The Birth of the Indian Head Injury Foundation

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The Maharaja of Jodhpur tells Cassandra Jardine about the Indian Head Injuries Foundation, the charity he set up as a result of the terrible injuries that his son and heir sustained in a polo accident in 2005.


His Highness Gaj Singh II, Maharaja of Jodhpur-Marwar, is not quite the solemn creature that his 1400-year-old title would suggest. Last year, his Christmas card showed Santa on his sledge, wearing a helmet. “This year I am not sure what it will be, but some joke to do with head injuries,” he says, chuckling at the thought. This moment of light relief comes after the sombre tale of the terrible injuries sustained by his son and heir, Shivraj, four years ago. As he tells that story, in a London hotel suite, a hint of a tear springs to his large Rajput eyes, reminiscent of Mughal miniatures. Those eyes were opened by his son’s experience to India’s dubious distinction of being the head injury capital of the world. One in 10 Indians suffers a serious head injury, more than twenty times as many as in the UK, a sad fact which he hopes will form the basis of a collaboration between the two countries. Neither seat belts nor helmets are worn outside India’s major cities; overcrowded cars, bike-sharing, women sitting side-saddle on scooters, and potholed roads


compound the problem. But none of those everyday hazards accounted for Shivraj’s injuries. His was a polo accident. In February 2005, the handsome 30-year-old “prince of hearts”, as the Indian gossip columns called him, was playing a match in Jaipur when he fell on his head. “A helmet prevents the skull being crushed but it doesn’t absorb the shock, and the brain get shaken around. It was very unfortunate that his horse fell on top of him,” says the Maharaja, 61, with understatement redolent of his Eton and Oxford days. Despite India’s chaotic roads, Shivraj had good treatment during the first “golden” hours, when secondary damage often occurs. From hospital in Jaipur, he was flown to Mumbai. None the less, the initial injury to his left frontal lobe, which controls speech, was compounded by a build-up of pressure within the brain, and he almost died in transit. “I thought it was equipment malfunction,” says his father, who was shielded from the grim truth.


No rehabilitation facilities exist in India so, after two months in Mumbai – no longer in a coma but still speechless and virtually paralysed – he was transferred to the specialists at Mount Sinai hospital in New York. There his father, known as Bapji, witnessed the first glimmer of hope that his son might make a partial recovery. “I didn’t generally attend speech therapy sessions – they said it would make him selfconscious – but I happened to be there one time when he was given lollipops to lick as his jaw muscles weren’t working. He was asked to point to a colour. Instead, he said 'orange’.” Home was deemed more helpful to his recovery than hospital so he returned to the Umaid Bhawan in Jodhpur, the vast palace, now partly a hotel, which is home to the royal family of the once independent princely state of Jodhpur, an area larger than Scotland. There, his father arranged an intensive programme of physio-, speech and occupational therapy to encourage new areas of the brain to take up the functions of


the damaged parts. Despite improvements, Shivraj’s personality seemed lost. “Then one day, just after a neuropsychologist had reported that he showed no expression, a cousin visited. Listening to him, for the first time Shivraj laughed and smiled.” Progress has been slow, but constant, on a regime of encouragement and tough love which has included two stays in the rehabilitation unit of London’s Wellington hospital. It took two and a half years for Shivraj to walk unaided, but he can now climb stairs with a handrail, sign his name and write short emails, though reading remains difficult. He plays Scrabble and chess, and has helped design a garage for his father’s 12 vintage cars. Speech has returned, though it is often inaudible. He can even drive himself, on the miles of private roads within the estate. “And he shoots,” says his father, alarmingly, “even though his hand shakes.” Few others could afford this level of care, or the servants who watch over Shivraj lest he fall, but the point about the prince’s recovery, his father says, is that it shows what


can be achieved by prolonged stimulation. “It used to be thought that improvements were limited to the first year or two, but after nearly five years we are still seeing changes. The brain can mend itself. It’s important to have a daily programme and to keep the patient motivated. We keep a diary, and photographs, and give him choices each day. As long as it is progress you keep at it.” Convinced though his father is that Shivraj “is all in there”, he will never be the dashing heart-throb of his school and university days in Britain (Eton and Business Administration at Oxford Brookes). Nor is he likely to run his father’s hotel business as was starting to do at the time of the accident, having worked with Schroders in Geneva and Jardine’s in Hong Kong. He remains a lonely figure, confined to his room for much of the day though able to venture out to do pooja (daily worship) with his mother and have silent dinners with his father, when HH isn’t travelling. “Eating itself is a big exercise for him, so we cannot speak,” he explains.


But the Maharaja is no longer solely concerned with his son. Over the past two years he has extended his interest in head injuries to a national and international level, launching the Indian Head Injuries Foundation with star-studded gala evenings in London and New York. Working with British and American neurologists, for whom India’s injured could provide an invaluable research resource, he hopes both to prevent head trauma, and improve care at every stage. While India’s private hospitals are world-class, there is widespread ignorance of elementary safety measures – helmets and seat belts. Nor is it generally understood what needs to be done in the critical “golden” hour or two after an injury when airways must be kept clear and wounds staunched to maintain the brain’s oxygen supply. Shivraj’s accident may have far-reaching consequences; more personally, it has taught his father to wear a seat belt. “But not a helmet – because I don’t ride a scooter, or a horse.”



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