Since the day we arrived here we had heard about the “Dr’s Camp” that was going to be happening while we were at the campus. January 18 – it seemed every child we had seen so far was going to come. We approached the day with a mix of excited curiosity and trepidation as we could not quite fathom how so many kids could be seen in one day. There was no official count of how many were expected and to us it seemed everyone was coming. At this point we are well acquainted with rooms crowded with children and their various family members. It’s always a little chaotic but it always some how seems to work, like many things in India.
The suspense continued to build as we waited for the doctors to arrive from Bangalore and finally, fairly late in the morning, we met the three orthopedic surgeons over a cup of tea. In typical western style, we were all wondering how we could possibly have time for tea. There were going to be at least 100 children to see! But we sat, sipped our sweet tea and got to know the surgeons, some of whom have been coming to Samuha since 1992 as part of the Bangalore Orthopedic Society. They reminisced about children they had treated and commented on the shift from primarily treating children affected by polio to the now highly prevalent Cerebral Palsy within the last 20 years. By the time we finished our tea we all felt confident in the surgeons and figured it must be time to start seeing children by now!
We were wrong. Obviously, it was the time for a welcoming ceremony and introductions. The training hall was packed full of children and their families – we could barely make our way to the front. We tried to imagine what would happen if we tried to run a clinic day like this at home with so much “wasted” time and could only picture a lot of anxiety! It was hardly wasted time as by the time the introductions and candle lighting ceremony was over we felt like a team and there was a familiarity between the professionals and the families. Something was said in Kannada, the local language, and the room emptied.
Within moments, three metal examination beds were quickly set up and the doctors were seeing children. The aim of the day was a screening clinic for children with various disabilities who would benefit from an orthopedic surgical intervention. It was under five minutes for each child and over 105 children, plus a few adults, were seen. Of those, 26 were referred for surgery. Not once did we feel that a child was unfairly assessed as much thought went into each interaction. It was impressive to see the skill and knowledge of these surgeons as they knew well what was feasible, the limits of resources and carefully considered the outcomes and risks. They consulted with each other over difficult cases and with us, creating a cooperative atmosphere and an incredible learning opportunity. Nearly every child walked away with a recommendation for physiotherapy. Before coming to India we were all pretty sure of our role as physiotherapists and the benefits of physiotherapy but after all of our experiences here, such as this surgical screening clinic, we all feel better prepared as advocates. We have seen the stark reality of what a lack of physiotherapy interventions and education looks like. At the same time, we have also seen the significant benefits of either physiotherapy as a stand-alone intervention or in conjunction with surgery.
The day was so much more than we could have ever imagined and we saw more variety of cases in one day than many practitioners will see in a year, a lifetime, really. If you can even imagine, we saw all of it in less than 3 hours. It was incredible. As students, where else can you see over 100 clients aged 6 days to well weathered and wizened with pathologies including Cerebral Palsy, congenital Osteogenesis Imperfecta, post-polio, Rickett’s, achondroplasia and pseuoarthrosis tibia.
For the 26 who were referred for surgery, meetings are held and funding arranged through various sources. So many aspects are thought of and taken care of, such as volunteers for traveling to Bangalore and care for other children who might be left at home. It was so wonderful to see the comprehensive and cooperative spirit here. The day ended with discussion about the possible underlying causes for the high rates of Cerebral Palsy and other disabilities in the area leaving us hopeful that investigation and recognition of these factors might lead to a decrease of disabilities in the future.
As we all reflected on the day we had respect for the programs here and the people running them. However, we also had even more respect for the resiliency of the adults and children living with disabilities here. They live, they adapt and they cope as well as circumstances allow and often in ways that we can’t comprehend. The day was educational, inspiring, and real.
– Josina, Sara, Madison, Krysta (UBC Physiotherapy Candidates)
*consent has been provided for all images
Phil Sheppard 