Poverty and disease . . . The vicious cycle . . .

I was debating to post the story of a little boy who came to our outpatient department yesterday. I worry that I look like a crybaby who keeps lamenting at the sad state of health affairs in places such as ours. . . 

AM, a 7 year old came sometime yesterday morning to OPD. His head was caked with pus. My Angel was wondering on what the diagnosis could be. To her horror, the cause of the severe infected wound of the head was a lacerated wound over the scalp. Almost half of the scalp was involved. 

It all started with a small wound caused by a freak accident at home. From their explanation, initially the wound was quite small. They had taken him to a local health centre where Tetanus Toxoid and cleaning of the wound. After they reached home, the wound appeared to start healing. But, then it appeared not to heal. 

They just could not afford another visit to a doctor. They heeded to the advice given by the local villagers. They started to put sindoor, turmeric powder and even cow dung over the wound. Somehow, the mother realized that she had to make a visit to a doctor. But, she just did not have the money. 

Well, couple of days back, she got hold of some money and has reached here. I've not yet gone into the details. I shall over the next few days. Today morning, after Nandamani came and reviewed the boy, the mother was in my office requesting that he be discharged as soon as possible. On asking the reason - she had only very little money and it would be difficult to be here. Nandu feels that the wound is quite bad and the scalp may give way and we may end up with a pedicle graft. 

Well, what prompted me to write this. I read this article in 'The Hindu' where 2 youngsters from the US tried to live in India at a 'an average Indian' with an 'average income'. Please do read this. 

To imagine an additional burden of health care costs is something unthinkable for almost 70% of the population. I face this stark reality almost everyday. As I sat writing this, one of my neighbors was at the door. His mother had a very bad episodes of burns about 5 days back. He wanted me to prescribe some medicines so that he could take it to her when he visits her tomorrow. She lives far away - about 40 kms away. But, it is too expensive for him to bring her to me, leave alone afford the costs of dressings or skin grafts or intravenous antibiotics . . .

Which is one of the major reasons why alternative and quackery systems of healthcare survive in rural parts of the third world . . . And one of the major reasons for my advocating fully subsidized care for burns injuries in our proposed burns unit . . . . 

And when people spend on healthcare, the most vulnerable within the family suffers . . . The women and the children . . . Well, I can go on and on - but the truth remains that empty stomachs haunt quite a lot of our countrymen when the better off among us look forward to McDonald's and Kentucky Fried Chicken opening near to our homes . . .  

Speaking of food, I should tell you about SD, who continue to be admitted. She was very sick after the surgery and we realized that she was quite anemic and had severe hypoproteinemia. I asked the family to bring eggs and milk for her diet. It took couple of days before they could buy it for her. I'm sure that they had to go to a moneylender for the extra resources. 

I've one child in acute care who has come in with diarrhea with severe malnutrition. It's obvious that the family has nothing to provide nutritious diet for the child. The best they can give is biscuits. . . And before I sign off . . . DR came for review couple of days back. He looked quite good. He told me that he is getting one egg and on and off vegetables in his diet . . . I wonder how he's managed it . . .  But, I'm happy that he's managed it and he's definitely improved . . .