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1947-2014 (Archived)
Jun 17, 2004
Sevaa of Motion
By Anju Kaur, SikhNN staff writer, Washington Bureau
Posted: Friday, February 25, 2011 | 01:11 pm

Sanjay was flat as a board. His spine was fused together and so were his hips. A particularly debilitating and painful type of arthritis had left him unable to move for the last 8 years. He could no longer work as a tailor to support his polio-afflicted wife and two young sons.

Then these pugree-waalay American doctors showed up to help.

Sanjay was among 47 patients selected for free joint replacement surgery to be performed by a visiting surgical team at the Dayanand Medical College and Hospital in Ludhiana.

It was late January, the day of the surgery. He was lying in a hospital bed, ready. But the doctors could not get a breathing tube into his mouth because his neck could not bend. He was sent out of the operating room.

“It’s just not my luck,” he told Daljeet Singh Saluja, the internist on the American surgical team, and Prabhjot Singh Likhari, the team’s coordinator. “Can I just stay in the ward tonight, and go home tomorrow?”

Sanjay was strong. He did not cry.

“We have got to do something,” Prabhjot Singh remembers saying. They took him back into the operating room. And this time, the anesthesiologist tried with great difficulty to maneuver the tube through his nose, down his stiff neck and into his lungs. It worked. The surgery was on.

Although Sanjay’s hips could not be replaced with an implant, the surgeon was able to remove a part of his diseased hips so that he could sit in a wheel chair or walk with crutches.

“Now I can thread a needle of a sewing machine and earn a living,” he said.

He was crying.

“The day we left, Sanjay sat up for the first time in years,” said Simon Mears, the Baltimore surgeon who operated on Sanjay’s hips. “Sitting with his wife and young son, it was a very special moment.”

Sanjay’s inner strength was remarkable yet typical of all the patients, he said.

“They put their faith in a group of visiting doctors to help them and did so with grace.”

Two Sikh and four American orthopedic surgeons led a volunteer team of 45 medical personnel to restore the quality of life of these poor people of Punjab who previously could not walk.

The team was organized by the Maryland chapter of Operation Walk, founded by Harpal Singh Khanuja, an orthopedic surgeon, and his wife, Maria. They were joined by Gurminder Singh Ahuja, also an orthopedic surgeon, and Prabhjot Singh, a businessman. All are from Baltimore.

The original Operation Walk USA was founded by Lawrence Dorr, an orthopedic surgeon, in 1994. Harpal Singh volunteered for a trip with him to El Salvador in 2007, after which he and his wife formed Operation Walk Maryland.

The volunteer non-profit provides free hip and knee replacements every year to financially disadvantaged patients around the world who suffer from hip and knee joint diseases.

Since its founding in 2008, the Maryland team has been to Lima, Peru and Quito, Ecuador. This year, they went to Ludhiana.

“We felt that it would be fantastic to go back there and do more for our community, too,” said Prabhjot Singh, chairman of the board of directors. “We go all over the world…. This time we decided: Let’s to do Punjab.”

He called on a grade-school friend who is now the chairman of the board of directors at the Ludhiana hospital. Both agreed.

In India, the hospital spent the next year upgrading its orthopedic department to conform to international standards, according to news reports. It began a search for candidates by posting flyers at gurdwaaraas, mandirs and throughout the city and rural areas. Its orthopedists identified and screened prospective patients for about six months.

In the United States, Prabhjot Singh planned the logistics and funding: finding sponsors, equipment donors, medicine donors, and transportation discounts for people and cargo. Shipping the medical equipment alone costs up to $30,000. The total cost can add up to $150,000.

Harpal Singh and Gurminder Singh put together the medical team: surgeons, doctors, nurses, implant specialists, technicians and therapists. They found an American company, Zimmer, to donate the replacement joints, which cost about $200,000.

The real cost of this endeavor is far greater because it does not include the services of the medical team, which also are donated. Considering that each surgery costs about $20,000 in the United States, this effort is very cost efficient, Harpal Singh said.

The 10-day tour of duty began on Jan. 26. They spent a few days screening and preparing patients, performed three-and-a-half days of surgery, spent the rest of the days rehabilitating patients, and left on Feb. 5.

“Nothing on this scale had ever been done over there,” Prabhjot Singh said. There had been eye surgeries where one or two surgeons go and volunteer. But this team had a tour bus parked outside the hospital, loading everyone in and out every day.

“It was awesome,” Harpal Singh said. “It was definitely the most successful trip in terms of the number joints we could do.” There were 47 patients who received 59 joints. Some received double implants.

Compared to the United States where mostly older people receive joint replacements, in India the patients were younger, in their thirties and forties. And because it was Punjab, most were Sikh, at least in name.

“It was depressing to see that a lot of them cut their hair and were shaving,” Harpal Singh said. “It bugged me a little.” It bugged all the Sikhs on the team but there also were many memorable patients who had kept their roop.

There was an aunty who did not want to take off her kirpaan and karaa for her surgery, Harpal Singh said. The doctors were afraid that an electrical current would go through her body, but she kept them on as they replaced her knee.

There was an uncle who was so determined and confident that he was going to walk again, Gurminder Singh said. Knee replacement is a painful procedure but the day after he had both knees replaced, he got up and started walking. He had an I-told-you-so smile on his face.

And there was another aunty who had been unable to walk for about 15 years, Daljeet Singh said. She could not do housework or go to the gurdwaaraa. There is no such thing as handicap access in India. Her greatest desire was to walk up the steps to the darbaar hall and listen to shabad keertan. When she began to walk, her family was speechless. They could not believe it.

“I have to give credit to the patients,” he added. “Their belief in God is so strong, that something better is on the way, and Waheguru would not let us suffer… This was the highlight of my career and personal life. I got just as much back if not more.”

Every patient had his or her own dramatic story. But the one common story they all took back home was their experience with the Sikh doctors from America.

“They took pictures of us,” Daljeet Singh said. “They were surprised that we were born and raised in American and still looked the way we do.”

“People were just shocked to see sardaars with full dhaarees from the United States,” Harpal Singh added. “(They) were impressed with how strong our ties were with Sikhism. It made them feel proud.

“And we were proud to be giving back,” he said. “I knew I would come to India to do sevaa. It’s one thing to volunteer in a clinic but to take team of 45 people to do that many surgeries was phenomenal.”

The impact of this sevaa went beyond the patients and providers. It also was a learning experience for the teaching hospital. Its orthopedic surgeons and residents received a crash course in modern orthopedics from the American team.

They learned how to fine-tune screening procedures. The hospital had screened 80 patients but when the team rescreened them they came up with many reasons why many of them could not have surgery. Many patients learned that they were diabetic or hypertensive. Some had severe dental infections that could lead to complications, a detail they had not considered. In the end, only 47 patients were admitted for surgery.

Dayanand orthopedists and residents also learned new protocols on how to deliver the proper care in pain management and patient recovery so that patients can go home in three days, as opposed to the hospital’s customary 10 days.

Coming from very modern hospital, this hospital seemed like an older facility, but it had everything, said Robert Sterling, another Baltimore orthopedist on the team. It had big open hospital wards with 15 or 18 beds lined up, not the kind of privacy American surgeons are used to, he said.

“But the biggest difference was the amount of family support,” he added. Every patient had at least one or two persons with them at all times. That was great, but we were not used to seeing that.”

For Sterling, like most of the team members, this was his first trip with Operation Walk Maryland and his first time in India.

His most memorable experience with the patients was after the surgeries were finished and he was helping with their therapy.

He remembered a 62-year-old woman with arthritis in both knees, barely able to walk because of the pain. Two days later, they were walking up and down a 60-foot corridor together.

She said, “Thank you,” the only English she knew. “That was the hardest part, not being able to communicate with them directly,” he said.

“The entire experience was overwhelming,” he said. “There was so much happening in such a short period of time, it was incredibly overwhelming.”

His first overwhelming experience in India took place even before arriving at the hospital, when the team visited Darbaar Saahib.

The Shiromani Gurdwaaraa Parbandhak Committee arranged for a presentation and guided tour of the gurdwaaraa and langar hall.

“It was moving to see the history and all of the people who were there,” Sterling said. They walked through the kitchen area where food was being prepared, and later sat down for langar.

“The site itself is a beautiful peace of architecture, which is the least significant relative to its status as a religious symbol,” he said. “To walk through and see people praying was a moving experience.”

For Mears, this was the most memorable moment.

“During the bus ride to Amritsar, two of our doctors, (Daljeet Singh and Harpal Singh) taught our entire group about Sikhism and about the Darbaar Sahib,” he said. “The most memorable part was being able to join in the langar. To me, I really started to understand a different religion and culture, one that I have great respect for. The way that so many people come to help in the preparation and serving of the food was amazing.”

The original plan was to visit Darbaar Sahib after the surgeries, before leaving India. But the plans changed and the only opportunity they would have to go to Amritsar was on same day they arrived in Ludhiana. They had just endured a 30-hour trip from Baltimore to Delhi to Ludhiana. But who needs sleep?

“The looks on team’s faces was amazing,” Gurminder Singh said. “They felt there definitely is something spiritual here.

“We got all our blessings beforehand. "



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