Dr Yadav (second from right) and his team have performed 112 knee and hip replacement surgeries in a region battling rheumatoid arthritis.
AT 3,300 METRES above sea level, in Ladakh, a team of specialists from Delhi’s AIIMS has achieved a rare feat — 112 knee and hip replacement surgeries.
That number also tells the story of how these doctors have been conducting temporary camps in a region that so far had little recourse when it came to cases of rheumatoid arthritis. The decision to ferry the doctors and medical equipment to Ladakh was taken over three years ago after AIIMS professionals realised how difficult it was for patients to travel all the way to Delhi.
Dr C S Yadav, a professor of orthopaedics at AIIMS for two decades, has worked alongside specialists from the institute to conduct health camps in Leh and Kargil. “In a majority of the cases, we saw that due to the geography, people suffered from chronic arthritis and required surgical intervention. Earlier, due to lack of facilities here, we would refer patients to AIIMS for surgery,” Dr Yadav said.
In 2014, Dr Yadav decided that his team would fly to the region and set up temporary infrastructure to conduct joint replacement surgeries. “The autonomous hill development council and the Asoka Mission in Leh came forward and said they would help patients get treatment in the district hospital almost free of cost. We conducted the surgeries in June and October last year, and crossed the 100-mark,” said Dr Yadav.
“We would take all logistics required for the surgery there. In 2014, when we started, we could conduct only nine surgeries,” he said. In 2017, Dr Yadav conducted 45 surgeries — 21 knee replacements in Kargil and 24 joint replacements in Leh. “The total number of surgeries now stands at 112. In June, we will go back and conduct more surgeries. But the focus this year will be on Kargil,” said Dr Yadav.
Dr Yadav’s team carries over 500 kg of equipment to the region and conducts surgeries at the Sonam Norbu Memorial Government Hospital. The team carries trial implants and a heavy power system. “We also carry the tourniquet and disposables required. But it’s the trial implants that are the heaviest. There are 10 sizes for the implants. We know in advance the approximate sizes — but to be sure, we have to carry different sizes. The team also carries equipment required for anaesthesia,” Dr Yadav said.
The team, stationed in the region for almost a week each time, starts the surgeries at 9 am and conducts at least six in 10 hours during the day. “The anaesthesia team also has to set up everything in parallel. In between, we see patients in OPD,” Dr Yadav said.
But the “real challenge” is the climate. “There is very little room for error. In Delhi, we have back-up in case of an emergency. Here, we perform with limited resources. But the real challenge is to keep yourself healthy. Conducting surgeries at 12,000 feet is a huge task. Nausea and vomiting is the most common challenge. At least 7-8 people from our team fall sick each time,” said Dr Yadav.
For Dr Ahmed Ali, who has been working in the district hospital in Kargil for more than 12 years, the AIIMS initiative has come as a boon.
“I see about 50 patients in the OPD every day, many of them suffering from rheumatoid arthritis, or inflammation of multiple joints. In severe cases, the damaged part of the joint has to be replaced. Not even one patient who underwent surgery here had to be referred to AIIMS for any complication. When people saw the results, more started coming forward,” said Dr Ali.
Citing the cases of 70-year-old Jumma Khan, a retired Army jawan, and a 58-year-old woman monk from Kargil, Dr Ali said, “These were the toughest cases. They could not even move due to severe pain and stiffness. Now, both have fully recovered.”