anonymous

14th September 2018

A Matter of Faith (1)

 A MATTER OF FAITH (1)

DR N.H. ANTIA

After graduating from Grant Medical College, Bombay in 1945, I spent two years as Captain in the Indian Army Medical Corps (General Duty Medical Officer) in and around Pune. My last posting was in Jabalpur. I got an early discharge from the Army and went to Britain where I spent nine years doing my Fellowship and various resident jobs in almost all subjects except neurosurgery. That was when I started doing plastic surgery under Sir Harold Gillies and later with Mowlem in London and Wallace in Edinburgh.

After that long stint in United Kingdom I returned to Pune and worked for three years with Dr E.H. Coyajee at the Jehangir Nursing Home which was a relatively small place in those days. I was the first full-time surgeon there and built the Surgical Department of the hospital where I did all kinds of surgery, including plastic surgery, general abdominal surgery, urology and even some chest and orthopaedic surgery.

During my stay in Pune I happened to go one evening on a pedal cycle towards the hills and saw the Kondhwa Leprosy Hospital which was still under the Government of Maharashtra. It was an old Scottish Mission Leprosarium which was in a grim state. There was a barbed wire fence and armed police standing outside. Inside it was filthy and dirty.

In those days, I didn't have much plastic surgery to do. At Kondhwa, I saw a lot of deformities, particularly of the face. I wondered if something could be done. Firstly, I could not find anything written in the books about this and I had not even heard of the work done in Vellore, where a hospital had been started a few years earlier. For another thing, I did not know how to start in that place since there were hardly any facilities. Shortly after that, the Kondhwa Leprosy Hospital was taken over by the Poona District Leprosy Committee under Dr.Bandorawalla. They certainly cleaned up the place. In the small circle of buildings put up by missionaries, one little building with many glass windows was the Operation Theatre and in the circle were the other small wards. A rickety wooden table with thin metal legs tied with a piece of string was the only furniture in the Operation Theatre suite! How was one to work under such circumstances? I could not get any nurse or doctor or anaesthetist to help me, but I picked up courage and took the instruments and gowns and everything else from Pune. For the first two visits, I had to go on my bicycle. But later a road was opened and I was provided with a jeep.

On March 13, 1958, I took the bold step of starting surgery at the Kondhwa Leprosy Hospital, seven miles from Pune. Naturally no one was willing to be the first guinea pig for this young doctor who wished to operate in a small room without the benefit of electricity, running water, a steriliser or an anaesthetist. I myself was scared not only of working under these conditions but also of contracting leprosy. But there was no other alternative, as my famous Chief, Sir Harold Gillies, had left Rs 100 at this Leprosarium for Dr Antia to start a Plastic Surgery Unit! A few months later came a letter from England to enquire as to what I was planning to do with his money! And so, start I must, and start I did. The first operation was for closing a hole in the nose of an old woman, Aminabai, possibly caused by syphilis which was wrongly diagnosed as due to leprosy. She was mentally not all there, and was the only patient who could be inveigled into being operated according to a complicated plan designed by Gillies during his visit: a cartilage graft in a tube pedicle under local anaesthesia. I found some patients to help me boil the surgical instruments. Another patient was taught to wear a cap and mask, gown and gloves, and he assisted me at the operation which went off reasonably well except that halfway during surgery, the rope holding together the metal legs of the table snapped and everything fell on the ground, including the patient! The operation had to be completed on the floor with the cartilage inserted after washing it in penicillin solution. There was no infection! Dr Ross Innes whom I met in England a decade later told me that while working as a missionary at Kondhwa in the forties, he used to carry this folding table to Pune to conduct operations and deliveries and that he was not surprised that the rope he tied to hold the legs two decades earlier, had given way.