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Asha Vihar is a development aid project in the state of Jharkhand, Eastern India, that takes a holistic approach comprising conventional and alternative medicine to deliver free healthcare to those who need it most. Anaesthetists Dr Lukas Fischer and Dr Peter Lembach embarked on a voyage of discovery when they volunteered at Asha Vihar’s annual surgical camp for children with musculoskeletal abnormalities, seeing at first hand how surgery can not only reduce pain and disability, but also offer hope for a future free from social stigma. Dr. Fischer explains how postoperative pain management depended heavily on using point-of-care ultrasound (POCUS) to guide needle insertions and provide regional anaesthesia, enabling life-changing interventions.
A lifeline for disadvantaged communities
Many people in India cannot afford health insurance or to pay for surgery that their child may have needed for many years. These families depend on charities such as Johar Gesellschaft Deutschland, which is well known across the Jharkhand region for delivering services that are free at the point of use. The charity has been running the Asha Vihar development aid project near Ranchi since 1996, providing conventional medicine, physiotherapy and alternative medicines – such as acupuncture, homeopathy and Ayurveda therapies – to the poorest families. It introduced ‘surgical camps’ in 1998, and its hospital is a much-valued source of employment in the area, with approximately 100 paid staff. Asha Vihar also runs humanitarian outreach projects to local villages, a computer school, an orphanage, and satellite clinics in the surrounding areas for people who are unable to travel for treatment.
Heading into the unknown
Anaesthetists from Germany and Austria have long been involved with the Asha Vihar project. Dr Lukas Fischer, an anaesthetist at the HELIOS Klinikum ‘Emil von Behring’ in Berlin – which has a focus on paediatric orthopaedics – learned of the charity from a colleague, who explained how fellow anaesthetists were taking leave from their day jobs to make short trips to India to work at the surgical camps. He volunteered his services and joined the team for the first time in January 2019. Never having undertaken a trip of this nature before, Dr Fischer did not know what to expect. He explained: “I was quite nervous when I got there. Apart from some phone calls beforehand, I didn’t know any of the team, and was unfamiliar with the region and the culture. It was a very new adventure for me, and I really didn’t know what I was heading into, but it turned out to be a wonderful experience.”
Annual surgical camp
The surgical camp primarily focuses on individuals with deformities of the feet, and runs annually for six to nine days, usually in January when the climate is least humid. In 2019, the volunteer surgical team, headed by Dr Hans-Georg Zechel, successfully treated 26 children aged between seven months and 16 years. “The most common type of deformity was club foot, but also deformities of the lower legs, such ‘tibia vara’ (Blount’s disease), a growth disorder of the tibia that causes the lower leg to angle inward, resembling a bowleg. We also treated two children with malunions of previous fractures that required correction, and one with changes to the shape of the bone due to osteomyelitis, probably as a result of underlying tuberculosis.”