Many a time we get so much used to things in life such that we find it difficult when we shift places especially in a country like India. And when it involves the scientific realm, one can only shudder in horror on how quite a good proportion of the population still take to the occult or try to take a short cut just for the heck of saving money.
Yesterday, I had the opportunity to deal with a young boy brought with a cobra bite - a full 8 hours after the incident happened - barely clinging to life. I had not seen one for quite a long time and I needed my senior consultant's help to clinch the diagnosis. Later, I was told that the family had taken the patient to a witch doctor and finished all formalities before even thinking to bring him to a medical facility.
To come to the second point - trying to save money by opting for short-cuts. The Satbarwa block has a institutional delivery rate of 18%. In the olden times, institutional deliveries was the order of the day - there just were not enough hospitals to deliver. Unfortunately, even with hospitals mushrooming almost in all the small towns of the country - we still have a good number of our ante-natal clientele who come in labour trying out the local quack before coming to NJH when things don't go well. And the most interesting portion starts after reaching the hospital. There is a lot of haranguing to ensure a normal delivery rather than a cesarian section even if indicated, irrespective of the condition of the baby. And this happens, not only with the poor whom we can understand, but also with the rich.
When I came to NJH in 2003, I was told by one of the resident nurses that it was believed that the first baby is only to widen the birth canal - and they care only from the 2nd one. I saw it in action today. 33 year old unbooked primi. Married for 10 years. First baby!!! Came with leaking. Per abdomen the baby was small for dates. And imagine - for such a precious baby, this lady had never thought of visiting a doctor even though she lived quite near to the main town.
The small abdomen necessiated an ultrasound which showed assymmetrical intra-uterine growth retardation. I advised for a cesarian section. The relatives will have none of it. By now she had gone into labour. The Hb was 8 gm%. After 5 hours, the husband asked me whether we can have the cesarian. Unfortunately, by then the baby was almost delivering. He rushed to Daltonganj for blood. The baby was caked in meconium and never breathed. I called the relatives and explained about the baby. The mother's family was disraught - but not the hubby's family. There were very happy to accept that the mother did not have a cesarian.
6 hours before this lady had arrived for admission - I had another heroic family, who was unwilling for a Cesarian section even after I told them that it was a brow presentation. I prayed that she would not rupture her uterus considering that she was 3rd gravida. The patient struggled for about 12 hours - all the while the family not agreeing for a cesarian. However, by God's grace, she delivered a baby with a funny looking frontal region after a long time in labour. I wish I could have taken a snap of the little warrior.
I wonder where does science go wrong is such situations. We have enough research and protocols on all these things - however, our fellow beings rely on the unknown. Rather, everybody looks like to have a love and hate relationship with the unknown. On the other hand, it is not uncommon to see people fall to rather very snobbish ideas of half baked quakes, soothsayers and witch doctors. I wish these poor people woke up to reason and science... There needs to be a 'opening of the eyes'...