The poliovirus passes through contaminated water or food into the body. When it affects nerve cells in a spinal column segment which regulates quadriceps (muscles in the thighs which enable us to walk upright), these muscles become weakened and the legs waste away from disuse and gradually distort. “It’s a devastating disease that can impact everything from the cervical spine to the foot muscle,” Dr. Varghese says. It’s also, he notes, an’ financial epidemic.’ “The worst affected are the weakest, people living on the outskirts where there is no hygiene, poverty is rife and immunity is weak.” India’s successful oral vaccine program Pulse Polio initiated nationally in 1995 took polio cases down from 50,000-100,000 annually in the 80s to zero in 2012. The last case of wild poliovirus was reported in 2011 when the disease was diagnosed with the 18-month-old Rukhsar Khatoon from the Howrah district of West Bengal. This was a children’s hospital when the facility was set up in the 80s—7,000 children have been served here since the ward was set up in the late 80s. Today, patients from Dr. Varghese are adolescents in their twenties and thirties who come from all over the world, from Gujarat to Guwahati, from Kerala to Kashmir. Disability surgery is not a concern for anyone, says Dr. Varghese — “not for private hospitals, because it is not money-making or attractive, and not for government hospitals, because the beds are filled by trauma patients admitted for emergency surgery.” Families do their best in the absence of access to treatment: they depend on homeopathy, go to faith healers, or untrained doctors who do not have access to treatment. The doctor often finds he is correcting surgeries that have gone wrong.