Against all odds

Mohamed Raishan Ahmed was born with spinal muscular atrophy, which made him unable to sit, stand or walk. Recently, the Maldivian underwent a rare, complex surgery in India that now allows him to sit upright. At 23, the fact that he is alive is in itself an achievement. But he has gone beyond mere survival-with a pursuit of excellence

- Nirmal Jovial

In July 2024, KIMSHEALTH in Thiruvananthapuram saw an unusual medical board meeting, as unusual as the case it was held for. "Before any complex surgery, we hold a medical board meeting where all specialists involved in the treatment, along with the administrative team, come together to review the case," says Dr Ranjith Unnikrishnan, consultant orthopaedics spine surgeon at KIMSHEALTH. "We discuss the pros and cons, outline anticipated risks, propose solutions and ensure the family fully understands the situation before obtaining their consent for surgery."

Typically, patients do not attend these meetings, with their family or caregivers representing them, says Unnikrishnan. But, in the case of Maldivian disability activist Mohamed Raishan Ahmed's surgery, Unnikrishnan insisted that the 23-year-old be present.

Raishan's condition stemmed from scoliosis caused by Spinal Muscular Atrophy (SMA) from birth, presenting several challenges. "SMA-related scoliosis is particularly complex," explains Unnikrishnan. "First, most patients with SMA don't survive this long due to the condition's severity. Those who do face significant limitations it doesn't affect the brain but severely impacts the locomotor system, leaving them unable to sit, stand or walk."

In Raishan's case, his hips were dislocated from childhood, and he had spent his entire life seated. Sitting upright was his primary functional need, but as his neuromuscular scoliosis progressed, it became increasingly difficult to manage with braces. The curvature of his spine had advanced to the point where braces could no longer hold him upright. Moreover, the braces caused pain and complications that made it impossible for him to sit without falling forward.