Healing Hands - Dr P. Raghu Ram

Dr P. Raghu Ram needs no special introduction to the city, or even to the field of medicine the world over. In this very special Republic Day cover story interview, the renowned breast surgeon reminisces about the 2015 Republic Day celebrations – when he was conferred the Padma Shri. 

You’ve been recognised nationally and internationally for your exemplary work. What have been your most memorable moments?
I will never forget the 66th Republic Day celebrations in 2015. It has been precisely five years since I was conferred the Padma Shri, which is one of the highest civilian awards of the land. I vividly remember receiving a call from the Ministry of Home Affairs on January 23, 2015, informing me that the Hon’ble President of India is pleased to confer me with the Padma Shri award, and I was asked if I would accept it. I was also told to keep this information strictly confidential until the Rashtrapati Bhavan formally announced the awards on the eve of Republic Day.

A year later, in 2016, I was conferred Dr B.C. Roy National Award by the Hon’ble President of India, which is the highest recognition that can be achieved by a doctor practicing in the country. I am the youngest surgeon ever in the history of Telangana and Andhra Pradesh, and equally, one of the youngest doctors in the country to have been conferred both the Padma Shri award and Dr B.C. Roy National Award. These have been the highest points in my life thus far. Over the past decade, I have delivered a number of keynote and other addresses around the world. However, the most prestigious thus far has been the Pandalai Oration in 2018. It’s named after Col. Pandalai, the Founder President of the Association of Surgeons of India, and it is the highest academic honour that can be achieved by a surgeon practicing in India. I am the first and only surgeon from the Telugu states to have delivered this most coveted oration in the 82-year history of the association.

I was conferred the International Gold Medal by the Royal College of Surgeons of Edinburgh in 2013, which is the highest award that the Royal College bestows to surgeons practicing outside the UK, and I am the youngest ever recipient of this coveted honour in the 515-year history of the oldest surgical college in the world. I have obtained the much sought after and prestigious FRCS from five surgical royal colleges (London, Edinburgh, Glasgow, Ireland, and Thailand) in addition to FACS from the American College of Surgeons. In 2019, I was conferred the Honorary FRCS (Thailand), which the highest recognition conferred by the Royal College of Surgeons of Thailand.

You’re also one of the youngest surgeons in the country to become the President of The Association of Surgeons of India (ASI). How does it feel to take on another leadership role?
I am blessed to be one of the youngest surgeons elected to serve as President of the ASI, which is Asia Pacific’s largest and the world’s second-largest surgical organisation that represents the entire surgical fraternity in the country. To have polled the highest number of votes ever and to have secured the biggest victory margin in the association’s 82-year history makes me conscious of the huge responsibility on my shoulders. I believe the Lord will guide me along this exciting and challenging leadership path of purpose, action, trust and hope.

What’s on your agenda for ASI this year?
I will strive to ensure creative leadership and accountable governance. My mission in the upcoming 12 months shall be strategic implementation of goals with a laser focus and determination to significantly improve surgical care in India. At the end of my term, I wish to be recognised and remembered as a people’s president.

The association is the voice for surgery in India, and its vast network and influence is reflected in its strong presence in the form of state chapters and city branches in all 29 states and union territories across India. In addition, it has 12 specialty sections comprising specialist surgeons practicing the art and science of: breast surgery, oncosurgery, gastrointestinal surgery, laparoscopic/minimal-access surgery, endocrine surgery, genito-urinary Surgery, paediatric surgery, plastic surgery, thoracic/cardiovascular surgery, and trauma/critical care surgery, apart from sections representing rural surgeons and surgeons in the armed forces.

My three major priorities as President of ASI for 2020 are to focus on providing education and training courses for surgical trainees and practicing surgeons in order to make them better surgeons with a humane touch. I wish to spearhead community service through the state chapters and city branches of ASI across the country by adopting villages. India is predominantly a rural country, with close to 70% of the population and workforce residing in villages. It is therefore my wish and desire that every state chapter/city branch of ASI adopts a village and undertakes initiatives that are village-specific for the greater good of the community. Also, I wish to establish rapport with the Government of India to ensure that ASI is actively involved in policy making matters relevant to surgery and surgical training.

Having spent a decade in the UK, what made you to return to India?
My parents are doctors; my father is a surgeon and my mother an obstetrician and gynecologist. They both served as professors in their chosen specialties in the government service for over 15 years. When my mother, Dr Ushalakshmi was diagnosed with breast cancer, certain startling facts glared at me. I realised that breast cancer was the most common cancer affecting women in the country. Due to lack of awareness and absence of an organised population-based screening programme, more than 70% of cases are in the advanced stages, with high mortality. Consequently, every ten seconds, a woman in India succumbs to breast cancer. My parents were there for me when I needed them the most. As their only child, they took great care of me. With my mother’s diagnosis, coupled with my parents ageing, I strongly felt the need to be with them when they needed me the most. Having completed structured training in our chosen specialties at world-renowned centres of excellence in the UK, my wife Vyjayanthi and I had everything going superbly well for us in the British Isles, with lucrative career opportunities. However, we took a bold decision to leave everything that the UK offered to us, lock, stock, and barrel, and returned to serve my mother and motherland in September 2007.

How do you look back at your return, and what were your goals for improving breast healthcare in the country?
Returning to India meant far more to me than anything else in life. I meticulously planned my life’s journey and relocated to India with a vision to transform my four dreams to reality:

1. Establish South Asia’s first free-standing, purpose-built breast health centre in an endeavour to provide world-class breast healthcare in Hyderabad. KIMS–USHALAKSHMI Centre for Breast Diseases, which bears my mother’s name, was established at KIMS Hospitals in October 2007. This is not just another cancer centre. Conceived and designed by me, this is a unique set up, where clinical assessment, imaging, biopsy and counselling are all done in a unit that is dedicated to the management of all types of breast diseases (both benign and malignant) by a committed multidisciplinary team. For well over a decade, the centre has made significant and meaningful difference in many lives. It has attracted patients not only from the Telugu States, but from all over India and abroad, and has brought about revolutionary change in the breast centre concept in India.

2. Spearhead a large-scale breast cancer awareness drive under the auspices of a foundation, and transform breast cancer from a taboo issue to a commonly discussed one. Breast cancer is the most common cancer affecting women in India. In many parts of the country, it is considered a taboo subject that is not openly discussed. With a vision to transform breast cancer from a closet issue and educate people about the importance of early detection, in 2007 I founded Ushalakshmi Breast Cancer Foundation, which is a not-for-profit charity. Over the past 12 years, under the auspices of the foundation, with the unwavering help and outstanding support from my dear friend, Jayesh Ranjan, I have championed a one-of-its-kind large scale breast cancer awareness drive across Telangana and Andhra Pradesh. No stone was left unturned. A number of unique and innovative events have been organised both in urban and rural regions, with many celebrity breast cancer survivors from India and abroad lending their support to the cause.

In 2017, inspired by Hon’ble Prime Minister Narendra Modi’s digital India dream, I conceived, designed, and developed the world’s first mobile phone app (ABC’s of Breast Health), which was launched by Shri Amitabh Bachchan. The app, which is free on both the Apple App Store and Google Play, provides information about every aspect of breast cancer and benign non-cancer breast health issues (more common than cancer) in twelve languages, explained in a simple, easy-to-understand format. The aim of this benchmark initiative is to counsel, guide, and educate women across the nation about various aspects of breast health so that they are well informed and better prepared, thus filling a huge void in breast health care in India.

3. Implement a population-based breast cancer screening programme. With the singular aim of ensuring early detection of breast cancer amongst underprivileged women and to find an ‘Indian solution’ that would hopefully save scores of lives, particularly in rural India, Ushalakshmi Breast Cancer Foundation in partnership with Governments of Telangana and Andhra Pradesh implemented South Asia’s largest population-based Breast Cancer Screening Programme. Since 2012, well over 2,00,000 underprivileged women between 35-65 spread across 4,000 villages in the Telugu states were screened for early signs of breast cancer by way of clinical breast examination (CBE) performed by 3,750 trained healthcare workers working for the government. Those diagnosed with breast cancer have been provided free treatment under the State’s Arogya Sree Scheme.

Following the successful implementation of this large-scale population-based breast cancer screening programme, in 2016, I was invited to be part of a steering committee set up by Ministry of Health, Govt. of India. The committee’s unanimous decision played a pivotal role in getting CBE incorporated into national cancer screening guidelines. In November 2016, I was appointed as a member of the Technical Advisory Group (TAG) set up by the Ministry of Health, Govt. of India, which is providing training materials and guidance in implementing the programme across the nation.

4. To form an association that brings together surgeons practicing the art and science of breast surgery to improve and standardize breast healthcare delivery in the country. Up until 2011, there was no dedicated surgical society that focused exclusively upon issues that concern breast diseases. Recognising the need to standardise breast healthcare delivery in India, I garnered support from the surgical fraternity and was the driving force in establishing the Association of Breast Surgeons of India (ABSI) in 2011, which represents general surgeons, surgical oncologists, and plastic surgeons treating patients with breast disease. ABSI has emerged as the voice for breast surgery in India. I had the privilege of serving the association as its Founder Honorary Secretary (2011-2013) and President (2015-2017).

How did you come to adopt a village?
I interacted with Mr Harish Rao, Hon’ble Finance Minister, Govt. of Telangana, who had come to felicitate me on being conferred the Padma Shri award in 2015. I expressed a view that my responsibility to society increased further, and that I would like to undertake some initiative outside my sphere of professional activity for the greater good of the community in Telangana. He suggested that I adopt a village and took me to Ibrahimpur, the remotest village in Medak District, which is his adopted village, too. And there was no looking back after that. As more than 70% of India’s population reside in rural areas, there is so much more work to do in these small hamlets. My parents, Vyjayanthi, and my children have joined me in this lifetime mission. I have always believed in the view that we come into this world with nothing and leave with nothing.

In adopting Ibrahimpur, the Lord showed me the path to a world of immense satisfaction working for the welfare of people who I had never known prior to 2015. The joy on their faces is immensely satisfying. All the projects conceived in the village by me over the past five years have been completed.

The projects completed thus far (2015-2020) include Vaikuntadhamam– a crematorium has been built on a spacious land in the outskirts of the village. This project provides much-needed relief to the residents during the most difficult times in their lives. Great care has been taken to ensure that this place looks like a spacious home and provides every possible facility and lots of open spaces with greenery for solace and peace.

Also, 46 sheep sheds (for all the 46 families in the village with sheep), with solar electrification have been built in the village outskirts. They are spread over three acres of land for sheep to be housed away from the village, so that they do not come into the village, thus preventing animal-borne diseases within the village. Home solar systems for 26 houses that provides a reliable source of 100% free electricity has been provided to the poorest in village, so as to ensure zero electricity bills for lifetime. A dining room in the village school was built. Students were eating their lunch in an open compound, which was causing great inconvenience and health hazards, particularly in summer. A digital study room was built as well – students have access to state-of-the-art audio-visual facilities, which provides a serene environment for study during breaks and school holidays. A health club/village gym and funding of private tuitions are also taken care of. 

What are your future plans?
My top priorities in the coming years will be taking augmented reality and artificial intelligence to rural India, and creating awareness about the importance of early detection of breast cancer in an earnest effort to save lives. In an initiative for the first time anywhere, life-sized augmented reality has been utilised for creating awareness about the importance of early detection of breast cancer. This initiative championed by Ushalakshmi Breast Cancer Foundation was launched recently during the International Breast Cancer Awareness Month (October 2019) by Ms P.V. Sindhu, who is also the first celebrity to feature in this unique campaign.

I have no words to express my gratitude to my dear friend P.V. Sindhu for standing shoulder to shoulder with the foundation in this landmark initiative. In fact, both of us were conferred the Padma Shri on the same day in 2015, and ever since then, she has been actively involved in the foundation’s activities.

Starting with my adopted village, Ibrahimpur, Ushalakshmi Breast Cancer Foundation will use this revolutionary technology to empower people in the villages about the importance of early detection and create the much needed awareness amongst the underprivileged section of the population. Hopefully, this will save scores of lives through early detection. I will seek the assistance of the Govt. of Telangana in utilising this technology to empower people in every village across Telangana. In the fullness of time, I shall also be writing to our Prime Minister to explore opportunities to replicate this initiative in villages all over India.   – as told to Sumana