3 January – New Year Thoughts

My last thought of 2013 was a look back at the factory so my first one for 2014 should be looking forward.

Sambhavna is a wonderful place, offering a wide variety of treatments to anyone of the gas or water affected people in Bhopal. Other hospitals should offer free treatment and medicines to the gas affected, though many will not give the medicines, but there are none for anyone affected solely by the water.

Although we see many patients each day there is a crying need for more clinics like this, situated among the bastis (or areas) here in northern Bhopal. Sathyu has chatted with me in the past about creating some satellite places that could be on a small scale with maybe a nurse and therapist present all the time, a visiting doctor, emergency equipment (with nominated first-aiders of course) and maybe a prescription collection service.

But that all needs money which, at the moment is not available.

In the meantime the service that we offer here in some ways only scratches the surface but is, at the same time, a boon and life-saver.

Within the treatments that the physical therapists offer we can do much good work both to help recovery and ease the stresses of daily life. We, in society, often fail to see the benefits of the latter yet that is where we can bring a huge benefit. The pity is, of course, that it is hard to monitor and gauge effectiveness. If someone has a broken leg and the therapy heals them faster and better than no therapy, we have a measurable benefit and research result. If it just helps someone ‘feel better’ and leads to them functioning in life and home in a more relaxed and positive way – well; who can measure that? No-one is even trying, in a scientific context. Yet it is always part of the treatment even if the measurement is the recovery part.

So the doctors refer the patients to Biju, Beena and now me also, usually for a specific purpose. Frozen shoulder, kyphosis etc.

There is one exception that I have. Mhd Khaleel is 72 but, in an affluent, ‘western’ sense probably looks older. He has been affected by the gas and water and, in health terms, is not in good fettle. He has some undefined mental problems and a heart attack a while back and now has aches and pains over his body. I suppose my UK doctor might call it fibromyalgia and, rather like back home, no-one really knows what to do about it. So he is coming to me for what I would call palliative care. As I write this today, he had about two-weeks of treatments from me in December and I referred him back to the doctor to see if he wanted to do anything else, and he has now been referred again. I did chat with Dr Jay about him, during the previous set of sessions and we basically agreed that the treatment for him is about long-term care and management of symptoms and conditions. And, who knows, the gentle physical work with that unknowing aspect of human touch, so lost in today’s societies, even here, may work miracles.

It really doesn’t matter if we don’t have a machine to measure the result or effect. As sensitive humans, we can make our own judgements and interpretations and KNOW, just know, it is helping. After the last session series, he reported being free of pain and that what helped was my treatments. Partly, this is from the human connection. He is a lovely man, and, despite his problems, always comes along smiling and joking. He is deeply religious and I have seen him doing his puja, or prayers, quietly to himself in the canteen area.

I think that our society values the work of the physical therapist too much in just physical effects. Yet we affect on many emotional and mental levels also. Many years ago, as the final part of my Shiatsu training, I did a project working with several paraplegics, ie people with some spinal cord lesion and paralysis in their lower limbs. One woman, Mrs Singh I remember her name was. She had everything organised with her family at home where I treated her and they were loving and supportive. But one day she quietly said to me, “you know, Ian, you are the only person who wants to touch me.” That thought brings a tear to my eye even today, 20 years later, and I remember Mrs Singh and her message for the world.

So it is with Khaleel. As Biju once said, “I don’t work miracles. I just do a few things with my hands.” Well, my message to all touch therapists is that, actually, you DO work miracles. Every time.

Yesterday, another elderly man who is still involved with Sathyu and Rachna in the campaigning, and has received a couple of impromptu 5-minute sessions from me was in for a nebuliser treatment, after which I did a short session on his legs before my next patient arrived. I asked Shabnam, the nurse and my translator, to tell him to come again today and I will do a couple of weeks sessions on him. I have had no referral from the doctors, and there is ‘nothing wrong with him’ but I’m going to do it anyway. And I am sure that if I asked them it would be OK.

Another patient, just over 60, had a stroke a couple of years ago and has only recently come for treatment. The main residuary effect was poor movement range and usability in his left arm, hand and fingers, the reason for the referral. I have done 18 sessions so far and the effect is brilliant. (Notice the fingers, he could not hold them straight just over a couple of weeks ago.) Not only that, but it has affected his wife also. She is happier with him as he had got into the habit of holding his arm bent (she remarked on it) and now he can straighten it and use his fingers more. So much so that she invited me to lunch a couple of days ago. So the miracle even gets passed around.

He continues to do the exercises I have given him and will improve still much more.

I mentioned the stress word earlier in this post and many people around here who attend this clinic and many who don’t will be suffering from a form of post traumatic stress disorder (PTSD). It’s a bit of an overused phrase, maybe, in UK and other western countries but is very real for servicemen and women returning from war zones. For those alive at the time of the disaster in 1984 there must be a huge potential effect and, maybe because of illiteracy and the ‘just get on with living’ attitude that tends to prevail in countries such as India, there is no specific attention given to it.

I know that Aziza, one of the nurses, still gets flashbacks. She was a young pregnant wife at the time and aborted the baby, literally as she was running away. She tells her story in The Bhopal Marathon (see p8). Her husband has since died from leukaemia, one of the common cancers here, doubtless brought on by gas and water exposure. Not surprising then that she suffers mental and emotional trauma. And there are many similar stories untold.

I remember someone, maybe Biju, saying there used to be a counsellor attending on a part-time basis but it was discontinued as no-one used it. Maybe there is a stigma about mental health problems as there is in many societies?

Perhaps some physical therapy would answer the need, but I wonder if any patient would talk with a doctor about mental or emotional issues. It is this sort of thing that leads me to think it might be an idea to let people refer themselves for body therapy (Panchakarma) as, I believe, they can for yoga. The only problem would be that we would need at least a couple more permanent therapists, and thus rooms but in my view they would pay for themselves in benefits.

Biju updates treatment records.

Maybe this is where the satellites could really come into their own.

It will be interesting to watch the development of the clinic over the year and into those following. As the 30^th anniversary will be this year in December, it is particularly important that we move forward.

Postscript: I wrote about the local elections a while ago. In Delhi, a new ‘people’s’ party entered the frame and removed the overall majority from the ruling party. It is developing as a national party and putting up candidates for the national elections later this year. Rachna Dingra, a widely experienced campaigner and speaker (and Sathyu’s wife) is being put forward for the Bhopal seat. She will, of course be campaigning on a range of issues, not just about the disaster but, as she says, many issues have similar if not the same arguments. Let’s see where that will take us into the future – Rachna for PM might be a little premature but dreams must be big.