Dr. Jay Koneru, and nurse practitioner Charlotte “Cha” Roberts recently traveled to Tirupati, India, to help patients and provide training to local doctors and nurses. Here, they provide an account of the trip.
After traveling for the better part of a day and a half, our team from VCU Health arrived in the bustling town of Tirupati, Andhra Pradesh, India—home to the Tirumala Venkateswara Temple and one of the holiest Hindu sites in all of India. The Eastern Ghats and the Tirupati Seshadri Hills are an Eparchaean Unconformity, representing a geologically remarkable epoch of serenity in the tectonic movements and orogeny of the Asian subcontinent. When our small plane landed in these peaceful hills, we had little inkling of what was in store for us over the next week.
Dr. Ravi Kumar, vice chancellor of the Sri Venkateswara Institute of Medical Sciences (SVIMS), and Dr. Durgaprasad Rajasekharand, chair of SVIMS’s division of cardiology, had brought us here as part of a celebration of the university’s 25th anniversary. We were to lead an intensive workshop for cardiac EP and cardiac ICU care geared toward advanced heart failure and resuscitation therapies. Collaboration with the institute is enthusiastically supported at Pauley. The planning was initiated six months in advance.
The day after our arrival, we attended the Silver Jubilee. The Vice President of India inaugurated three state-of-the-art facilities specifically built for the advancement of women in medicine. We were humbled when he conferred to us visiting professorships in nursing and medicine.
The week was filled with EP procedures and rounds with the medical and nursing teams in the hospital. ICU rounds, educational lectures and numerous ablations including Ventricular Tachycardia ablations, and pacer and defibrillator implantation with rudimentary tools, constituted our daily routine. Every working day seemed short for us, despite 14-hour workdays.
We were impressed with the quality of care that was being delivered. While the resources, especially technological resources, are significantly less than those in the U.S., the patient care outcomes are excellent. The nurses and physicians were eager to learn that the care they were delivering was consistent with the standards in the U.S.
As coronary intensive care unit practitioners, we were particularly interested in the care of patients with acute myocardial infarctions. SVIMS performs over 300 primary percutaneous coronary interventions a year. While we were in the cath lab, we had the opportunity to see one of these cases. With far different tools, the average door-to-balloon time is 56 minutes, a metric that would make any hospital in the U.S. proud.
Our visit also gave us a glimpse of the expanding role of Indian women in healthcare. From the Women’s School of Medicine and its wall dedicated to all the female Nobel prize winners to the joy and serenity of the Child Care Center, which is free for all the staff, there is a new and critical focus on empowering women. We also witnessed the ever-present spirituality, humility and charity of this institution. Each day in the main hospital courtyard, there is a “soup line” that serves a hot meal to all of those in need.
Despite Tirupati being a serene zone for seismic activity, this mission has generated tectonic thoughts and emotions for all of us who participated. The VCU-SVIMS collaboration is still in its infancy, but more trips are being planned. The next focus will be the advancement of advanced heart failure services and the development of a cardiac transplant program. We are hopeful that in the future some of the SVIMS staff will also be able to spend time with us at VCU Health.
Clockwise from left: In August, Dr. Jay Koneru and Nurse Practitioner Charlotte Roberts were honored at the Silver Jubilee celebration of the Sri Venkateswara Institute of Medical Sciences in Tirupati, India. Koneru and Roberts consult with the local medical staff. TheY often worked 14-hour days attending to EP and ICU patients AT the weeklong clinic. Roberts enjoyed participating in rounds and training with the SVIMS nurses.