Dear Fellow Members,

First, I have to thank Hari Prabhakar, for introducing me to Drs. Nandakumar Menon and Shylaja Menon. They are the one who established the Adivasi Hospital in Gudalur.

Hari,  a Johns Hopkins undergraduate student has developed a great rapport with them and the hospital staff. Hari is the one responsible for unveiling the mystery of sickle cell disease in this population. He spends all his vacation time  at Menon's place in Gudalur in serving and researching this population. Though he is younger than my children he has become my inspiration for me to visit this Adivasi (Ancient Tribal) Hospital during my visit to Chennai and Vavipalayam.

After our site visit in Vavipalayam- Coimbatore, we left at about 4 pm by car to Gudalur. The only short route was to climb the Ooty hill to go down into Gudalur via the Mudumalai forest. We were warned and discouraged by our relatives who advised us to skip the trip to Gudalur, because of the bad road conditions and the risks involved, but we were determined to visit this hospital. As informed the roads were bumpy, treacherous and terrible, it took 5 hours to reach Gudalur instead of usual 3 to 4 hours.  We reached Menons place at around 9.30 PM. It was pitch dark and appeared goofy until we entered Menons house.

Our hosts greeted and treated us well with a nice dinner and we were chatting for a while. Dr. Nandakumar Menon is a surgeon with specialization in hand surgery and Dr. Shylaja Menon is an OB/GYN, both completed the training in USA and was in practice in USA for few years. In 1987 they came to a realization and decided to move and direct their service in an under served rural area in India. They chose Gudalur tribal area were there was a desperate need for doctors. Currently there are 15,000 tribes in this area, the life expectancy of this population is 40 to 45. These innocent tribes have been essentially driven into the deep forest by the proliferating civilization around, pushing them to hunger, poverty and death. Menons entry into this area has obviously lighted a bright future for this population who were once in verge of extinction.

It was 11.30 pm when we went to bed. The plan for the next day was to visit the hospital, the tribal training center and the elementary and middle school- all started by the Menons'! 

Gudalur Valley situated in the tri-junction of the three South Indian States of Tamilnadu, Kerala and Karnataka, it is the home of over 25,000 Adivasis (Tribes). Five different tribes viz. Paniyas (60 %), Bettakurumbas (20%), Mullukurumbas (5%), Kattunaickens (10%) and Irulas (5%) were inhabiting this forested valley for many centuries. Displaced from their own land by big Tea Estates, migrants from the plains and by Government authorities, there population was dwindling down, when there were many good samaritans came to liberate and help them. Though ultimately, they were partially able to assert their political and social rights, their health care needs were not met until Drs. Shylaja and Nandakumar Menons landed in Gudalur, willing to be part of the health program. Having the ideal combination of skills as Gynaecologist and Surgeon, they were what the "doctor ordered" and the people were looking for ! Thus was born the "Gudalur Adivasi Hospital" (GAH), in 1990.

Drs. Menons' were on call 24/7 for the first 7 years. They attended to outpatients, inpatients, made home visits through the deep woods, up the hills and down in the valleys, did elective and emergency surgeries, ran lab tests, typed and cross matched, gave blood transfusions, besides training the tribes as health care workers. They trained the tribal girls as nurses. It was a major cultural change for the girls - from innocent village life to a three-shifts-a-day routine in the hospital. Training had to start from elementary Maths and English.These adivasi nurses have become experts in conducting deliveries, in assisting both these doctors in surgeries, in the general administration of the hospital, in ordering and managing the drug stocks, in designing systems to monitor the performance of the hospital and in analysing the financial aspects of the hospital management.

Shylaja and Nandakumar should be well known for their hospitality, they have dedicated a well furnished room for their guests. This is located in the middle of a massive library in the upstairs of their home and there were at least 2000 books in that library. The bed room was nice: cool, cozy and comfortable. The exhaustion from our treacherous travel naturally put us to sleep and we slept very well. At around 6.30 am I woke up listening to the feeble sounds of birds, the room was still partially dark. I got up, walked gently not to wake up my wife, moved the drapes to peek through the closed see-through glass windows. The view was spectacular- the green velvetty hill, trees, plantations under the morning gentle sun, no sound or sight of civilization. Now, I understand why this couple moved to Gudalur!

When I walked down to Kitchen, Shylaja was already up, ready to go to the hospital. She made coffee for us. It was there home grown coffee, still I can feel the flavor and the taste in my mouth. She said she has an elective surgery to do that morning, I was curious, I asked, "what kind of surgery? "Tubal ligation". I asked, "Who gives anesthesia?" She said, " I do...epidural." Nandakumar walked into the kitchen, asking us whether we were ready to go for a walk.

They have two German shepherds and two cats, all friendly with each other and became friendly with us too. The dogs are left loose in the night time to chase the animals (wild bore) away from eating the vegetations in the garden. After chaining the dogs we walked with the dogs through the Menons 2 acre property enjoying the sight of their coffee and tea plantations, banana trees, lettuce garden, pond, flowering trees, etc. As we stepped out to the street and passed through the people, every person in the street respectfully saluted at Dr. Menon. The people sitting in the bench in a petty shop stood up as we passed by to show their respect. To me, it was like watching the movie, Gandhi, I felt as if I am walking with Gandhi! It was a mile long walk, half the way through Nandakumar says, "next comes my treadmill stress test", there I see an up hill street. I managed to pass the test huffing and puffing. On return, the slope looked even steeper, it took a while for me to go down. Dr. Nandakumar had no problem he ran down like a kid. He is about 4 years senior to me. I think 'Good'alur should do good to health!

When we returned from our morning walk Shylaja was ready to leave for the hospital. Ms.Gowri, Menons' daughter greeted us with a nice smile. She takes care of the elementary school and teaches the children, she insisted us to visit the school after the hospital visit. The lady cook gave us hot dosa with sambar, chuttni and we sipped another fresh home grown coffee.

The Adivasi Hospital is about 300 feet from Menons residence. From the living room of Menons house one can see the hospital. It appears small from outside, but it has several facets. Since its inception it has gone through constant expansion. The proximity of the hospital to their home allows them to attend to any emergencies immediately. Recently a tribe was brought in with a grievious injury secondary to an elephant attack with profuse bleeding, Dr. Nandakumar saved his life by an emergency surgery . I was wonderting who would be the doctor for this couple in this forest particularly if its an emergency, when I asked them Shylaja answered, "we treat each other". "One time he was dehydrated from persistent vomiting, I gave him IV fluids here at home and he got alright" and laughed and said, "he ate too much of Jack fruit!"

It is a 20 bedded hospital basically catering to the tribes, there are 250 deliveries performed every year and it is increasing year after year, it has a special care nursery for new born babies, operating room, lab to perform cytology, basic chemistry, electrophoresis, new born screening for sickle cell, T&C for transfusions, pharmacy is managed by nurses with all kinds of medicines from Aspirin to Zantac. 

The entrance of the hospital greets with the Board that reminded me of Hari Prabhakar.