Quake victims record high rate of amputations

Due to acute shortage of para-medical staff, it has become an uphill task to render post-operative care to these patients, thereby increasing the risk of post-operative diseases. Some cases of post operative infections have already been reported.

Dr Mohan Algotar, Orthopaedic Surgeon and Associate Professor of Surgery, Grant Medical College, says, "Mental rehabilitation of these patients with amputated limbs should have started immediately to help them cope with the loss of limb(s). Psychiatrists and specialised counsellors are the need of the hour. But failure of timely treatment will lead to problems for their mental recovery. And in any case, their mental rehabilation is likely to cause more difficulty than the physical one."

Dr Algotar along with doctors Arun Patil (orthopaedic surgeon), Vivek Deshmukh, Sarang Devre (both plastic surgeons), Prabha Yadav and Renu Patel (both pediatricians) was in the first medical relief teams to reach Bhuj on January 26.

At an average of 250 to 300 patients a day, the team treated an estimated 1,500 patients during their Gujarat stint. The villages of Mankua, Sukhpar, Kodki, Mirzapur, Bharasar, Fotadi, Dhamadka and Bhuj are likely to record a high number of amputees, they said.

According to Dr Algotar, other commonly prevalent injuries include multiple trauma, multiple injuries, chest, facial and head injuries and the compartment syndrome (hampering blood circulation to the limbs).

"We have put plaster of paris casts for the stabilisation of external wounds. But in most cases they need to be operated upon. But dearth of staff and shortage of speciality surgical material is hindering operations and such specialized treatment. Doctors are not enough. You need dressers for daily dressing of wounds. All these factors are getting in the way of proper medical attention," said Dr Algotar.

The minimum period required for healing of wounds is six weeks. The amputees need physiotherapy to reduce pain.

Due to fear some of these patients refuse to sleep in makeshift tents. "They prefer open spaces. The night temperature is four degrees celsius. Therefore in addition to the other post operative infections many of them are also contracting respiratory tract infections like pneumonia, asthama and bronchitis," he said.

There is a shortage of dressing material and antispetics too. Incidentally, the concentration of medical staff is more in the urban and semi urban areas as few are willing to go into the interiors to treat the affected there, say doctors. Pharmaceutical companies, NGOs and hospitals should concentrate on setting up mobile laboratories for blood and microbiological investigations, they say.

"We are just treating them. Medical investigations are necessary before proceeding in most cases. Unless this is done we cannot give the patients proper antibiotics. Besides there are many diabetic patients. We need to check their blood sugar daily to keep it under control. As this is not possible in the given circumstances their wounds have aggravated and are not healing. There is a need for medicines for diabetics which is not forthcoming. We could lose more patients due to the inability to control their diabetic condition," said Dr Algotar.