(Kindly note that this post is written on the basis of an incident which happened in hospital today. I have enough reasons to believe that what I think has happened is true - but I do not have any solid evidence to prove anything)
SD had delivered about a week back by Cesarian section for a dead baby with a hand prolapse. We had discharged her today. We knew that she was quite poor. Unfortunately, we had sent the chart for billing and the family was informed about the bill.
Sometime around mid-morning I had a local well off person who came in saying that he was helping out to pay off her bill and that he would need some charity. Dr. Nandamani asked him why he is interested in paying the bill. He replied that the family works in his house and therefore he wants to foot the bill. Dr Nandu smelt something fishy and told that unless a male member of the house comes, he would not do anything.
The well off guy came to me and I sent off for the chart. The chart was in Dr. Nandamani's hands. Nandu called me and told me what he is suspecting. It was then that I realised that there is something major happening here which has missed our attention. The patient was from quite a far off place (Leslieganj). The fact that one of the relatives mentioned that the family works at the house of the well off guy sent alarm bells ringing in both of us.
It is quite a common practice that we see at NJH where well off local people pay off part of the very poor's bills and comes on their behalf to get some charity. Many times, we had ignored it and we were also told that such payments were made with the help of donations taken from local people.
I called a male relative of the patient who told me that whatever payment was being made is wholely from the side of the patient. I asked the relative where the money was. He told me that it was with the well off person. I asked him how they were able to mobilise such an amount. They told me that they pawned a cycle, few jewellery and some of it was given by relatives.
The bill was 11,0000 Indian Rupees. The family told us that they will pay 8,000 Rupees. I told them to pay Rs. 4000 Rupees and wrote in the chart. Later, as I asked the cashier on how much was paid - I was astounded to find that the well off guy had insisted that he takes Rs. 8000. It was obvious. There was more to the payment that was done than a mere help to a needy patient.
Or is it just wild and wishful thoughts ? ? ?
Meghnath (then in a small mission near Ramanujganj)was contacted around 1984 by the Palamau SP of the time. The SP had read Mahashweta Devi's article in EPW. Mahashweta Devi had quoted Meghnath on the existence of this practice. A survey was done and quite a few were freed. Sainath has also described the situation in 1993 in his book Everybody Loves a Good Drought. Not impossible that it still exists.
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