Saturday, 8 August 2015

A fractured leg leads to a loss of livihood - when one is poor.




Chinapaapakka, Teja's mother, told me 'Vennai kodukoni vachchinappudu, baanda pagili poythundhi' (As the butter was coming together during churning, the pot broke), referring to her daughter Teja. 

Teja is Varalu's sister, married to Ramamurthy in Dinapeta, a neighboouring Dalit hamlet. They were a cheerful and hardworking family, even if landless and very poor. Teja, illiterate, cheerful, moved with a smile that danced its way into all hearts. The smile became weaker after her husband sustained multiple fractures when a drunken driver of a milk van knocked him down, and he stayed bed ridden for eight months. But when I met them, Ramamurthy, her husband, admitted to pain, but had only good words for the milk company which had paid the hospital bills in an out of court settlement ! After 6 months they discovered that the bone has not set right, and a re-operation is needed. No milk company was seen anywhere ... on whose assurances they had withdrawn claims.

After the accident initially they got admitted into a private hospital, hoping for the best care. The private hospital kept them and damaged the leg with poor quality operations, till Ramamurthi was unable to pay anymore. Then they were discharged unceremoniously. They then went to the government hospital.  And the festering infection in the fractured leg continued to go from bad to worse, and was on the verge of needing an amputation.  

They were in the Tirupathi government hospital when I spoke to them initially. They had spent 30,000/-  Teja said they took loans. I dared not ask at what interest, and I have no idea how she can repay.  They had no idea when they could return to the village. They had no hope of Ramamurthy even labouring again - and they own nothing, not a cow, nor a cent of land. Teja simply wanted her husband able to walk again, and come back home. Their son is in 11th, and somehow his education should continue, they hope. When I called up Teja's husband, Ramamurthy, on the bed in the govt hospital in Tirupathi, he was only wishing he coud manage to walk again. That he will probably never again be able to work and earn, and that Teja will have to singly labour, was not on their  minds now.When I asked him how he was he cheerfully told me, 'Baagunnaanu madam'.  ('I am well madam'). I had to ask him sharply what he meant by that. he said that with the painkiller tablets he feels no pain. He continues to be bedridden though, and one has no idea for how long - and that he does not even mention ! But, on asking, he said he cannot walk, as the knee does not bend, and consoled me saying that as he had been completely bedridden for the past months after the accident, the knee will take time to loosen. They are getting more X-rays he said to check up he said - I hope the bones have not fused wrongly.


And then he asks with the usual village solicitousness after my daughter and my husband., and again I am humbled totally.  

Only when I ask him about expenses and say I will send money does that eagerness come into his voice, and he asks, 'How will you send ? ‘Eppudu madam ‘ ('When madam'). because even loans has proved difficult over these long months of no income and rising expenses. He explained that the hospital gives food for one person, and Teja has to buy her food from the carts outside, and some medicines also need to be bought.  I know that Teja will be existing on one idli per meal. And for a landless dalit to have lost his ability to labour is a straight road to penury and destitution. Then the government hospital dischaged him because they needed the bed.

Vandana, whom I have never met in my life, and whom I discovered to be my school junior on FB,  moved some worlds to search out a doctor for him between Puttaparthi and Chennai and Tirupathi. I called up Ramamurthy to ask him, and as usual the cheer and robustness in his voice, as in that of all village people, restored me. I go to console, and come back consoled. He did not moan, or ask for any assistance. They never do. He did not sound like a young man in pain, and who knows clearly that his only livlihood as a labourer has been put paid to. When I told him not to fear, he told me there was no fear. When i asked him if we should organize going to Puttaparthi or Bangalore he said that Tirupathi was easier logistically with family support, and we could review a little later. I told him not to worry about expenses, and to please call for any need. And that after he came back home, we would look after costs. And he agreed happily, and left me consoled. A young, illiterate, assetless man of maybe 30 who sees his future livlihood destroyed - giving stregth and courage to me.


Vandana found a hospital in Tirupathi itself, underwrote the expenses, and operations on the damaged legs restarted. The infection and pain and swelling came down. Ramamurthy was sent home between operations as the leg had to heal before yet another operation. 


Feb 2015
Now after one round of surgeries, they are at home waiting for the two month period before the next round of surgeries. Teja called up sounding so happy - the landless family thought that Ramamurthi would lose his leg after having stayed bed ridden and worsening over 8 months. Now they feel he  will survive. 

He was able to walk slowly with his walker onto the road also. After three botched operations, each of which sent them deeper into debt, the bone itself had got infected. That was now corrected with care at this hospital.


When I  went to Dinapeta to see Ramamurthy and Teja, Teja said hesitatingly that there was no rice at home. I told her that I had already asked her to collect all provisions from the local shop where I was maintaining a running account. The people are poor, but hesitate to take too much of a favour, given their innate decency. I had to again ask them to feel free with requirements, as unless he eats well and rebuilds health, the next operation cannot happen. The poor live so much on the brink. Their son Satheesh. Satheesh is in 11th, and though he would weep at the condition of the family, he steeled his heart and studied while staying in the SC hostel, and passed his exams successfully. The village children are made of fine steel - that bends but never breaks


Aug 2015
They went to the hospital full of hopes that the leg will be operated and the last operation done and finally Ramamurthi would edge towards normalcy. But the doctor told them that the leg would never bend at the knee again. The operation post accident was so botched up that though the leg is saved from amputation  knee movement cannot be acheived. That information was delivered to them yesterday. Varalu told me Teja has been weeping since yesterday.

I  discussed the doctor, and he explained that in the last surgery the deep bone infection was addressed, which was otherwise putting the leg itself at risk. The next surgery is because the fractured bone  has stayed as seperate peices and a peice of thigh bone would have to be grafted on to address this. But Ramamurthi's bones are so fragile and weak in calcium that they cannot take the surgery, and so it has been postponed. But restoring knee mobility is impossible.

He said that had they come to him in the first place by now Ramamurthi would be running around. But these are the ways and roads the poor tread.

9 March 2016 at 08:24 ·

Ramamurthi called up from Dinapeta. He told me robustly that he is trying to walk without the walker. My heart crumples each time I deal with these situations, and each time it is their own robust cheer that pulls me up again.

Two years to date since that fateful day when the milkvan knocked him down and put paid to his labouring days with which he sustained his family. I asked to speak to Teja to try to counsel her into the third major surgery for her husband's leg. She had gone for deweeding labour for some farmer, and he said she would call back in the evening. Due to the delay of months when they ran from pillar to post trying to balance need with financial ability the infection had gone very deep necessitating multiple interventions, and an inability for complete recovery also.

This story is merely indicative of many many others. Here as my friend stepped in to cover the cost of lakhs that the operations entailed the story turned this way. In another case it would have been a silent amputation and a family's descent into destitution. It happens oftener than we would like to think.




 
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I spoke to the doctor at Tirupathi today and he said that the surgery would be done after examining of the bone could take the weight of screws. Last year I have kept Ramamurthi on some ayurvedic medicines which are excellent for bones. I hope it would be possible.  

27 August 2016 ·
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He now walks erect with a small stick, with a pronounced limp. I remember when I saw him in bed two years ago, with rods sticking out of his legs as multiple botched surgeries had been done, and then as their money and coverage had run out they were set back to their village. They had lost all hope. Ny heart also somersaulted when I saw his swollen leg full of scars.

Over two year, and three corrective surgeries, things are improved step by step. The cost of the operation went into lakhs, which my friend took on. The doctor said that if he come on day one, instead of much later after many wrong interventions, he would have been on his feet long ago, and working. The doctor also said that if he had come a month later gangrene would have set in, and his leg would have been amputated.

Ramamurthi focusses on the second fact, and is glad that he is well and walks around. So are Teja and Varalu. One more operation is due as the bones have not joined naturally, and a peice has to be fixed from elsewhere in the gap.
 
 

 
(Teja in happier times - in the orange saree)

The beginnings ...

Varalu called to ask if she can use what she gave Eashwaramma for her sister's husband who has been bedridden for 6 monts after an accident. The cut made to insert rods to handle the multiple fracture was not healing. I asked her to, and also said I'd ask Dr. Girija and confirm further medicines. Varalu called up from her sister's house in Dinapeta, and for the first time I heard Teja's voice flat. Though she still eagerly enquired after my daughter and Nagesh - a deep civilizational culture and courtesy cannot go easily.But I suppose six months of bedridden illness, for a landless family, and with al money at home having dried up, will finish the cheer of even the most effervescent person. But when I told her that she could get the walker for him, and that Varalu would drop off a sack of rice at home for immediate needs, her cheer returned.

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