Project Vithai: Using doorstep pediatric treatment to transform lives

Six-year-old Siva* performs his best dance moves as the sounds of drumming and joy fill the blocks of Kannagi Nagar during festivals. On other days, he chatters away while the television plays, expresses his strong dislike for pei padams, and puts himself in the roles of slick cop “Singham” and his parents “Motu” and “Patlu.” Ammu*, Siva’s mother, is still in awe at her daughter’s lively behavior and conversation. Siva was non-verbal and required assistance to walk when she was diagnosed with cerebral palsy, level 3. This was two years ago. “Siva was like a doll, and I would have gone up and down so many palwadis’ stairs, who refused to let him in. He now helps me with cleaning the home, pays attention to what we say, looks at everyone, and speaks so much that people joke that he’ll get into trouble eventually, says Ammu.

Of the 34 kids in Kannagi Nagar and Ezhil Nagar, Siva was the first to get free therapy from Project Vithai – Pediatric Therapy on Wheels, often known as the blue bus. For more than sixty minutes, Siva, a five-year-old, uses this bus as his playground. He practices his walking techniques by scaling a red ladder and going up and down a ramp. Siva had a two-year developmental delay when he first came, at the age of four and a half. He can now express his demands and build phrases, and his comprehension skills have improved. We are actively addressing the issue of his continued difficulty creating noises, says Helena Ponmudi of the Madras ENT Research Foundation’s Audiology, Speech, and Language Pathology department. Regarding the physiotherapy aspect, R Divya Devi, the MIAP therapist, reports that while Siva exhibited extreme stiffness and was unable to cross sit, she is now able to walk and run.

This project, which was started in November 2022 by the Varshini Illam Trust and Project Vithai, the idea of founding Trustee PV Varshini, offers children in marginalized regions between the ages of 0 and 5 free doorstep treatment sessions. Like clockwork, the blue bus with a whirring sound comes in Kannagi Nagar at 10 am, treating children with disorders like cerebral palsy, attention-deficit/hyperactivity disorder (ADHD), Down syndrome, autism spectrum disorder (ASD), and postural issues. Thirty-three beneficiaries in Kattankulathur Block, twenty in A.I.R. Nagar, and thirty in Perumbakkam are treated when it travels through the resettlement zones.

A kid at the adoption center of Varishni Illam Trust was identified as having cerebral palsy in 2021 during the pandemic; because to prompt intervention, she was able to get therapy and treatment. Curious in what happens to kids in poorer neighborhoods, the trust investigated the infrastructure that was already in place and evaluated SPASTN services. “They informed us that the 95% dropout rate was the main problem. If they visit once a month, nothing magical will happen; frequent treatment sessions are required. It’s crucial to screen at the appropriate moment, comprehend the illness, and continue treatment, according to adviser Deepa Murali.

In the moment, the project functions like a well-tuned machine. Every day, community volunteer Kalai* knocks on doors in Kannagi and Ezhil Nagar and strolls past a number of pastel-colored houses decorated with paintings. She is equipped with questions for young parents to determine if children in this region have developmental abnormalities, using the UNICEF scale and the Trivandrum Developmental Screening Chart. “We inquire about the number of children present and any difficulties they may have reaching developmental milestones. The information is then categorized into positive, negative, and high-risk categories and uploaded into an app.” The following time they visit the families, Helena and Divya gently warn the parents and persuade them to leave their kids off at the therapy bus—a difficult effort.

Singing “Dosai amma dosai, amma sutta dosai, arasi maavu, amma sutta dosai,” Divya gently assists a baby with cerebral palsy in stretching and grasping toys. Unfazed by the cries and screams, she gently assists the kids in doing occupational therapy while holding a pencil and helping another ADHD youngster concentrate. Helena and the other two therapists are asking a different youngster, “unga kannu enga?” or “What is this? What color is this? Which hue are you weaning to? Parents cram onto the bus and listen intently as they are instructed on exercises to do at home. They may also choose to attend the neighboring center, which is open five days a week. Goals are based on severity, and sessions are customized to last anywhere from 25 to 45 minutes.

Although early intervention is crucial, access and awareness issues arise in places like Kannagi Nagar and Perumbakkam. “You see the doctor when you are unwell, but only after you recognize that something is wrong. Making people aware that there is an issue is our aim. We say, “You don’t have to think about all this; we are coming to your area,” even if once they learn that they may not have access to money or transportation. It will be simpler to solve an issue as soon as we recognize it. Antoinette Pavithra, clinical supervisor at MERF, emphasizes that rehabilitation, whether it be speech, hearing, or physiotherapy, and housing, gets simpler. “Every child is unique, and services are provided based on those needs,” the speaker continues. We label the rest of the population as abnormal as a tiny percentage has distinct demands.

Helena claims that since the epidemic, therapists are dealing with speech delays and language difficulties due to screen usage and less social connection. Because of this, early intervention is still very important.

As “you would see tempo travellers, there’s a hump and you can’t utilise that space so we thought about a bus which is more sustainable,” Deepa argues that this bus, a scalable model, might aid in this endeavor. Currently in the planning stages, Project Vithai aims to map out and replicate this endeavor across Tamil Nadu. This bus has traveled great miles, winding through several roads and ravines around the city. It has also documented the successes of various kids in reaching their goals, tracked their progress, and cleared up many parents’ doubts.

At the same time, Ammu is working to break free from the stigma and persuade parents of the value of therapy. “This much change was brought about by intervention, but I didn’t think they would assist as much as they did. Siva will soon begin school, and during meetings, I remind other parents that God has given us children, and it is our responsibility to care for them. There ought to be no society in which kids are denied access to this kind of treatment. She ends, saying, “My child has improved, and early intervention is necessary for children everywhere.”