It was December 9, 1975—a cold morning in the tribal village in Mahuadanr in Bihar, India. The valley was filled with an eerie mist coming down from the hills surrounding the village. Champa, a 5-year-old malnourished girl with sunken eyes, an emaciated face, and a huge ascites, was carried by her mother to the small one-room clinic. She was semiconscious; her lips were dry and pale. Her listless limbs hung at her sides.
By the end of the day, there were hundreds of similar men, women, and children from the remote village Sabagh who had walked more than 30 miles through the muddy dirt path of hills and jungle to get to the clinic. They all looked exactly like Champa or worse. Some of them were carried on the shoulders of men and women who were not as sick as them. The Jesuit priests from Australia opened the doors of the parish building and school for use as a makeshift hospital. Patients who were jaundiced, malnourished, and full of ascites filled the mud floor.
Two Medical Sisters
The newly formed clinic had two doctors who were Catholic nuns: Dr. Melanie and Dr. Romeo. They were Carmelite Sisters from Kerala, a small state on the coast of the Arabian Sea in southern India. According to the Eastern Church, Christianity began in Kerala, centuries before the Western influence. It is not unusual for young men and women from Kerala to accept priesthood or become nuns. As in many parts of the world, the Catholic Church played a key role in building educational institutions and hospitals in India.
Due to their academic excellence, Drs. Romeo and Melanie had received a scholarship from the Notre Dame Sisters to attend medical school at the University of Ottawa, Canada. The two sisters were strongly discouraged by many faculty members to pursue medicine; faculty thought it would be too difficult for them and encouraged them to consider nursing as a career, but they were determined to finish medical school.
When the Carmelite Sisters asked the newly graduated Canadian-trained Drs. Romeo and Melanie to join this tiny clinic in the remote village, they had no idea what was in store for them.
Their two-room clinic in Mahuadanr had no electricity, telephone, or running water. With the mud floor and wooden walls, you could hardly call it a clinic. Drs. Romeo and Melanie had no idea what to do with this sudden influx of patients. They drained the ascites and started patients on steroids and diuretics. All patients received three meals a day, vitamin supplements, and warm blankets provided by the priests and nuns.
Miraculously, Champa and many other patients slowly got better. However, Drs. Romeo and Melanie still did not know the cause of the ascites or jaundice.
A Weed Was the Culprit
The sisters started tracing the patients back to their village, where it seemed time had stopped more than 200 years ago. The villagers were so poor; they survived on the Gondli grain (a type of millet). After talking to the villagers, the sisters soon became suspicious that Jhunjhunia, a weed growing with the Gondli may be the culprit.
According to the villagers, “even our dogs became ill and died after eating it.” The tribal people were forced to eat the weed-contaminated grains because that was their payment for their work for the landlords. None of the upper-caste Hindus who owned the land and employed the tribal men and women became ill because they did not eat these grains.
The sisters wrote to the All India Institute of Medical Sciences in New Delhi, one of the largest teaching hospitals in India, and sent it samples of the Gondli weed. Badri Nath Tandon, MBBS, MD, who was Head of the Gastroenterology Department at All India Institute, sent a team of doctors to help the sisters and identify the cause of this sudden onset of ascites. He sent the samples to the Toxicology Department of Medical Research Council in Surrey, England.
They confirmed the Jhunjhunia seeds contained the toxic substance pyrrolizidine alkaloids. Dr. Tandon and his colleagues made the diagnosis of veno-occlusive disease of the liver from this toxin.1
By that time, more than 1,000 patients had died from this illness. Repeat requests to the authorities fell on deaf ears. The upper-caste Hindus who owned the land convinced the poor tribal villagers that the illness was caused by an evil spirit.
Drs. Romeo and Melanie and their colleagues never gave up. Finally, an effort by an external medical team lead by Dr. Tandon convinced the government to take action. Jesuit priests and nuns led local tribal leaders in a massive weeding program, which cleaned all the contaminated crops. By the time it was complete, more than a year later, thousands of lives were lost.
‘My Guiding Light’
Sister Dr. Romeo was my mother’s older sister. As a little boy growing up in a small village in Kerala, India, I viewed her as my hero, guiding light, and inspiration. Even at the age of 74, she continues her work for the poorest, at Carmel Hospital in a remote village in India. She is the only doctor at that hospital, where she treats cerebral malaria and tuberculosis, performs cesarean sections, repairs hernias, and removes inflamed appendixes.
As Dr. Albert Schweitzer said, “The purpose of human life is to serve and to show compassion and the will to help others.” My aunt, Dr. Romeo, lives by that credence every day. I know I can never match up to her selflessness and sacrifices, but she will always inspire my humble journey as a cancer doctor. ■
Disclosure: Dr. Abraham reported no potential conflicts of interest.
Reference
1. Tandon BN, Tandon HD, Tandon RK, et al: An epidemic of veno-occlusive disease of liver in central India. Lancet 2:271-272, 1976.
