• Lymphoedema – collection of fluid in any part of the body due to failure of the lymphatic system – is a huge public health challenge in the form of Lymphatic filariasis (elephantiasis).
  • Elephantiasis is endemic in 250 districts in 20 states, putting 600 million people at risk. Kerala has 6 to 7 lakh cases.
  • The new clinic at Kochi can treat the disease almost fully, giving a ray of hope to patients from across the country. It is the first one in India to offer a multi-disciplinary approach which has proven to be the most effective in treatment.

In a major relief to patients of lymphatic filariasis (elephantiasis) across the country, India’s most comprehensive lymphoedema treatment clinic has been established at the 1,300-bed Amrita Institute of Medical Sciences in Kochi. 

The state-of-the-art facility follows a multi-disciplinary approach, combining the traditional Manual Lymphatic Draining (MLD) technique and Complete Decongestive Therapy (CDT) with latest surgical advancements, like connecting lymph nodes and vessels to blood vessels using micro surgery. This has the potential to cause a significant reduction in oedema and the associated death rate.

India has the highest number of lymphoedema patients in the world, a crippling condition involving the collection of body fluid in any part of the body, leading to its abnormal enlargement and eventual disability. The incidence is high mostly due to lymphatic filariasis (elephantiasis), a tropical infection with the filarial worms transmitted through mosquito bites.

Dr. G. Manokaran, Clinical Professor, Department of Plastic and Reconstructive Surgery, and Chief of Lymphology Services, Amrita Institute of Medical Sciences, who is considered India’s foremost lymphoedema expert, said, “Lymphoedema is a major health problem in India, next only to malaria. Lymphatic filariasis (elephantiasis) is endemic in 250 districts in 20 states, putting 600 million people at risk. Kerala has about 6 to 7 lakh cases of this disease. The patients, mostly poor and marginalized, suffer mental, social and financial losses, leading to life-long stigma and poverty. To make matters worse, an increasing number of people are acquiring lymphoedema as a side-effect of cancer therapy. This clinic at Amrita Institute of Medical Sciences is the first one in India to offer a multi-disciplinary approach, which has proven to be the most effective in treatment, along with latest medical and surgical protocols.”

Dr. Subramania Iyer, HOD, Centre of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, shared, “Lymphoedema is a disabling condition which affects large number of the population. The main causes include breast cancer treatment and filarial infections. Unfortunately, because of the lack of comprehensive care, effective treatment is not made available to most patients. The objective of starting such a comprehensive care unit and launching training program for lymphoedema therapists is to take leadership position in providing better care for patients and make their life more productive.”

The new clinic will also be a Centre of Excellence for the Management and Treatment of Lymphoedema and will conduct research with international collaborators. In addition, it will offer training programmes for lymphoedema therapists, in association with the Lymphoedema Alliance of New York.

The clinic’s trained lymphology experts can perform MLD and CDT on patients before they undergo different types of surgery, including micro-vascular procedures, for both functional and aesthetic results. The patients are also provided post-surgery rehabilitation and pressure garments, along with regular counselling. The use of newer diagnostic tools such as Lymphoscintigraphy and MR Lymphangiography helps to plan the treatment effectively.

A global conference of the world’s top experts in lymphology was conducted at the Amrita Institute of Medical Sciences from November 18-20, 2016, to discuss various issues in the management of lymphoedema as well as devise India-specific strategies. International experts from Italy, Sweden, France, Spain and USA participated.

While neighbouring countries of Maldives and Sri Lanka have successfully eliminated lymphatic filariasis, India is yet to achieve the feat.

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