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Southern States - Karnataka

A disease that has left many crippled

By Pramod Mellegatti

SHIMOGA JAN. 17. The crippling disease, also known as the ``Handigodu Syndrome'', continues to make the life of its victims, who are mostly dalits and backward class people in parts of Sagar taluk of the Shimoga District, miserable.

The disease, first noticed in 1975, was named after a village from where the maximum number of cases was reported. Subsequently it was named ``Endemic Familial Arthritis of Malnad'' because of its presence in the Malnad region. Cases of the syndrome have also been reported from Malnad parts such as Sringeri, Koppa, and N.R.Pura of Chikmagalur District.

The disease has brought in its wake numerous socio-economic problems. Most of the patients being poor farm workers, their earnings stop once they are crippled.

The disease has been noticed in 55 villages in Sagar taluk of Shimoga District. The affected are poor, illiterate, and ignorant, solely depending on farm labour to eke out a living. Of the 350 victims, nearly 280 are dalits while the rest belong to other backward classes.

Symptoms of the disease are acute pain and swelling in the hips and knee joints. The disease is viewed in three gradations. While a patient can move about with difficulty in mild to moderate attacks, movement is not possible in severe cases. In acute cases, the limbs are badly crippled and bent making the victims crawl.

It was by chance that the disease was detected in January 1975 when four patients came to the Government General Hospital at Sagar with complaints of severe joint and hip pain. After examining them, the local doctors suspected that they had developed neurological problems and sought the opinion of experts.

It was followed by a visit of a team of experts, led by K.S. Mani, a neurologist from NIMHANS, Bangalore, to the affected parts within a month. After the clinical evaluation, the team ruled out the presence of neurological disorder and attributed the pain to the bone and joint disorder.

Further, a team from the National Institute of Nutrition, Hyderabad, which studied the cases concluded that the disease confined to the dalit colony affecting all age groups was non-contagious and non-infectious.

Finally, the Indian Council of Medical Research (ICMR) was approached in 1983. Though a series of experiments and examinations was conducted by experts, they could not come to any conclusion on the cause of the disease.

Responding to the request of the State Government, the ICMR held a high-power committee meeting in Bangalore in 1983, wherein it was decided to open a research project on the ``Handigodu Syndrome''. The four-year ICMR research project began in 1984. Experts from various medical disciplines formed separate study groups and visited the affected places to conduct tests.

The State Health Department constituted a research team consisting of an assistant research officer and investigators to assist the ICMR team. As the Government General Hospital at Sagar became the nerve centre of all research activities, it was further strengthened.

Twenty-one corrective surgical operations were conducted by H.K.Srinivasmurthy which helped some crawling patients walk.

Though the ICMR wound up the first phase of its research work in March 1988, local teams continued to visit the affected people to keep a tab on the latest developments.

Practically there was no research work on the disease until the ICMR team visited the affected parts in Sagar in June last year as part of the second phase of the research project being taken up under the leadership of S.S.Agarwal of the Sanjay Gandhi Postgraduate Centre, Lucknow.

The main work of the second phase of the research involves x-raying of patients, along with the family history of the affected persons, to help the researchers to take up a genetic study. It is expected that the x-raying will be over before the ICMR team's visit to the affected parts in January.

The Shimoga Zilla Panchayat has donated a mobile van to bring the patients to the hospital and take them back to their places.

H.M.Chandrasekhar Bhat of Handigodu, who has been appointed as a social worker by the ICMR, has proved to be a good Samaritan by his prominent role in the early detection of the disease. Mr. Bhat makes frequent visits to the affected villages to make personal enquiries of the patients, and arranges for their shifting to the hospital.

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