pellet Roli Srivastava

Dr. S Natarajan says over 500 cases of eye injuries were brought to the hospital since July 9.
His youngest patient was all of five. Mumbai doc works relentlessly in Kashmir hospital to remove pellets and correct retinas, and gets a perspective on life

Dr. S Natarajan recalls a peaceful morning near Dal Lake in Srinagar in 1989 when a curfew was suddenly imposed. Shops quickly downed their shutters and people retreated home. He was visiting the city for a medical conference. It was his first experience of watching the city come to a standstill, like it would so often in the years to come. Nearly three decades later, Dr. Natarajan, a vitreous retina surgeon of international repute, almost instinctively responded to a message on a WhatsApp group of ophthalmologists seeking a retina specialist to treat the mounting cases of eye injuries at the Shri Maharaja Hari Singh (SMHS) Hospital in Srinagar. Dr Natarajan reached Srinagar last month, and this time moved through the city’s deserted streets in an ambulance – commuting from the circuit house where he was put up to the hospital, where he would work 16 hours on average every day, performing surgeries to remove pellets and repair retinas – complicated procedures that on average lasted for over an hour.

“In some cases, the surgeries felt like driving through a hailstorm,” he says, speaking to The Hindu on Friday, a day after he returned to Mumbai from Srinagar. Dr. Natarajan makes the hailstorm reference not in terms of the challenge the surgery posed but how the pellet-injured eye appeared. He shows a video of one such surgery – a blood-layered eye surface and a hazy mass of red in the place of gel in the back of the eye. The damaged retina is corrected once this blur of blood is cleared from the eye’s surface and the back.

The nature of injuries wasn’t unfamiliar to Dr. Natarajan, who runs Aditya Jyot Eye Hospital in Mumbai. He sees such cases in toy gun or even firecracker injuries among children and young adults. Only this time, it was the sheer volume of cases he was treating that was a new challenge. And for this reason, when you ask Dr. Natarajan personal stories of the victims, he pauses. “I was just operating. Where was the time to talk,” he says.

But the data he gives is indicative – the youngest patient he operated upon was five years old and the oldest 22. Most pellet victims were in the 15-20 age group. He operated upon 41 patients during his first visit to Srinagar from July 24 to 29 and another 46 pellet victims from August 22 to 25. He says over 500 cases of eye injuries have been brought to the hospital since July 9, of which he operated upon the most complicated ones. And, he says there was no drop in pellet victims between the two visits. “On the day I left, 14 people were brought in,” he says. He estimates that 90 per cent of all injured are coming to SMHS. A select few, those who can afford to, are going to AIIMS Delhi and L V Prasad Eye Institute in Hyderabad – again indicative of the socio-economic background of the victims.

The nature of the injuries ranged from simple to very complicated. If in some cases, the pellet had just touched the eye, in others more than one pellet had pierced the eye, and in some cases the pellet had gone through the eye and got lodged in the skull. “In one case, I removed a pellet and the next day, another pellet appeared in the eye,” he says. In another case the pellet was ensconced on the back of the retina.

However, it is too early to say if the vision of people with pellet injuries will be restored following the marathon surgeries. “They have to be monitored at six weeks, three months and one year,” Dr. Natarajan says. For this reason, he will be travelling to Srinagar again next month.

A nudge and a philosophy

Dr. Natarajan, who was assisted by Dr. Kenshuk Marwah from Delhi and Dr. Syed Azgar Hussain from Chennai, said the ophthalmology department at SMHS was well equipped and had skilled doctors, but were overwhelmed by the volume of cases streaming into the hospital. So when the WhatsApp group message beeped on Dr. Natarajan’s phone, his consent to take up the surgeries was indeed instinctive, but one that was already on his mind.

Mumbai’s former top cop D Sivanandan, who is closely associated with the philanthropic work of Dr. Natarajan in Mumbai, had suggested to him to take up surgeries of pellet victims in Srinagar. Speaking to The Hindu, Mr. Sivanandan said he made the suggestion at the peak of the unrest, when pellet injuries had started making news headlines. So when the NGO Borderless World Foundation sought an ophthalmologist to help pellet victims, he responded immediately.

The NGO, which comprises a group of doctors from Maharashtra, funded his travel and he offered his service for free. But then, Dr. Natarajan, a third generation eye doctor, says he owes it to society. “My grandfather used to hold free eye camps where he would volunteer. I had a scholarship so I paid Rs. 250 for my MBBS, which was on taxpayers’ money. So this was payback time for me,” he says.

Asked if as a doctor he sees it as his responsibility to make a suggestion to the government on the use of pellet guns, he says he has become philosophical and can only suggest revisiting Gandhi’s Ahimsa lesson.


Source-the Hindu