A Man on a Mission

Altruism Leads to Indigent-Care Hospital in India

Dr. Van Cise Knowles’ Medical College of Georgia education prepared him well for his career, but he grudgingly acknowledges that a few lessons he had to learn on his own.

Medical school didn’t prepare him, for instance, to perform surgery in a parking garage. Or to treat desperately ill people in triple-digit heat that on a good day was relieved by the dull whir of a fan. Or to serve such an endless line of polio and leprosy patients that he barely noticed the fever, body aches and rash that signaled his own brush with Dengue fever.

But then, not every doctor goes to the farthest ends of the earth to treat the world’s most impoverished people. To Dr. Knowles, it’s all in a day’s work.

“That’s why I became a physician,” he says simply in a low, gravelly Southern drawl. “Growing up, I always thought about giving, and particularly giving in a field that helped others.”

Dr. Knowles, whose father was a Methodist minister, grew up in Albany, Ga., earned a biology degree from the University of Georgia, then enrolled in the MCG School of Medicine to embark on the ultimate giving career.

After graduating in 1966, he completed an MCG internship, served two years in the Navy, went back to MCG for a general surgery residency, then hung his shingle back home in Albany.

His practice was fulfilling, and he and wife Wesley certainly stayed busy with their growing family—a daughter and twin sons—but Dr. Knowles had a vague sense of restlessness. His service somehow seemed lacking. He knew there was more to do, more people to help, more ground to cover.

He shared his frustration with an anesthesiologist friend over dinner one evening in the early 1980s. Their pastor, Dr. Bill Hinson of First United Methodist Church in Albany, had recently challenged the congregation to serve beyond the narrow boundaries of their hometown. Dr. Knowles and his friend decided the only way to do that was … well … to do it.

Their first mission trip was to Neyyoor, South India in summer 1984. In some ways, the place was paradise. Beaches, forests and waterfalls abounded. But so did poverty. “Every disease was poverty-related,” Dr. Knowles says, citing everything from malnutrition to intestinal diseases borne of filthy water and sparse protection from the harshest elements of nature. Adding to the challenge was the fact that most people had such limited access to health care that their diseases were often far-advanced.

“We saw lots of exotic surgical and medical problems, including elephantiasis, malaria and Dengue fever,” he says, noting that his own bout came in 1986. By that time, the mission trips had become better-organized, with more volunteers coming along and rolling up their sleeves. The group had moved from Neyyoor to the even more primitive C.S.I. Somervell Hospital in Karakonam, South India, a single-room facility staffed by one physician and seven assistants.

“When I led our team back to Karakonam in 1989 after sending funds for a new well for water and a 10-kilowat generator for electricity, we did 100 surgical cases in an operating room made out of the ambulance parking garage,” Dr. Knowles says. “Indian air-conditioning was a fan when the electricity worked. Our biggest case was a subtotal esophagogastrectomy with staples—the first staple procedure in India!”

The successes were exhilarating, but the limitations intolerable.

“As time went on, we realized that two weeks of work used up all their resources,” Dr. Knowles said. “They’d run out of stuff and we did, too. It’s kind of hard to operate without sutures and antibiotics.”

His mission group, which had grown into the Southwest Georgia Medical Mission Team, Inc., collected donations to improve and better equip the clinic. The task sometimes seemed insurmountable. In addition to the medical challenges, Dr. Knowles struggled to keep his family afloat financially. His children were older now, and he had college bills to pay.

“Every time I went to India, it cost me two weeks of my solo practice, plus lead time and recovery time,” says Dr. Knowles, who was also making mission trips to central America. “I just made up my mind that God was going to take care of me and things were going to work out.”

“He was a solo practitioner, so when he was gone, the bills kept coming but there was no money coming in,” says wife Wesley. But she fully supported her husband and considered the financial constraints a minor problem.
“Van and I always lived a very conservative lifestyle,” she says. “Our children weren’t showered with a lot of things, but they got along just fine. We decided that God provides.”

Her husband’s persistence paid off. Each time the mission group returned to Karakonam, the facility got better and better. “Every single year that the group returned, there was progress,” Mrs. Knowles says. “I think it’s due largely to the continuity of the people in India. Some of the same doctors and nurses who were there from day one are still there, still involved. I think that’s the secret. They’ve been in our home and we’ve been in theirs. We’ve watched each other’s children grow up. You build relationships.”

Today, the single-room clinic has grown to the 500-bed CSI Dr. Somervell Hospital and Medical School. “We serve a very large indigent Indian population that would otherwise get little or no care,” Dr. Knowles says. “And yes, there is now air-conditioning for the 14 operating rooms and ob-gyn delivery suites.”

When a devastating tsunami struck in 1996, the hospital took over, treating hundreds of victims.

The hospital also houses a nursing school for 80 students and a medical school with 100 students per class. Over 800 full-time physicians, teachers, nurses and support staff fill the rosters. Residency programs are planned for public health, ear-nose-throat, obstetrics/gynecology, ophthalmology and general surgery.

Four outreach clinics supplement the service.

“A fifth one is planned in the southernmost, most indigent, tsunami-ravaged part of south India,” Dr. Knowles says. “This mission hospital will continue to serve this indigent population for many years to come. It is an awesome task, but we’ve come so far.”

Two years ago, Mrs. Knowles and their children—Amy, Kenneth and David, all of whom now work in health care—surprised Dr. Knowles at the Karakonam hospital to celebrate his retirement from his Albany practice. His children have all followed in his footsteps: son David does mission work, and Ken and Amy participate in disaster-relief efforts. “We never preached to them [about volunteerism],” Mrs. Knowles said. “But I think being exposed to it made a difference.”

Dr. Knowles’ children aren’t the only ones who took note of his altruism. He was recently honored with the American College of Surgeons’ International Humanitarian Award. Dr. Knowles took the honor, as he takes all other, in stride. “I’m just a general surgeon from the sticks,” he says. “But surgeons can make a difference.”

-- Christine Hurley Deriso