An outpatient clinic in the field

  • Around 8% of India's population has a disability. The Foundation's volunteer team of traumatologists visits the villages of Andhra Pradesh to care for patients who need treatment or surgery

Traumatologist Xavier Manubens and orthopedic technician Muthu arrive at Kanekal village (Andhra Pradesh) to spend a day assisting new patients and monitoring patients with disabilities already treated. Since early in the morning, this extraordinary working couple permeates the makeshift outpatient clinic with their personality, which will be visited by a score of people. With just a few tables as stretchers and a laptop in which Xavier keeps track of more than 6,000 patients that have benefited from this program since its inception in 2003, is "all set!" to start, as Manubens utters with his deep voice.

They arrive in buses or rickshaws; they are children or adults with different types of physical disability in the lower or upper extremities and needing medical attention. Usually, the most frequent cases are accidents, unhealed wounds that end up infected, polio, hereditary malformations, cerebral palsy leading to physical impairment, etc. A boy happily enters the room to see again the doctor who carried out his operation years ago and who will now make a follow up; another one comes with tears in his eyes because he knows that his disability can improve. Xavi and Muthu start to work and decide the best option in each case: orthopedics without surgery, corrective cells, surgery, etc. The visits keep pace and all of them are full of emotion: a "parade" around the office to see how a patient walks on a prosthetic, a game sitting on the floor face to face with the doctor to examine legs mobility, a "high five, kid" and an "I see you at the operating room next week." Everything happens without a lab coat but with all the rigor and dedication.

"What is most essential is to change the lives of those living in rural areas with no resources that are already concerned and for whom the change will represent an improvement," explains Manubens, who warns that "it is also important not to create new problems", so sometimes it is better not to intervene. "The operation does not only change them physically, but involves a change in their lifestyle. Children are malleable, but we need to assess whether it is good or not to act with some adults, avoiding intervening in a life that is already built around their physical condition," argues the traumatologist, as this can mean a catharsis of their previous life.

Some of the questions that Muthu and Xavier make to patients are: "Who do you live with?", "How you normally move?", "What are you currently working on?", since it is essential to know their daily routine to devise the most appropriate solution in each case. They face various challenges that solve talking to patients and their companions, such as the fear to surgery of some skeptics, the difficulty for women as they typically need the consent of men to have a surgery, and teaching relatives how to carry out proper rehabilitation at home.

These days of patients detection (or screening camps) in different villages are part of a program coordinated by Xavier Manubens and Dr. Luis Lorenzo that began in 2003. Within this program, a group of Spanish traumatologists take turns to continuously cover the service from September to February. Their objective is to support the Vicente Ferrer Foundation (VFF) in the area of ​​traumatology, since doctors of this specialty are scarce in this part of India, which is basic to treat people with disabilities. During their stay, Spanish volunteers identify beneficiaries in several villages (to facilitate the transfer of patients), perform operations and make follow-up visits after interventions or treatments.

For this work to be fruitful, it is very important to maintain a close relationship with people with disabilities. For this reason, the vikalangula shangams (or groups of persons with disabilities in different villages) are the key. The field staff of the VFF has the first contact with potential beneficiaries, organizes awareness talks explaining the whole process to families, and follow-up during rehabilitation. In India, it is estimated that between 5% and 8% of the population has a disability, a condition for which they suffer discrimination from society, besides the discrimination caused by poverty in rural areas.


Xavier Manubens keeps track of more than 6,000 patients © Nina Tramullas/VFF


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