Bringing in the expertise

Patients from across the valley thronged the free medical camp for spinal injuries at Khyber hospital which had invited a team of specialists from the ISCS, Delhi. Aliya Bashir reports.

Wheelchair-bound Muneer is silent and his eyes look weary. A white cloth is draped over his “lifeless” legs. He is one among the hundreds of patients waiting for their turn to consult the spinal injuries specialist in the free medical camp organised by the Khyber Hospital, Srinagar in collaboration with Indian Spinal Injuries Centre (ISIC) Delhi.  The health camp was held on May 21 and 22.

A patient with spinal cord injury

Muneer Ahmed Bhat, 17, a resident of Abi-Guzar, Srinagar had suffered spinal cord injury in 2005 when a bullet hit him in the back while he was playing cricket near his home and left him a complete paraplegic (complete and permanent loss of ability to send sensory and motor nerve impulses to the muscle groups and body functions that are controlled by nerves). He is unable to control bladder activity and consequently uses a Urine drainage bag.

His elder brother says the delay in treatment had reduced the chances of his recovery. “Whatever was possible from our side we did that, but things would have been better if the doctors had not wasted time in just referring us from one hospital to another which caused much blood loss and delay in his surgery. Thus leaving him paralytic for a life,” he said.

After the incident, Muneer was unconscious for a week.

“When we came to know about this camp, we were happy to interact with the spine specialists who can guide us on medical as well as rehabilitation side,” says Muneer’s uncle, who accompanied him to the medical camp.

The X-Ray

The team of doctors from ISIC Delhi saw around 300 patients during the two days. One of the visiting doctors said that the patients who visited the hospital for the check-up were suffering from spinal disorders which includes back pain, degenerative spine, deformity, infections and osteoporosis and in orthopaedics-knee replacement and paediatrics orthopaedic. Similarly, on the rehabilitation side, patients availed the facilities of physiotherapy like occupational therapy, peer counselling and vocational counselling.

“Being a hilly-region with a lot of army interference, anti-social activities and tough lifestyle where people either stand or sit for longer hours which affects their backbone. These are some of the major causes for the spine and ortho-disorders,” says Abhishek Srivastava, business development analyst, ISIC.
Most of the patients visiting the camp were new cases, say doctors. The camp is part of the tie-up between ISIC and Khyber hospital.

“We choose Kashmir after we realized that it has a growing number of patients with spine injury problems who may require various spine and knee surgeries or conservative treatment (medicines or physiotherapy) depending upon the type of the cases. Out of the total patient inflow, 70 to 80 per cent of the patients would have lived a healthy life but due to lack of medical services in the state and own negligence of patients,” says Abhishek. “So we came here to extend our services to Kashmir and we realize that people don’t have financial support for a costly treatment so we are working out with Khyber (Medical Institute) to carve out some mechanism where the patients can avail the services at reasonable rates (price).”

Abdul Rehman Parray, 27, a resident of Jablipora, Bijebhara was rendered complete paralytic on September 11, 2003, when he fell from a tree just two months after his marriage. His MRI shows the injury at D-12 level.

“There is no rehabilitation available that would have help people like me to learn to cope. But, now I spend time with people having the same disability who boost my willpower and provide me with the energy and strength,” he says while adjusting his wheel-chair to be a bit comfortable.

Parray says that he can’t afford to go outside the state for treatment as he is unable to repay the debt he has taken for the treatment, which is still continuing.

“After the injury, the patients with spinal cord injury must immediately consult the spine surgeon to avoid complications and achieve early recovery. We have received the majority of spine injury cases here whose condition could have been far better with early intervention. But, the cases were delayed due to lack of medical treatment, medical negligence and mostly due to lack of rehabilitation,” says Dr Kalidaas Dutta, spine specialist from ISIC.

Spinal injury is a low-incidence but a high-cost disability which needs to bring significant changes in the lifestyle, especially the diet which the body can tolerate. Fractures of the spine can be very serious with paralysis and loss of control over bladder and bowel movement in some but generally, they are minor with no neurological involvement. Fractures of the cervical spine (neck) and thoracic spine (chest) have more chances of being associated with paralysis then the lumbar spine (lower back).

Gurdeep Singh, 43 is an example of medical negligence as he was left complete paralytic after an operation to correct his herniated disc. He is wheel-chair bound now.

“In 2002, I had my dorsal spine surgery, I came in the hospital walking to operate my disc, but when I gained consciousness, I saw myself crippled,” says Gurdeep, a resident of Iqbal Park, Srinagar. “More than Rs 7 lakh went into the treatment over these years, apart from making me a life-time dependent person.”

With a high number of traffic accidents and more than two-decade long armed insurgency, Kashmir is home to thousands of injured including the ones with spinal cord injuries. However, there are no specialist doctors to treat spinal cord injuries.

“We want Khyber hospital should be a convenience for those who move to Delhi or other states for their treatment and also who couldn’t afford to move out. So, we are in the process to upgrade their staff to handle the emergencies especially for spine injuries and other technicalities in post-operative care to diagnose, relieve gross misalignments and other structural problems of the spine to minimize cellular-level damage of a patient and thus stabilizing the vertebrae to prevent any further injury,” says one of the visiting doctors.

The ISIC is the only specialist hospital in India for spinal cord injuries.

“More than 300 patients both men and women, mostly in the age-group of 40 to 60, came to the hospital for a check-up and other tests free of cost. Most of the cases require immediate medical intervention and rehabilitation,” says an official in the administration department of the Khyber hospital.

“Out of 70 per cent of cases with knee problems, 50 require total knee replacement and other patients with spine-related problems are mostly in the need of rehabilitation. In these two days, we got an overwhelming response. Despite the curfew on the first day of our program people came from far off places to visit the hospital,” he added.

The ISIC hospital was set up in 2000 by Major HPS Ahluwalia with a $10 million aid from Italy. Ahluwalia was crippled four months after he scaled the Mount Everest in May when he received a gunshot wound in his neck at Sonamarg during the 1965 war between India and Pakistan.

The spinal injuries specialist were invited by the Khyber Medical Institute- the only hospital in the private sector across J&K that runs a cath lab and conducts certain complicated procedures.“We are in various tie-ups with major hospitals in India that help us flying in the expertise for the patients rather than encouraging them to fly out for treatment,” an executive of the hospital said.

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