“Lions for Stoma Care” Workshop In State of Jammu & Kashmir, 24-27th July 2008
Posted by IOA TODAY Editor in IOA President
Saturday, November 1. 2008
Report By Dr Harikesh Buch
Introduction: State of Jammu & Kashmir ( State of J & K ) is the Northern most state of India. It has a population of around 500,000 & capital city is Srinagar. Other big city is Jammu. Since it is a border state with Pakistan it has lots of civil disturbances all the time.& has presence of large brigades of Security & Army personnel. Due to close proximity to Himalayan mountain ranges, climate is very cold for 4-5 months of the year & there is lots of snow in winter from month of December to March.
The states main revenue is from Tourism because of its natural beauty. But due to frequent civil disturbances, business of tourism & its allied industry get affected very often resulting in to lot of unemployment & presence of large scale poverty. But in spite of these adversities the average level of education is quite high even amongst ordinary people whose main language is Urdu. They are mainly non vegetarians in their dietary habits.
Background Information: In November 2007 only ET Mrs Hassina Wani from entire state of J & K of India attended Asia Pacific ET nursing Association (APETNA) meeting at Tata Memorial Cancer Hospital , Mumbai . She wanted help to organize a workshop in Stoma care in state of J & K since she is the only person trained in stoma therapy in the entire state & finds it too difficult to cope with demand of work in Stoma care besides her duties as a Joint Nursing superintendent.
Kashmir has very high incidence of Urinary Bladder cancer because of smoking tobacco & therefore high incidence of Urinary stoma. Because of frequent civil disturbances, being a border state, there is lots of incidence of traumatic ( gunshot & stab wounds & injuries due to shrapnel ) bowel & bladder injuries resulting in temporary intestinal & urinary stoma as well.
Because of civil disturbances major manufacturers of ostomy appliances do not have regular distributors present in the state & therefore these supplies are not easily available. Due to poverty, patients with stoma can not buy the required ostomy products as well & have to do away with locally innovated ostomy products made some times from material used to prepare parachutes.
Kashmiri Ostomate with innovative Ostomy Bag – July 2008
It was in this back ground we had arranged a workshop on stoma care to train local nurses & doctors under the project “ Lions for Stoma Care “ at Sher-e Kashmir Institute of Medical Sciences ( SKIMS ) in Srinagar. SKIMS is a 600 bedded tertiary care hospital with under graduate & post graduate medical courses & state of the art facilities for treating patients & doing research.
We trained 32 nurses from all over the state including 12 nurses from Jammu which is 450 KM away from Srinagar & one from Leh ( Ladakh ) which is at 12000 feet higher then sea level. There were about 8 residents in Surgery who were also trained.
Programme of Workshop :
Like any major workshop inagural function was attended by about 200 nurses, doctors & faculty staff of SKIMS. It began with prayers followed by welcome addresses by various faculty staff members & final speech by the director of Skims Prof. Dr Abdul Hameed Zargar.
Opening Ceremony: 24th th July 2008.
Welcome Mrs Zubaida Akhtar, Dep.Nursing Super.
Introduction to “Lions for Stoma Care “ Dr H.G.Buch, Vice President IOA
Status of Stoma care in J & K Mrs Hassina Wani, Jt.Nursing Super. & ET
Well Come to SKIMS Prof.Syed Amin Tabish Prof.I.A.Bukhari
Dean’s address Prof.G.H.Quadri
Stoma Care & SKIMS Prof A.H.Zargar,Director of SKIMS
Vote of thanks Mrs Haleema Jahan, Depu.Nurs.Super
24 to 27th July 2008
Following topics were covered during the entire workshop which was attended by about 32 nurses & 8 surgical residents .
Pre test Quastionnaires were given to all trainees to find out their exist in knowledge about stoma care.
Topics Speaker
1.Current status of StomaCare Mrs.Hassina Wani
2. Anatomy, Physiology of GI tract & surgical Indication of GI stoma Dr. Sadaf (Ass.Prof.)
3. Anatomy, Physiology of GU tract& indication of urostoma Dr.Saleem wani (urologist)
4. Types of Digestive stoma Dr.Rouf (Surgeon specialist)
5. Indications & types of Paediatric stoma Prof. Rekha Patnayik Paediatric Surgeon
6. Stoma siting Mrs. Hassina Wani
7. Pre Op. Bowel preparation Mrs. Zubeda Akhtar(DNS)
8. Post Op. care & Assessment Mrs. Tabasum Irshad (stoma Therapist)
9. Nutrition in stoma patients Mrs. Nasreen Paul(Dietician)
10. Principles of Pouch application Mrs. Hassina Wani
11. Radiation /Chemo.&Local &national colorectal cancer scenario Dr.Manzoor Banday
12. Current stoma care Nationally Mrs. Hassina Wani
13. Ostomate’s life – Patient’s perspective Mrs Minal Kothari
14. Ostomate`s life-family members perspective Mrs. Tushma Kothari
15. Colonic Irrigation Practical Demonstration Mr. Ahmad (Stoma nurse) & Dr H.G.Buch
16. Discharge planning & post Op. Assessment Mrs.Tabasum Irshad
17. Practical session & meet the ostomates Group
18. Complication free stoma surgery Dr. Harikesh Buch
19. Psycho sexual problems Dr. Harikesh Buch
20. Patients counseling Mrs.Hassina Wani
21. Rehab. centre/AOA/IOA Dr. Harikesh Buch
Post test: Questionnaires were given to all attendees to assess their knowledge & understanding of stoma care training.
Meeting with Ostomates & Forming an Ostomy Association: Last day we had meetings with about 25 ostomates & their family members (Significant others).
Local Ostomate with ET Mrs. Haseena Wani, Srinagar – July 2008
We encouraged them to speak about their concerns in life & problems they are facing in J & K State. We gave them hope by sharing our own stories of Life with a stoma & how we have over come difficulties & got fully rehabilitated to live a near normal life. We also shared with them how if they form a group/Association of ostomates; they can form a pressure group to influence government & Ostomy products manufacturers to provide ostomy supplies & stoma care in J & K State.
By creating awareness & getting educated in stoma care it was emphasized that they can prevent divorces amongst married couples if one of them have to under go stoma surgery. Many ostomates came forward with their stories & how they will work themselves to establish association locally to help hem selves.
There is a desperate need of training to health care professionals & supplies of Ostomy products for these poor patients in J & K state. We have started the beginning but lot more work needs to be done in future.
We carried with us as well as shipped lot of ostomy products supplies for J & K state to be distributed free of charge to poor & needy ostomates. These products have been received by Lions Tara Chand Bapa Hospital in Sion , Mumbai under the project “ Lions for Stoma Care” from kind donations by“ Friends of Ostomates World wide, Canada.” (FOW, Canada).
We gave some financial help also to Dept. of ETs, SKIMS, Srinagar from money received from “Lions Clubs International Foundation” (LCIF). These financial help ( Aid In Grant money ) came from LCIF to Lions club of Sion , Mumbai because of joint agreement of mutual assistance for the project “ Lions for Stoma Care “ signed between Lions club of Modena-Willigelmo & district 108Tb of Italy & Lions club of Sion, , Mumbai in December 2006 in Mumbai, India.
Dr Harikesh Buch President , IOA Mrs Minal Kothari Lion Dr Bharat Pathak
Members project “Lions for Stoma Care” Mumbai, India.