Sunday, June 16, 2013

Physiotherapy at NJH

This is a guest post by Ms. Sheron Mathew, our physiotherapist. Sheron completed her graduation in Physiotherapy from the Christian Medical College, Vellore.

I was sponsored by Emmanuel Hospital Association for my graduate studies in Physiotherapy at the Christian Medical College, Vellore. As I was the fag end of my internship, I got information that my 2 year service obligation would be at Nav Jivan Hospital, Satbarwa. I wondered where exactly this place was? 

To my horror I found that this was in the middle of Naxalite infested territory. I was scared in the beginning, but the realisation that God has called me to serve at NJH with a purpose strenghtened me.

I was elated to find out that NJH never ever had a Physiotherapy Department.

Yes! Finally I get to be the Boss. And I get to choose how to keep the department. What colours the walls should be ? I get to choose what type of things should be kept in dept. A big awesome physiotherapy dept which has all the new equipments – standing table, tilt table, IFT machine, Ultrasound machine, electrical stimulation, new plinths for patients, lots of toys for cerebral palsy kids, different gym balls. 

That was me thinking as a fresh graduate from the Christian Medical College, Vellore, where everything was provided well; - doctors, physios, occupational therapist, speech therapist, psychologist, implements, exercise machines, special rooms - without which I thought I won’t be able to run physiotherapy department.

All these thoughts lasted till march 31st 2013, when I had an opportunity to visit NJH for 1 week along with Ms. Ruth Ann, Physiotherapist who had extensive experience abroad and in mission hospital set-ups including other EHA Hospitals.
         
Sheron along with (from Right to Left) - Mr. Dinesh, Dr. Nandamani, Dr. Ron Hiles, Ms RuthAnn
All my dreams appeared to vanish off when I saw the hospital for the first time. I couldn’t see anything to build up the Physiotherapy Department. This was the first time I saw a really rural mission hospital and that too in one of the most impoverished regions of the country. Miss. Ruth Ann gave me ideas as to how I can start the dept. I went back to my department in CMC, Vellore the next week and was making frantic enquiries with my colleagues, seniors and friends who had served in mission hospitals. I was surprised to hear about creative ideas of different treatments used in the absence of hi-fi and latest technology, innovative methods of using pipes for splints, or AFO (ankle foot orthosis) made out of wood and plastics.

When I was there in NJH in March, during rounds one of the doctors mentioned me that when doctors come to hospitals like this they have to re-learn their medicines. I was not sure of what he meant at that point of time. But now I can see the clear picture.

I realised that setting up a new department is not about buying new things, or putting new colours on the wall or contructing and designing a special room. It’s all about finally trying to explore new ideas which is cost effective without any compromise of the quality of treatment.

One of the problems at present I face is perceptions of staff and people about the discipline of physiotherapy. Most them believe that it is only medicines, injections and surgery which can cure a person. Which of course, stands true in lot of cases but not in all. In conditions such as stroke, cerebral palsy, spinal cord injury they need more than medicines or injections to make them walk, stand or even lift their hands. 

Then, there is another group of people here who think physiotherapy is all about massage or “KHASART” to be fit, and physios are the people who treat only back pain, neck pain and shoulder pain. 

During the past 3 weeks in the hospital and after few village visits, I found that though there are quite a lot of patients who need physiotherapy, most of them are unaware of services they can avail, and end up being in their house on a bed or in a corner of the house for their lifetime.

I’m excited about the Community Based Rehabilitation Project for People with Disabilities in the surrounding communities. It is a blessing for me to be of service to the community through this project. It’s a long way to go but I  hope one day people with disabilities would be finally be able to live with maximum independence possible.

Then, there are stories of ignorance fueled by unscrupulous practitioners and quacks.

In last 2 weeks I had 3 cerebral palsy children who came for physiotherapy. The father of one child told me that doctors elsewhere told him that his child is floppy because her muscles aren’t strong and she needs medicines to make it strong. The mother of the second child told me that the doctor they saw last told her that her son needs a surgery so that left Side starts working.

The family of the third patient knew the condition of their daughter. But before they left the department the father queried, “What is the life span of children with such problems?  We are old now. Once we die, no one will be there to take care of her or feed her. Even her own sister won’t look after her because she has her own family to look after. We wish her time (to die) is much before ours.” This question is something I don’t know how to answer.

Before coming to NJH, I wondered at what sort of a job a physiotherapist would do without an orthopedician or a neurologist or a PMR (Physical Medicine and Rehabilitation) doctor. Till now I got to see patients in almost all those fields -  Respiratory problems including patients on the ventilator, Snakebite patients who has nerve damage due to compartment sydrome or those who require fasciotomies, acute Cerebral events, Cerebral Palsy and Musculoskeletal pains of all types.

Well I think that’s what serving in mission hospital means, where Jesus is the Great Physician, consultant in all fields, rather the main consultant who guides His children to provide the best service in the middle of all limitations to fellow beings created in God’s own image.

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