Professor G.V.K. Asan (1935-2010) was a renowned Periyarist, scholar, orator, author and a great thinker. His works include “Gora’s Positive Atheism and Free Will”; ‘Thiruvalluvar on learning, knowledge and wisdom’ etc; He had served as the Deputy General Secretary of the Dravidar Kazhagam (DK). Dr.Dr. Velu Thambi is the grandson of Prof. G.V.K. Asan.
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As a student of Pennsylvania State University (U.S.), pursuing my Post Graduate (PG) course in Physical Medicine and Rehabilitation (PM&R) I would like to state at the outset that this special course revolves around the health care of persons with disabilities. I would be appearing for the United States Medical Licensing Examination (USMLE) to qualify for my Post Graduate Degree. It is like the Union Public Service Commission (UPSC) exams conducted in India. In fact United States Medical Licensing Examination (USMLE) is one of the most challenging exams in the world. My objective is to contribute one day or the other to the growth and establishment of the Physical Medicine and Rehabilitation (PM&R) in India, for the welfare of thousands of persons with disabilities. Of course, I am aware of the truth that they are all differently abled.
In Tamil Nadu the fertility rate has alarmingly dropped to the level of 2.1 children per woman. This would cause a steep rise in ageing population. In the U.S. we call it “Silver-Tsunami”, implying the graying of hair in the elderly. Gradually this would lead to serious social and economic problems. The health care costs would increase owing to age-related ailments. Financial burden would be on the younger population. The elders could even be abandoned by them. Other domestic problems may also crop up in families. The elders with disabilities need our support and care before it is too late. Through PM&R establishment, disabled youth can also be saved in the early stage of disability. This is today my vision and mission.
PM&R takes care of everything needed for prevention, diagnosis and treatment of several disorders. It includes correction of physical deformities too. Disability is the loss of a certain function of the body. It can be present in many forms, either temporarily or permanently; sudden or gradual; visible or hidden – in both, the young and the old. Disability of any sort disturbs the physical, mental or social wellbeing of a person. A doctor who specializes in PM&R is known in the medical world as PHYSIATRIST.
Tamil Nadu needs a strong PM&R infrastructure to handle the crisis. In all the health care centres, medical colleges and government hospitals, PM&R departments must be established. In MBBS course itself PM&R should be included in the curriculum. Nursing and paramedical courses should also train students in Physical Medicine and Rehabilitation (PM&R). All the relevant topics such as anatomy and neuro physiology should be taught by physiatrist doctors. Rehabilitation centres must be established all over Tamil Nadu in rural and urban primary health centres.
Low birth and death rate could make the population stationary. This would be disastrous for Tamil Nadu. The demographic cycle is likely to get severely affected. People more than the age of 65 years could be proportionately more than the lesser age groups.
The health needs of the ageing population would be on the rise. Medical experts feel that non-communicable diseases could cause serious complications such as stroke, dementia, limb loss and could also lead to death. Steps should be taken by the Government of Tamil Nadu to provide long term care to the ageing population.
The first institute for PM&R in India was established in 1966 itself at CMC Hospital in Vellore, Tamil Nadu, by Dr.Mary Varghese, who was herself a disabled person, but there was no further development. There is acute shortage of physiatrists. Hence, the quality of service in PM&R centers established later is far from satisfactory. Patients in Tamil Nadu move to other major cities because PM&R is inaccessible and also unaffordable here owing to several factors. Only the wealthy and influential minority are able to benefit in Tamil Nadu through PM&R centers, that are only a few. There is a dire need of remedial measures by the Government of Tamil Nadu. The Union Government should extend its support. Most of the world countries have already taken steps for world-wide growth and development of PM&R. We also need more number of Post graduate M.D. courses in PM&R since there is a scarcity of specialists in this field. By collective efforts future goals must be concentrated upon by top priority. A new revolution in this particular health care system should kick-start soon.
Several health care systems already implemented by the Government of Tamil Nadu are indeed commendable. We hope many more schemes follow. The number of persons with disabilities increases by road traffic accidents (RTA). We need productive steps to solve this common problem. Traumatic Brain Injury (TBI) also affects survivors of road accidents and makes them disabled. Such patients need Neuro-rehabilitation services.
Students should be motivated to pursue studies in this particular field, PM&R. Syllabus for U.G. and P.G. medical courses must be revamped with a redesigned and innovatively framed curriculum. The Ministry of education under the control of the Union Government has to prioritise this development. The present Government of Tamil Nadu is undeniably a champion of disability – rights. Let us hope our objective would be achieved fully in future. Persons with disabilities need our support and care – not lip-sympathy.
Martin Luther King once said – “Of all the forms of inequality, injustice in health is the most shocking and the most inhumane”. Recalling his words, I wish to conclude by stressing that persons with disabilities should never ever become victims of discrimination in the health care systems. Their grievances all over the world would get redressed if PM&R infrastructure is established everywhere. This would ensure social justice for all the persons with disabilities. There is hence a dire need of pivotal, proactive remedial measures and perfect implementation. By establishing PM&R centers in large numbers, we can set a precedent to health care systems world wide.
