Sunday, March 26, 2017

Oh . . . Ragi . . .

After quite a long time since we had been trying to reintroduce Ragi into the local diet (since 2011), we still don't have any data to prove that we've made any impact.

However, I keep hearing stories on how many more farmers grow millets in the Palamu region now.

And, on and off we get to eat ragi dishes when I visit mission stations, like the 'Ragi puttu' we were served last week at Chandwa.

I was told that this dish is relished by quite a many of the residents there.

May the tribe of ragi lovers increase . . . 

Thursday, March 16, 2017

Nowhere to go . . .

It was the festival of colors early this week. The whole country was in celebration. With our Prime Minister getting a major boost to his 'make India great again', the celebratory mood was well felt in every nook and corner of our communities. There were major things coming for the poor . . . the rich will be taken to task . . . there will be no more corruption . . . no-one will ever go hungry . . . there will be no more deprivation . . . there will be no more need for charity . . . 

I'm encouraged . . . I see a glimmer of hope for the marginalized and the poor in our communities. 

On the day of the Holi festivalI had just the sort of patient, who I feel should not exist in 2022, when the country celebrates it's 75th Independence Day. 

Mrs. A was not an unknown face. In fact, quite a many members of her family comes to us when there is a serious medical issue. In fact, it was just few weeks back that her nephew was brought to us with clinical meningitis and he made a miraculous recovery. I've known Mrs. A since the day we reached here. She was a known hypertensive and had been on irregular treatment. But, the last time we saw her was in October, when we diagnosed her to also have quite severe Ischaemic Heart Disease with some amount of cardiac failure and a bad pneumonia. 

As with the majority of our patients, she did not want to be taken to a higher centre. The maximum we could do to evaluate her was a Peripheral Smear and an ECG. Yes, not even an X-Ray. She made a miraculous recovery. 

But, she never returned for treatment. Alas, we also did not notice that she had not turned up for her regular medications. 

Her husband brought her in a miserable state sometime late morning last Monday (Holi). She was coughing with quite a lot of phlegm. Clinically, she got a bad pneumonia again which was causing quite a lot of stress on her badly damaged heart. I told the family that she needs evaluation. They told me that the maximum they could spare today was 500 INR. As usual they were not willing to take her ahead.

Over two days with some medicines to treat her lower respiratory infection and support her flailing heart, she made a miraculous recovery.

Reasons for her not coming for regular treatment for her high blood pressure and cardiac failure - they are very poor. There is one son who goes to work in the nearby town. He cannot go far as he has to look after his aged parents. There are couple of other sons who are earning a living in faraway places. They hardly come.

Now, it would be a great thing if such patients are taken care of. There are two ways to do it. The first is to ensure that the public health care system is robust.

And the other is to imagine that they don't exist. If the latter is the solution, people like me remain busy. 

Thursday, March 9, 2017


It's been a long time since I blogged in this one. It's almost an year since we got back to Palamu region, in a smaller place than before, where I'm much more accessible to those who could benefit from my skills.

I thought an incident which happened few days back in one of the peripheral dispensaries that I serve deserves a documentation.

At around noon, a group of villagers reached this place with an middle aged lady who apparently had a snakebite early in the morning. It was already 6 hours past. She showed no symptoms nor signs of any envenomation.

To make things easier, they had brought the snake along.

It was an easy identification. A Common Kukhri.

After the bite the patient had tingling sensation at the bite site, by which the villagers concluded that it was a venomous snake bite. A 'snake expert' in the village confirmed the same explaining that snakes with bands are poisonous and all the more colorful the snake, all the more venomous.

A 'jhad phuk' was called. He agreed to flush out the poison for a princely sum of 5000 INR, which the family readily agreed on.

So, here was a family who had already spent 5K INR and wanted me to treat her for envenomation.

I told the family that there was no symptoms and signs of envenomation, which I don't expect from a non-venomous snake. The family was absolutely sure that the snake they brought was the culprit.

I told them to throw off the dead snake into the heavily forested area nearby and go back home.

Couple of them appeared not much convinced. There was talk on taking her to another 'jhad phuk'. They carefully packed the snake into a bottle and was off for a second opinion.