,000 and as of now we have received additional pledges totaling $ 20,000. I have received overwhelming interest in the Emergency Medicine project from every one who I spoke to and am very confident that I can raise an additional $ 20,000 from the alumni before the end of my term as president.
Please call me directly (914-718-6126) or write to me (rkairam@gmail.com ) if you can, with additional suggestions, comments, criticism.
Sincerely, I remain
--
Ram Kairam