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CMC PMR, A WHO Collaborating Centre Ability Day The birthday of Dr Mary Verghese was celebrated at the Mary Verghese Institute of Rehabilitation on May 26, 2011 as Ability Day. There was a culinary fest, in which persons under care and their relatives participated with great enthusiasm. A wide variety of dishes were prepared and sold for lunch. The proceeds will go towards helping economically challenged persons under care. Rehab staff also played a major role in ensuring this event went off smoothly. A couple of persons under care had also burnt the midnight oil to come up with hand-crafted notepads, covers and articles of daily use, which attracted ready buyers. Jayapaul, an alumnus of Rehab who had been rehabilitated under the oversight of Dr Mary Verghese and also worked with her at Rehab, was the chief guest. He shared his experience from the days of Dr Mary Verghese. The Rehab Letter was also launched on this day with the first copy being handed over to The World Health Organisation (WHO), a part of the United John Samuel of Tiruvannamalai by Jayapaul. Nations, has selected the Physical Medicine & Rehabilitation (PMR) Department, including the Mary Verghese Institute of Rehabilitation in Bagayam (Rehab), of Christian Medical College as a WHO Collaborating Centre for Capacity Building, Rehabilitation Technology and Disability Prevention. Specific to rehabilitation of persons with spinal-cord injury and acquired brain injury, this recognition is additional confirmation, if any was needed, of the pioneering role played by CMC in the field of Physical Medicine & Rehabilitation for more than 45 years and counting, especially in effective low-cost methods that have immense relevance in as well as other emerging nations of the world. This designation is for a four-year period and may be extended at the discretion of WHO based on evaluation of the role played by the institution.

Spinal Care India Spinal Care India is an aspiring Pan-India organisation aimed at working for the betterment of the quality of life of persons with spinal-cord injury. Long in the works as an idea, this organisation now has a structured form. It has been registered as a trust that is promoted by the Mary Verghese Trust for Physically Handicapped. Appropriately, the trust deed was signed on May 26, 2011, the birth anniversary of Dr Mary Verghese, the pioneer of PMR in India and founder of Rehab in the early sixties. Spinal Care India will focus on activity in and in online forums for starters. We hope the quality of work would help the organisation grow and serve as an umbrella forum for small groups working in related causes in different parts of the country. This is a long-term aspiration.

the rehab letter july-september 2011 a rehab alumni network publication ability Just a sample of his potential

Narasimhalu (Chennai) is all about ability in diverse areas despite facing the most adverse physical challenges.

Tennis stalwart Modifying cars for physically challenged

Biju Verghese, a physically challenged person from Erumeli, , is the first in India to receive the license for the alteration of cars. His best moment was when he received the award of ‘Best Inventor of India’ from the then President Dr. A P J Abdul Kalam. Undefeated in nine years, Esther Vergeer of Belgium has a winning streak He modifies 13 models of cars to make them that stretches beyond 500 matches in wheelchair tennis. suitable for physically challenged persons and has Even Roger Federer and Rafael Nadal come nowhere near to besting this modified 200 cars so far. If you need a modified mark. car, please contact him at +91 94473 59094.

the rehab letter july-september 2011 a rehab alumni network publication bonding vision Harsha, aged 18, studies in Class XI in Little Flower Convent in Chennai. When she was about two, brain fever had placed her in a position similar to Anjali. Support of a loving and caring family ensured she started her schooling. Harsha has had access to the world of Braille and is a voracious reader. The two started speaking regularly on the phone and thus was born a spontaneous friendship that both describe as ‘close’. Harsha ushered Anjali into the world of Braille and also visited her in Rehab, Bagayam. With constant guidance and inspiration from Harsha, Anjali mastered braille in the space of a few months. The poem ‘Be the best’ was Anjali’s first "written" communication in many years, thanks to her serendipitous Harsha visits Anjali at CMC Rehab, Bagayam friend, Harsha. The lives of Anjali Kumari and Harsha Jain were perhaps Be the best destined to intersect, inform and inspire. The path to the two coming together has been as challenging as one can ever Life is a test imagine. Try to be the best Anjali Kumari, aged 26, came to CMC and the Mary Verghese To make a name and fame Institute of Rehabilitation in mid 2011, having spent almost eight But one thing my friend keep in mind years in bed. Life is not a re-exam Living in Ranchi (Jharkand), she was a fine school-going child in So be the best. Class VIII when she lost her vision following a febrile illness. It Keep hope as the input did not end there. Her spinal cord was impaired. And the outstanding as the output Her lower limbs became paralysed and Anjali had to discontinue Yes my dear, be the best her schooling. Lack of access to quality treatment and Leave the rest rehabilitation meant eight years in the wilderness with just her Try to be the best out of waste dad and mom for company. All the best to be the best in every part of life A year into her stress, she had lost her only brother, too. Light a lamp or a ray of light Let it shine till the end of life Anjali had not heard of Braille and hence never got to read anything. Listening to music was about the only recreation. Harsha, a hard taskmaster, gives Anjali regular assignments, In 2011, her family came to know of Christian Medical College, reviews and preserves them. She describes Anjali as a deep and brought her for an assessment in the hope of making thinker who could do much with a bit more confidence and is a difference to her life. helping her get there. One of the doctors remembered another girl with similar Harsha wishes to become an English teacher. For Anjali, the challenges, having treated her at the PMR OPD in CMC four doors to the future have just opened. She now dreams of years earlier. He introduced Anjali to Harsha. resuming her studies. In an inspiring 20-minute telephonic conversation, Harsha Faced with challenges in vision and mobility, the two girls are connected with Anjali and made her believe in giving wings to determined to make a mark. To meet them and watch the hopes and thoughts, even as eyes and legs were failing the chemistry between the two is a heart-warming experience. What heart. a real-life tale!

the rehab letter july-september 2011 a rehab alumni network publication alumni tracker Kudos Hyundai, Bravo Sam

When we met Sam Moses at the Rehab Mela in 2011, he was distinctly downbeat. He was unsure if he will be able to resume a good job in Hyundai Motor Company near Chennai, even as he recognized he was luckier than many in the degree of damage. He used to work at the paint shop in Hyundai when the third major accident in his life led to an impairment of mobility. The first two accidents had caused deep damage to his thighs and face; he still has plates in place in the facial region to hold his jaws together. Having overcome them, he was now faced with a new challenge. His damage was not as intense as is mostly the case in spinal cord injuries; but nonetheless, it had affected his mobility and body systems enough to put a major question mark Back in business mode but... on his future. Anand Kumar of Chennai had a spinal cord injury in 2010 at the cervical level. This left him with only partial use of his hands. He underwent a four-month rehabilitation at Rehab, Bagayam. Since going home about six months ago, he has struggled to maintain a balance between his work and rehabilitation. For the first few months, he focused on his exercises, as if he was at Rehab, with specific time lines for therapy on a daily basis, and as a result, his business went for a toss. Had this continued, it would not have done him any good, as it was effectively shutting a means to a livelihood. He then recognized that this was not the way to go and decided to renew his focus on his construction business. Today, he is at it full throttle, visits his work sites using a car and a wheelchair, manages his business contacts with his mobile and oversees the business from home, too. With rehabilitation support at CMC and the Mary Verghese The good thing is he has moved out to the outside world and Institute of Rehabilitation, he was soon mobile using a single resumed his activity. This has come at a price. Anand says he crutch, but Hyundai had told him to work on further progress. An has now almost completely stopped his exercises and has uncertain Sam went about his exercise regimen with regularity, moved back even compared to where he was when he was hoping to get fit enough for the job.In July came good news for admitted into Rehab. Sam. Anand is yet another example of how spinal cord injured persons Hyundai decided to retain him in his job at the paint shop. His struggle to achieve the right balance between work and fitness. co-employees have also been good to Sam. Peer counselling is now under way to get Anand to resume his They would not let him do any hard work initially, but he is now exercises and move towards a healthy balance. at full tilt. Not surprisingly, he is a major auto buff. There is a lesson for every person with a spinal-cord injury, be it On being taken back by the company, Sam Moses, on his in the early years or later years of the new avatar. Each of us Facebook page, thanked friends at Hyundai, the doctors & must strive to always strike a healthy balance between work, therapists at CMC & Rehab and Jesus. We wish Sam the very family life and focus on fitness. If necessary, take the guidance best and hopefully no more accidents, major or minor. of experienced peers and/or Social Workers at Rehab.

the rehab letter july-september 2011 a rehab alumni network publication alumni tracker In full uniform

With Manoj Kumar in the picture is his doting sister, Divya. Manoj, then aged six, had a high-level spinal cord injury in 2010 and has moved on in an admirable manner. Manoj and Divya study in Anita Matriculation School in Vepery, Chennai.

RIP Nikhil

Nikhil from Kerala suffered a major road accident near Johannesburg in South Africa in 2010. After a month and a bit of treatment there, he came to Rehab bearing the scars of a severe brain injury. Good family support meant serious effort to get him back on track with the aid of doctors and therapists. Nikhil barely responded to the valiant efforts at Rehab. Only when his baby of less-than-two years was around and made noises could one notice a flicker of response from Nikhil. After about seven months in Rehab and in Vellore in order to get in for the next round of rehabilitation, Nikhil succumbed to his injury, leaving behind his young wife and baby. The image of his dad holding his forehead to ensure neck stability, as he used to be on the standing table is etched in the mind of those who Raghu Naidu, a stellar model is no more happened to observe this in PT. We pray for strength and a bright future for Nikhil’s child, wife and parents. For many years now, Raghu Naidu has been the show case example of a successful rehabilitation, especially in a distinctly rural setting. Rigorous training and hard work enabled Raghu Naidu to stay a farmer despite a spinal cord injury that made mobility tough for him. He learnt not just walking with callipers and crutches, but also how to navigate tough terrain and use them in his agricultural land in the process of farming. His hard work also ensured financial independence for his family. He brought up his two children and ensured they were well settled in life. He has recently passed away. We should remember Raghu Naidu as the trail-blazing farmer who made light of his physical challenges to work with dignity, earn his living and enjoy the respect of his peers, therapists and doctors. We remember him fondly and pray for his soul and family.

the rehab letter july-september 2011 a rehab alumni network publication alumni tracker 1800 425 1210

Spinal Care India has a Toll-Free Number that can be used by persons with spinal cord injury / disorders to connect with experienced peers. The objective of the Toll Free is to facilitate easy networking and provide informed guidance on key issues facing the SCI community. The Toll Free Number of Spinal Care India is 1800 425 1210. There will be no cost for any person calling this number. We are taking steps to spread awareness of this number. We believe it would help in especially guiding the newly spinal cord injured persons to ensure they have rehabilitation at the right place and right time. We would have more to report on how the Toll-Free is working in the next edition of The Rehab Letter.

Peer get-togethers galore

Get-togethers of spinal cord injured persons were held in different parts of Tamil Nadu as well as in Mumbai. Salute please Taking cue from the annual Rehab Mela in Vellore in February, Paneerselvam, who lives in Tiruvallur, has come a long way in the mini-melas were held in Ambur, Arni and Tiruvannamalai. We almost-three years since his spinal cord injury in 2009, which left appreciate the efforts of Minnur Mahadevan, Bhaskar, John him a tetraplegic with a C6-level compression. Samuel and Lourdsamy in organising the events. His was an incomplete status, which enabled doctors and At Amar Seva Sangam in Ayikudy, the annual get-together was therapists to work on his available abilities to restore a modicum held in the first weekend of August and attended by about 50 of mobility. With assistance from the therapists, he started peers. walking using an elbow crutch. The police department also adopted a supportive approach. He was permitted to resume duty and attend work for only four hours between 2 PM and 6 PM in the initial days. By sheer dint of hard work, Paneerselvam pushed himself and was soon attending to his duty full time. He has been able to get back to good quality work in his role. This did not go unrecognized. This year, he has received a major boost, as he has been promoted to sub-inspector rank. This enhances his quality of life. We are proud of this policeman who has willed himself to almost complete rehabilitation.

In Mumbai, Nina Foundation conducted Spinal Injury Awareness Day on June 25. December 3 These get-togethers of peers provided a forum for medical World Rehabilitation Day. review, discussion among peers and interaction with the local community.

the rehab letter july-september 2011 a rehab alumni network publication epitome of courage The knowledge-imparting movement she began several years ago pulls on today, though not with the same verve and vigour. The organisation called Chalanam (meaning movement in Malayalam) she gave shape to has made a lasting impact in the region. Under her patronage, as many as 200 volunteers joined Chalanam, and this organisation runs six schools for the physically challenged. Rabia could mobilise 60 neighbourhoods as part of a programme she initiated for women's empowerment even before the popular Kudumbasree movement came into existence. They experimented in many things, including paper works, envelopes, pickle and A Life beyond polio + cancer + tetraplegia handicrafts. Rabia now manages a Jan Sikshan Illness has not stopped her from reaching out to people. Rabia Sansthan unit, offering several has overcome many hurdles to be where she is today. job-oriented courses to K.V. Rabia is the village woman from Malappuram who rose to women, including saree global fame by kindling the light of knowledge in hundreds of designing and electronic repair illiterates, despite being confined to a wheelchair. works. Apart from coordinating Struck by polio, she has not walked since she was 14. several village industries for women, she manages a Having survived a cancer attack at age 32, Rabia broke her women's library as well. backbone in a miserable fall in the bathroom five years later. The village of Vellilakkad owes much to Rabia for facilities such Once described by her teachers as a `tape recorder’ for her as road, power and water supply it got a years ago. excellent memory, she has been suffering memory loss after the Her heroic fight against odds has found its way to the school fall. The incident paralysed her below the neck, totally textbooks..“Never be proud and arrogant when God showers incapacitating her. you with blessings; and never whine when God tests you with For six months, she was confined to a waterbed. Diabetes, troubles and crises,” she tells visitors. blood pressure and cholesterol followed. A drastic change in food intake led to peptic ulcer, which currently annoys her more than anything else. Today, Rabia cannot hold a telephone receiver for five minutes. “My hands are so weak I cannot even hold a book properly for a few minutes,” she says. She has been advised against using mobile phones because of her cancer history. She also keeps away from computers for health reasons. Yet her inner spirit burns bright and indomitable. “I don't give too much importance to this temporal life. I will continue to serve In 1993, Prime Minister Narasimha Rao honours Rabia society the best way I can… and what matters more is the life Source: Edited extracts from an article in The Hindu after,” Rabia says, reposing an unflinching faith in God. (www.thehindu.com)

the rehab letter july-september 2011 a rehab alumni network publication new therapists

Samson & Ann Patricia (Occupational Therapists) Ramesh, Ligie John, Shikha Lal & Manoj (Physical Therapists) We welcome them onboard and wish them an enriching experience at our Alma matter.

More Physiatrists in the making Happenings Christian Medical College has been permitted to increase the PT Interns training program: A four-day training program for number of post-graduate seats in the specialty, Physical the new senior interns in Physiotherapy was conducted over a Medicine & Rehabilitation, from one to four effective this year. two-week period. The PT staff at Rehab imparted the training. Three doctors have enrolled for the program – Jane Thanks: We thank Paul Ernest, Anne Greta, and Charles who Elizabeth, Prashant Chalageri and Kriti Mishra. Due to a have completed their stints at Rehab. technical reason, only three could be enrolled this year but On to PG in PT: Senthil Velkumar, a part of the PT team at there would be four, going forward. Rehab for five years now, has been permitted to go for his post- graduation even as he stays on the rolls of CMC. He has joined the KG College of Physiotherapy in Coimbatore. WHO Workshop: Social Workers, Dr Guru Nagarajan and Elango, attended a workshop on community-based rehabilitation organized by the World Health Organisation (WHO) in Bangkok. They shared the extensive experience accumulated over two decades. Pediatric Treatment Area: As Rehab now regularly has several children under care and rehabilitation, a new dedicated facility for them has been started. A separate team of therapists takes care of the toddlers. This facility ensures the children are also not subject to exposure to persons with brain and spinal cord injury, some of whose behavior can, at times, frighten the children. This enhancement in the number of seats for post- graduation in PMR is welcome news not just for CMC and Rehab, but also for the rehabilitation of persons with spinal- cord injury and brain injury across India, as quality expertise will spread far and wide. The candidates would have the benefit of a holistic rehabilitation set-up at Bagayam. Our best wishes to the aspiring physiatrists.

the rehab letter july-september 2011 a rehab alumni network publication rehab image

An image from Painting Competition for physically challenged children held by Charanalayam Foundation at Rehab on July 2, 2011.

Peers Outside Rehab Dr Ketna Mehta has been one of the most active peers in building a network of spinal cord injured persons. She is a fine example of how the physical challenge imposed by an injury to the spinal cord can be fully overcome with the right approach. Ketna had an injury in 1995 due to an accident while paragliding. She managed her rehabilitation without going to any of the specialized institutions available for this purpose (there were only two then, Vellore and Pune). Yet she has led a vibrant life and served as an inspiration. Her dream is to have a world-class rehabilitation centre in Mumbai. She has been working towards this end for many years now. She also completed her doctorate by focusing on this very issue. She has also advocated the cause in many forums. She founded the Nina Foundation in memory of her sister, Dr Nina Doshi, who was instrumental in inspiring Ketna during her rehabilitation. Nina always encouraged Ketna to be self-reliant, to stretch beyond her limits, to become independent and to pursue her professional and personal goals. Dr. Ketna Mehta is now the Dean of the Welingkar School of Management in Mumbai. She has been doing outstanding work in networking and counseling persons with spinal-cord injury. She publishes One World that focuses on issues of interest to the SCI-community. Check out the gamut of her work at www.ninafoundation.org.

the rehab letter july-september 2011 a rehab alumni network publication meet a fellow alumnus When you meet Gnanamurthi, you cannot miss his intense desire to be as independent as possible, which is striking, especially in the remote setting in which he lives. And his journey, post a spinal cord injury, has been tougher than most, at least as far as paraplegics are concerned. Following a fall, he faced a future that had many a challenge, not just in mobility. He had his rehabilitation in Vellore but a rude shock awaited him when he returned to his village, Palaya Arangal Durugam near Ambur. His family, which appeared to support him well while he was at Rehab, became less keen after he returned home. He too wanted to be on his own and prove a point. In a small and remote village, which was barely accessible in those days, Gnanamurthi showed great determination. He rented a small hut in the hope of generating income by doing odd jobs. Slowly on his own, he began to get back on the right track. Having done just enough to take care, he started to look around and got involved in the community. He played a pivotal role in his village getting basic amenities, including a road, a water tank and a public distribution outlet. Such good work meant the community became his home. Folks in his village appreciated his activity and became a source of support. Once he had become well recognized, the family wanted to change tack. Slowly, they absorbed him into the fold. Today, he lives in his village, does farming and has recently picked up four cows with borrowed money to start a new line of activity. Gnanamurthi prefers the comfort of nature than even the more recent facilities that are available if he wants and sleeps in the open. He has stayed clear of even a mobile despite having been offered repeated support. He offers tender coconuts and chicken roasted live to visitors. A smile and an independent streak cannot be missed even as parts company in his beautiful village.

Skin Care Routines In the last edition of The Rehab Letter, we had outlined broad guidelines for good skin care. We now focus on routines that would also help in ensuring good skin care: • Cut your finger nails at least once a week, say every Saturday. This is important to avoid damage by scratching, during digital evacuation of stools and applying needless pressure while doing work. • Cut your toenails at least once in 15 days, as a nail break can be harmful and take much time to fix. • Ensure that your trousers, tracks and shorts do not have any buttons on the backside, as they would be a pressure point. • If you are not managing your waistline in a disciplined way, ensure that your trousers are of comfortable size, as otherwise the buckles can cause skin abrasion. • In doing transfers from wheelchair to other surfaces and vice versa, ensure that your buttocks do not hit the wheels. • Every time you take off your calipers, it is important to run a check on the skin. • If any part of your calliper is damaged, get it immediately rectified before using; else a damaged calliper can cause a variety of problems. • If you travelling by car, auto or bus, especially in summer, be careful not sit on the rexin cushion seats. Place a towel or bed sheet or a cushion and then sit. Else, the accumulated heat on the rexin cushion seats can affect skin quality. • Do not rest in the comforts of an airbed, waterbed or air cushion. If you do not turn every two hours or do push-ups at least every 15 minutes while sitting, none of these expensive options can protect your skin. There is more on this topic on the next page. • Last but not the least, take bath every day and apply a dash of coconut oil every day to body parts vulnerable to pressure. Do consult a doctor to get suggestions/advice specific to you.

the rehab letter july-september 2011 a rehab alumni network publication