Wednesday, December 7, 2011

le skippy

Bicycling Australia Feb/Mar 1994

Monday, December 5, 2011

Sweeping leaves on a windy day

I love the colour, the sound, the smell of India. It is an incredible place of immense diversity and depth. There is a part of my brain that comes alive when I am in India. My senses heighten, my mind races. I feel breathless. It is wonderful to be back.
Sunday. A day of travel. A flight from Singapore to Mumbai. Runway problems in Mumbai and a flight delayed. A quick lunch with Ramesh and his family. Hello. Goodbye. A flight from Mumbai to Nagpur. A flight delayed. I meet again with our driver, Ramsing. We do not understand each other but we smile and hug. A human bond re-established. We understand each other. We drive to Amravati. Deft handling: man and machine one and the same whilst hurtling through the cacophony of traffic that so typifies India. Ramsing is a magician. At Amravati I meet up with Dilip and the Australian contingent of the team regroups. Dinner at 11pm. We sleep in the house of Avinash.
Monday. Up at 0430 and we gather the three young interns that will join us on the camp. This is India yet I am still amazed how much stuff can fit in one vehicle. Avinash, Dilip, myself, those three interns, driver and assistant. Plus bags and gear. For now, I feel thankful that the team is only half that of last year. A small team where no-one is superfluous and we will have to work hard to get through the cases. This is India. Where things are done at the last minute. And plans often change. Where making do and compromise is a way of life. We drive to to the Mahatma Gandhi Tribal Hospital in the Melghat region of central India. We are greeted by Ashish and Kavita. We unpack, have lunch, then start the clinic. We identify what we can do within the constraints of this small hospital. We finish later than expected. The villagers wait a long time.
Tuesday. The anaesthetic team had arrived overnight from Nagpur. By India’s frenetic timetable I had gone to bed too early. No doubt there was much for them to catch up on. These are Dilip’s friends and colleagues and they join the camp because Dilip is here. I remember Bapat from last year. Relaxed, experienced, capable and overweight. She radiates a comforting reassurance. She brings 3 junior anaesthetists with her. We start work at 8am. We have a lot to get through but the start is slow. The start is always slow. And frustrating. The oxygen cylinder is empty. The couplings for the replacement cylinders don’t fit. Things are not ready. I watch and wait for activity to show signs of effect. The first case gets underway just before 9am. By midday we have completed three cases. Then the calvary arrives from Nagpur. Dilip’s good friend and fellow plastic surgeon, Shailesh, who I know from the camp last year. And two orthopaedic surgeons, Makaranda Dhopavkar and Abhinav. The pods are coming for the first time. And they come with their equipment. The theatres hum with activity. And good work gets done.
Wednesday. The cock crows as the dawn breaks. But India has already awakened. Today is more of the same. A hearty breakfast: Indian fare typical for this area, always a variety of dishes, all vegetarian. A gradual build up of activity. Either theatres are getting more organised or I have accommodated. Activity peaks by midday. Then things grind to a halt as the anaesthetists prepare to leave. As does Shailesh and the orthopods. By 2pm they are on their way back to Nagpur. We have lunch and use this time to visit Ravi in his home village. Dilip, Avinash and Ravi have all worked in this small village. They have a deep attachment to this area. Dilip went on to train as a general surgeon and then a plastic surgeon with further training in the UK and Australia. Avinash started his physician training but gave this up and started Prayas. Theirs is a complicated story. Ravi stayed in the village. He still lives in the house the villagers built for him a quarter century ago. I meet Ravi’s wife, Smita. She is more talkative this time. “I meet you last year. You were tien then” . “A team?” . “No” . “Teen?” . “No, no” . “Thin?” . “Yes, yes. You were tien then. You are now fat.” We have dinner with Ravi, Smita and their adopted daughter, Swati. They have two sons - one manages their farm nearby, another studies to enter medicine. Ramsing joins us. I sit listening to their conversion on a swing chair made of rough iron and wood, worn smooth over time. I feel at home in a house and country that is not mine. I do not eat much.
Thursday. We have a lot of work ahead of us. Vijay has arrived overnight from Nagpur. Confident and capable he juggles two patients, a revision parotidectomy under a general anaesthetic and a post-burn contracture under local anaesthetic and sedation. I had forgotten how much of the work is post-burn contractures. How often they require skin grafting. How menial I find the task. How my skill sets are woefully inadequate for this camp. How frustrating the language barrier can be when you have a job to do. How I hate disorganisation. How much I like things my way. How I am not, by nature, a team player.  Before midday the anaesthetic team from Akola arrives: Nitin and Sharayu. Vijay has played his part in keeping the theatres running. He returns to Nagpur. His father is unwell. Parikshit arrives as Vijay leaves. Like a younger Shailesh, he too is plastic surgeon hailing from Nagpur. He brings with him his reliable electrocautery machine and his assistant, Digambar. Unqualified but young, skilled and efficient like the pretty nurse assistant that had earlier arrived with Bapar. They are effective. The theatres hum with activity. And good work gets done. We finish late.
Friday. Our efforts for this year are at an end. Ashish tells me we have done 54 surgical cases. We did 56 last year. But the cases were bigger this year and Dilip is satisfied. For some people we have made a difference.