The medical care of the survivors should be based on the principle of ‘First do no harm’: therapy administered to patients must not compound the injuries sustained as a result of exposure.
Therapies that do not contribute to the toxic load of the body are integrated into provision of medical care as far as possible.
Integrated systems of therapy must be based on the specific symptom complexes presented by the survivors as opposed to attention to individual symptoms.
A proper system of registration and constant monitoring of the effect of therapeutic intervention and research into the health status and efficacy of treatment must be integral to the provision of medical care.
Most visitors walk to the clinic from the severely-affected communities. Newcomers are welcomed, registered (which allows for accurate recording of medical data along with follow-ups on those who drop out of treatment) at a rate of 5–10 per day, then given a healthbook and a consultation.
The patient may be seen by a general practitioner, a gynaecologist or a psychiatrist. Dr Ali Quaiser, one of Sambhavna’s GPs, explains that visitors are not made to feel like patients at Sambhavna:
‘We try to have a friendly atmosphere. People are frank, apart from relating their health problems, they also report their frustrations, their home lives. As well as looking after the physical health of those who come here, we are also taking care of their spirit.’
Great care is taken to ensure that any drugs that are prescribed do not add to the damage already caused. As a matter of principle the clinic buys its medicines from the only non-profit collective in India producing quality medicines.
A thorough medical examination is one of the salient features of care at the clinic. Because it is usual for people coming to Sambhavna to be accustomed to neglect, mistreatment and queues in dismal government, or private, hospitals, first-time visitors have been known to down in tears, explaining that in all these years no doctor has ever listened to their chests or felt their pulse during examination.
Since little is known about the efficacy of different drugs in treating exposure-related injuries, special efforts are made to monitor the effects of both Western medicine and Ayurvedic therapies. Doctors and other therapists have evolved a system of grading the severity of different symptoms so that relief obtained in each can be documented with some degree of precision. Clinical data of each person is entered into a database with analysis on a monthly basis for assessment of efficacy of different therapies.