CHENNAI : As drumbeats and delight during festivals echo through the blocks of Kannagi Nagar, six-year-old Siva* busts out his best dance moves; on other days, he chatters as the television plays, expresses his vehement distaste towards pei padams, and assigns his parents the characters of ‘Motu’ and ‘Patlu’ and himself, slick cop ‘Singham’. This energetic conduct and dialogue continue to amaze Siva’s mother, Ammu*. Two years ago, Siva — diagnosed with cerebral palsy, level 3 — could not walk without support, and was non-verbal. “Siva was like a doll, and I would have entered and exited the steps of so many palwadis, who rejected his admission. Now, he helps me sweep the house, understands what we are saying, looks everyone in the eye, and talks so much, that people jokingly warn us that he’ll get into trouble one day,” says Ammu.
Siva was the first among the 34 children in Kannagi Nagar and Ezhil Nagar to receive free treatment from Project Vithai – Pediatric Therapy on Wheels, or simply the blue bus. This bus is the five-year-old’s playground, for over an hour, Siva clambers up a red ladder, and walks up and down a ramp, honing his walking skills. “When Siva arrived, he was four-and-a-half years old, he showed a developmental delay of two years. Now, he can construct sentences, and convey his needs, and his understanding abilities have developed. He still faces difficulties in producing sounds, we are currently working on that,” explains Helena Ponmudi, Audiology Speech & Language Pathology from Madras ENT Research Foundation. On the physio side of things, the therapist from MIAP, R Divya Devi says, Siva was not able to cross sit, and showed severe tightness, but now can walk and run.
Established in November 2022, this initiative by Varshini Illam Trust and Project Vithai — the brainchild of founder Trustee PV Varshini — provides free doorstep therapy services to children aged 0 to 5 in marginalised areas. The whirring blue bus arrives at Kannagi Nagar at 10 am like clockwork and treats children with conditions including cerebral palsy, autism spectrum disorder (ASD), Down syndrome, attention-deficit/hyperactivity disorder (ADHD), or posture problems. It drives around resettlement areas and treats 37 beneficiaries in Perumbakkam, 20 in A.I.R Nagar, and 30 in Kattankulathur Block.
Origin story
In 2021, during the pandemic, a child in Varishni Illam Trust’s adoption centre was diagnosed with cerebral palsy, and with early intervention, she received access to therapy and treatment. Harbouring the query of what happens to children in lower-economic areas, the trust probed existing infrastructure and assessed services SPASTN. “They told us that the major issue was the dropout rate, which was 95%. No magic can be done if they come once a month, the therapy has to be regular. Screening at the right time, understanding the condition and continuing therapy is important,” says Deepa Murali, an advisor.
Cut to present, the project works as a well-oiled system. Daily, community worker Kalai* walks past several pastel-coloured buildings with murals and knocks on several doors of Kannagi and Ezhil Nagar. Armed with the Trivandrum Developmental Screening Chart and UNICEF scale, she is prepared with questions for young parents, to assess if children in this area have developmental disorders. “We ask them how many kids are there, do they have any problems with achieving milestones, and after segregating them into positive for a condition, negative or high risk, the data is entered onto an app.” On their next visit, Helena and Divya visit the homes, carefully alert the parents, and convince them to drop their children at the therapy bus, far from an easy task.
“Dosai amma dosai, amma sutta dosai, arasi maavu, amma sutta dosai,” sings Divya as she slowly helps a baby with CP stretch out, and grip playing objects. Undaunted by the screams and crying, she tenderly helps the children dabble with occupational therapy, holding a pencil, helps another child with ADHD hone their focus. Meanwhile, Helena and two other therapists coo to another child, “unga kannu enga?” or “What is this? Which colour is this? What colour are you weaning?” Parents fill the bus, watching keenly as they receive instructions on the exercises to conduct at home and may visit the nearby centre which provides services five days a week. Tailored to the condition, sessions vary from 25 minutes to 45 minutes, and goals depend on severity.
Early intervention is key but in areas like Kannagi Nagar or Perumbakkam, lack of access or awareness proves to be a hurdle. “When you have an illness you come to the doctors, only if you understand you have a problem. Our goal is to make them understand there is a problem. Once they understand, (they might lack access to) finances or travel, but now we say you don’t have to think about all this, we are coming to your area. As early as we identify a problem, it’ll be easier to fix it. Be it speech, hearing or physiotherapy, and habitation, or rehabilitation becomes easier,” highlights Antoinette Pavithra, clinical supervisor at MERF. She adds “Every child is unique and services are provided based on those needs. Because a small population has a different set of needs, we call the others abnormal.”
Plans ahead
Post-pandemic, Helena says, with screentime and lack of interactions, therapists have to deal with speech delays and language disorders. With this, early intervention continues to be crucial.
Deepa suggests that this bus, a scalable model, could help in this endeavour 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.” Project Vithai is at the drawing board, charting and replicating this initiative across Tamil Nadu. Covering long distances, this bus has snaked into many lanes and gullies across the city, and has mapped the improvement of several children, recording their triumphs of achieving targets, and answered the confusions of many parents.
Meanwhile, currently, Ammu is on a mission to convince parents about the importance of therapy, and maneuvering past the grip of stigma. “I didn’t have trust that they would help this much but intervention brought this much change. Siva is now going to start school and I tell other parents during meetings that god has given us kids, and we must take care of them. There shouldn’t be a world where children don’t get access to this care. The way my child has improved, children across the world must receive early intervention,” she signs off.
*Names changed
Children receiving therapy
20 A.I.R Nagar
37 Perumbakkam
30 Kattankulathur block
34 Kannagi Nagar