Of poor healthcare . . .

I'm away from the hospital for some unforeseen reasons. We've been staying at another place for the last week. As we stayed at this particular place, word went around that I was a doctor. I had quite a number of people coming to see me and take advice on their medical conditions. 

I thought I should mention two cases - both these cases summarize the present state of Indian healthcare. 

The first one - A couple in their late thirties. They had been married 14 years - and were not able to conceive. Since the last 3 years, they had been going to multiple places for treatment. The impressive part - there was already a diagnosis made of azoospermia. That was 3 years back. The horrifying part - the poor lady has been subject to all sorts of tests to check out problems from her side . . . including a laparoscopy.

To investigate the wife extensively for infertility when the husband has a problem of azoospermia . . . I wonder how will you justify this. The couple had spent about 30,000 INR so far . . . 

The second one - The place I stay in had a large party for the local villagers. As my friends and me walked through the grounds where all the villagers were having their food, I noticed one young mother feeding a very malnourished child. As I moved closer, it was obvious that the child had cerebral palsy. I asked the mother about the child. The child was more than two years old. She looked all skin and bones and the whole body was limp including her neck. She must have weighed about 5-6 kilograms. 

The mother told the sad story. She had given birth to the child at home. The newborn did not cry after birth. One of her relatives rushed the baby to a nearby health centre run by Catholic nuns. The journey took a whopping 2 hours. I was surprised to hear that the baby cried as soon as the sisters at the dispensary gave the treatment. 

A hospital delivery should have most probably given the poor mother a healthy baby. It was so difficult to visualize how this child was going to grow up in a remote village where the nearest road was a one hour walk away. Electricity, potable water, regular availability of food . . . all of it was a premium. 

First of all . . . a very corrupt healthcare system. Second . . . a healthcare system which is more concerned about building super-specialty hospitals and researching about rare medical conditions when quite a lot of countrymen do not have basic access to healthcare . . . 

Over the last week, it is becoming obvious that we may not be able to continue to NJH . . . However, my heart breaks to know that I would be leaving a community whom we were trying to help out from the effects of both the above issues . . . 

Looting in broad daylight . . .

Today, a poorly built young man come to one of our doctors. He had a contrast enhanced 18F-FDG whole body PET-CT Scan in his hand which he held out to me and told me that the concerned doctor has told him that he has tuberculosis in his blood.

He had come to NJH as we had a reputation for treating tuberculosis patients. 

One look on his face and his history was enough to make a very strong suspicion of Sickle Cell Anemia. He had a huge file with him. Our doctor was hopeful that there would be something in there about the diagnosis. The names of the hospitals he had gone through were huge enough to have their own websites and online fixing of appointment etc.

Other than the PET-CT Scan, he had a complete hemogram (4 times), liver function tests (4 times), serum iron studies, detailed stool examination (3 times), ASO titres, echocardiogram, HIV, ultrasound abdomen, widal tests, couple of chest X-Rays. He has been admitted and on multiple intravenous antibiotics for quite some time. 

The total costs of the latest treatment for him has come to something around 70,000 INR.

The poor guy had gone to one of the metropolitan cities in the country for job. And then he fell very sick with severe body pain and fever.

He was always sick since childhood. He had been to many places. Nobody has told him anything till he took the PET-CT Scan when the concerned doctor told him that he appeared to have tuberculosis in the blood. 

However, the reason for me to put up this post was because of the absence of a peripheral smear report in his treatment file. Nobody had told him about the possibility of sickle cell anemia. 

I wait for the reports of the sickling test and peripheral smear . . .