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Jan. 2, 2001

Doctors trek to India

Volunteers staff charity medical camp

By Billy Cox

In 1998, when Daljit Saini returned to the destitution and the ailing masses in his native Punjab, a local cleric asked him: Why? Why are you here?

Saini, a radiation physicist, paused, then told him how as a kid he used to steal fruit from a nearby garden. "I told him I felt I needed to pay it back," Saini recalls. "And he said, 'With interest.' "

There are worse sins, to be sure, and certainly more convenient ways to do penance than confronting the nightmarish poverty of India. But for a handful of medical professionals preparing to make a pilgrimage in February, perhaps a better term is enlightened self-interest. As Sheila Kashkari, a pathologist from Ohio, puts it: "I'm taking an early retirement to do this. I feel it's the best thing to happen to me since med school."

The nonprofit, donation-supported project is called the Maheshwar Charitable Foundation, and the numbers are astonishing. Since setting up its first charity medical camp in 1996, the volunteers estimate - without spending a dime of government money - they've been able to treat 30,000 patients for various afflictions, including 960 successful cataract surgeries and intraocular lens implants.

At the core of this story is a self-deprecating, retired business executive from Melbourne who squirms under spotlights and defers to the caregivers. "They are the ones who do the work," insists Maheshwar founder Deepak Kapoor.

But those who've worked with the 65-year-old agree: Without Kapoor, and his wife, Sheila, there would be no mission.

For all of its successes in India, however, the Maheshwar pipeline - chaired by Merritt Island ophthalmologist Dr. Mukesh Aggarwal - is looking to broaden the field. This year, the Kapoors will travel to Africa, laying the groundwork for charitable medical intervention in Kenya before the end of 2001. And there's talk of sending volunteers to meet the medical needs of aborigines in Australia, as well as forays into pockets of poverty in Northern Ireland.

"I think we're just getting started, really," says Dr. Bill Dunn, an adventure-seeking eye surgeon in Daytona Beach who calculates he performed 50 operations in "less than two days" during his first trip to India last year. "This is something pure, it's medicine as we learned in school. It reminds me why I entered this profession in the first place."

According to Kapoor, it's no accident the Maheshwar (meaning "spirit" in Hindu) Foundation has turned the clich "Think globally, act locally" inside out.

Born near the India-Pakistan border amid a confluence of disparate cultures, Kapoor can converse in 12 languages.

For years, he coordinated international business affairs for Johnson & Johnson. That's where he made a wealth of contacts, particularly in pharmaceuticals.

He retired to Brevard County in 1990, following a son who worked here. A Unitarian who plugged into the area's small but vibrant Indian community, Kapoor struck up a friendship with Melbourne's Dr. Silas Charles, the Indian-born philanthropist who founded the Cancer Care Centers of Brevard.

The CCC was a local outgrowth of the internationally renowned Christian Care Center that Charles built from scratch in southern India in 1985. Charles was impressed by Kapoor's vision of a hospital; he encouraged Kapoor to give it a shot.

"He's a very dogmatic guy, a straight-shooter," says Charles, who shares resources with the Maheshwar Foundation. "He struck me as a man who knows how to get things done."

As he assembled his thoughts and visions, Kapoor was struck by the fundamental paradox of medicine in America. There was plenty of work to be done with poor families here, and there were doctors interested in donating services to the local low-income community.

But it wasn't realistic.

"I have 100 physicians and doctors here who say they would love to do free lab tests, free screenings some Saturday or Sunday at a public school. I have drug companies who would be glad to make donations. But they tell me it is impossible, that it cannot work," Kapoor says, "because of liability issues. And that is a shame."

There are no such complications in dealing with the desperate throngs of India. No insurance hassles, no HMOs, no payroll, no personnel or legal issues, no cumbersome paperwork.

Nothing but marathon hours of practicing medicine. No more, no less.

"When I give doctors an orientation (on India), I tell them, don't think you are going to solve anyone's problems, because you won't," Kapoor says. "What you will see is a major disaster, like a hurricane. I say, this is about your own transformation. We are there for only one reason: We are there for us. The only good you will be doing is for yourself.

"Whoever walks in is like God incarnate. They bring with them a lot of hope. We are their servants."

Mission begins

Kapoor led his first official medical expedition to Punjab in 1996. It was preceded by months of scouting locations, satisfying bureaucrats, assessing resources and logistics, screening potential patients. Skeptics found it hard to believe doctors would travel all the way from the United States, at their own expense, to mend castoffs with no hopes of repayment. Local officials also had to be persuaded that conversions to Christianity weren't on the agenda.

Only five volunteers - including a cardiologist and a physician - followed Kapoor to Punjab the first year. Conditions were primitive.

"There were no facilities. Mukesh (Aggarwal) had to pitch tent in 30-degree weather, and heated water turned to ice," Kapoor says. "Our first camp, I was bitten all over by insects. It was very difficult."

Conditions today at the Maheshwar Foundation's now-permanent base in the town of Tanda remain spartan. Even in winter, space heaters aren't allowed in doctors' offices because, Kapoor says, they put a psychological and physical distance between physicians and patients, many of whom wait for hours in the cold.

But in five years - with various disciplines entering the field, including dentists, pediatricians, gynecologists and orthopedists - the Foundation has made significant strides.

It built and operates a 25-bed hospital attached to a Sikh temple, and it runs satellite treatment camps in outlying villages, at no charge to indigent patients. Hospital visitors - 700 to 800 daily - are provided free meals during their long waits. And today, there's a full-time staff: one dentist, two physicians, three nurses, two dental assistants - all local.

But each year, in advance of the visiting American contingent, Kapoor drops in to assess logistical needs. The crush never ends. Sometimes, he says, peasants scheduled for surgery at the hospital in Tanda will walk for days to make their appointment with the Americans.

Exhilarating fatigue

For Dunn, his first trip to Punjab last year was as validating as it was exhausting.

First came the 20-hour plane trip to Dehli, via Switzerland via Atlanta. Arriving in the middle of the night, Dunn and his Daytona Beach crew (a nurse, an optician and her husband) hopped a rental car for the 12-hour drive to Tanda, with camels, cows, bicyclists and huge trucks competing for the narrow blacktop.

Following a meal and a brief rest, Dunn went to work. For the next 72 hours, he and colleagues performed cataract extractions and lens implants, restoring sight to 150 people, most of whom were dressed in native garb, gowns, turbans and ceremonial daggers.

An interpreter was available to translate their blessings afterward, but the tearful embraces formed the only language that counted.

"I'd like to think we could serve as positive motivators for the Indian doctors to start taking care of their own people," Dunn says. "There's a lot of socialized medicine over there, the poverty is overwhelming, and most of the people just fall through the cracks. I think our work has to make an impression on them. They know we're not in it for the money."

Dunn doesn't even know how much the trip set him back; several thousand dollars, anyway. But that won't stop him from rejoining Kapoor next month.

Also undaunted by the expense will be Dr. Hal Kushner of Daytona Beach. An ophthalmologist and surgical fellow with the World Health Organization, Kushner has worked in demoralizing locales such as Haiti and Turkey. This will mark his first trip to India.

Kushner discounts the suggestion that spending five years as prisoner of war in Vietnam factors into his desire to help impoverished Third World residents.

"I've been lucky in this profession. It's been very fulfilling," Kushner says. "But I'm 60 years old now, and I'm starting to run out of gas. There's too much work to be done out there without trying to give something back while I can."

Daljit Saini, the chief medical physicist for Cancer Care Centers of Brevard, was with Kapoor from the beginning. When he looks at the numbers - up to 10,000 patients receiving some form of medical treatment on an annual budget of $10,000 - Saini is convinced of the limitless potential of human ingenuity.

"Going to India is like having a baby," he says. "At first, what you remember is the pain, and you say, never again can I do that. But then, like most mothers, time passes and you think, I want to do that again.

"I think most people are good, and they want to help others. But sometimes, you need someone who can put people together, like Mr. Kapoor."

Deepak Kapoor dismisses the attention with a flick of the wrist. "I am preparing for my long journey," he says. "This is the stuff that will help me find peace."

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