(A Paediatric nurse from Germany who visited KHW-India from November ‘05 to March ‘06 and provided valuable services to our Special Needs Centre in Tilwara, Rudraprayag. She expresses her opinion on her one month visit to the region)
I stayed for one month in the Special Needs Centre in Tilwara, a remote village in the Himalayan region of Rudrpapryag and worked with a highly motivated set of volunteers from Samvedna. This centre caters to the needs of the ‘differently-abled'.
My visit was during peak winter month of December. During my stay I realized the uncomfortable conditions the volunteers work in, with no electricity and water. A highly motivated team, I was amazed how they could create things out of nothing and give ‘differently-abled' children hope and a chance to change their lives.
During my stay I keenly noticed the lives of the women in the mountains. The women work very hard and not only carry out household chores but also shouldered responsibility to feed the family by working in the fields. One of the pressing issues faced in the mountain is an under developed health system. Women and children suffer mainly from malnutrition. There is no Outpatient Department, hardly any Doctor or trained midwife. People walk nearly 20 kms or more to get to the nearest hospital or trained medical person and the other pressing social issue rampant in the community are gender problems.
I still remember a 30 year old lady she seemed a lot older. I noticed further and realized she was unable to move and could only do so with the help her arms and feet. She walked in small steps with the help of a stick, very stiff and very slow. Her movements were restricted she could not sit up without help neither could she communicate since her speech was not very clear. Her father came to me and said ‘She is pain doctor please give her painkillers.' I was told she had a serious infection when she was 13 years old. The father could not remember what her problem was; he just remembered that she felt sick and had fever for a very long time. ‘And then slowly' he said, ‘she could not walk and move. The mother used to carry her to the roof and make her lie down for the whole day. My first reaction was ‘Did you go to a doctor?' ‘No' he said. ‘Please give her painkillers.' I was taken aback to see her pitiable state and astonished by the fact that despite her condition she had never received any medical treatment. Cases like these were shocking and the sad fact still remained of the poor infrastructure and accessibility in these remote mountain communities.
I have beautiful memories of the region and its people, but one in particular I will always cherish. My experience with a young boy named Sagar, a nine year old who came to the centre with his mother. His mother carried him on her back all the way from their village; I couldn't help but appreciate her commitment and determined willingness. She placed him in a sitting position and placed his arm in such a manner that he could balance his own body. His limbs had no coordination and he could not do anything. As I spoke to the mother I was informed of a complicated pregnancy and an unsupervised delivery which was conducted by untrained women of the village. I was told Sagar did not cry for the first five days and they suspect that he he suffered from cough and cold which restricted his development.
There was no coordination between visual perception and movements. Even his speech muscles did not work. I identified Loco- motor disco ordination, delayed speech development and a complete retarded development because of a missing or delayed feedback for all groups of muscles. We did not find any stiffness or tightness in his joints which was a positive sign as it gave us some hope in his case.
The aim was to make him walk, to increase coordination between left and right hand to enable him with life skills where he could exist more independently eat his food, change his clothes etc. we also taught Sagar's mother to help him exercise and build his self confidence. Along with the volunteers I developed an individual therapy-plan for Sagar for the next three weeks. This plan included physiotherapeutic exercises, logopaedic exercises and also recognition of daily objects and making him aware of his environment .After three relentless weeks, he attempted his first steps with a slight help. His face was radiant with pride.