We walked into the clinic of our nongovernmental organisation to find a young man sprawled on the floor face down and crying in pain. We were told that Velu (name changed), an Irula tribal from a village about six km from the clinic, had been fetching water from the well when he had felt a sharp pain in his abdomen, cried out and fainted. He regained consciousness in a few minutes and was brought to the clinic in severe distress. He was gasping for breath and said every deep inhalation was making the pain in his abdomen worse. Even the slightest movement elicited severe pain.