‘It is because of my friends and family that I am still alive,’ states Dr Vivek Karthikeyan, recalling the time he spent in a critical condition at a hospital in Bengaluru in 2014. During the two months spent recovering from a road accident, his friends revisited incidents from his past to make him feel better. What kept Dr Karthikeyan going was the memory of having led his football team to victory, years ago, when they studied together in medical college. He wanted to play football again; and, his time as a patient inspired him to work and contribute towards society’s welfare.
Today, Dr Karthikeyan and his wife, Dr Sudipta Mahto, live in Kodaikanal, where they run an initiative called Sirumalai Health Centre that works to bring good-quality, affordable healthcare to Kodaikanal and its surrounding areas. They have a clinic and conduct regular outreach camps in rural areas such as Vilpatti, Attuvampatti, Pallangi, Pethuparai and Chinnapalam. When the clinic opened in March, Dr Karthikeyan and Dr Mahto drove to far-flung villages of the Palani Hills on Sundays to organise medical camps in a bid to diagnose and provide better low-cost healthcare. Both are family health practitioners who completed their post-graduation in family medicine at Bangalore Baptist Hospital, where they met. ‘We have this passion to be closer to the community, work at the grassroots level and be trustworthy doctors for our locality.’
Landing Up in the Hills
The couple had considered several places to set up their base before choosing Kodaikanal. While working in Vellore, they spent months travelling through the country trying to find the right place to set up a clinic: the Himalayas, Dehradun, Andhra Pradesh. And then a trip to Kodaikanal made everything fall into place. Dr Karthikeyan recalls, ‘It was our first wedding anniversary, and we took a road trip to Kodaikanal. We stayed at Van Allen Hospital. I really did not want to spend too much money in a touristy place.’
Unfortunately, no hospital in town could offer openings to both of them. However, on their way back home to Vellore, they received an offer to work at Leonard Hospital in Batlagundu. This is where the couple worked for almost a year before relocating to Kodaikanal. While working at Batlagundu, they made several trips to Kodaikanal during weekends to soak in the cool air and dream of setting up a clinic before they moved for good early this year.
Until recently, Dr Mahto worked for Devadoss KHMS (Kodaikanal Health and Medical Services) during the day and visited Sirumalai between 5 and 7pm. She is now available in the mornings as well and offers additional support on administration. Currently she has taken on the responsibility of conducting the village medical camps on Sundays, along with two staff members at Sirumalai Health Centre who help manage the dispensary and administration, while Dr Karthikeyan manages the clinic. A part-time employee comes in the evenings to maintain accounts.
The location of the clinic was chosen to serve the medical needs of the Vilpatti panchayat as well as the town of Kodaikanal. ‘Google Maps helped us a lot,’ Dr Mahto says. ‘When you type “medical centres in Kodaikanal”, you will find them in Poombarai and one in Mannavanur, Kodaikanal and Perumalmalai. Vilpatti, which is the biggest panchayat in Tamil Nadu, does not have a medical centre.’ Dr Karthikeyan wanted to be available for the rural and tribal populations because they are underserved and healthcare is poorly managed. ‘Lots of quackery has been observed,’ he says. ‘So, we wanted to be there.’
Dr Karthikeyan has a rich and diverse background in serving the medical needs of people living in rural and tribal areas. He has worked in an Adivasi hospital in the Nilgiris’ Gudalur for one and a half years, at a rural hospital run by CMC Vellore for two years and at the critical care unit in Bangalore Baptist Hospital for two years. Dr Mahto completed her undergraduate degree at the Amrita Institute of Medical Sciences, Kochi, and worked at Manipal Hospital, Bangalore for a few years. After a gap year, she pursued her master’s at Bangalore Baptist Hospital. A short stint at CMC’s Low-Cost Effective Care Unit (LCECU) as a college trainee exposed her to the world of community-oriented primary care.
Through their interaction with the Kodai community, the couple found that medical care facilities of good quality were still largely unavailable in rural areas. And, reaching the hospitals in Kodaikanal from the various villages and hamlets scattered acrossthe Palani Hills was both expensive and time-consuming. ‘Though house-to-house visits would be much better to understand the people, they were not feasible,’ the couple told TKC. ‘So we got some seed funding from our friends and family and started free camps in five places: Vilpatti, Attuvampatti, Pallangi, Pethuparai and Chinnapalam.’
Similar Rural Healthcare Initiatives
Mobile healthcare units catering to rural areas are not new to the Palani Hills. Van Allen Hospital, the Government Hospital and Rural Pre-Ventures have all been running programmes that offer healthcare services to different rural areas across the hills. ‘These clinics might happen in a school, at a ration shop, on a veranda and, in some places, under a tree,’ says Dr Vijila Isac, about the work chiefly undertaken by her husband, Dr R Isac David, in a well-equipped van. Both work at Van Allen Hospital. The van has an ECG machine, equipment for basic lab tests, and a minor surgery can even be performed inside it, according to Dr Vijila. Currently, Dr David visits eight villages, including Kookal, Gundupatti, Adukkam , Palamalai, Attuvampatti and Vilpatti.
There is also a state government scheme called Makkalai Thedi Maruthuvam, launched in 2021, to offer healthcare to those who are unable to visit the primary, private or government healthcare centres in person. And, Rural Pre-Ventures organises outreach programmes in the village of Poombarai. Doctors volunteer their services, and medical camps are regularly conducted there, as a result.
Still, there are many rural pockets of the hills that do not have access to medical care. The doctors at Sirumalai Health Centre have taken on an ambitious initiative, serving the community, of Vilpatti specifically, with their own funds. Building on this with the help of friends, they seek contributions from corporates and society at large to further their projects.
‘Initially, we wanted to hold camps to understand our population,’ says Dr Karthikeyan. ‘The Chinnapalam community in particular reached out to us and specifically requested a medical camp as facilities were lacking there. All the other areas were suggested by the Vilpatti panchayat president. So we met up with the village leaders and the informal leaders. Then we conducted the camps.’
Interestingly, Jayapradha, who helps handle Sirumalai’s dispensary, was first a patient of Dr Karthikeyan’s, when he worked in Batlagundu. She was a teacher at St Xavier’s at that time, after working as an ophthalmic technician for 11 years at Pasam Health Centre. Her legs were swollen. Although Dr Karthikeyan diagnosed it as lymphoedema, a chronic issue, he could not help much as he was based in Batlagundu, while she lived in Kodaikanal. After Dr Karthikeyan moved to Kodaikanal, Jayapradha walked into the clinic one day without realising that he was the same doctor she had spoken to. As part of her treatment, Dr Karthikeyan arranged for a physiotherapist from another hospital to visit the clinic everyday to massage her legs. Seeing her health improve, Jayapradha’s mother was keen that her daughter join the clinic.
Between May and August, more than 3,000 patients visited the clinic every month across three categories: paediatric, chronic and adult. The numbers have been fairly steady, with a substantial portion of chronic and paediatric patients. Timely intervention in diagnosing and prescribing treatment goes a long way in saving lives; when left untreated, chronic diseases prove fatal later on.
‘It is so unfortunate that even our rural people suffer from lifestyle diseases. They are not sedentary people. They work hard in the fields. In spite of that, there are a lot of cases of diabetes and coronary heart diseases,’ states Dr Karthikeyan. ‘One of the other ailments that we have found to be surprisingly common is respiratory diseases—people with wheezing, coughing and chest phlegm. And then there are skin diseases due to exposure to sunlight. You walk in the sun, you get sunburnt. Redness is the first stage, and then you have patchy eruptions that get very itchy at the end of the day. We do not see many such cases in the plains. Also, we see a lot of gout,’ says Dr Karthikeyan.
‘I used to sweat and feel pain in my chest and stomach and feel light-headed for ten minutes. After four to five hours, the pain would return,’ says J Selvaraj, a 61-year-old mason from Pethuparai and a patient of Dr Karthikeyan’s.
He had earlier sought treatment from another doctor but the pain did not subside. When he visited Dr Karthikeyan, an ECG was taken and he was prescribed a strong dose of medicine for a stomach ulcer. ‘Henceforth, I will come here only,’ states Selvaraj.
Planning for the Future
Dr Mahto manages an enthusiastic Instagram page for the clinic, where she records the kind of work it undertakes, in detail. She has also enlisted the help of her school junior to create an electronic medical record (EMiR) for the clinic, as data was necessary to submit proposals for grants.
In April, Dr Karthikeyan and Dr Mahto managed to collect Rs 1,42,000 through crowdfunding to purchase a spirometer to assess patients with respiratory issues. A portion of the funds also went towards a computer with power backup to digitise patients’ health records. From May onwards, the clinic was able to monitor their progress with proper records of patient visits.
Now, the couple is looking to expand; they are raising funds for a second clinic in Perumalmalai, and are close to their four lakh target, as of October end. ‘Dr Karthikeyan feels that he has to give something back after his accident as it was his second shot at life,’ says Dr Mahto. ‘For me, if in this world I have the ability to touch somebody, it can be a few people, it is enough for me. If I support this person’s dream, it does a larger good. Let me just be a part of it.”