Latest blog post:The Matador of Smiles
"The matadors are here, let the battle begin!", cheered my co-physician Sharad (name changed) as we began to scramble through the 300 patients brought to our Ambulatory Clinic by the Forest Ranger’s vans at the Kokrajhar forest in Assam.
After finishing my internship from the highly sophisticated, state-run JJ Hospital in Mumbai, my life was going to change forever as I decided to volunteer for a tribal health mission for the Vanvasi Kalyan Ashram in the monsoon of 2010.
As our jeep pushed through the narrow mud lanes, I could see hutments ravaged by the Brahmaputra floods, homeless running away with their belongings, officials distributing food packets and cattle floating along the banks. The chaos evoked horror and yet a lot was still to come.
Our camp had three cane-walled rooms that harboured 3 doctors, 5 nurses and 7 attendants. It was overwhelming that they were used as the OPD, the ward, the lab, the pharmacy and also the OT and catered to nearly 500 patients per day. Most of my patients were Bodo Adivasis (nomads) oblivious to the world; we may have been the first few doctors they had seen in decades. To some we were saviours; to others just warlocks.
Every challenge here was as inflated as the resources were deflated. Once, we admitted a 3-year old, puffy, severely malnourished girl Arita (name changed) with persistent loose motions. Clinical judgement suggested Kwashiorkor; hence we began treating diarrhoea with supplemental nutrition. 6 days on, we realized we’d missed the target by miles as the bloating worsened on the face, urine ceased and the child went pale in shock. I desperately pulled out the portable ultrasound to examine the kidneys, and to my utter horror they had crumpled to the size of a candy wrapper.
I knew that it was a contracted granular kidney. Umm! Or maybe looking at the abdominal guarding it could even be a ruptured polycystic kidney or in this part of the world even a ruptured renal Hydatid cyst. There was nothing to confirm. 2 days later, Arita succumbed to toxaemia and respiratory failure, she died in my arms.
With remorse in my eyes, I unsuccessfully tried to hide my tears as I desperately carried Arita’s body for 800 km to Kolkata for a post-mortem; only to discover Meiloidosis Glomerulonephritis, a rare manifestation of Burkholderia pseudomallei infection. Still a student, my heart quivered and mind perplexed over the dilemma of putting an early diagnosis in the resource deprived jungle.
Unfortunately at Kokrajhar we were 800 km away and centuries behind even from the idea of a renal transplant or even the RIGHT antibiotic.
Then, would a diagnosis have helped at all?
The hours of work may not tire you, but the incapacitation and helplessness will. Scarcity often causes conflicts; it makes hope fragile and crushes your wine-coloured dreams. I often wept in frustration over our utter failure to mitigate such ubiquitous human suffering.
Several heads peeping into the Pharmacy window, hundreds of expectant mothers waiting for a single ultrasound machine and the neglected infections often more severe than the textbook photographs made these challenges worth pursuing.
The unshakable spirit and enthusiasm of the Bodo volunteers left me spellbound. Hours after hours they walked barefoot into the deep forests convincing the tribal-folk, cooked food for the homeless and nursed the ill. From 8 in the morning to 7 at dusk they persevered with no signs of exhaustion. Each day ended with patients going home in the same matadors that brought them in, smiling and waving hands.
Torn by utter poverty, deprived of any state support, repeatedly attacked and raped by naxals; to see these innocent faces smile was nothing short of divine.
As I packed up on my last day, I wondered if I had just begun to realize the true altruism that Gandhi once proposed, "No matter what you do it will always be insufficient, do it anyways". Walking with the tribes in their desperate moments has only strengthened my intent to continue my battle.