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Posted by Gregory Karelas

Almost one year ago, I wrote a piece for this blog titled “The Transformative Power of Paint”. Its purpose was to elucidate how small gestures can make great change. It was a pleasure to write and depicted beliefs that I still hold true. Thus, when the experience of touch emerged as a theme for further writing, a reflection of its transformative power seemed fitting.

Nima (name changed for confidentiality purposes) is a 24 year old woman, who came to Bayalpata Hospital’s Emergency Room four months ago for hand contracture and severe burn injuries across her face and body. Nima suffered from epilepsy and had fallen into a fire while seizing, causing the burns and contracture that brought her to us. It was not the first time that she had endured this unfortunate coupling of space and disorder. Nor was she the first patient we’d treated for similar injuries caused by those same events. Widowed and without children, Nima had no family. Her father was alive and seemed to be her only support beyond our hospital. But he was a migrant worker, who spent most of the year in India and had likely not seen or spoken to Nima in months, if years prior to her accident. Thus, when Nima settled herself into our Inpatient bed, she perhaps unknowingly took our staff as her family and our hospital as her home.

Loneliness is a curious feeling. I don’t reference the kind that comes from missing companionship. I mean the kind that comes from feeling forgotten. One Thursday evening a member of our Nursing staff unfortunately yelled at Nima for shaking another patient. The nurse meant well and ultimately protected the patient in Nima’s grasp from physical or emotional harm. Yet, to Nima’s dismay, the nurse never accepted her explanation of why. Nima had tried to help the patient by mimicking traditional healing rituals that she had surely seen and likely undergone before. But her justification was lost on an understandably shocked nurse. Explanation seemed futile. Hurt feelings painted the room. And the young woman with epilepsy and a burned body–the one who had so eagerly made her home within ours–decided to run away.

In two months at our hospital not a single person from Nima’s village had come to visit her. From her bed in our Inpatient Unit, she had once felt special among our staffs and patients. And, as has happened to so many of us in the past, in a swift turn caused by misunderstanding, she felt completely alone. Or so I gathered.

Word quickly spread that Nima had tried to leave the Hospital. Our staffs took out their torches and began to canvas Hospital grounds with hopes of finding her hiding as opposed to halfway down the night-veiled hillside beneath us. Luckily, Nima shared that hope with them. I found Nima twenty minutes later, sitting in the dark next to our water tanks, crying to the consolations of Tulla and Dr. Payel. It seemed that Nima had never intended to leave the hospital. But she had every intention of sharing her sadness with someone.  Dr. Payel and Tulla sat on Nima’s one side. I sat on the other. And the three of us took turns between holding the flashlight and rubbing Nima’s back.

Yet it wasn’t until Raviman arrived, Bayalpata Hospital’s charming young pharmacist and Nima’s crush apparent, that she began to smile again. His own smile radiated and seemed to brighten her night with playful questions regarding her post-escape plans and how she could consider leaving without saying goodbye. Although aware that they were friendly, I was surprised to see that the two knew each other so well. And despite my foggy idea of their discussion’s details, I did know that Nima stopped crying. In fact, she began to laugh. And we all did in return.

So why couldn’t I stop crying when Raviman reached over and touched her face? There was nothing unique about it. The two had been laughing about something and then paused. Raviman invited Nima to take dinner with us all in the staff canteen that night, since her staged escape had run past patient mealtime. And, despite her resistance, she was clearly tickled by the uncommon invitation. Yet right before we stood up to walk to dinner, Raviman reached over–as if toward a sister or recently rediscovered friend–and touched the burn on the side of Nima’s face. It lasted only a moment and seemed perfectly natural. And I don’t know if Raviman even realized the effect that his gesture had on me or, hopefully, on Nima. But it was powerful. And it moved me enough to write this post.

To me, the transformative tenderness of touch is its ability to make people feel loved. Anthropologists have long devoted hypotheses and studies to touch’s therapeutic value as a vehicle of healing through connection.  For who can deny the feelings of comfort engendered by a loved one’s hug, the bond created by a reaffirming handshake or the enthusiasm shared by an energetic high-five?

Yet touch clearly has the ability to hurt as well. Physical violence and inappropriate contact are sadly prevalent in the lives of so many, and especially in Achham. Fighting among drunkards brings too many patients to our Emergency Room. Sexual assault is frequent enough that our Hospital does not allow female staffs to walk home alone after nightfall. And domestic violence is common enough that no one flinched when one staff member took leave last month to escape the beatings she claimed her husband had taken to giving her.

The tenderness of touch is inspired by compassion and defined by grace. It’s what moved Raviman to reach into Nima’s sadness and remind her that she is human, that she was not forgotten, and that neither the losses in her life or deformities on her face and body would ever change that. It offered human connection to a person in the throws of emotion I cannot fathom. And perhaps it’s what Nima needed most of all. Raviman touched a side of her face that was deformed, marred by burns and still bandaged after two months of treatment. And while I marvel at how a single moment of connection was able to suspend feelings of neglect and isolation, I was inspired by its simplicity and cried for lack of knowing any other response.

 Nima joined us for dinner that night in the staff kitchen. She sat at the head of the table, next to Raviman. And she returned to her Inpatient bed soon after.

May this account of human emotion and simple exchange forever remind us of the importance of tenderness in all we do. In a place like Achham, where life is hard and work is defined by challenge, it becomes easy to fall into survival mode; to protect oneself with a thick exterior and to mistake aggression for fortitude or gruffness for honesty. But we need reminders. We must always remember that the truth of our work lies in human connection. And that the courage to overcome injustice lies in a single moment of connection. May our work forever promote our ideals. May our commitment to caring for a people forgotten only strengthen in time and practice. And may our work always seek connection over forgetfulness, patience over speed and tenderness above all.


Gregory Karelas is the Country Director of Nyaya Health.  He graduated with an MSc in Medical Anthropology from Oxford University. 

2 Responses to “The Transformative Tenderness of Touch”

  1. Agya says:

    Beautiful write-up! Very touching.

  2. Amber says:

    Incredible story that almost moved me to tears. It is amazing how our small gestures can hurt or heal, and you’ve expressed this so powerfully. Thank you for sharing!

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