Devaki, 76, looks forward to the visits of the mobile care unit, which helps her care for her disabled son. (photo: Meenakshi Soman)
The Kanya Kumari Social Service Society’s mobile clinic visits patients in remote regions of Tamil Nadu. (photo: Meenakshi Soman)
On a home visit, Father Vinu Joseph and Sister Savari Arul administer medication to Vasudevan. (photo: Meenakshi Soman)
Sree Kumar, left partially paralyzed by a falling tree, receives a home visit from the Kanya Kumari Social Service Society. (photo: Meenakshi Soman)
Many proper names in the article are given with initials, which is a common practice in Tamil Nadu.
In a picturesque village in the southern Indian state of Tamil Nadu, L. Crystal lives in a sizable house surrounded by lush greenery. She shares it with her husband, N. Palmani, and daughter P. Sreeja. The house, however, is filthy — to the extent that snakes have laid eggs within its walls.
Palmani’s diabetes is out of control. Inadequate access to health care has left him bedridden; he has not visited a doctor in months. He lies in bed in a room flooded with rainwater; he and his wife do not have the money to fix the leak. Sreeja has special needs, limiting the ways she can contribute to the household. Crystal wears a torn sari.
Once upon a time, theirs was the most prosperous household in the village, which lies in the district of Kanyakumari, along the coast at the southernmost tip of India. Crystal worked as a teacher. But their circumstances changed amid mounting health issues and an investment gone wrong, setting off a downward spiral into poverty.
Crystal and her husband have two other children — a son and a daughter — now estranged.
But the family has visitors every week. The Rev. Saji Elambasseril and his team from the Kanya Kumari Social Service Society (K.K.S.S.S.) run a mobile clinic that provides palliative care for those who have nowhere to go or no one to turn to for help.
One morning, the Rev. Vinu D. Joseph, Sister Savari Arul, volunteers Suja Rani and G. Sudha, and driver J.M. Praveen visit the family — one of many under their care. They chat with Crystal, Sreeja and Palmani. Sister Savari checks Palmani’s blood pressure and sugar levels. Father Joseph leads a prayer session. It feels like a normal day.
In a variety of ways, the team strives to bring this sense of normalcy, care and dignity to its clientele.
“We look forward to the visit and prayer,” Crystal says. “It gives me hope.”
Founded in 1972, the K.K.S.S.S. is the social services arm of the Syro-Malabar Catholic Eparchy of Thuckalay, and focuses on addressing the needs of the poor and the marginalized communities in the Tamil district of Kanyakumari.
“K.K.S.S.S. does things like skill development training, computer classes, child care centers and nursery schools and tree plantation programs,” says Father Elambasseril, who has directed the society for the last five years.
In 2016, the society began a mobile clinic to make health care available to poor and underserved communities in the eparchy. These consist principally of the Adivasi, or indigenous communities, and the Dalits, who occupy the lowest rung of India’s historical and technically illegal caste system.
“Their needs are quite specific,” Father Elambasseril says. “They live in isolated places and see others as outsiders,” he says, adding that the society has enlisted the aid of men and women among the various communities as volunteers and coordinators, who alert program leaders when someone needs their help.
The mobile medical team, called the Mother Teresa Palliative Care Unit, visits some 300 families who receive assistance from K.K.S.S.S.
“Some of these families live in remote and far out places. They live by themselves in jungles. Access is difficult. But we find a way,” Father Elambasseril says.
R. Vasudevan lies on the floor of a small room. He lives in a small hut in the Dalit village of Ittakaveli. The tropical humidity is at its peak this late October afternoon. Mosquitoes buzz around.
Vasudevan was 21 when he fell off his motorbike. People around him thought he was drunk; no one called for help. Because of the delay in medical attention, his paralysis from the waist down became permanent.
“I’ve been bedridden for the last 27 years now,” the 48-year-old says. “But I am mentally strong and have been able to survive this.” Despite his suffering, he radiates good cheer.
His mother, Devaki, 76, is his full-time caregiver. “I have three daughters,” she says. “They visit occasionally and help bathe him.”
Both Devaki and Vasudevan look forward to their weekly visit from the Mother Teresa care team. “The priest prays. The volunteers and the nurse make conversation. I have visitors,” Vasudevan says, smiling.
Today, Sister Savari changes his catheter.
“If he goes to the hospital for a catheter change,” Sister Savari says, “it will cost him 300 rupees [a little over $4].
“We come here and do it for free.”
Nearly an hour and a half later, the mobile ambulance is ready to leave. The voice of Father Joseph praying fills the air.
“It gives me so much comfort knowing that someone is praying for me,” Vasudevan says.
Father Elambasseril says some of the more marginalized communities, such as the Dalits and Adivasis, face significant challenges.
“It’s a cycle of poverty and debt that’s almost impossible to break,” he says.
“On top of that, alcohol is a big problem in these communities. They brew their own liquor from palm trees,” he says. “Alcohol poisoning and liver failure are the primary causes of death.”
Most of the men and women in the indigenous and Dalit communities are day laborers. The area in and around Kanyakumari is known for its rubber estates, and much of the available work centers around tapping rubber trees.
“Let’s say they earn 500 rupees a day; they often spend 600 on drinking,” Father Elambasseril says. “They have no bank accounts and no savings either.”
Some individuals, however, do own a bit of land.
“But they live in hilly areas where there are wild animals,” the priest says. “That means there’s no cultivation; any farming they do is destroyed by wild animals, such as elephants and wild boars.”
The village of Kulasekharam is home to Selva Raj and his family. He used to load trucks. One day while on the job, a needle punctured his leg. He did not realize what had happened. Two days later, he woke up in the middle of the night amid severe pain and bleeding.
“I had no idea what was happening. We went to the hospital the next day,” he says.
The doctors advised a leg amputation. Selva refused. “They did another procedure, but the wound has needed dressing every day for the last year and a half,” he says.
Selva has not worked since. His wife has served as breadwinner, working at the cafeteria at a school nearby. The couple, along with two adult children, live in a tiny room measuring 10 feet by 10 feet.
“Life is hard,” he says. “But I should be up on my feet in about two months thanks to the mobile ambulance team.”
Faith plays an important role in healing, Father Joseph says.
“Most people we work with are Hindus,” he says. “But it is not a factor in our service to the people. And these communities welcome us because we help when no one else does.”
The families are open to homilies, rosaries and prayers.
“When people are suffering, they need prayers. We pray for them; prayer and faith can work miracles.
“We also give them counseling to cope with their circumstances,” he adds.
Care for psychological and spiritual needs “helps as much as medicine,” Father Elambasseril says. “Those who are suffering physically also need love, care, affection and acceptance.”
In the village of Alancholai, Sree Kumar was an arborist. Two years ago, as he was cutting a rubber tree, it fell on him, paralyzing him from the waist down.
“People pulled me out from under the tree. But they pulled hard,” he says. That hard pull led to a severe hip joint injury.
The mobile medical care team visits to check up on him, chat and pray for him.
“That’s my socializing for the week,” he says. “The team comes to my house, they cheer me up.”
When Father Joseph sings a hymn, he closes his eyes and enjoys it.
Sister Savari, while new to her role as the team’s nurse, has worked with Adivasi communities before.
“The tribal women are shy about going to hospitals; they have their own beliefs and customs. They prefer using wild medicinal herbs to treat themselves. That’s how they’ve survived for hundreds of years,” she adds.
“But sometimes they absolutely need to go to a hospital and don’t.”
The society’s ambulance is parked about two miles down a steep hill. The team climbs the incline to reach a remote place called Anaimukham and visit Vijay Kumar, who had a stroke a couple of years ago caused by high blood pressure.
“He didn’t even know he had the condition,” says Father Joseph.
Vijay lives in a dilapidated hut with his family. Nearby, his wife and daughter look after two grandchildren, both toddlers.
In the surrounding area, poisonous spiders have woven huge webs. There is no cell phone signal; the nearest such conveniences of modern civilization lie half an hour away.
“We come here to check his blood pressure every other day and to make sure he is taking his medicine,” says Father Joseph. “Someone has to keep an eye out. So we do.”
But making headway into Adivasi and Dalit communities can be
“Access is hard because of where they live,” says Father Elambasseril. “There’s a lack of infrastructure. There aren’t proper roads, buses or trains to get them into towns and cities. Or for others to come here,” he says.
“Also, people think we’re here to convert them. But once they realize that we’re not here to do that, but to genuinely help them, they welcome us.”
The Kanya Kumari Social Service Society also has plans to expand.
“We’re already making a positive difference in the health and well-being of people with life-limiting conditions,” Father Elambasseril says.
“We’ve been giving them care for the body, mind and spirit. We hope to extend this service to other areas, too.”
One way the society has made a positive impression among groups that might otherwise seem inaccessible has been through educational opportunities in towns throughout the southern reaches of Tamil Nadu.
Jenisha G.’s father is a rubber tapper. “But I don’t want to struggle the way my parents have,” she says. She is training to be a lab technician at a medical college in Vettuveni.
Gini P.’s story is similar. Her father taps rubber, too. “I’m studying to be a nurse in Bangalore,” she says. This is her first year as a nursing student.
“I know nursing will give me the chance to work in different places, even abroad,” she says. “That way I can earn some money and help my parents.”
Monisha A.J., Adlin Amadsiya and Anila Mol express the same ambition. The three young women, all from the Syro-Malabar Eparchy of Thuckalay, study at St. Alphonsa College of Arts and Science in Karungal.
“The eparchy helps with that,” says Father Elambasseril. “We provide financial aid as well as encourage them to go out there and be someone others can look up to.”
For Jenisha, the aspirations are wholly practical.
“I want to be successful and earn for myself,” Jenisha says simply. “That way I can help my family, too.”
Anubha George is a former BBC editor and writes on Kerala culture. Based in Cochin, her work has been published in Scroll.in, The Good Men Project among others. She also teaches journalism at India’s leading media schools.