The NMJI
VOLUME 18, NUMBER 5

SEPTEMBER/OCTOBER 2005

Obituary

Hildegard Sina

(27 June 1937–9 August 2005)

Hildegard SinaHilde 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 for them.
  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 of Vazhikadava.
  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 babies.
  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.

MOHAN RAO
Centre of Social Medicine and Community Health
Jawaharlal Nehru University
New Delhi
mohanrao@mail.jnu.ac.in

 

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