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Drs Roopa and Narayanan Devadasan: Incredible odds, fighting the gods

By Mari Marcel Thekaekara

Until the '90s the tribal people of Gudalur Valley summoned the Bettakurumba gods for all their health problems. It was years before Drs Roopa and Narayanan Devadasan could begin to change the tribal health scenario. But slowly and painfully their determination paid off. Now the Bettakurumba gods have started sending patients to the Gudalur Adivasi Hospital!

Dr.Roopa The pair were helping a classmate Dr Subash Kini to do a complicated surgery when the summons came. Their health worker Badchi arrived breathless and tired to announce that Manbi a young Bettakurumba girl was in labour. Manbi's ante-natal checks had revealed that she could have problems. The urgency of the situation had been drilled into Badchi. So she rushed to Gudalur, 18 kms from her forest settlement, to inform the doctors that the countdown had begun.

Roopa left Deva and Subhash busy completing the operation and rushed to Theppakadu, Manbi's village home. The 16-year-old girl had started labour a few hours earlier. The inside of the hut was filled with older women. Manbi lay by the fireplace moaning gently. The women chatted casually, exchanging stories and gossip. Alternately they encouraged and admonished her. "If you make such a fuss now what will you do when the pains really start."

Manbi's problem was a classic one. Chronic protein deficiency because of an all-rice, no-dal diet made most tribal women high-risk patients when they became pregnant. Manbi's village had recorded three deaths in the space of two months only a year before.

Roopa, with some of her patients

Roopa took out her stethoscope and blood pressure kit and examined the girl. As expected, her BP had begun to climb. But before giving her the necessary drugs, an internal examination had to be done to ascertain the extent of dilation that had taken place, among other factors. Roopa explained this painstakingly.

There was immediate resistance. An unintelligible babble broke out. And then the verdict. Intractable, implacable. The gods had forbidden such an examination.

Roopa was aghast. She had expected a ban on admitting the girl to hospital. And had come prepared for a tough delivery inside the dark tribal hut. But she was totally unprepared for this new turn of events.

An hour passed and Deva arrived with Subhash. The two of them paced up and down like expectant fathers. Inside, Roopa waited tensely. The atmosphere was charged with electricity. All chatter had ceased. Manbi's moans increased. Badchi and Kali, the health workers, tried to reason with the older women. They were deluged with angry rebukes . The younger women looked frightened, worried for Manbi, but afraid to oppose the elders and the gods.

Another hour dragged on interminably. Minutes seemed like hours. The women went into a huddle. Then they asked Roopa to go outside. It was time to call on the gods.

Even as she left the hut, Roopa knew there was little chance she would be allowed back inside.

She waited outside with the men. It grew dark and figures began to emerge from the shadows. The drums were pounding out a message. Beckoning everyone to the séance. Then the music began, mournful and eerie. The drumbeats continued at a steady pace. The chanting of voices rose, piercing the still forest night. The Bettakurumbas had begun communicating with their gods.

Soon, one or more of the elders would go into a trance. He would become the Swamy. His voice was the oracle. Speaking for the gods. And once the oracle spoke, there was no going back. No Bettakurumba would dare defy the diktat.

The babble went on relentlessly. Now reaching a crescendo, now falling. At 9 o'clock they heard a scream. There was the sound of muted excitement. Something had happened.

Kali ran towards us. The baby had been born. Mother and child were safe, alive! "Thank god," breathed Roopa. "You mean thank the Bettakurumba gods," retorted Deva cryptically.

After the initial relief, the meaning of Deva's wry comment sank in. The Bettakurumba gods had won. And though we had prayed to all our individual gods to save Manbi's life, the incident would condemn many other women to die at home when a few lifesaving drugs could save their lives.

Deva's first case when he arrived in Gudalur was in the same village of Theppakadu. He detected a sturdy, ten-year-old lad with meningitis. But it was already too late. The child died before the anguished young doctor's eyes. It was doubly tragic, for it reinforced the village belief "you walk into a hospital on your own two feet, but they'll carry you out a corpse."

In the ten years since their arrival in the monsoon of '87, Deva and Roopa saved many Manbis from certain death. Their training at CMC Vellore's Community Health Department prepared them well for the arduous work ahead. It was a tough task, all of it uphill, but in five years they managed to change the tribal health scenario. Gradually. Painfully. Slowly. But ultimately, their determination paid off.

The turning point came during a measles epidemic. Deva and Roopa with health workers Kali and Badchi went around the villages desperately trying to convince people of the importance of vaccinating their children. One Theppakadu hamlet responded positively, another negatively. Then the epidemic hit the village. All the vaccinated children escaped. And all the non-vaccinated ones got measles. The message went home dramatically. And mothers began to bring their children for the dreaded "injection".

The last time there was an epidemic, the entire population queued up for their shots, to the amazement of the health team. Theppakadu had ceased to be the bane of their lives.

Roopa and Narayanan Devadasan have proved that committed doctors CAN work in backward, neglected areas of the country. And work effectively to create sustainable change.

The gospel according to CHAD Vellore (as preached by Deva and Roopa) is to demystify medicine. To teach rural people and especially illiterate ones, to treat treatable diseases and immediately refer serious ones. Infant and maternal mortality has come down dramatically. Diarrhoea deaths of children have almost completely stopped. They've preached the CHAD gospel well.

However, the biggest success of all is a religious conversion. There is a new diktat in Bettakurumba villages. The Bettakurumba gods have started sending patients to the Gudalur Adivasi Hospital!

But that's another story.