Interview with Lt Gen BNBM Prasad, SM, VSM, PHS, Director General Hospital Services (Armed Forces) by Editor-in-Chief Hasibur Rahman.
Lt Gen Prasad, it is really a honour to meet. You have been a physician and Pulmonologist of international repute. Recently you have been appointed as Presidents Surgeon. How you rate your journey in Armed Forces Medical Services?
I am really proud to be a part of Armed Forces Medical Services (AFMS). AFMS is a glorious organisation with a splendid history of 252 years and service rendered across continents in both peace and war. I did not have much knowledge about this organisation when I was a medical student at Mysore Medical College. It was that historic victory by Indian Armed Forces in 1971 against Pakistan leading to the creation of Bangladesh that inspired me like many of my colleagues. After joining AFMS in 1977 soon after my graduation there was no looking back. In a career of almost four decades, I have served the nation in different capacities as a medical officer, specialist and medical administrator in various parts of the country. Army Medical Corps(AMC) gave me everything: most importantly opportunity to serve my mother land and contribute my best besides making me an officer, gentleman, valiant soldier and a super specialist etc. I rate this journey in this superb organisation very high and the sense of satisfaction I had with every step during this marvellous journey is beyond any words.
You have just mentioned about glorious AMC. Can you elaborate on this?
AMC in a long journey of 252 years has always strived for excellence under most difficult conditions. Before independence AFMS personnel performed their duty admirably well both within and outside India as they saved many lives while swiftly shifting dying soldiers from open battle fields to well entrenched dug in operation theatres where surgeons toiled to save precious lives by their dare devil acts. Despite adverse conditions and primitive medical knowledge, these valiant medical personnel won the hearts and minds of every one by their gentle healing touch and precise first aid. War created heroes so also medical personnel of exceptional abilities.
Post independence AMC, made great strides by incorporating the best of the medical practices and moving ahead of their civilian counterparts. AMC did exemplary job in all their combat missions and earned the praise of every one for their professionalism. Combat medical care became stepping stone for advancements in emergency and critical care to evolve as a highly specialised branch of health care today. AMC driven by passion to serve the nation had many stalwarts who led upfront by their raw courage, intellectual abilities, compassion and scientific temperament.
AMC is an epitome of personalised and compassionate care, an exemplary organisation is totally dedicated to the Nation and following the glorious tradition of Sarve Santu Niramaya. In these challenging times when public health care is on the verge of collapse and corporate health sector has become too commercial AFMS hospitals are beacon of hope in the country for their undisputed abilities in providing comprehensive health care. In nut shell there is no doubt that AMC is a glorious organisation, one of its kind in the world.
Are you satisfied with standard of Armed Forces Hospitals?
I have seen tremendous strides being made by AMC in optimising health care. AFMS has moved ahead of others from basic medical facilities of grand old military hospitals to the creation of modern hospitals having the state of the art health care facilities, specialists proficient in latest technology and many new drugs used for the first time in the country. AFMS has entered a new world of Medicine where everything is available on touch of a button and robots are the new doctors replacing the dare devil acts of surgeons of yester years. I must add here that AFMS has been continuously augmenting her combat medical capabilities despite large and expanding clientele base and many challenges related to emergence of new forms of diseases. Consequently, AFMS has advanced medical facilities even in small hospitals located in remote and border areas that are fully geared to meet all health challenges of military operations under varied conditions. These hospitals are capable of carrying out proper triage followed by emergency surgery and medical therapy required to save life and limb before being swiftly transferred to higher centres for highly specialised care. Apart from their combat roles these hospitals provide primary health care and emergency health care to even civilians as a part of good will mission.
You are aware that some of AFMS hospitals including Prestigious Army Hospital(R&R) and Command hospitals have excellent facilities unmatched even by corporate hospitals of repute in this country. Not only that we have the best health care professionals. I am a witness to this fact how our dedicated health care personnel used to toil day and night to save precious lives despite heavy work load while I was the Commandant Command Hospital (EC) Kolkata. AFMS can boast of excellent health care facilities through their large chain of hospitals unmatched by any leading Armed Forces of the world. Today AFMS can offer excellent primary secondary as well as tertiary care in their network of hospitals spread across length and breadth of this country. Good work done by AFMS in both peace and war including emergency and disaster medical relief operations in many natural calamities such as earth quake in Nepal and floods in Kashmir as well as in Tamil Nadu have been lauded by many experts and civilian population always look forward to AFMS for medical aid at the time of crisis.
How much support from Government you receive on modernization of hospital?
Government is highly proactive in extending all supports towards modernisation of AFMS hospitals and to make them the state of the art capable of providing the best health care.
Have you got command hospital in every state including J&K and how do you rate them?
AFMS has command hospitals as per command structure of Indian Armed Forces and as such don't have a command hospital in every state. The state of J&K has a command hospital and I must say that this command hospital has been doing a splendid job in combat medical care. Most of the command hospitals have tertiary care facilities and are also actively involved in medical education and research besides providing excellent health care to vast clientele. There is hardly any difference among command hospitals regarding the delivery of quality health care. Last year the coveted Rakshamantri trophy was bagged by Command Hospital (EC)Kolkata.
You mentioned about medical research in AFMS. How does AFMRC differ from other medical research activities in the country?
You are aware that Armed Forces are operating under different environmental conditions and have representation from every segment of society cutting across language, geography of the state, ethnicity and religion. As doctors in AFMS, we come across all types health issues that may not be seen in a given population of a particular area. Say for example troops from rest of the country posted in north-eastern regions are vulnerable to falciparum malaria since it is endemic in these areas. This is true of high altitude problems encountered among lowlanders who have been inducted to high-altitude than permanent residents of these regions. Due to varied deployment of our troops in all types of terrains in India and abroad, an in-depth understanding of effects of environmental factors on health of troops with different background is essential and AFMS has been focusing on these aspects in their research activities. It is indeed a matter of pride that Armed Forces Medical Research Committee(AFMRC) under the able leadership of DGAFMS have been relentlessly pursuing service oriented research activities and have emerged as pioneers when it comes to medical research related to military medicine, marine medicine, aviation medicine and health problems of high altitude and tropics. Today we have many experts in high altitude medical research from AFMS including present DGMS (Army) Gen Velu Nair and ADG (MR, H &Trg) Maj Gen JKS Parihar who have been contributing relentlessly through their research work in their field. It is noteworthy to mention that Major General JKS Parihar had the rare honour of performing modern cataract surgery at the highest altitude of 14106 feet above mean sea level, never performed before by anyone in the world and now finding a place in Limca Book of world records. Apart from these exceptionally outstanding individual contributions, collective contributions of many from AFMS towards growth in these specialised fields are immeasurable.
India has a long border with her neighbours in high altitude ranges. Can you highlight what are problems faced by the soldier under these harsh conditions?
High mountains are formidable barriers for healthy living. You are aware that Indian soldiers are deployed in some of the most treacherous high altitude areas such as Siachen Glacier where ordinary mortal cannot even reach and survive. Our troops not only bear continuously most hazardous and life threatening environmental conditions namely sub-zero temperature, high winds, rarity of oxygen, low barometric pressures, intense ultraviolet radiation exposure but are at great risk of physical injuries and getting buried under avalanche. Soldiers who are mostly low landers lack adaptation advantages to such environmental conditions and are vulnerable to various health issues. These include acute mountain sickness, pulmonary oedema, chronic mountain sickness, frost bite, chill blains, ultraviolet radiation injuries to skin and eye, physical injuries due to fall, avalanches etc. Unfortunately due to natural calamities beyond control, Indian Armed Forces have lost many precious soldiers while were posted in these areas.
Are medical facilities adequate to treat high altitude related medical problems in these areas where Armed Forces are deployed?
Today we have adequate knowledge, trained man power and necessary infrastructure to treat high altitude problems even in very high altitude ranges of Siachen Glaciers. AFMS has well established High Altitude Medical Research Institute in Leh that has contributed immensely for the development of High Altitude Medicine apart from saving many lives from death related to high altitude exposure such as acute mountain sickness, high altitude cerebral edema and Pulmonary edema.
Basic medical facilities including emergency medicines, oxygen and portable hyperbaric chambers are made readily available in forward areas to treat high altitude related problems excellent casualty evacuation to nearby military hospitals by air even from remote and difficult areas has been great life saver since most of these emergency cases have been effectively managed with almost 100% recovery. It is a matter of pride to say that military hospitals located in Gangtok, Leh and Srinagar have been doing a commendable job in treating such cases round the clock. On preventive front, troops being deployed in these areas have to undergo detailed medical screening and follow stringent acclimatisation schedule. These proactive measures by AFMS have significantly contributed to keep our soldiers fighting fit despite adverse milieu beyond control.
General you have been dealing with medical education in AFMS. Can you highlight what measures are in place to produce health care professionals of good quality?
AFMS can be proud of having some of the finest institutions of learning in India with excellent facilities to train medical officers, Nursing officers and para medical staff. Armed Forces Medical College(AFMC) Pune has been rated as one of top few medical colleges in the country imparting very high quality medical education at both undergraduate and post graduate levels. AMC College and Centre has been doing a great job in training highly skilled paramedical staff while the College of Nursing have been in forefront for Nursing education in the country. In AFMS, medical and paramedical staff are encouraged to gain knowledge and skills by providing them with maximum opportunities for training in reputed institutions both in India and abroad besides conducting regular seminars, workshops, bed side clinics etc. AFMS has regular collaborations with friendly foreign countries and train their defence personnel. There is regular exchange programmes in place. Many measures such as revision of policies, updating guidelines, strict implementation of existing policies on various health issues and regular monitoring mechanisms have made medical education in AFMS robust and of high quality.
I have heard that you have very neat and clean hospitals in AFMS. What is the contribution of AFMS in Swachh Bharath Abhiyan?
I must confess that AFMS is highly enthused and inspired by the Swachh Bharath Abhiyan initiated by our honourable PM Mr Narendra Modi. Undoubtedly AFMS has been proactive with well laid out protocols with strict monitoring mechanisms for ensuring healthy living conditions for troops and families. Our hospitals are well maintained: neat and clean. We have excellent biomedical waste disposal system in our hospitals.
What is your vision for AFMS hospitals?
AMC has a splendid vision about the disease and care it has to offer to a soldier. Our primary focus should be the health and fitness of of the soldier at all times. Every soldier should feel safe and sound and death can't triumph in terrains unsurmountable and enemy the most deadly as there is a doctor of AFMS who defies nature , instills hope, saves life and brings back all that is majestic and glory of the valiant. This miraculous transformation is possible by being a professional. We in AMC are angels or God in human form that every soldier wants as a companion at the time of calamity. This is the dream of this glorious AFMS.We can realise by dedicating ourselves for a noble cause through discovery of new ideas and developing them for delivering on the ground.Following lyrics outline challenges and vision for our glorious AFMS Hospitals.
On personal front I want to ask something about late Field Marshal Manekshaw. I learnt that you were associated with him during his later years and was at his bed side when he died. Can you high light great qualities that you observed in him?
As his doctor, he asked incisive questions about his medical problems and was eager to know the truth. Once he was convinced about my understanding and my honest approach to his problems, then his faith in me as doctor was complete and unquestionable. He had highest respect for all his doctors and medical staff who looked after him. He was the most obedient patient who valued all those who cared for him irrespective of their age or rank with utmost humility and plenty of compliments.
As a close observer being associated with him, I can say with conviction that he was virtuous with the best of head and heart. He was brilliant and humane with eye for details and had extraordinary ability to foresee a problem and act well in time before others could even realise. He had razor sharp intellect and was always engaging with his troops to win their hearts and minds. He was forgiving and kind hearted with uncanny ability to get the best out of his team. His intellectual honesty and courage of convictions were legendary. He stood like a rock with those who upheld military values and was ready to sacrifice his career for the cause of the nation.