Long before advanced hospitals, air ambulances and modern medical equipment reached the remote islands of Lakshadweep, there were nurses who kept the region’s fragile healthcare system running with little more than skill, determination and courage. One such nurse is Hindumbi Kaurom Kakkada, whose decades-long career was shaped by emergency deliveries under candlelight, surgeries during power cuts, dangerous sea journeys to reach patients, and countless nights spent caring for people with limited resources. Honoured with the 2023 Florence Nightingale Award by the President of India, Kakkada’s journey is a testament to quiet service in some of the country’s most challenging healthcare settings. In this interview, she looks back on the hardships, life-saving moments and unwavering commitment that defined her remarkable career.
What first inspired you to become a nurse?
I grew up in Kavaratti at a time when even basic healthcare was a struggle in Lakshadweep. People would suffer silently because doctors were few, medicines came late, and travelling between islands during emergencies was extremely difficult. As a young girl, I saw families panic during illness because there was simply nobody around to help immediately. Somehow, those moments stayed with me deeply. I always felt that if I could stand beside people during their most helpless moments, my life would have meaning. Nursing never felt like just a job to me. It felt like service, almost like a responsibility towards my people.Even today, the greatest happiness for me is seeing a patient recover, seeing a mother smile after a safe delivery, or hearing a child cry for the first time after a difficult birth. Those moments made every hardship worthwhile.
Did your family support your decision to enter nursing at that time?
In the beginning, naturally, there was worry. At that time, nursing was considered a very demanding profession, especially for women living on remote islands. My family knew the conditions were difficult, like long hours, emergencies at odd times, and travelling between islands in dangerous weather. Still, my father came from a background of service and sacrifice. He had participated in the Dandi March with Mahatma Gandhi during the freedom movement. So somewhere, the value of serving people was deeply rooted in our family.Over time, they understood that nursing was not simply my profession, it was my calling. Their support gave me the strength to continue, especially during the toughest years when we had very little infrastructure and almost no rest.
What was healthcare like in Lakshadweep when you first started working there?
It is very difficult for today’s generation to imagine those conditions. When I began working, hospitals had only the most basic facilities. Power cuts were common. Sometimes surgeries and emergency procedures were done under kerosene lamps because electricity would fail in the middle of treatment. Sterilisation often depended on stoves and manual methods.Medicines had to come from Kochi, and delays during bad weather were very common. There were very few doctors and nurses, so everyone had to take on multiple responsibilities. In some periods, only two or three nurses managed entire wards with nearly 50 patients.Communication between islands was also extremely poor. During emergencies, we depended on fishing boats or naval ships because there were no fast evacuation systems like today. Every day demanded patience, improvisation, and courage.
What sacrifices did you make personally to continue serving in remote islands?
There were many sacrifices, but at that time, we never thought of them as sacrifices. We simply did what the situation demanded.I missed countless family occasions, festivals, and important moments because duty always came first. There were days we worked continuously for nearly 24 hours because there simply weren’t enough staff. Even after childbirth, I had to return to work much earlier than expected because patients needed care and there was nobody else available.Working in Lakshadweep during those decades meant your personal life was always secondary. But when you are standing beside a patient fighting for life, your own tiredness disappears for that moment.
What were the biggest challenges of serving patients in isolated islands?
The biggest challenge was time. In emergencies, every minute matters, but in isolated islands, reaching patients itself was often a battle. The sea could become dangerous during monsoons. Boats could not move easily. Communication between islands was delayed. Sometimes we received information very late and had to travel overnight through rough weather to reach patients, and once we reached there, resources were extremely limited. We had to depend more on experience, calm thinking, teamwork, and quick decisions than on machines or advanced technology. There were many situations where we had to save lives with almost nothing in our hands except training, courage, and faith.
How difficult was it to access medicines, transport, or emergency care back then?
Today people can access medicines and emergency services much faster, but during those years everything depended on the sea and weather. Medicines were brought from Kochi, and if the weather became rough, supplies could get delayed for days. Emergency referrals were also extremely risky. There were no helicopters or quick transport systems available regularly. Patients had to travel by fishing boats or naval vessels, sometimes in severe weather conditions. I still remember many nights when we travelled carrying critically ill patients while praying silently that they would survive the journey.
Can you take us back to the night you conducted a delivery on a ship using candlelight?
That night is still very vivid in my memory. It was during the monsoon season in the 1980s. We received information that a pregnant woman in Amini Island had already gone into labour and her condition was becoming risky. We travelled overnight on a naval ship because shifting her back safely was no longer possible.The sea was rough, the weather was bad, and electricity was unreliable. Inside the ship and later on the island, we had to depend on candlelight and emergency lamps while preparing for the delivery. There was no question of comfort or fear at that time. All our attention was on the mother and baby. We conducted the delivery under extremely limited conditions, but thankfully, both survived safely. Even today, when I think about that night, I feel emotional because it reminds me how fragile life can be and how determined healthcare workers had to be in those days.
What was going through your mind during those moments?
In such moments, you do not have the luxury to panic. Inside, of course, there is pressure and fear because two lives are depending on you. But you train your mind to stay focused. I kept telling myself repeatedly, “The mother and child must survive safely.”When resources are limited, concentration becomes even more important. Every decision matters. Every second matters. As nurses, we learned very early that during emergencies, patients look at us for hope. So no matter how worried we feel internally, we have to remain calm for them.
Were you scared something could go wrong?
Yes, absolutely. Any healthcare worker who says they never felt fear during emergencies would not be telling the truth. There were many situations where facilities were limited, weather conditions were dangerous, and patients were extremely critical. Naturally, there was fear that something could go wrong. However over the years, we learned how to control fear and focus on responsibility. We relied heavily on teamwork and experience. In difficult situations, courage does not mean absence of fear, it means continuing your duty despite fear.
Is there one patient or incident you can never forget?
One incident I can never forget was a critical maternal emergency from Agatti Island. The patient had severe bleeding and urgently needed surgery, but advanced facilities were not available there at that time. We had no choice except to transport her back to Kavaratti by fishing boat. During the journey itself, we continued a blood transfusion while travelling through rough sea conditions. Every moment felt uncertain. We were all worried whether she would survive long enough to reach the hospital. After finally reaching Kavaratti, an emergency C-section was performed successfully, and both the mother and baby survived. Even after so many years, I still remember the relief and emotion all of us felt that day. It truly felt like witnessing a miracle.
Have patients ever returned years later to thank you?
Yes, and those are some of the most emotional moments of my life. Many mothers have come back years later with grown-up children and told them, “This is the nurse who helped bring you into the world.” Some patients still remember incidents that even I had forgotten. In Lakshadweep, healthcare workers became part of people’s families because we stood beside them during their hardest moments. That bond is very special and cannot be measured by awards or recognition.
What kept you motivated during emotionally exhausting days?
The trust people placed in us kept me going. In remote islands, patients depended on us not only for treatment but also for emotional support. Sometimes simply holding someone’s hand or reassuring a frightened family became part of our duty. There were exhausting days, sleepless nights, and emotionally difficult losses. But the feeling that our work could save someone’s mother, child, or family member gave us strength to continue. That sense of purpose is what carried me through decades of service.
Did you ever think of quitting?
There were certainly moments of exhaustion, like physically and emotionally especially during staff shortages and continuous emergencies. However I never seriously thought of leaving nursing. Somehow, nursing became part of who I am. Even after retirement at 60, I returned within three months because I felt incomplete staying away from patients and hospital work. Service gives meaning to my life even today.
What did it feel like to be honoured by the President of India?
It was one of the most emotional moments of my life. I never worked expecting awards or recognition. Most healthcare workers in remote regions serve quietly for decades without anybody knowing their struggles. So when I received the Florence Nightingale Award from the President of India in 2023, I felt it was recognition not just for me, but for every nurse working silently in difficult conditions across the country. I also felt proud that Lakshadweep’s story and challenges were being recognised at a national level.
After decades of silent service, does this recognition feel emotional?
Very emotional. When I look back now, I remember the long journeys through rough seas, emergency deliveries under candlelight, sleepless nights during outbreaks, surgeries during power cuts, and years of working with limited resources. There were many moments of struggle that nobody outside Lakshadweep ever saw. So this recognition feels deeply meaningful because it reminds me that every sacrifice, every difficult night, and every patient we fought for truly mattered. This honour belongs not only to me but to the entire nursing community and to the people of Lakshadweep who trusted us during their most vulnerable moments.
