10/02/2016
The village shimmered in colors and a delirious commotion. It was the annual Thiruvathira festival in the Bhagavathy temple at Kadakkal – a remote village in Travancore in the 1930s.
Far from the madding crowd, yet in the thick of it, walked a young man, recently married, along the dusty village path that led to the temple, lugging a camera. He seemed curious about the village, its people and mores. Leave his penchant for good frames, but the man had come here in a more serious mission. Dr. Govindan was the new medical officer of Kadakkal dispensary. His first job, since his education in Madras Medical College.
With the keen eyes of a photographer and the astute mind of a doctor, Govindan tried to read the new place around him. But the land and its texture, the people and their customs, all remained submerged in the shades and darkness, away from the festival frenzy. When the wave of crowd finally trickled into absolute silence the doctor saw the dregs at the bottom.
“The population was scattered and a vast majority of people were poor,” Dr. Govindan noted in his album.
Two hardbound ones survive the time to tell us the story of Dr. Govindan’s travails in Kadakkal 85 years ago. The dark albums wouldn’t open without a crackle, feebly holding back the past and its tales.
“He documented his work with photographs,” says Krishnakumar, son of Dr. Govindan, who runs the prestigious Govindan’s hospital in Thiruvananthapuram, while carefully turning the pages of the album, handed down by his late father.
Young Govindan sometimes had to walk long hours under a tyrannical sun to reach the sick and the needy in Kadakkal. “Many lived by the paddy fields where they worked,” he noted. The land went stygian black after sundown, save for occasional fireflies winking in some corner, and bashful lamps burning from little huts. It was ridden with superstitions and apothecaries. The doctor worked diligently, making slow but definite strides into the mysterious world where English medicine was considered the last resort. His broad forehead, inquisitive nose and considerate eyes behind round frames had a reassuring air about them, which could put the people at ease. Now they wanted him to look into their deeper sores and aches.
The more the locals became comfortable with the young physician, the less relaxed the latter grew. He checked his books. The marks he repeatedly saw on many patients wrinkled his brows.
This was no simple lesion.
The sore came in all shapes and colors. For a few, it had started ulcerating. Crushed noses, faces half-eaten by sores, feet and palm gnawed away by strange skin diseases, bow-legs. The poor people, who mostly belonged to lower castes, were all strangely connected to a sore they carried in their body.
There were cripples, invalids. The doctor’s hand was soon full with strange cases, and he slowly realized that the village was in the grip of freakish pandemics.
This was no ordinary situation, and no ordinary measures would work. The only solace was the fact that the young warrior in white coats was no ordinary man either. Govindan, son of Sanku vaidyan, began to quiz his patients again and again, took their responses against the textbooks he studied.
Reading the features, he finally discovered that beneath the sores lay a spiral-shaped bacterium - Treponema pertenue, - a distant cousin of the bacteria which causes Syphilis.
Yaws. That was the name of the disease on the loose.
Yaws is a chronic infection that usually occurs in warm humid region – Asia, Africa, and South and Central Americas. In its long history shrouded in mystery, the disease has caused enough damage in various parts of the world. Overcrowding, malnutrition and poor hygiene collude to make bed for the bacteria.
You touch an infected person and you take the disease. That is how Yaws spread. A cut or bruise on the skin comes handy for the bacterium to waltz in to a new system.
‘Mother yaw’, the primary sore comes at the germinal stage of the infection. But among the poor farmers who work in the sun, who would care a lesion about the size of a one rupee coin? Case would be dismissed with a sigh. A couple of weeks go by, as the crust of the elevated lesion darkens, roughens, wrinkles, and falls off leaving a base that resembles the texture of a strawberry.
No home remedies squash the strawberry, nor dry it up.
The infected leaves it for more serious matters. It persists for months or even years. Now it is play-time for daughters – Daughter yaws- tiny little heads, to peer out through cracks and fissures of the feet. Stage 2.
But the moment the patient recognizes that his defensive mechanism has succumbed to the infection, the bacteria pull a crazy trick. They lay down their arms. Unconditionally. The symptoms in the body vamoose save a sore or two.
Miracle relief? Has the home remedy worked? Far from it. It is the sea pulling back from the shore moments before a Tsunami - a lull before the full-scale sortie.
Stage 3. The nasal cartilage crumbles in along with the nose. Bones yield to severe pressure and bends. Skin, tissue, joints share the impact to make the patient a cripple for life. Extensive ulceration follows rendering the patient unfit for any walk of life.
The doctor had met his enemy and battle lines were drawn. But where is the weapon?
Govindan had a friend, a Chemistry professor in the University College in Thiruvananthapuram - Narayanan Potti. The friends soon met and quibbled over the effectiveness of different chemicals in human body. They must find an elixir, which could salvage a whole village. Potti now had to go to his lab to translate the main points of their discussion into some meaningful experiments.
When he finally came back to the village, the young doctor had a weapon in his hand, a magic bullet, named Bisota, a stew of chemicals born in the laboratory of his friend, after many weeks of experiments. Bisota was Sodium Bismuth Tartarate.
The place was vast and the sick were abundant. The doctor began to comb the village for the infected to administer injections. When the phenomenal task was finished, Dr. Govindan counted – he had given more than 12,000 shots.
“Intramuscular injections on thighs,” he noted in his album. The photographer in him kept close company with the doctor, taking pictures of the affected parts of the sick. If at all there would be a revival, the miracle must be well documented.
In Thiruvananthapuram, the chemistry professor who prepared the medicine, waited for the good word to arrive from his friend.
Weeks went by and results began to trickle in from odd corners of the village. Gradually, they swelled into a torrent.
Bisota had started its magic!
Dr. Govindan lugged his camera merrily around to capture the changes the new medicine had brought in. He knew the enemy had retreated, and what remained on the sores he saw were the crumbled and deserted citadels of Treponema pertenue.
Many decades have passed and the doctor is gone. Kadakkal Thiruvathira is still a major festival of this town locked between Thiruvananthapuram and Kollam. Along with the myths that go round about the local deities, old people talk about a man who came to rewrite their destiny long long ago.
For Krishnakumar, a doctor himself, these albums that crumble at touch are the last linkages to a village ridden with an infection; to a doctor who salvaged it with the help of a couple of his friends; to his father. If these fine threads to the past snap, our poorly documented history could never be able to save this real life account from turning into yet another myth.
For most myths are raised from the ashes of undocumented facts.
(CORRECTION:This story has been corrected to say that the organism that causes yaws is Treponema pertenue, not Treponema pallidum.)