Formation of the Super-Speciality hospital project implementation team.

My family consisting of my wife Dipti, son Sai Gunaranjan and daughter Sai Sumona had driven down to Brindavan ashram from Pune around April 20, 1991 for Swami's Darshan and also to be with my parents. I noticed a flurry of activity with many persons going in and out of Trayee Brindavan building every day. This seemed quite unusual. I was told that Swami had asked the current team of expatriate project engineers to leave and had decided to take over the execution of the Super Specialty Hospital in Puttaparthi with immediate effect.

I asked Maj. Gen. Mahadevan (Retd.), then State President of the Sathya Sai Seva Organizations, Tamil Nadu, about any possibility of my involvement in this project even if it meant supervision of construction of the compound wall. He said there was no chance as everything had already been decided. Crestfallen, I could only observe the people.

Our stay in Brindavan got extended as my parents wanted us to spend some more time with them. Due to an urgent meeting which could not be postponed, I decided to leave the family in Brindavan and travelled to Pune for a day or two before returning. Around 8.15 am the day after my arrival in Pune, my father informed me that he and the rest of the family had just come out from the Interview Room in Trayee Brindavan and that Swami had given him the responsibility of executing the Super Speciality Hospital project and wanted me to assist him. My father asked me to drop everything and proceed to Chennai to meet him and Col. Joga Rao (Retd.) at the Head Office of L&T Construction Division. My job was to understand and take over a complete set of working drawings and details from them and bring them to Puttaparthi. My father also informed me that I would be required to stay in Puttaparthi till completion of the project in November that year.

Finally, I was able to tell my father that although I was overjoyed at being chosen by Swami my concern was whether my wife could manage two school going children and run the house for the next 6 months on her own. My father informed me that Swami directly asked her in the Interview Room itself if she would agree to Him giving me the assignment. Knowing how keen I was and also appreciating the once-in-a-lifetime chance, she said yes without batting an eyelid. When I think back to this episode, wherein the Lord of the Universe thought it necessary to ‘take’ permission from an ordinary person’s wife before entrusting that person with a responsibility, this exemplified the humility of the Lord and the fact that he took no one for granted. Swami always said ‘My Life is my message’, and this was a wonderful example.

This would be my second opportunity to serve Swami, the first being in 1985 when He had me design and prepare architectural drawings for the Western Canteen building the construction of which was supervised by my father.

Project initiation by the ‘new’ team

Swami had handed over the responsibility to four people - my father Brig. Bose, Mr. N.P. Vithal, Mr. Shyam Sundar Tolani and myself. The days that followed were extremely busy with endless meetings with vendors of equipment and supplies. Many of these meetings were held in Trayee with Swami being the gracious host piling food on one's plate. This was a surreal experience which I will cherish forever.

Air India had offered to provide free freight from overseas destinations to Chennai for items earmarked for the project. These were to be stored in the godown of W.S. Industries in Chennai as they arrived, to be sent to Puttaparthi by road as and when required.

It was decided to give priority to the Cardio Vascular and Thoracic Surgery department and all efforts were to be concentrated towards this goal. My father and I left for Puttaparthi by road on 21st May 1991 to take charge of the project site but had to return to Brindavan ashram due to disturbances as a result of Rajiv Gandhi's assassination. We finally left and took charge of the project site on the 25th of May.

I returned to Brindavan after leaving my father in Puttaparthi on 30th May to report to Swami the state of progress of civil works on site as well as the available labour strength. After having done so, Swami permitted me drop my family in Pune but asked me to return by 7th June or so when He was going to inaugurate a private Hospital in Bangalore. He particularly wanted me to study the layout and arrangement of the cardiac ICU which He wanted replicated in the Super Speciality Hospital.

Working with L&T

The L&T project engineers were understandably apprehensive about the abilities of a group of ‘devotees’. On top of that, my father was 82 years old at that time, Mr. N.P. Vithal and Mr. Shyam Sunder were retired and in the late 60s while I brought up the rear at 40. They naturally found it hard to believe that this motley group had been assigned with a mandate to complete the project within the next 5 months.

It took some collective effort on our part to convince them that although we could sing bhajans we could also be professionally competent. We had a very constructive relationship thereafter.

After surveying the entire project site on 25th May we were quite alarmed that there was little progress in the main hospital structure. Over the next few days, we had extensive discussions with the L&T project team to chalk out and implement completion of the East wing which housed the cardiac related facilities. We were able to come up with a detailed phase-wise schedule which I carried with me to Brindavan and handed them over to Col. Joga Rao (Retd.) who would show them to Swami.

We were also concerned that no work at all had been undertaken with respect to construction of the main entrance dome which was the most important visual element of the entire hospital structure.

The main dome was to be supported on 16 RCC columns along the periphery and had to rest on hard strata. Instead of excavating pits for each of the RCC columns individually, L&T decided to do mass excavation of the entire area under the dome. This served two purposes - one it was faster although more expensive and the other was that it provided firm ground to support the enormous staging and scaffolding structure to enable casting of the dome more than 25 metres above. With a view to taking advantage of this situation we proposed to Swami through Col. Joga Rao (Retd.) that instead of refilling this entire area, we be allowed to turn it into a basement which could be used as a store. Swami did not approve so it was refilled and compacted.

The hospital design was prepared by Triad Associates, an UK based architectural firm. Thus, the original design provided an entire mezzanine floor of 2.5 metres or approximately 8' height running the entire length of the curved corridor on the first floor. All services including water, electrical cabling, medical gas pipelines, etc. were to be housed in this area for easy maintenance. While this may have been a necessity in harsh European winter conditions, we felt this was a wastage of space as these services could easily be located above the first-floor slab thus freeing up vast floor space which could be utilised in other ways. There would be a little extra cost due to the increase in height to match the floor height of rest of the first floor. Swami agreed to our proposal and thus many new departments came up which were not there in the original

design.

Swami is the ultimate doer and we are merely His instruments

In our eagerness to save money and bring down costs we proposed replacing the marble floor in public areas with cheaper locally sourced stone. Swami turned this down and specifically instructed me that no specifications must be changed from the original proposal. To emphasize His point, He told me that just because the hospital was to cater for poor and needy patients it must not look like a cheap hospital. He told me that there must be "Show" so that patients entering the hospital for the first time should feel they are in a "palace" and were not being taken for granted. He advised all of us not to be unduly worried about costs.

By far our major concern was the timely completion of the project. Since I was not present on Swami's birthday the previous year, I assumed rather naively that we had to only complete the Civil works related to the project by November of 1991 with installation of equipment and services to follow thereafter. I was stunned to learn very soon that Swami had already announced that the inauguration of the hospital would coincide with an open-heart surgery. It seemed impossible to achieve this target in less than 6 months given the location and lack of infrastructure. With no internet and scratchy telephone services, our regular and most reliable means of communication with L&T head office in Chennai was through the driver of the daily Chennai-Puttaparthi-Chennai bus service.

Well-known art historian and designer Prof. Keith Critchlow had been engaged to design the various embellishments and decoration to the hospital structure. While these were indeed very well detailed and beautiful, it was an onerous task to convert them into brick and mortar.

We managed to convince Col. Joga Rao (Retd.)  on the need to simplify Prof. Critchlow's intricate designs as we just did not have enough skilled artisans or "stapathis" to complete the work in time as each concrete pillar had to be done individually. A steel scaffold had to be erected for each pillar and it took the stapathi with 2 assistants at least 2 days to complete one pillar and we had a humongous number of them. Our suggestion was to simplify Prof Critchlow's intricate design so that this could be incorporated in the formwork of the RCC pillars itself requiring only a little bit of finishing to be ready for painting. Swami would have none of this and our suggestion was summarily rejected. Stapathis were located and hired from all over South India to complete this work!

Later on, Col. Joga Rao (Retd.) informed us that Swami was against any changes in the external look or elevation of the building no matter how difficult it was to execute lest it was said that the project could be completed in such a short time because the original design was simplified.

Philips had been given a turn key contract for setting up the Angiography Catheterisation lab completely. The equipment had already arrived in Chennai from the Netherlands in crates with an instruction that it should be transported to Puttaparthi without being subjected to bumps. That was easier said than done as the road from Chennai was full of portholes as a result of heavy rains that year.

It had been decided earlier between the head of Philips medical equipment division and us that their equipment was too large to be brought up through the staircase. The solution was that the entire crate would be raised by crane and inserted externally into the space provided for the lab. We would construct a temporary external wall in the lab which would be demolished and reconstructed once all the equipment was in. The Philips engineers also informed us that they would open the wooden crate only after we provided a dust-free and air-conditioned environment. This requirement was impossible to fulfill and so they unpacked and assembled the equipment with civil works still on.

There were problems galore. Due to erratic power supply from the State Electricity Board, a standby diesel generator set from a reputed manufacturer had been procured and installed. However, it soon developed a problem belching copious amount of dark grey exhaust and consuming large amounts of fuel. There was nothing anyone could do as shutting it down even for a short period was not an option.  

The large UPS system, again from a well-known manufacturer, had also arrived and was in the process of installation and commissioning when we suddenly found that the batteries that came were not charged. This was in the evening of 18 November 1991. The nearest place where these batteries could be charged was Anantapur – 80 kilometers away. Thanks to the resourcefulness of L&T, a vehicle was quickly arranged to transport these large number of batteries. By the time the vehicle reached Anantapur, the electrical workshop had closed. Somehow, they were persuaded to open and the batteries put on charging for the night. The duly charged batteries arrived at the hospital site by afternoon of 19 November and the UPS finally commissioned.

The four members of the Super Specialty Hospital project team had a designated place during Darshan, and Swami would often come and speak to us and allow us to do padnamaskar before leaving for the project site. He had also allowed us to use His green Jeep as our means of transport. One day in early October of 1991 Swami came to us during Darshan time and looking sternly asked "hospital engineers " to proceed towards the interview room. We were woefully behind schedule and could not comprehend how we could have a functional hospital in a month and a half. That day Swami did not call anyone else for an interview and we were sure that we would be reprimanded for the slow progress of work. Childishly we were rehearsing what answers to be given should Swami asked us questions on various parts of the project. Swami finished giving Darshan and still looking stern without a smile on his face, gestured towards the interview room. By then we had all broken into a cold sweat expecting the worst. We entered the interview room and Swami closed the door after us, switched on the light and seeing our grim faces and demeanor gave us a beautiful smile. He said that we were called to be informed that the Prime Minister of India Shri P.V.Narasimha Rao would be inaugurating the hospital on 22 November 1991. Swami went on to say that He was happy with the progress of work at site and stated that what others would have taken 5 years to complete, Swami had done it in 5 months. He went on to say that His engineers should look smart when presented to the Prime Minister so safari suit lengths for each of us had already been packed and kept ready. As the other members of the team had a pension and I was self-employed at that stage, Swami called me aside and slipped a 500 rupee note into my hand and said that this was for stitching charges. He advised me that as Puttaparthi tailors were not good enough, I should get it stitched in Anantapur. There was absolutely no time to do so.

This was a very important lesson for me that clearly demonstrated that once He has decided to do something; there is nothing that can come in its way. He had willed that this seemingly humongous project be completed on a certain date and so it would be. The other lesson for me was that Swami was sensitive to the fact that I was the ‘youngest’ and not on a pension. For this reason, He felt an extra responsibility to hand me 500 rupees for stitching charges. Needless to say, I have kept this amount safely! The other take-home message for me was that He is the doer and we are merely His instruments.

The final stretch

Around 9 pm on 20 November there was a knock on the door of the room given to me. On opening the door, I found a very excited Dutch gentleman who was the Head of the medical equipment division of Philips. I had met this gentleman first in May at Brindavan ashram and subsequently during Guru Poornima that year in Puttaparthi. He told me that he had just witnessed a "miracle" and wanted me to follow him to the Angio Cath Lab in the hospital right away.  On the way to the hospital site, he stated that what he had witnessed earlier that evening was indeed a miracle as far as he was concerned. He said during his last visit about a month ago to the hospital site he saw bricks being carried manually by labourers and thought to himself that while we wanted the latest equipment in the Cath Lab, we were still following ancient construction practices involving manual labour. He wondered how on earth could we operate such a sophisticated piece of equipment in a place with very limited infrastructure.

Moreover, Mr. Vishwanathan their project engineer had made it clear to us that he would open the wooden crates only after air-conditioning was functional and the entire area was dust free as the equipment was sensitive to dust. Since this was not possible, we practically forced him to get on with the installation after sprinkling some vibhuti over the crates. To add to their problems, they discovered to their dismay that Philips in Holland had forgotten to send some extra PCBs (Printed Circuit Boards).

Philips were resigned to the fact the Angio Cath Lab they had set up would turn out to be a complete disaster as none of their pre- conditions were adhered to by us. On reaching the Cath Lab he showed me images of a procedure completed earlier that evening and recorded on 70mm film. He pointed out a number of blood vessels a few microns thick that could be clearly seen. He went on to explain that he had installed similar equipment in various parts of the world but had never achieved the clarity and resolution he saw to his amazement that day. He said he would call this his Gold Standard and would try and achieve this in the installations carried out by Philips the world over.

Dr. Venugopal and his entire team had arrived from AIIMS, Delhi for the first surgical procedure on the morning of 22 November 1991. Hon. Prime Minister was supposed to witness this along with Swami on CCTV so everything had to be right and it was. There was a heavy downpour on the night of 21 November and we all rushed to the project site to assess the situation. We were aghast to see a shallow lake over the entire seating area for the next day's inauguration function. A quick decision was taken to bring in dumper loads of quarry dust from a stone quarry set up by L&T a few kilometers away. My understanding was that over 100 dumper loads of quarry dust was off-loaded on the water-logged areas with earthmoving machines levelling them evenly. This operation went on throughout the night and was completed by early morning on the 22 November. The sun came out brightly and am pretty sure that most of the special invitees for the inauguration had no idea of the scene only a few hours ago. The inauguration function went off flawlessly and so was the surgical procedure in the Operation Theatre.

Our team was given a few days off to let the surgical team from Delhi complete their assignment. I was the only member of the team not permanently residing in Puttaparthi and sent a request to Swami through Col. Joga Rao (Retd.) that I be allowed to stay and complete the Super Specialty Hospital project. A few days later Swami called me for an interview and after creating a navaratna ring advised me to go back to Pune and be with my family. He said I should start getting back to professional life after taking leave of absence for six months. I am eternally thankful to Swami for allowing me this wonderful opportunity.

 Jai Sai Ram