|VOLUME 18, NUMBER 5
(27 June 1937–9 August 2005)
Hilde is no more. She died on
9 August 2005, after valiantly fighting cancer for many years.
While I am shattered I lost a friend, the hills around Mitraniketan
Hospital must be devastated; the people there, the poor in
particular, have lost an extraordinarily dedicated doctor who
provided medical care of course, but more importantly perhaps,
her favourite prescription, TLC q.i.d. (Tender Loving Care
four times a day).
The Mitraniketan Hospital, situated in the Cardamom Hills of
Kottayam district, Kerala, started as a treatment and maternity
centre in the mid-1960s when Dr Elizabeth Baker, wife of the
legendary architect Laurie Baker settled in Vazhikadava, near
Vagamon. They had moved to Vazhikadava from the Himalayas following
the Indo-China conflict of 1962. There was no medical care
available for a radius of 25 km in the region, home to small
farmsteads and some tea plantations. When the Baker children
grew up, and sought to move to Thiruvananthapuram for their
schooling, they found two remarkable women to run the hospital
In 1973, Alina Cattani, an Italian nurse and Dr Hildegard Sina,
who had both worked to create the Pushpagiri Hospital in Thiruvalla,
came to work at the Mitraniketan Hospital. Hildegard was born
in Bonn and had done her MD from the University of Munster
in 1962. They had come to India in 1966 as part of a group
of doctors and nurses, the Auxilaria Femina Internatinale (AFI)—among
them was Dr Claire Velluth who won fame, and the Padma Shri,
as a leprologist in Chinglepet, Tamil Nadu—committed
to the Church, and service to the poor. But soon they were
distancing themselves from the Church in India, which they
saw as an elite institution.
Mitraniketan, provided the ideal setting to practise a different
kind of medical care, of relevance to the poor. Combining curative
and preventive services, it provided extremely low-cost, but
effective, care. Girls from the surrounding areas were trained
as nurses, laboratory technicians and X-ray technicians—and
of course, providers of lots of TLC. What was also remarkable
was the unique socialization process: everyone lived in one
house, shared meals and the small returns from the hospital.
As a matter of principle, they used generic drugs when they
could; they also practised acupuncture. They reached out to
the tea estates and the surrounding areas with immunization
and antenatal care. It was not long before babies in the area
were being named Sina and Alina!
Alina and Hilde took over the Mitraniketan Hospital formally
in 1980, running it as a non-profit trust. Among the trustees
were their friends Nalini Nayak and Father Tom Kochery of the
Kerala fisherfolk movement. Over the years, the hospital has
grown into a 60-bedded facility, nestling in the rainy hills
I worked in Mitraniketan for almost two years between 1978
and 1980. I’ll never forget the time we were asked to
help after a cow had calved at Nadanouke, at the edge of the
next hill. The poor terrified cow had a uterine prolapse and
we did not know how to sedate her. We tried, but were unable
to save the cow. Soon Hilde was learning the details of bovine
sedation. What also struck me—and remains with me to
this day—is how effortlessly Hilde read the Bible and
Marx together. She kept abreast of various movements: the fisherworkers’ struggles,
the women’s movement, the health movement—of which
she was an avid supporter, the Narmada Bachao Andolan, the
struggles of the dalits and so on.
I spent 5 terrible and extraordinary days with her between
15 and 20 June this year, just a fortnight before she passed
away. These days were also strangely, miraculously rich and
redemptive. I was seeing her after 22 years. But over these
years—age has a horrific maw, swallowing often love,
friendships and even their memories—we had kept in touch,
and it was as if we had been seeing each other, talking to
each other regularly. She was the last person I actually wrote
letters to, although she made fun of me when I occasionally
said they were ‘hurried non-letters’.
Hildegard in 2005, weak, weighing 35 kg, knowing she was dying
soon—and determined not to be buried in the Church, was
no different from the Hilde of 1983: warm, loving, curious,
funny and, above all, engaged. It was merely her body that
had betrayed her, but she was indomitable in her interests.
She named books she thought I should read and hadn’t.
She promised me she would read my new book—she had kept
it on a bookshelf close to her, although I knew she wouldn’t
be able to read it.
One evening she made me sing for her. Songs I didn’t
know I still knew: the Beatles, Bob Dylan and Joan Baez. She
could barely sing her favourite song: ‘Weave me the sunshine
out of the falling rain; Weave me the hope for a new tomorrow
and fill my love again.’ But Hilde never ever needed
filling her love again. She was surrounded by her friends,
the nurses she loved, her three foster daughters and their
Cruel ironies never cease. Hilde had done her MD dissertation
on late radiation reactions following irradiation for carcinoma
cervix and carcinoma colon. She was diagnosed to have carcinoma
cervix in the early 1990s, but refused to consider going to
Germany for treatment, since she had applied for Indian citizenship.
Following irradiation, she had serious complications and, uncomplaining,
went through a series of surgeries, calling herself a ‘two-bag
doctor’. With her colostomy bag and her urine bag, she
continued normal life, working ceaselessly. But it was carcinoma
colon that, diagnosed two years back, finally felled her.
She obtained her longed-for Indian citizenship in 2000. But
with this came the blow that she had lost her licence to practise,
since she was registered in the Medical Council as a foreign
doctor, permitted to practise in India. It was then a Kafkaesque
nightmare, between the Delhi office and the Thiruvananthapuram
office of the Medical Council.
My deepest regret is that I couldn’t be of assistance
to her to get her this recognition she sought so much, although
I had done a bit of running around in Delhi. She was forgiving: ‘What
does it matter now?’ She asked me to help find a replacement
for her; not a money-minded doctor, obviously not a doctor
who replaces TLC with technology.
But Hilde is irreplaceable.
Centre of Social Medicine and Community Health
Jawaharlal Nehru University