Friday, November 27, 2015

From North with love ... here's to a start !

My chest throbbed with immense pain while watching the movie” Ira handa yata,” Under the sun and moon. This movie reflected the 30 years of war that ruined the lives of millions in this country, and I felt it deeply as I was a victim of it since I was born and until I finished my medical degree. The tears of the living dead and the cries of the innocent had been reflected sharply throughout the film as I witnessed most of it myself during the time I served in an immediate post war area. The theme it carried not only bears a clear history of the war but also the humanity and its relativity towards the nation.

It takes a lot of courage and kindness to look at one another with love and compassion even when one has lost almost everything he owned. “It’s so good that it all ended doctor” every single person I met, told me, that their lives are so much better, the children are safe and they’ve returned “home”.
It was not all sunny and bright! Every day I come across hundreds of people who come to us with all their illnesses. Billions of fears, tears and pains seem to flock beneath their smiles. Even though they greet us with a smile sometimes, I have come to an understanding that it’s not easy holding all that down. Most people I meet seem to have tiredness in their faces; we can’t expect cheerful grins from them as they have lost their happiness on the road to salvation.

Rangamma (pseudonym) was a 42 year old admitted with very low hemoglobin. Apart from her medical conditions it was her eighth pregnancy, in which she carried a high risk for postpartum problems. Risk of heavy blood loss, still birth and gestational diabetes are high in elderly, multiparous women (women who have given birth to more than one child)
“Your hemoglobin is very low and considering your age, risks are high you know.” I tried to explain her situation.
“Even though I had seven children, I lost six of them doctor Amma,” she said. Amma is a word of respect in this language.
Her older boys were taken by the terrorists to be trained as child soldiers and she lost two children during the tsunami that hit the coastal areas. Tears dropped down her cheeks and I was struggling to contain mine.
“I have only one child, who’s 16 and wanting to go abroad to his relatives. Is it wrong for me to have more children doctor?” she asked.
Ramya (pseudonym) was about 26 weeks pregnant when she was diagnosed with gestational diabetes (high blood sugars during pregnancy).  We started her on soluble insulin as her blood sugar levels were rising up on each visit for blood sugar series. As her condition was manageable with the insulin I had to explain her on injecting it herself and the care of insulin .
“You should store this in a refrigerator…”
“Doctor, we don’t have a refrigerator. Do I have to stay here? ” she interrupted me.
This is a common question we always come across as most of the villages don’t even have electricity.

There were four other kids and she was pregnant with the fifth. She had most of the factors that indicated that it is a high risk pregnancy. Her condition will be severe if she’s unable to use medications at home. They’ve returned to their villages recently to their roofless homes with shelled walls. The rural hospital seems to be far away from her home and keeping her here was also a challenge as she had 3 months to go.

Asking them to come to a closer residential area for this matter was a joke as they never understood that life risks are greater than a piece of land they owned.  They barely have homes and survive on Kuli weda (menial labor) which pays about 200 to 300 Rupees a day. It’s not enough at all for a family of six.  After so much of debate and a talk with her husband, he agreed to paddle every morning and evening to the hospital nearest to them for the insulin and we taught the method of storing it in a clay pot buried underneath a cool spot in their garden or home.
Every day we come across these kinds of problems and we seem to be the listeners and bearers of their pain. Hospital is the sacred place for them to resolve all their issues and sometimes family matters too.

They expect us to resolve all their problems but all what we can do is merely help them with unrealistic solutions such as inform about them to the welfare society of the hospital, social workers or a helpful NGO.
Coming for clinics seems the only chance for them to dress up and travel. They come there with the best clothing they have, not to mention that they love silver and gold. Most of them are dressed in sarees bathed in gold or silver dust. At the end of the physical examination rounds we transform into shiny golden statues by all the dust from their sarees and salvars.
On their long run for survival many lost their homes and were taken as a human shield by the terrorists till the final battle from town to town. So, almost all of them with chronic diseases had lost their clinic books or diagnosed cards from past along with their homes, valuables and family members. Yes family members too!
Whenever we ask them what happened and why couldn’t they secure those cards or books, a river of tears fall out with the war wounded history. Lives of these people have torn, twisted and blasted sometimes but regained as I write this note now, that’s the change we see at present in this end of the country.
War had hit them really hard. Almost all seemed to bear a scar or a wound from the past.  A shell, a bullet or a bomb blast written all over it. It was so painful at start but we overcame the pain as this was a common sight.
Communication was the key of our profession as we had to ask everything to understand the illnesses. When I was posted there I had no fluency of Tamil language in which 98 percent of this community spoke.  It was the time that I regretted the most for not having any interest to learn the other language. I had to, somehow learn it and become a pro to survive and serve here. My Transformation into a Tamil language pro within weeks was a surprise to all and how I overcame that challenge is another story…