Heights of ignorance . . . cont'd

I had quite a few people asking me where the incident mentioned in my previous post had happened. 

That's the most unfortunate part. 

The incident happened at a place called Lehelehe which is just beyond Satbarwa, which is our nearest village market. 

One more incident about a family which has been branded as having killed their neighbor by witchcraft has come to light. This is also at a place which is quite close to our hospital. 

Below is the newspaper clipping. 

The family is being boycotted by their fellow villagers on the orders of the local village government (The Panchayat). 

Another example of ignorance and the 'fear of the unknown'. 

Fear and Frustration

As I heard the story of SD, it was the sad face of PD which came before me. And her moans of pain and distress. 

PD had a history very similar to SD. 

After having tried to deliver normally at her home, PD came to us couple of days back. The diagnosis was almost the same as SD. 

Rupture Uterus with septicemia and severe anemia. She was on the verge of going in a circulatory collapse. Few years back, we would have taken her in. Maybe one of our staff themselves would have donated her blood. And we would have taken her in for a laparotomy. And she would have made it. 

Now, things have changed. A sort of fear has come after recent happenings in one of our sister institutions. 

The next best thing we could ask was for them to arrange for blood. 

It was nearing dawn when PD was wheeled in. Everything was explained. As always, the first choice was for them to take her to a higher centre in Ranchi. They preferred that we manage her. 

PD pulled through till the blood came. But, we were in for a surprise. We had asked for 3 pints of blood. 

The relatives came with one pint. The doctor on duty did not need to look much into the pint of blood to decide that it was diluted blood. We sent it for hemoglobin. It was a measly 3.6 gms. 

On further inquiry, we found out that they had paid 3500 for the blood, ten times of what it took to get blood from the government blood bank. It was obvious . . . the blood bank in the district hospital did not have the required blood group. And they could not give them a donor. 

So, someone had fixed them up with an agent who arranged the pint of blood. 

It was nearing evening when I went to talk with PD's relatives. I told of the predicament. Meanwhile, some more relatives of PD had arrived. 

Thankfully, they were ready to take PD to a higher centre. 

There is not much reason to believe that she would not have survived the journey to Ranchi. But, she could have ended up as a maternal death too. I don't know.  

However, we could have served her well had we had the freedom to draw blood here, transfuse her and do the surgery. I'm sure that the family would end up selling quite a lot of their possessions to fund her expenses. 

Yes, we would have broken the law and ran the risk of ending up in prison. 

I wish we had an additional clause in the laws of blood banking in India, where hospitals which are beyond a certain distance from a blood bank which could guarantee the supply of blood 24X7 be allowed to draw fresh blood and use it in emergencies. 

Could someone advocate for this? And we could do well with quite of few supporters of this amendment in the law. 

Breaking Rules . . .

SD got discharged today. 

She is alive today because someone went the extra mile to take care of her. 

SD had been trying to deliver her baby at home for 2 days before she arrived at the rural hospital quite far from her home. This particular hospital was not her first choice of care. She had gone to the government hospital. They refused to take her. 

She was quite pale and looking bloated up. It was an obvious rupture uterus. And she was in shock.

The nurses rushed to the doctor on duty, 'No b.p, pulse . . . what shall we do?'

'Rush fluids . . . and ask one of the relatives to donate blood', the reply was fast. 

There was no blood bank in the hospital. There was no chance that a blood bank could be there. Electricity was a premium. Then, there was the need for qualified staff and space. 

A technician drew the blood . . . Quite oblivious of rules, rather laws, which could end with him in jail. Possession of empty blood bags in a hospital without the license for a blood bank was in itself a criminal offense.  

The hospital was in a remote location. Nobody in the administration bothered much about what was happening. It was an area which was infamous for social unrest. And there were stories about frequent incidents of highway robbery on the way. There was the fear of being taken hostage or looted if one went to inspect the place. 

And it had the aura of being famous for people getting better after being given no hope elsewhere. And there was not much money involved. After a long journey to this place, there was not much hope of being paid under the table for favors given. 

So, nobody bothered.

It was good for SD that nobody bothered. She is alive today because of the emergency blood transfusion. The nearest blood bank which guarantees blood of all groups round the clock is about 5 hours away. She would have been most probably dead if the family took her further. 

However, things have changed. News was conveyed about how a similar hospital has been taken to the dock for flouting rules. 2 staff were jailed. Another 3 have been called and is in danger of being jailed for nothing less than 3 years.

Another patient who would come now with a history similar to SD will be referred. Unless, the staff in the same hospital decide to volunteer to go to jail.

The fact that SD would have been a Maternal Death makes this issue all the more serious.  

Intriguing, ain't it. Technology has grown so much that we have been able to save lives which would have been long dead in it's absence. But, to counter it have come in laws which has affected the way technology is used.

(This is a true incident which happened in a remote hospital in India last week. The identity of the hospital and the people involved are not disclosed as this can invite criminal proceedings) 

Heights of ignorance

Below is a news item which was quite prominent in our local daily. For those who don't know Hindi, I've written up a summary of the news. 

The story is that of a lady who died of a snake bite. She was buried. 

Then, the body was exhumed and witchcraft done to resurrect her. 

Not once . . . but twice. Yes, the body was exhumed twice. First, by the husband's family and later by the parents of the lady. 

Amazing . . . Isn't it? 

Vocational Training . . .

Today was a red letter day in the history of the hospital. 

As part of our work in this region, I've always dreamed about starting some form of vocational training for the youth in the communities around us. The reason being that there were quite a lot of young men and women who dropped out of school. Most of them were into odd jobs. Those who had fields did a bit of farming. But, those who did not have fields resorted to manual labour as well as migration to faraway regions for unskilled labour. 

There have been discussions about what all courses we could do. The plans were for courses for electrical maintenance and repair, driving etc for young men and tailoring for women. 

Dinesh, our maintenance manager was quite enthusiastic about starting the program in driving and electrical maintenance. However, because of the major workload in the unit, the program never took off. We looked for other people who could shoulder the responsibility, but failed. 

Then, there was a chance meeting with one of our partner organisations, who introduced us to a lady who used to teach tailoring. That gave us the idea to start off a tailoring school for women. 

The school was inaugurated today by our Panchayat Pramukh, Mrs. Urmila Devi. There was not much funds to start off this venture. As you can see from the snap, we've used a old house in the other campus to house the class. 34 students have enrolled for the first batch which would extend upto 6 months. 

I hope although this is a very small beginning, we would be able to see this venture growing so that more young men and women will benefit.