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CASES MATERIA MEDICA GENERAL ARTICLES ABSTRACT MISCELLANEOUS Q & A

Case 83: Reaching out to the Unreachable- Part 2

Dr Savitha S Wani

Community Health Services Coordinator- IASH / MLDMHI- Bengaluru.
Ph- 9901460878, drsavitha@hotmail.com

There is an enormous difference in Homoeopathic Practice in urban area and rural areas. The experiences shared here will demonstrate the differences.

THE BACK GROUND: Institute for Advanced Studies in Homoeopathy (IASH), Bengaluru has collaborated with the Dr M L Dhawale Memorial Homoeopathic Institute (MLDMHI) Mumbai to "Reach out to the Unreachable" in rural Bengaluru. The first charitable unit under this collaboration - "Dr M L Dhawale Memorial Instituteís Standardized Homoeopathic Clinic managed by IASH started functioning at Ravagudulu village, Somanahalli panchayat, Kankapura taluka in the year 2006. Ravagudlu village is situated about 32kms from Bengaluru on Kanakapura road. This Panchayat has 12 villages. The second clinic on similar lines networked with another NGO - FIRFLIES Ashram is the "Mary McBride health centre" situated in the serene atmosphere of the ashram in Dinnepalya village.

The geographical area served through this unit is the population of Kagalipura, and Thalagatpura, They are Talukas situated about 30 kms from Bangalore city on Kankapura road. Kagalipura Panchayat has 24 villages; Thalgatpura Panchayat has 13 villages. These villages with a consolidated population of 35000- 40000, though are distance wise close to the capital of the state lacks in basic medical facilities! They do not have a primary health care centre and has no other medical facilities. A large population of aged, women and children are in need of basic medical care. The only district hospital is 15 kms away. Hence our objective of reaching out to the unreachable seemed appropriate when we started operating from these clinics. In these villages dwell socially and economically challenged people, 80% dependent on agriculture, 70% illiterate, and completely ignorant of health and hygiene.

Reaching out to these needy people was not easy!! Starting off was not any issue. The challenge was to make homeopathy as a main health care medium and sustain it. The Clinics function as primary health care providers on an OPD basis, which was not enough. We had to adopt a multi faceted mode of approach - like Camps, Adopting schools, Community health worker programme. Camps are specifically designed and planned like Cardiac camp in association with Narayana Hrudayalaya, Diabetes detection camp, Anemia detection camp, 0pthalmology camp in association with Nethra dhama hospital. The patients seen at these camps are followed up at the regular clinics. One such camp was the diabetes detection camp held at both Ravagudlu and Fire flies units simultaneously on September 28th 2008. The following is the numbers/statistic of both clinics put together.

 No of pts screened  171
 Known diabetics on OHA  13
 Detected during the camp  25
 No of pts on treatment at Our clinic post
 Camp
 22

The below case shared here is a fall out of this camp.

Dr PHANIDRANTH is an active member of IASH since 2001; he has also trained at MLDMHI Palghar. Ph- 9341063838.

Mr B, Age- 42 Yrs, Education: SSLC, Occupation: Carpenter. DOC: 11-11-08. Married since 18 yrs, Son- 1, Daughter- 1. Father and Mother have expired.

Our identified Community health volunteer had coaxed this pt to attend the diabetes camp. The CHV had recognised that this patient was not looking his normal self and was looking tired most of the time. Pt did not complain or say anything about his symptoms.

Ptís wife is a registered regular pt with the CHS- IASH/ MLDMHI. His daughter is also under treatment through the school we have adopted. Pt was not averse to Homeopathy treatment but was averse to getting himself checked when he did not have symptoms. Hence he had to be coaxed.

The CHV is the link between the villagers and the doctors. He / she are residents of the community and hence the villagers trust him more than the doctor who is an outsider. CHV is also a multi purpose worker -informant/ compounder / delivery boy for medicines/ driver if the Physician has to visit the Pt is unable to come to the clinic. etc; He/ she is in constant touch with the physician over the phone.

The CHV programme is yet to take formal shape at the IASH/MLDMHI Bangalore unit.

Information passed on by the CHV about this pt - " pt is reserved and most often stoic so people donít mingle much with him

CHIEF COMPLAINTS

Location Sensation & Pathology Modalities Accompaniments
Endocrines Detected Diabetic at the screening camp
Pancreas Asymptomatic
RBS: 218 mg / dl

ASSOCIATED COMPLAINTS

Location Sensation & Pathology Modalities Accompaniments
Rectum Burning while passing stools < after stools
since 8-9 months Had undergone haemorrhoidectomy > 3 after pain killers
since 2 Wks > 2 cold water

PHYSICAL CHARACTERISTICS
PERSPIRATION: Scanty2, Partial, arm pits, not staining and non offensive
APPETITE: Normal
DESIRES: Salty things2, milk, eggs, spicy
STOOLS: Constipation tendency, Stools dry.
URINE: Normal
Sun < skin tanning
THERMALS: Hot
SLEEP: Good, disturbed due to thoughts especially related to his uncle and aunt, he cant get back to sleep if sleep is broken.
SEXUAL LIFE: Happy healthy

FAMILY HISTORY: Father: Cancer -throat

LIFE SPACE
Patient is native of the U Village, born and brought up there. His parents passed away when he was a small. He was looked after by his uncle and aunt who did not have their own children. They took care of him providing him food, shelter and clothing which patient remembered often during case.

PP had some knowledge about the family background when his wife's case was taken. His wife had given picture of MIL as being very rude, quarrelsome, always accusing and troubling DIL. She was suspicious and used to gossip about others and her DIL's. Patientís wife was very unhappy living in the joint family and desperately wanted to shift from that house which husband never supported. PP had then spoken to Pt regarding his wife and then Pt also had expressed his helplessness. When pt's case was taken his location was clearer. He said he was given food, clothing and shelter when his parents passed away and no one else took care of him.

He was then only child at home but later his uncle and aunt had a son and yet both were taken equal care. Pt also took care of his brother very well; he liked him very much, and showed lots of responsibility towards home, his care takers and his brother.

The gratefulness for their care and affection bestowed on him was evident in his behaviour. This could be attributed to the responsible, dutiful aspect of his nature.

As they grew up and got married he saw that his aunt-mother under estimated pt in front of others. She spoke very rude about pt and his wife and passed bad comments about them. This used to irritate patient but he could do nothing. Emotions, especially anger got suppressed.

By keeping quite and not reacting was the only way he could show his gratitude and so he felt that he should never shout at them. He always tried to convince his wife and always asked her to adjust. During interview there were tears when he spoke about these things. He would not express his feelings with anyone, would keep it to himself and go ahead. An overt suppression of feelings was clearly visible. . This whole scenario was going on for few years now. Pt feels that whenever there were issues at home coming up, he would feel weak. "May be my illness has started then" is what pt said.

Despite their insulting, rude behaviours pt said he can never leave his uncle and aunt. Added to this their son died in a road traffic accident. This had jolted family a lot especially his uncle and aunt. Pt also had taken care of the brother very well and though he did not have so much of affection.

The death of the brother was few months back and pt feels that his health must have further detoriated because it meant he had now lost the support / affection.

Somatization as a defence mechanism was very clearly evident along with suppression.
The totality drawn was-

  • Ill effects of Suppressed anger
  • Sentimental and Retentive person
  • Responsible and duty bound
  • Cr- Salty food2,
  • Thermally hot
  • Tendency to constipation- Stools dry
  • Perspiration scanty
  • Stoic, Reserved behaviour

Natrum-mur 200 1 dose was prescribed on 11-11-08 and here is the follow up-

Date Mental state Sleep Stools RBS prescription
17-11-08 Better SQ No burning 110 mg/dl Nat-mur200 1 dose
02-12-08 Better Better Normal   Nat-mur200 1 dose per week  for 3 weeks
30-12-08 SQ Good Normal   Nat-mur200  1 dose
20-01-09 Not much disturbance Good normal FBS-126
PPBS- 169
mg/dl
Nat-mur1M 1 dose  followed by Placebo
24-03-09 Generally OK       Placebo

The last RBS reading on - 4th April is 116 mg/dl. Pt is maintaining on placebo.

CONCLUSION- We are indebted to our mentors (Faculty of MLDMHI) for showing us this way. In this less traveled path, we intend to move ahead.

Case: 84
A Case of Allergic Rhinitis

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