The article by Sada Reddi in last week’s issue of this paper, about the development of orthopaedics as a speciality in Mauritus, prompts me to share some bits and pieces of our recent medical history which I am sure will be of general interest.
I start by supplementing the information about orthopaedics in Sada Reddi’s article, which correctly points out how the polio epidemic of 1945 spurned the development of the specialty, and that of an important allied profession to orthopaedics, namely physiotherapy. Whatever I will write is not as a professional historian, which I am not and Sada Reddi is, but in the spirit in which history is looked at in India – itihasa: iti hi asa: this is the way that things were, anecdotal accounts either directly witnessed or passed on, rather than analytical versions or inferences about events and people.
One of the pioneers of orthopaedics in Mauritius was Dr Ghadially, who was of Indian origin, a Parsi from then Bombay. He trained in England immediately after the Second World War and came to Mauritius in 1956, on the recommendation of Sir John Seddon. I had the privilege to work with Dr Ghadially at the PMOC from 1982 till 1984, when he finally retired from the Ministry of Health, taking over from him the responsibility of running the Plastic Surgery and Burns Unit which he had set up formally in 1969. This was in addition to my duties as Orthopaedic Specialist, just as Dr Ghadially used to do.
In fact, it was Dr Ghadially who initially gave me some insights into the development of these two specialities here, and later I learnt some more from Mr John Fitton about whom I will write in a little more detail shortly. I learnt from Dr Ghadially that after the polio epidemic, the Colonial Secretary delegated John Seddon to Mauritius to take stock of the situation and make recommendations. John Seddon was the right choice, because he was an expert in the study and management of what are known as ‘peripheral nerve injuries.’
I make a brief digression to explain what is meant by peripheral nerve injuries. Nerves are like miniature electric cables that relay information from the brain to the rest of the body, and their sizes vary from the thinness of a thread to about one centimeter. This is the size of the sciatic nerve – most laymen are familiar with ‘douleur sciatique,’ which involves this large and long nerve that runs from the low back, arising in the lumbar part of the vertebral column, down to the leg, one on either side. Nerves go to bodily organs inside the body cavities such as the abdomen and the thorax, but also to muscles in the limbs and the trunk.
In the limbs, they can be damaged – crushed or cut – when the limbs suffer injury such as during a road accident, or with a knife or broken glass pieces especially where the nerves are in a superficial location, at the wrist for example. That is what is referred to as ‘peripheral nerve injuries,’ the management of which has itself developed into a major subspecialty of orthopaedics. A pioneer in this field at Oxford in the 1930s and 1940s was John Seddon. It may be noted that the polio virus leads to damage of peripheral nerves at their origin in the spinal cord, and as these nerves are responsible for the movement of muscles, the latter therefore are weakened as a result of polio, leading to paralysis and inability to walk.
One of the recommendations of John Seddon was the setting up of a special hospital to treat the sequelae of polio, and to send an orthopaedic surgeon to take charge of the treatment of these cases, many of whom required operations on their legs. The surgeon who came over was John Fitton. He was then a Resident Surgical Officer at the Pinderfields General Hospital in Wakefield, about 10 miles to the south of Leeds. Pinders, as it is generally referred to there, is well known for its School of Physiotherapy, and it was no surprise therefore that John Fitton’s team comprised physiotherapists from there.
John Fitton came to Mauritius in 1947, and left in 1949. He used to stay in the Floreal area, near the polio hospital which when we were kids from that region (Curepipe-Road and Floreal) we knew as ‘l’Hopital Mangalkhan.’ He went on to become a Consultant first at the Leeds General Infirmary, and subsequently at the St James’s University Hospital there. He continued to be a Visiting Consultant at Pinders, where I met him when I worked there in 1976-1980. He had a collection of slides of orthopaedic problems in Mauritius, and on the occasion of an end-of-year Open Day at Pinders, he showed a slide of a tuberculous abscess (known in the jargon as a ‘collar-stud abscess’) of the wrist in a Mauritian patient, made from a photograph he took in 1949.
His daughter was born here, and several years ago she came to Mauritius to inaugurate the ‘John Fitton’ ward at PMOC, certainly a well-deserved tribute, but which is also overdue to some of the other stalwarts such as Ghadially and Bathfield amongst others. John Fitton passed away in the mid-1990s, but had visited Mauritius a couple of years earlier, as a guest of the Teckham family, whom he knew very well from his association with Dr Phillipe Teckham, also an orthopaedic surgeon from Leeds. I met him then too, at Dr Teckham’s residence and we had a very interesting conversation. A few other colleague orthopaedic surgeons have also known and worked with him in Leeds.
As for Dr Ghadially, when Dr Alms who was in Her Majesty’s Service left Mauritius in the 1950s, he was sent here by Sir John Seddon on an assignment of a year, but he went on to spend the rest of his life in our country, and passed away at his residence in Granum Road, Vacoas about ten years ago. When he saw that patients needing plastic surgical procedures — such as those suffering form extensive scarring after burns, children born with congenital anomalies such as hare-lips and palates, deformed ears and fingers, etc., – were not receiving the appropriate treatment, he ‘recycled’ in plastic/reconstructive surgery and burns at leading centres in the UK during his long overseas leaves. That is how he came to practise that speciality in addition to his orthopaedic activities, and which I humbly inherited from him when he retired.
I have given but a glimpse, but there is much more to share of course!
* Published in print edition on 21 June 2013