Southern India – All the way Down

I’m sitting in my bedroom writing this on a tablet without a keyboard. This is the first of 5 weeks that I will be spending with s friend and classmate Clare, and our preceptor (fellow Queen’s grad) Jamie. It is also the first week of the final placement of my master’s before I am completely done with it. Our journey here was brutal as is expected when your flying across the world. Toronto to Istanbul, Istanbul to Mumbai, Mumbai to Trivandrum, then a 4.5 hour taxi ride to Amar Seva Sangam. For decades now ASSA has been an unique facility in Southern India providing care for people with disabilities. We will be working in the spinal cord unit, something that I have not had much experience with.

Couple resident goats on site

We arrive in the early evening completely exhausted. However I have been sitting, drinking, and eating like crap for the better part of the 30+ hour transit, so I muster up the will power to go for s run. I have been to India before, where I found out the really awkward way that staring at people is not considered rude. The people here tend to stare with intense eyes, but as with many countries, a smile and a wave helps shatter the tension and you become the token Chinese guy in town haha. The weather is unapologetically tropical. Smothering humidity gives skin an instant and constant glisten, and you struggle to feel clean for longer than 10 minutes after your shower. The roads are narrow, and the diving line down the middle of the road is mostly ignored by the local motorists. This could be any tropical Asian country. Rural Taiwan? Thailand? Cambodia? But what seals it in is the free roaming cow I see every few minutes haha. ASSA is remote. Like located between 2 small towns, no running hot water, nearest city is r hours away kind of remote. This should be interesting.

One of the many cooks preparing our food

In all honesty I was struggling to find the excitement for travel that initially motivated me to apply for this placement. I had just come off 8 weeks of placement in small town Ontario, and had a mere weekend to relax and decompress before jumping into a plane to India. We meet Jamie, a 6 year Queen’ OT alumni. She’s been doing travel OT in the US and UK since she graduated, and has been traveling her way south to Tamil Nadu for 3 weeks. Meeting her brings s sense of relief to me. Thank God she isn’t stuck up and a stickler for minor details. She cares first and foremost about helping the patients, and leaving ASSA having completed a viable, self sustaining project. Excellent. Her eagerness to travel the area also helped get me out of my slump and ignite that excitement that I had when I found out I was accepted to international.

So, my patients. Kris (pseudonym) has a severe back deformity and sitting causes pain. Our first order of business was to design and build a back rest that provided comfort and support roar him in a sitting position.

Gary (pseudonym) requires training for lower extremity dressing, and general upper body strengthening. I’ve been working with him on strengthening muscles that help with independent transfers. The more he is capable of doing by the time he is discharged, the more accomplished he will feel in his daily life at home, and the easier it will be for his caregivers to take care of him.

We are specifically working with patients with quadeplegia. Basically that means the spinal cord was damaged in the cervical (neck) region, leaving the patient with limited arm function, and no leg function. Trunk and bowel control is often poor as well. The best way for me to describe practice here is creative adaptation. With resources and professionals so limited, I can’t simply find out what s patient needs, and refer to a specialist. Patient needs a custom back rest? Its up to me to design, mold, and fit it onto the patient. No company of experts to refer to. Everything requires you to look at what is available, what the paint needs, and creatively finding a way to meet those needs. I can already tell this very hands on approach to OT practice will appeal to me. It’ll certainly keep things interesting!

On day 2 we made a splint using the standard thermoplastic we use back home. However, without any of the tools, it took 3 of us positioning the patient’s hand, boiling kettles of water, and shaping the splint to make the finished product! Our project in our 5 weeks here will involve making a resource for patients and their care goers. Our plan is to train key stakeholders at ASSA and have them provide future education sessions on SCI to help with s smooth transiting back home. Hopefully everything goes ad planned!

The island temple off in the distance
The island temple off in the distance
The Kumari Ammam temple at Kanya kummari
The Kumari Ammam temple at Kanya kummari
Taking a stroll by through the local neighbourhood
Taking a stroll by through the local neighbourhood
Kids playing by the boats
Kids playing by the boats
Some kid playing cricket
Some kid playing cricket

A high up view of the beautiful coastline

When the weekend finally arrives we make our way to Kanya Kummari, the southernmost point in India. first order of business is meat (I could feel myself wasting away), and booze (ASSA has a strict no alcohol policy on site). In fact, Saturday night e brave a walk down a shit smelling alley to a wine store to buy beer. We’re swarmed by locals asking for photos that we have to make a b-line out of there. The things we do for booze when deprived.

We brave the lines of local tourists and and mid day sun to go to the island temple here. after a delicious lunch on Sunday, we wander through some of the small streets along the beach, eventually finding a white Catholic cathedral in town. I especially like interacting with the kids here because it really seems genuine. with adults that come up to take photos with us, I cant help but feel that id the result of the glorification of western culture. I could be wrong but who knows. Back to work for another week!


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