FOR WANT OF CHLOROQUINE TABLETS (Most probably)

I am sure we are all familiar with the rhyme which goes . . .

For want of a nail the shoe was lost.
For want of a shoe the horse was lost.
For want of a horse the rider was lost.
For want of a rider the battle was lost.
For want of a battle the kingdom was lost.
And all for the want of a horseshoe nail.

I had a frantic call from our duty nurse sometime around 7 pm today (4^th November, 2011). There was somebody who was brought dead and she just wanted me to come and confirm the death. Something which is quite routine in many of the hospitals.

I took my sweet time to go in. On reaching the emergency, I was surprised to see that the unfortunate soul was a very young lady. However, there was one more person – a living one, lying in the bed adjacent to the stretcher carrying the dead body. I thought it was quite unusual.

I identified one of the local fellows whom I was familiar. The story he had to tell was a very tragic one. It seems that the young lady lying dead in the stretcher was the wife of the man lying on the examination cot. Both of them had been sick since the last week and presumably had been on some treatment from the local quack.

The lady had been unconscious since yesterday after having been very sick with high grade fever for the last one week. Her husband was also sick. The neighbours had noticed it and had been advising them to go to a doctor. But, they never took it seriously.

It was only today morning that the couples relatives and neighbours realized that things have taken for the worse. They had been pestering the husband to take his wife and himself to NJH. The husband needed a whole day of persuasion to bring his wife to hospital. But by the end of the day, she was dead.

I examined the husband. He looked severely sick. He was running a very high temperature. His eyes were bloody red and his sclera showed that he was severely jaundiced. Most probably, hepatitis secondary to falciparum malaria which probably killed his wife too.

I wrote out the inpatient chart for him and ordered for some basic investigation before starting treatment.  I went back home after writing some intravenous fluids to get him hydrated. As soon I reached home, I received a call from the emergency nurse who told me that the young man has refused admission. The reason – ‘we are quite expensive, and he did not have any money.’

He had walked out of the hospital and was nowhere to be found. The rest of the people had gone with the dead body of his wife and he had also gone behind them.  There was nothing we could do.

I felt sad for the family. While I was examining the young man, one of relatives was holding the only child of the couple – a two year old girl – quite oblivious of the tragedy that has befallen her. From the way the man had responded to us – I could only shudder at the future of the little girl, with no parents to raise her.  

Stories such as these are very common in the rural parts of the developing world. Lives which are quite cheap; lives which are expendable. Nobody cares if such people died. I felt sad that poor people around our institution finds us quite expensive. I wish we could be such a place where the poorest of the poor can walk in and get life-saving treatment.

Treatment for this young couple who are in the prime of their life would not have been expensive if they had come in the very beginning. It may have involved giving a course of chloroquine or a course of antibiotics. The paradox remains on how difficult it is to convince the ignorant and the poor about how easy it is to save lives.

So, ultimately, families are being destroyed all for want of a basic knowledge that timely health care can save lives. But, the problem remains on access to basic healthcare for quite a lot of our population. Is anyone listening?