Its week 2 of my time in Southern India on placement at Amar Seva Sangam. I’m continuing to work with my patients and build their independence. this week we got a chance to do some home visits, 1 for a current patient, and 2 paraplegic patients that have been discharged earlier this year. The weekend brought us to the magnificent city of Madurai for some much needed meat and booze (as I feel most weekends will be for).
We visited the famed Meenakshi Temple, a square complex with 5 outer gate towers, or goporums, each with over 100 intricately figurines. A temple had been present around 1300, but the compound as it stands today was first constructed by the first Nayak king, King Viswanatha Nayak, around the 17th century. The 2 East goporums accommodated the king’s procession into the temple from his palace, the Thirumalai Nayakkar. His massive amounts of wealth allowed this king to build such amazing, oppulent structures. In fact, the palace today is a mere fourth of the size of what it was originally, and it was already pretty huge!
Nowadays, money has the power to also do great things for people, there’s just no getting around it. Research shows that for spinal cord injury patients, what determines your overall outcome is namely social support, education level, level and severity of injury, and financial resources. During our visits, this week, the two paraplegia patients had quite a bright outlook. Level of injury was lower, one could walk short distances, and both were fully independent with all areas of self-care (that’s mainly your feeding,toileting, bathing, mobility etc.). One guy was even fortunate enough to have parents buy a second house in the edge of town, and make it fully accessible for him and his wheelchair. Affluence, in this way, is power. Power to accommodate a life change, power to have options to choose from.
In stark contrast, when we visited the family of our patient with quadriplegia (he isn’t due for discharge until end of July), the only word that came to mind to describe the situation was “grim”. This man is on a wheelchair and has limited control of his arms – he needs someone to take care of him. The house was very small, steep steps leading to the front door, and doorways too narrow to fit a wheelchair through. Both parents have their own health problems, leaving a sister with a baby to care for him. Absolutely no money for equipment or home modifications, let alone a move to a new home. The family knew it would be grim for him if he came home. Life would be better at ASSA. This was absolutely heartbreaking. What’s worse is that his wife left him after the accident, taking his two children with her. I’m told this is common practice in India. Cruel, but again, likely driven by the fact that the man will likely not be a breadwinner for the family anymore, leading her to search elsewhere. It seems to always come down to money one way or another. I now know that every time he puts on a smile for treatment, it’ll be a testament to the bravery of knowing what potentially lies ahead for him, but not giving up on himself. It’ll be a hard push of therapy for the next few months for sure.
As cheesy as it sounds, visiting these homes, whether in town or in remote villages, makes you realize how much we have in the western world. If I were to (God forbid) have a serious injury, I could count on my family and friends, as well as a strong healthcare service to provide me with the rehab and care I need. This is not to be taken for granted and is something I’ll take with me into practice and life.
Finishing on a lighter note, Madurai is really a beautiful city with wonderful people. As with all popular tourist attractions, be aware of touts and scams (we encountered a tuktuk tout immediately after we got off the train), but also open to people who are genuinely trying to talk to you. The rooftop bars are not to be missed – a great place to have a cold beer after a long, hot day at the temple! As a bonus, take the train there for a slice of true Indian life. We did, and on our way back, the only space left was the luggage rack above the seats. Guess where we sat?