I traveled to join a hospital in Rajakkad, Kerala, India, but a communication gap occurred, and someone else had been selected by the time I arrived. This hospital, located in the hill district of Idukki in the southern Indian state of Kerala, was run by missionaries. The sisters at Rajakkad were apologetic and told me about an opening at a nearby hospital, St. Xavier’s in Elakkal. And so, I serendipitously became a resident doctor there.
St Xavier’s hospital is located on a small promontory overlooking the main road. The view of the western ghats was spectacular. The green hills were covered in mist during most of the day and as night fall, the clouds slowly came down and settled in the valley. The climb to the hospital from the road was short but steep. I met the head sister and the resident doctor, Rodney. This hospital was run by the Medical Sisters of St Joseph, an oriental congregation ascribed to the Syro-Malabar church. The hospital had a nunnery attached.
Founded in the 1960s, this hospital was the only source of medical care for a large population living in the hills for over three decades. The catchment area was huge, the location was comparatively remote, and we had to go to the settlement of Kunjithanny to buy supplies.
We had morning and evening clinics, with patients admitted to the wards throughout the day. We treated patients suffering from typhoid, tuberculosis, injuries, bronchitis, bronchial asthma, and leptospirosis, among other conditions. Agriculture and plantation work were the main occupations and leptospirosis was not uncommon.
The hospital slowly declined in importance. There were inpatient wards on the first floor, but most beds were vacant. We did not handle obstetric cases; a doctor couple practicing in Kunjithanny mostly handled the deliveries. We were good friends with them and used to occasionally go to their place for dinner.
One of the challenges of working in small hospitals in rural areas was isolation—physical and mental. Mobile phones and the internet were still in the future. At Elakkal, luckily there were two of us to converse. Rodney was active in local prayer groups, had many local friends, and had been there for a few years. Having a doctor friend is always welcome in these isolated areas.
I stayed in a house uphill, accessed by steps from the hospital. The hospital owned land on the hillside—a region called the high ranges within the spice hills of Kerala—and cultivated spices like cloves, cardamom, ginger, and nutmeg. The location was spectacular and the temperature pleasant. It gets cold during the winter months. The view from the porch of my house was magical and I spent most evenings watching nature’s amazing display.
The attached nunnery had more gardens and a kitchen. One of the retired sisters was dedicated to horticulture, growing red, yellow, pink, and white roses in the cold misty air. The other sisters looked after us, providing breakfast, lunch, tea, and dinner.
The hill station of Munnar was nearby. The round was developed by the British using local labor and wound up through densely forested hillsides. Beyond Munnar were the estates of the Tata Tea company, responsible for growing the Kannan Devan brand of tea. On holidays usually one of us stayed back at the hospital to attend to patients. But on one occasion, Rodney, myself, and locals decided to go on a day trip to Eravikulam National Park. The park is famous for the Nilgiri Tahr, a breed of wild goat. We had a good time, but unfortunately were set upon by leeches. The bites on our legs continued oozing blood for nearly a day.
My cousin came to visit me for a few days, and we took a trip to Marayoor and the Tamil Nadu border. Marayoor is famous for its natural sandalwood groves. Sandalwood, pleasant smelling and expensive, is subject to illegal cutting and export.
I eventually left the hospital for my residency and Dr. Rodney shifted to a bigger hospital nearer to his home and eventually migrated to Australia. We were relatively isolated and traveling to my hometown took nearly a day. The nineties were a different time and place. I wonder whether I would be able to adapt to the lifestyle today. I have become used to being constantly in touch through mobile phones and the internet.
Serving in a small rural missionary hospital was a learning experience. Soon it was time to say goodbye—always a bittersweet experience.
I visited the hospital and the sisters once around six years after I had left during the late nineties. I also visited Rodney at the new and large hospital where he was working. My stay at Elakkal provided me with a detailed insight into the lives of rural people in one of India’s most developed states. I developed an admiration for and empathy for the common people. My interest in the health humanities was ignited and has grown over the intervening decades. Beautiful Kerala is surely God’s own country!