The curious case of ‘Plasterophobia’

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It looked like any ordinary day – the same room, the same operating table, the same pain. The patient waiting for medical care even nursed a common injury – a fracture – and the solution was also simple – she needed a cast. But the moment I uttered the word plaster she screamed and jumped from her chair as if she had seen a cockroach. (Now, the truth is that I, too, would have done the same if it was a roach!)

With some effort, we calmed her down and I spoke to her attendant, explaining that she needed a plaster to set right the fracture. But when I mentioned the word plaster she became restless and started screaming again. It dawned on me that she had an irrational fear of putting any part of her body in a cast.

I tried to reassure her saying that it was not unusual for a patient to feel anxious, but it would help her heal. She was unconvinced. Instead, she shared with me that when she sees her hand or arm enclosed and immobile, or even if she sees someone else’s in a plaster, she imagines that the individual’s life or soul is trapped inside and s/he will suffocate and die.

Now, what she was experiencing was something uncommon. It was a psychological phenomenon similar to claustrophobia, which I termed PLASTEROPHOBIA.

The essence of the matter was that she had a phobia and probably needed some psychiatric help, but I had to put that plaster! What came to my aid was my Indian skill of JUGAD. There is a material called fibreglass, which works in a way similar to plaster but the colour and consistency is totally different. We showed the patient the pink-coloured fibreglass and made her touch it to feel the jelly-like consistency. That reassured her and she agreed to go through the procedure. Then, instead of a cotton bandage, we used a long sock (what we call a stockinette) to wrap the forearm. I requested her friend to keep her engaged in conversation throughout the procedure. I quickly prepared the cast out of fibreglass, manipulated and placed the limb in the desired position, and quickly wrapped it with the crepe bandage. She cooperated fully since she was under the illusion that her ‘nice’ doctor had done away with the ‘plaster’!

Unfortunately, just when everything was going smoothly, an enthusiastic aide loudly enquired, “Is the plastering done?”

No sooner had the word plaster reached her ears than she became restless again and was yelling and jumping. The entire staff had to hold her hands and legs so that I could complete the job.

When everything was done and I had explained what medicines she needed to take and was bidding her goodbye, at the door, she turned back, smiled and said, “What do you think I am going to do? Keep it this way? Nooo.. I am going to remove it as soon as I go home!”

Medical camp conducted in Nampally Vyayamshalla

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Dakshas team members took part in a comprehensive medical camp that was conducted in the Nampally Vyayamshalla school.

The school, which caters to a lower income group of 700 students, was sent a set of pre-screening questions prior to the medical camp. The subsequent results from the pre-screening questions revealed that 24 students had musculoskeletal problems.

 Of them, a few were found to have calcium deficiencies and birth abnormalities. 

Students’ parents, who were also present, and were counselled on how to proceed with medical care. The school and the Dakshas team have also followed up with the students to ensure that they receive the required medical care and, in certain instances, also extended financial support.

Quite a few medical conditions can be prevented, and having regular screening greatly helps in identifying issues that can be treated before they begin to affect the quality of life of the person.

The Dakshas team conducts camps in rural areas every Sunday with the coordination of United Care Development Services, a Philanthropy Exchange platform. They see around 25 patients a day. Most of the patients have problems with their back or knees, which are due to daily activities. Along with prescribing medicines, patients are taught exercises to alleviate the condition and given advice on activity modification. Those who need follow up or surgical intervention are identified and a follow-up is done by the team to ensure that they receive care.

Dakshas’ work in partner institution: NS Old Age Home

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Every month, an organisation that Dakshas works with, will be featured in the blog. As of today, Dakshas works with 8 old age homes, 6 clinics and several hospitals.

NS Old Age home in Mehdipatnam, is one of the eight old age homes that Dakshas works with. The institution takes care of 24 abandoned or below-the-poverty line, aged residents and includes four bedridden patients. The institution has a co-ordinator in-charge, a cook and two caregivers.

The caregiver, who has received Multipurpose Health Worker training under Dakshas’ Multipurpose Health Worker program attends to the regular hygiene and health needs of the four bedridden patients.

 In addition, Dakshas also sends a supervising physiotherapist to help with the tasks. 

General physiotherapy is done for those who need it. Exercises are done three times a day, each session lasting for 30 to 40 minutes. The supervising physiotherapist demonstrates the exercises, which are repeated by the residents with the help of the caregiver.

Every Saturday a doctor of a different specialization visits the old age home. As of today, visits have been made by general physicians, a psychologist, an orthopaedic and an otolaryngologist (ENT).  

Dakshas has also implemented STEADI (Stopping Elderly Accidents, Deaths and Injuries) programme, to prevent the residents from falling, in all the old age home that we are working with. Bathrooms have been equipped with proper lighting, grab bars and non-slip rubber mats. Further, all team members have been trained to follow the programme and to keep an eye out for anything that may cause an injury to the residents. 

Before Dakshas started its work with NS Old Age Home in 2019, the institution did not have any medical support and the need for a caregiver was acutely felt.

Dakshas’ services have helped the Home in improving hygiene, managing musculoskeletal issues and even psychological problems. In fact, of the two paralysed patients that have been receiving physiotherapy, one is now beginning to walk again!

Dakshas’ journal club launched

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Dakshas’ constant endeavour has been to nurture its team. The nurturing happens in terms of growth of knowledge, skills and the individual. One of its initiatives has been the  journal club. The journal club provides a space where its medical professionals meet and discuss the latest trends in their respective fields.

The club consists of six physiotherapists and one orthopaedic surgeon who meet once a week to present and discuss a topic at each meeting. The topics that are  discussed revolve around musculoskeletal problems, new programs, exercises and ways to improve protocol. The club helps the team learn and implement new ideas and changes in the protocol.

Journal clubs came into existence in the 1800s and have widely promoted knowledge sharing. A summary of a paper would be presented by one or two members to the group who has read the paper. Following the presentation, the floor is open to discussion and questions by the attendees who may ask different aspects of the experimental design and critique the methods. Having a journal club at Dakshas  helps our expanding team stay abreast of the latest medical knowledge and protocols. 

Dakshas presentation at N/Core Soiree

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At the culmination of its six-month incubation at N/Core, Nudge Foundation, we had an opportunity to present Dakshas at a soiree organized at the Mumbai Cricket Club, along with 11 other incubatees. These highly charged not-for-profits had been selected from an initial pool of five hundred applications. 

The six month incubation saw us learn the importance and challenges of solving problems at scale. We learnt to grow our ideas, instead of our organizations. How capacity and ecosystems could be built to achieve these goals. An exceptional series of co-founders from successful start-ups shared their learnings. We were each connected to one mentor and a N/Core team member. The mentor set a strategic vision, while N/Core helped tactically. 

Dakshas went through a transformation through the incubation period. We not only opened up our service platform to external clinical entities, but also launched a product initiative that can scale as big as the problem we tackle. We developed a support system of our own, which morphed into an Mentor-Intern program, wherein management grads with a year or two work experience were tied to senior mentors in their respective fields. An internal leadership development program and building  of the core team stabilized the program at scale. Impact analysis was formalized, refining our future trajectory. N/Core is an excellent incubator that effectively communicates its idea of scaling start-ups in a manner that cannot be ignored. 

All this culminated in the presentation on the 28th of Nov 2019, when we presented the ‘new’ Dakshas. It came as a pleasant surprise when the program was selected as the best of the lot by mentor vote, while another impressive venture, Mitti Cafe, was judged the best by audience poll. We now have a goal to link every single poor patient to each unused resource in the health sector. We invite you to partner with us on this journey.