Set in serene misty mountains and verdant valleys, enlivened by birdsong and scampering monkeys, an AIMS’ outreach programme is steadily unfolding in the Wayanad District of North Kerala. The Amrita Kripa Charitable Hospital at Kalpetta was inaugurated in late 2004. Directed by the husband and wife team of Dr. Sanjeevan Vasudevan and Dr. Ajitha, founders of the Pain Relief and Palliative Care Department at AIMS, the mission of this hospital is to serve the indigent people of the area who need access to good medical care and, in particular, to treat the Adivasi population.

Adivasis are the tribal inhabitants of the Wayanad region. The name Adivasi means the first inhabitants who stayed, implying that they were the original inhabitants of this area. They are an aboriginal people who have lost their lands, traditional livelihoods and usually live exploited and impoverished on the margins of society. 

In its first year of operation the hospital served approximately 30,000 patients, of whom 20,000 were Advasis. The Adivasis are treated totally free of charge and other patients are charged a minimal fee for treatment and medicines. The first year of operation was also marked by the inauguration of a telemedicine link between AIMS and numerous medical camps held in tribal areas at a distance from the hospital. Plans for the near future include expanding the locations of the medical camps from the current three locations to eight, offering monthly specialty clinics staffed by doctors from AIMS and increasing the diagnostic services available to the patients.

The tribal patients suffer from a variety of complaints including infections, particularly of the upper respiratory variety, anemia, gastritis, injuries, hypertension and heart disease. At the root of many of their problems is malnutrition and lack of knowledge of proper dietary habits. The majority of the tribals work as day labourers and on a day when there is no work, there will be no food in the house. At the hospital many severely malnourished babies and young children routinely are seen. Malnourishment at this young age leads to lifelong diminished mental and physical capacity. The children who are seen at the outreach medical camps and at the hospital are weighed and given supplemental medicine and their mothers are given simple and practical nutritional instruction. On repeat visits the children will be checked to see if they are gaining weight and if the mother is following instructions. Already many children have been given a better chance in life and older patients have had long term illnesses cured. Some of the patients visited other free hospitals previously but had no improvement. 

The higher rate of cures at the Kalpetta hospital likely has to do with the fact that the staff treats the patients with the utmost concern and courtesy - from the receptionist who registers them first, to the nurse, doctors, and the pharmacist who sees them last.  Drs. Sanjeevan and Ajitha look deeply into the patients’ eyes when they listen to their symptoms and advise treatment. It is clear that they make real human contact with each patient and that they are interested in each one as an individual. The tribal patients, who often look a little apprehensive when they enter the doctors’ offices, visibly relax and look relieved when they leave. Studies have shown that when the patients have faith in the doctor who treats them, the healing rate goes up.

Treating the tribal patients effectively requires both sensitivity and a knowledge of their culture and lifestyle. The reality of the tribals is quite different from that of the dominant society. They live in the present without a strong sense of time. Most of them will only have a vague idea of their age and their general sense of chronology is not developed. They have not traditionally lived in a world full of facts, figures and linear information and get confused by too many questions. They are not a questioning people themselves. They don’t think much about the future and don’t have the habit of saving their money. On a day when they don’t get work and earn money, there may be no food in the house, so they simply fast; however, they don’t seem to fear the future or have the level of anxiety from which many people in the modern society suffer.

For the doctor, information about symptoms and duration of symptoms can be difficult to ascertain.  The Adivasis are a quiet and uncomplaining people with a naturally stoic nature.  It takes experience with them and intuition to come up with a diagnosis in some cases.

The patient load is large and the complaints are fairly standard. When asked if they don’t get bored working six days a week doing the same thing hour after hour, day after day, both Dr. Sanjeev and Dr. Ajitha said that they like their work and they like the patients. As Amma has often said, “When there is love, there is no boredom.”  Love is clearly at work in the Kalpetta hospital. 

Love is also at work in the dedication of volunteers who organize the outreach medical camps. They are the ones who find the place to hold the camp, inform the people and make it possible for the doctors and hospital staff to arrive and within minutes set up a clinic and treat large numbers of people in the short amount of time available. 

One such camp is held bi-weekly at Modakkara, an hour’s drive from Kalpetta, past paddy fields, hills of tea and coffee plants and tall mountains majestically silhouetted in the distance. A local resident had donated the piece of land and local volunteers joined together and built a small hall to be used as a medical centre where they invited the doctors to hold a bi-weekly medical camps. On a typical day there are nearly 100 patients waiting to be seen, mostly women and children of tribal origin. Patients are first examined by the doctor and then receive free medicine from the hospital pharmacist.

Another tribal area in the region is on the Karappuzha River where a dam is nearing completion. As the river is blocked and forms a lake, many villages have disappeared and productive agricultural land is now under water.  he tribal residents of this area are in a perilous situation. Several families that had fled once from the rising waters would likely need to move again. They live in small, inadequate shelters made from wood and tarps, which leak in the heavy rains.  These people owned virtually nothing except a few cooking pots, ragged clothes and one or two simple tools. Most seem to suffer from respiratory infections. 

In contrast to the usual cheerful demeanor of these people, many of the tribal residents have become totally despondent. After visiting the area along the Karappuzha River, doctors Sanjeev and Ajitha decided that none of the residents would have the ability to come to the Kalpetta hospital and that a camp should be organized for them. 

One piece of land has become an island and is home to 250 Adivasis.  They will lose their homes as the water continues to rise.  No provision has been made for them by the government.  The M.A. Matrh is looking into the possibility of building houses for these people. A quote from Amma is posted on the wall of the Kalpetta hospital: “May the tree of our life be firmly rooted in the soil of love. Let good deeds be the leaves on that tree.” The tree of charitable activities in the Wayanad is clearly firmly rooted and rooted in love.  The tree already has many branches and its fruits are being experienced by the needy people who have no one else to care for them.