Quack, quack: beware of "docs"
Author: Dr. Deepak Sharan
Posted on April 12, 2003.
This is the complete article, part of which was published in
The Times of India dated March 27, 2003.
"I could twist a man one way and cure flux, fever, colds
and the diseases of the climate; shake a child and stop scarlet
fever, croup, and diphtheria; and cure whooping cough in three
days by a wring of the child's neck."
- Andrew Taylor Still, the "lightning bonesetter"
(1874)
A nine-month-old girl in Bangalore nearly died recently following
attempted bone setting by quacks. All she had was a common dislocated
elbow after a fall, with no external wounds. After a week of massage,
manipulation, applications of splints and herbal pastes, she presented
in a comatose condition. Says Dr. Deepak Sharan, Pediatric Orthopaedic
Surgeon and Chief Resource Person, Govt. of Karnataka’s
Corrective Surgery Program for Locomotor Disabilities, “This
child had the entire upper limb swollen like a balloon, with the
neurovascular condition of the hand in a precarious (pre-gangrenous)
condition. The dislocation, of course, had not been reduced, but
the child had developed pyomyositis or pus formation in muscles
and was septicemic. Nearly half a litre of pus was drained out.
She was pale as a sheet and her hemoglobin was only 5 g%. Soon
thereafter she developed septic arthritis (pus formation) of hip
requiring another operation (arthrotomy).”
According to Dr. Sharan, a similar case he had treated in the
recent past was another girl of the same age who had septicemia
and septic arthritis of hip following ‘branding’ (using
hot iron rods) treatment for fever. During assessment camps conducted
for the Govt. of Karnataka in Tumkur, Kollegal and Doddaballapur,
to identify children with locomotor disabilities for corrective
surgery, Dr. Sharan had encountered numerous debilitating limb
deformities resulting from failed folk healing and bone setting.
This experience was echoed by State Government Orthopaedic Surgeons
who had attended a series of workshops recently on ‘Appropriate
Corrective Surgery for Locomotor Disabilities’. Says Dr.
Sharan, “To add to the problem of huge numbers of children
afflicted with natural causes of disability like cerebral palsy
or polio, we have steadily increasing numbers of man made disabilities
due to inappropriate treatment of common injuries, burns and infections.”
Injudicious massage for injuries around the elbow leads to stiffness
because of extra bone formation (myositis ossificans) or joint
instability due to ligament damage following forcible manipulation.
This is in addition to the risks of infection, gangrene (due to
damage of blood supply), deformities or fractures that fail to
join.
Despite the fact that injuries are the leading cause of death
and disability for the age group 1-19 years, the medical
facilities available in peripheral centers for management of common
fractures remains abysmal. Many District or Taluk level Government
Hospitals do not seem to have the infrastructure (instruments,
mobile x-ray, anaesthetists, etc.) to treat fractures except by
plasters. This leaves the field wide open for quacks. There has
been a general failure among the health planners in India to recognize
the importance of timely surgical care in preventing disability,
where it tends to be viewed as a luxury.
This trend of seeking treatment by bone setters and native healers
can be understood in remote areas which may lack medical facilities.
But why are such practitioners so popular even in cities like
Bangalore? Many educated and well to do people rationalize such
treatment by stating that disciplines such as Osteopathy and Chiropractic,
based on manipulation of spine and joints, are very popular in
the west. Unfortunately, our native practitioners undergo no systematic
training apart from obscure “manual” techniques secretly
handed from father to son, and have no knowledge of anatomy and
the damage they can inflict on nerves and blood vessels by blind
manipulation. The successful cases that many healers boast of
probably were those that either did not have a bone injury or
those that were minimally displaced. The tremendous psychological
influence of "popping bones back-into-place" (whether
the bone is dislocated or not) has been a potent factor in maintaining
such practice as a general trea
Many people go to bone setters when told that surgery was the
only option. Many social or religious misconceptions abound about
surgery and some people would go to any extent to avoid surgery,
especially in children. Fractures heal very quickly in children
and a delay of a couple of weeks while seeking native treatment
could mean a lifetime of disability.
Although both children described above made complete recoveries
from a life-threatening condition, the sad aspect of it all is
that their parents sought the help of quacks because of abject
poverty. Paradoxically, both were eventually treated completely
free of cost, thanks to the unsung Radhika Mandal, a charitable
organization that has also sponsored 20 other successful operations
in the past year for poor children with complex deformities due
to polio, cerebral palsy, club foot, congenital dislocation of
hip, etc. over the past year. Radhika Mandal has pledged continued
sponsorship for poor children who may benefit from corrective
surgery. Contact Maharaja Agrasen Hospital, Padmanabhanagar on
6393361/6390362 for details.
