Bandh . . . Time for a break

We have been having quite a lot of problems in our region which has been reported quite a bit in the media. I’m not here to comment on who is right or wrong . . . but a bit on how life has affected us at NJH, because of 2 days of bandh which has been called tomorrow and the day after, It is true that we’ve not had general strikes for almost 3 months since September 2012.

However, I have a hunch that things are not going to be the same at least for some time. There are multiple reasons for the same.

Coming back to the way things go haywire at NJH when there is a bandh. . . or do we get a well deserved break as one of my friends recently put it.

We had registered a team of our hospital staff to go to the Christian Medical College, Vellore for a training in Critical Care. With the amount of very seriously ill patients whom we’ve been dealing with of late, I had been planning this since last year. 

Now, the team of 4 was supposed to leave on Monday to board their train from Ranchi. Because of the bandh, the team had to leave today for Ranchi. Now, they would be sitting jobless for the next 2 days in Ranchi.

Then, we were planning to visit Ranchi on Tuesday for some major purchases. However, the bandh for two days means that Tuesday would be a busy day in the hospital. Which would mean that I’d rather be in hospital on Tuesday.

In addition, I realised that it would be a rather relaxed day in hospital on Monday. So, I could take a chance of doing the work in Ranchi on Monday.

Presto, I had to take a decision on Saturday afternoon. To go to Ranchi in a short notice of 3 hours . . . or not. I remember that my better half and the kids had been looking at the prospect of couple of days away from hospital. I suggest that we all go together.

Well . . . you can imagine us getting the 3 kids ready with all the packing for 3 nights away from home. Angel is quite well adapted to this sort of sudden planning. So, there was not much problems.

I had quite a lot of work to settle in the office. I was out by 3 pm and the whole family plus the critical care team was out of the hospital campus by 3:30 pm.

We reached Ranchi by 7 pm and had dinner at one of the hotels which was not a very good experience for the money we spent. 

But, we were surprised by the fact that it was less cold in Ranchi than it was at NJH. It was a welcome relief for all of us . . .

Am I relieved that I’m away from NJH ? ? ? Well, that’s something we’ll decide once we return back. Because, when I left the hospital, the Acute Care was full. There was no bed left. Then as we drove, I got a call about a boy who had come with an overdose of Bhang . . . a local form of canabis.

More on the Bhang and the patients in Acute Care in my next post. 

I shall relax for the next 2 days.

(This post was written on Saturday, 12th January, 2013 and was not posted because of poor internet connection)

Bandhs . . .Bringing Life or Death

Well, many of you may not know what does a 'bandh' mean. Well, it's basically the term given for a general strike in India. There is one more name for a general strike . . . hartal. For me, a native of Kerala and a present resident of Jharkhand . . . both the words are quite familiar. During my school days, we all used to look forward for a bandh as that would mean a welcome break from school. Now that I head an institution, a bandh is not a very welcome word as that would mean a decreased patient flow to the hospital and a hurdle in procuring supplies. 

Yesterday was the 30th bandh of the present financial year in this region. There are umpteen bandhs organised at the national level, state level, district level and now even at the panchayat level. We've had many occasions when a visit to the nearest town, Daltonganj or the state capital, Ranchi had to be cancelled midway as the locality through which we were travelling had organised a bandh. 

We had 2 days of bandh occurring quite close . . . 20th was a Bharat Bandh against multiple issues especially the hike in diesal prices and 22nd (yesterday) was a state wide bandh organised by teachers to protest against the government not giving in to their demands. Usually, it is announced that most of the bandhs exclude essential services like healthcare . . . However, ultimately no-one is totally immune to these bandhs. 

For us, the lack of regular medical and surgical supplies ensue that even a bandh day could become crucial in the smooth running of the hospital. 2 days of bandh in a space of 3 days with 23rd being Sunday has brought in havoc. On the 19th, we had taken enough plans to store enough cyclinders. Unfortunately, our plans were done all awry by a heavy demand on oxygen supply because of two eclampsia patients and one krait bite on ventilator. Another unconscious patient brought in by one of our close friends only made matters worse. 

It is quite a paradox. Many a time, one feels that the reason for calling a hartal or bandh is quite justified. But the amount of damage it does to people is something totally unacceptable. On one hand we hear about so much million rupees lost because of the strike . . . But, we do not hear much stories about individuals and families who lose out because of a bandh.

The young guy on the ventilator has been on it since the last 5 days. The oxygen supply to the ventilator is going to run out any moment . . . And then, it will just be atmospheric air being pushed into his system. He has started to respond after almost 4 days in the limbo . . . GCS of 3/15. 

There had been occasions when patients who were ready to go to a higher centre could not proceed on account of a bandh. 

I'm afraid that few of our patients are going to lose out. They have come here because they are too poor to go elsewhere. 

I've failed them by not ensuring that we have enough oxygen cylinders. There was a time when 8 oxygen cylinders used to last a week. Now we need at least 5 cylinders a day . . . With no bandhs I would not have had any difficulty at all . . . We have about 12 cylinders of our own and the daily school trips ensure that we have an uninterrupted supply. 

All because of couple of bandhs . . . lives unnecessary lost or maimed for life . . . 

Bandhs . . . Contributing to disease mortality . . .

It's a bandh here today - the Indian name for a General Strike. The best part is that nobody had any clue about it till today morning. Our vehicle was on it's way to Ranchi to pick up one of our good friends when we found about the strike. It seems that the call for the strike came yesterday night. And to add insult to the injury, it's a 2 day strike. 

It's not even a week since we had a 2 day strike - on the 30th and 31st May. The second day was a strike all over India in protest against the price rise of petrol.

For NJH, bandhs have rather been a regular feature. During the 2010-11 financial year, we had a total of 75 bandhs. 2011-12 has been better with only 54 days of shutdown. The current financial year has already seen 14 days of bandhs (including todays).

The curse of the bandh culture did not even spare us during our summer vacation. The day we were supposed to travel from Trivandrum to Othera turned out to be a bandh . . . with us losing our train tickets. 

When we were kids, bandhs used to be a welcome break. It is still not an uncommon sight to see kids playing cricket on the street during bandh days. 

However, it is not so for the country as it is calculated that we loose quite a lot on the economic side when the politicians decide to call a strike for a day, leave alone two days.

From a healthcare point of view, it is a terrible tragedy. We've had umpteen number of very sick patients who arrive too late or find it difficult to travel to a higher centre in Ranchi. 

We already have a patient, UD, a 30 year old mother of 3 who was bitten by a krait sometime early morning today. Although the family knew that she had to be brought as soon as possible, it took them almost 6 hours to find a driver who was willing to drive them to us. By she reached a good 8 hours had passed after the snake bit. 

She was in respiratory depression. Interestingly, there was no derangement of blood parameters. Usually, krait venom is both neurotoxic and hematotoxic. Now, it's almost 12 hours since the patient came. Unfortunately, the paralytic symptoms continue to persist. She is not yet on the ventilator. But, we are keeping a very close watch. . . 

I'm sure if she could have come earlier, her symptoms would not have been this bad. 

There are more stories I could tell you about patients who lost their lives because of bandhs. It could be different in cities but in areas like ours where is not much of a choice when it comes to selecting a care-provider, bandhs can turn out to contribute to disease mortality and morbidity . . . .

Please do pray that UD will make it . . .