Polio victims are a common sight on the streets of Indian cities. There was a time, less than a decade ago, when eradicating polio from India — home to nearly half of the world’s polio cases — seemed impossible. However, after years of relentless work by dedicated community health workers and vaccinators who went from door to door, village to village, giving every child those precious two drops of the vaccine, the tide turned and the country saw its last case of polio in 2011.
Still continuing the good fight, Dr Mathew Varghese is a true legend of the war against polio. An orthopaedic surgeon, he runs India’s only polio hospital ward that offer free corrective surgery for people with deformities associated with the disease.
Pillar of community
In the 1990s, when the viral epidemic crippled more than 50,000 children each year in India, Dr Varghese rolled up his sleeves and waded into uncharted waters at St Stephen’s Hospital in Delhi, and has been there since. “I stayed on because it is easy for patients to track me. They keep coming back for braces, and other minor issues,” he says. “In fact, few of the patients who got married and have college-going children still come to me for health advice like a family physician.”
I wish there’s no need for my ward. But I know there are so many out there, with paralysis, who will keep coming to me as long as I am alive.”
Getting all the way to zero cases, to track down more than 170 million children behind every door of every dwelling in this vast nation has been a long, hard and arduous journey. Widespread poverty, dense population, poor sanitation, high levels of migration and a weak public health system made the task that much more difficult.
Reminiscing on his early years in hospital, the surgeon who has transformed thousands of lives, says, “in the beginning, the ward was busy with rapid turnover of patients and the combination of paralysis varied from patient to patient”.
“I was stimulated to study more, think more and understand the nuances of managing paralytic patients,” adds Dr Varghese. “But I never understood the social dimension of the disease. I began to understand that aspect — of what it means to be paralysed and poor — only when I started going to an urban slum to do voluntary work.”
Link between poverty and polio
To Dr Varghese, poverty and polio are inextricably linked. Those living in extreme poverty are far more likely to contract polio and being paralysed by polio can prevent a child from rising out of poverty.
Seen as a pioneer by the polio community, Dr Varghese works on an 18-hour schedule daily. At work, he doesn’t wear a watch, studiously avoids almost all phone calls, and never accepts an incoming call from someone unknown. “I don’t like the concept of working to a clock time, and avoid distraction,” he says. “I work to complete a task and see or operate all the cases I need to.”
Many patients, including some of the poorest in the country, who are paralysed in their lower limbs hear about the ward and travel to Delhi in the hope of correcting bent legs and feet. No one is turned away.
“We never postpone cases for want of time. We never say ‘no’ to a patient,” Dr Varghese says. “I’m not sure how many patients I have operated on but easily several thousands,” he adds.
The polio ward at St Stephen’s Hospital was started by surgeon Dr Balu Sankaran in 1987, who “convinced” then hospital director Dr Lucy Oommen to start a free ward for poor patients. “In the 50s, Dr Sankaran was trained in the US with the best surgeons in the world when polio was common there. I was lucky to work with him, and picked up several surgical tips and tricks from him,” Dr Varghese says.
Lower numbers
Over the years, the number of surgeries has dwindled. “Earlier, the numbers were higher — at about 600 patients a year. But now a lesser number of patients occupy the beds for a longer time.”
These days, he mostly treats people in their early 20s, who contracted polio in their infancy. “Treating deformities of older patients is difficult and takes longer time. The surgery is not technically demanding but the decision-making can be tricky.”
Most are equipped with a pair of calipers and have to undergo at least three operations to straighten each hip and knee to be able to walk.
“Restoring the dignity of human existence, of seeing a non-walking patient stand, and walk, is immensely satisfying.” That work and the joy it brings, he says, “no amount of money can ever buy.”
To Dr Varghese, who has devoted his entire career to restoring mobility and dignity to those left crippled by one of the world’s oldest diseases, reconstructive surgery is “life changing”.
“It removes the social stigma of being disabled. In fact, many young women have found their life partners after surgery.”
Simply put, he assists with therapy, surgery and more. Since it takes patients a couple of months of multiple surgeries and rehabilitation at the hospital to be able to walk, Dr Varghese says he interacts “very closely” with patients. “I listen to their non-medical problems such as education, job and marriage!”
Lack of funds
“Oftentimes, I request some Rotary International members and some of my wealthy patients to financially help patients who are poor and not well-educated, in setting up small shops. Some ask for help buying a house but I haven’t been able to find any sponsor for that.”
In fact, lack of funds is a “huge barrier” for polio treatment in government-run hospitals, but one of his most steadfast collaborators on the frontline of India’s polio eradication efforts is Rotary International. “Since 2001, Rotary has been very supportive, funding 50 per cent of the expenses for reconstructive surgeries at St Stephen’s.”
While Rotary club organises health camps where the needs of polio patients are assessed, and non-profits such as the Jaipur Foot provide free prosthetics, no other hospital in India has a ward devoted to polio patients, says Dr Varghese. “There’s only a handful of senior surgeons who have the skills and the wisdom to assess and do corrective surgeries. Corporate hospitals are not interested as polio is a poor man’s problem.”
For Dr Varghese, there’s little time to rest. Although there are no accurate figures as to the total number of polio-affected people in India, health experts put the number at over four million. Most of the patients are from the northern Indian states of Uttar Pradesh and Bihar, which recorded the country’s worst affected polio cases.
“There are so many out there who need help. I am only doing a small bit,” he says.
He wants to heal more, and frequently travels around the country, training young surgeons and medical students on how to address conditions such as club foot and polio. “It’s just another way to help more patients,” he says. “I train doctors at government-run medical colleges because that is where the poor go.”
“But when students come up to me and thank me for my classes, I feel all that I am doing is worth the effort,” he adds.
Recently, Microsoft founder Bill Gates on his Facebook page described Dr Varghese as his “inspiration” and his “real-life hero” for “fighting and [having] dedicated his life for polio eradication in India”.
“I feel more humbled than elated. While it feels good to be recognised, I am uncomfortable with the publicity,” says Dr Varghese. “However, my work continues as before…”
Working day
In the last three decades, Dr Varghese’s work routine, a testament to his persistence, has remained the same. “My working day starts at 5.45. I have tea with my mother and watch BBC news. It’s my way of keeping in touch with the world. When I leave home at around 7.15am, most people are sending their children to school or having their morning walks. When I get back it is usually close to midnight.”
Despite his hectic schedule, Dr Varghese says he manages to find time to do things unrelated to work. “I love photography and making portraits. My friends often joke about it saying, ‘Mathew is never without a camera, for one never knows when God will appear’.” He chuckles. “I read obsessively as well.”
It’s been seven years since polio was detected anywhere in India, and worldwide victory over polio is in sight too. It’s a significant milestone that the surgeon quietly celebrates. When asked what his dream now is, his answer is simple. “I wish there’s no need for my ward. But I know there are so many out there, with paralysis, who will keep coming to me as long as I am alive.”
Suparna Dutt-D’Cunha is a writer based in Pune, India.
