Showing posts with label apathy. Show all posts
Showing posts with label apathy. Show all posts

Wednesday, September 14, 2011

Nasbandi and Indian Chemists and... other stuff...

I have been setting aside a LOT of stuff inside my head with the tag "has got to go down on blog" for such a long time, that I've started forgetting all those stories and the details that go with them. So, without further delay, I'm just going to try and put it all down in this post. Here goes.

Location: Casualty Department, Tertiary Hospital in Mumbai.

A young man walks in, almost runs in, then sits down, panting, and and tells us: "Mujhe nas bandhi ka operation karwana hai". We all stare at him, pretty amazed (at least I was). I turn around, to check with the MO, and confirm whether he really does mean what I think he does (that he wants to get a vasectomy done!). The MO asks him, "Are you married?" He says no. Then the MO asks him, "Who told you to get this operation done?" He says he figured it out by himself, after watching the Govt. ads on TV, which said that you get paid by the Govt. if you volunteer to undergo a vasectomy. He said his sister was very ill, admitted to a private hospital, and he was falling short of Rs. 900/- for her treatment. She was his only sister, he wanted to save her, so he decided that undergoing a vasectomy would be a good solution. I don't think the ad explains the actual implications of the surgery. Anyone seen the ad? Then tell me what it shows because I haven't seen it. Embedded below is an ironic as well as hilarious video regarding nasbandi that I found while trying to search for a government ad video on the internet.

Anyways, the man didn't seem to realize that undergoing this surgery meant that he would not be able to have a child in the future. He just seemed concerned with the monetary compensation he would get. We sent him away, telling him this wasn't an option for him and that he should probably get his sister treated at a government institution if he wanted to save some money.



Location: Casualty Department, Tertiary Hospital in Mumbai.

An old lady is brought in on a wheelchair, transferred from a peripheral private hospital. She comes with reports of deranged RFTs and S. Creat at 8.3. She gives a history of irregular, unsupervised intake of NSAIDs and other Ayurvedic medications over the past two years, to treat her joint pains and some form of arthritis she supposedly had. The medicine registrar on call cites her chronic intake of NSAIDS as the cause for her renal failure. Makes me think about the tons of patients we subscribe NSAIDs to rampantly, everyday, with or without indications, and without thinking about the dangers of a situation where a patient may start self prescribing and abusing those very same NSAIDs. After all, how difficult can it be to read a drug name, ask the drug dispenser what it is used for, and, upon hearing the magic words 'pain relief' start popping it as and when your fancy arises after obtaining it from your friendly local chemist!

Location: Ob/Gyn OT, Tertiary Hospital in Mumbai.

A patient is taken up for an emergency LSCS, she was already in labour when she came to the hospital...I was posted in anesthesia and I just cannot remember what the indication for her LSCS was. Sorry about that. So anyways, she was wailing and screaming loudly the entire time inside the OT, everyone there was distracted because of her, and this while another surgery was going on in the same room. She had to be given her spinal, twice by the housie, I think the first time it was unsuccessful, thanks in no small part to her screaming and thrashing around. Then, when she didn't stop screaming at all, even after two attempts at a spinal, the senior anesthetist came and asked them to give it for a third time before starting the surgery, just to be safe. Inspite of this, the patient continued her voracious wails of "Aaaaaaa....owwww....majhyaa aai la bolva...aaaaaaeeeeeee" ("Owww....get me my mother...please...aaaaaeeeeeee") at a shocking volume, and atleast 20 people gathered to watch the spectacle. Finally, the obs people started the surgery in all this confusion, it was an emergency after all.

About 10 mins into the surgery, the patient seemed to be calmer, and had taken to just calling out for her aai in a normal voice as opposed to screaming. Now the much-more-visibly-relieved-looking-anaesthetist asked the patient, hopefully: "Aata tumhala dard kami jhala na?" ("Has your pain reduced now?") to which the patient (whose uterus was about to be cut open, may I remind you!) who had so far not given up on her incessant wailing, replied: "Ho, aata jara kami aahe, pan tari pan majhya aai la bolva!" ("Yes, now my pain is relieved, but you must still get me my mother!") At this, the 20 people who were inside the OT spontaneously burst out laughing at the same time, many of them shaking their heads in disbelief. I suppose the wonders which mothers can make happen in this world have no bounds! And I am sure that was the noisiest day ever in the history of that particular OT.

Location: ANC OPD, Peripheral urban health centre, Mumbai.

A young handicapped pregnant patient comes in. She seems to have a deformity in both lower limbs. She doesn't even use a wheelchair, she crawls in with the support of her hands and knees. Her mother accompanies her. We find out that she is unmarried and is now about 8 months pregnant. The patient refuses to take anyone's help to get onto the examination table, and shouts at the doctor for trying to help her. When after several attempts she's unsuccessful, her mother and the doctor try to help her, but it's still not possible to lift her onto the high set examination table. Finally we get her to agree to lie down on the floor of the room and get examined. When asked why she didn't get married, we find out that the father of the child is also handicapped, and he is also unemployed and doesn't have any family to look after him. So they chose not to get married. The patient's family is currently looking after both of them. And it is understood that they will have to look after the baby as well. When advised a visit to an obstetrician in a proper hospital, since this was just a health centre, the mother says she cannot afford to take her daughter by a taxi to any hospital, and the daughter being disabled cannot travel by any other modes of transport available in this city. The patient then crawls out, after telling the doctor haughtily that she need not prescribe any medications because she wouldn't be taking them, and then bursts into tears while leaving. Her mother plans to conduct her delivery at home itself with some local woman's help. I cannot even begin to imagine what it would feel like to be in that patient's place. The entire episode left me pretty dumbstruck.

Her one story just seemed to highlight so many issues in the country - lack of proper rehabilitation or a support system for handicapped people... the handicap-unfriendly public transport system... societal bias against handicapped people... poor reach of healthcare services to the people who need them the most... unemployment... motherhood outside marriage... and I don't know what else!

I'm still reeling from the shock of this story here.

Okay, I have forgotten the rest of the stories. Yes, there were more.

Anyways.

On another note, today's feature in HT Cafe 'Is your chemist the drug-peddler?' was quite interesting, informative and amusing. Being all three at the same time is definitely an achievement. Reading that article reminded me of when, about four years back, I was suffering from some kind of a UTI, and had already taken two courses of medications from my family doctor, with no great relief. I was a lost kid in my 2nd year MBBS at that time. So then, the third time I went to the doctor, he got irritated by me I think.

He wrote my prescriptions, and told me to get one particular drug from the chemist and sent me off with a wide smile. I went directly to the chemists' from there, and gave him the prescription. The chemist read it, gave me a long stare, then got the meds for me. He asked me whether he could keep the prescription. I was mildly surprised, but didn't think too much, gave it to him, and went home. At home, I opened up my brand new, hitherto-untouched pharmacology textbook, and looked up the drug the doc had prescribed. It was a tricyclic antidepressant! With embarrassment I now realised why the chemist had wanted my prescription. I felt angry and insulted, and got up and threw the entire strip, untouched, into the dustbin, and vowed never to go back to that particular doctor! Thankfully, my UTI resolved soon enough so I didn't need to either ways. But this reminds me that the chemist at that time was a good one, who did his job well. And he probably thought I was a teenager with issues. Oh well.

On yet another note, being posted in PSM (Preventive and Social Medicine) is taking its toll. I thought that working in the branch would actually involve practicing some preventive and social medicine. But I am starting to doubt whether the PSM people even practice medicine at all. They just seem to occupy themselves with being lazy, supervising the interns, making us run the dispensary and do all sorts of other clerical work, being humongous pains regarding attendance and (god-forbid!) dropped tablets, and incorrectly treating patients. Let's just hope this trend isn't really as generalized as it is appearing to be.

So. I think that was about enough to make a blog post. Entertaining or not, you tell me.

I will now head off to bed. And to yet another day of new stories to tell you people.


Thursday, May 5, 2011

Day 4 of Medical Interns' hunger strike in Maharashtra

Medical interns all over the state of Maharashtra went on a hunger strike from 2nd of May, 2011. Today is Day 4 of the strike. What started off with 24 medical interns and students on hunger strike from various medical colleges across the state, has intensified to now include about 114 interns on strike, of which 20 have been hospitalized.

The demands? An increase in the monthly stipend of interns from the current Rs. 2550, to Rs. 13000. Maharashtra is the state in the country with the lowest interns' stipend, with other states offering much higher stipends (West Bengal - Rs. 14000, Jharkhand - Rs. 9000, Delhi - Rs. 13000, Assam - Rs.12500, UP and Bihar - Rs. 7000).

Any person with even the slightest common sense would see that paying an intern Rs. 2550
 as monthly stipend is a joke. Yes, agreed internship is a part of our medical education. But why the disparity in stipends across various states? Should we suffer because we chose to live/study in Maharashtra? The Government officials say that since medical education is sponsored by the Government, we cannot expect them to pay us a good stipend as well. But if we compare the fees during MBBS in every state, fees in Maharashtra are on the higher side, while the stipend is the lowest in the country.

So if other State Governments can afford to educate their medical students and pay them a good stipend as well, are they suggesting that Maharashtra is the poorest state in the country that can't even support it's own health professionals? We know that cannot be true.

As medical students we have studied for so many years, while our peers have started working and supporting their families, and now when we finally start working, at ages of 23-24, we still can't sustain ourselves with the measly pay we get (Rs. 85/day). In a city like Mumbai, where I live, that wouldn't even get me three square meals per day. And most of us still have years of studying ahead of us.

Seeing the state apathy towards the well-being of it's Doctors, there will be no wonder if the quality of health care services goes down the drain, if it hasn't already reached there.

After repeated failed attempts to make the Government sit up and take notice these past few months, the interns were forced to go on a hunger strike. Even after that, the Government continues it's apathetic attitude.

Since the last 4 days, interns have been sitting inside a pandal at the Kamgar Maidan opposite KEM hospital in Mumbai, on a hunger strike. No-one has even batted an eyelid. Media coverage has been lukewarm, political response has been almost non-existent, negotiations with the Government have yet to begin, and the interns who are not going hungry are so relieved to get a few days off from work that they don't even come to the grounds to show their support.

Every evening, we are told that tomorrow there will be a meeting, and the issues will be resolved. Every evening means one more hungry night.

I cannot even begin to think what the people who are going hungry must be going through.
Today I am ashamed to be an Indian and a Maharashtrian, and disgusted and appalled by this state of affairs.

To all my co-interns who haven't shown up to support the strike - You may not want these demands to be fulfilled, it may not matter to you, there may be more important things going on in your life, but many of your co-interns really need this change. An increase in the stipend would make a world of change to them, and to their families back home where they live in the villages of Maharashtra. If they can go hungry for days altogether to fight for what they deserve, can't you just show up and extend your support? If and when the stipend increases, are you not going to accept your increased monthly salary? Are you going to refuse the increased stipend, like you're now refusing to show up and fight for this cause? Is it not your duty towards your classmates and friends to support them in their cause?

To the government officials - Well, I am sure none of them will be reading this, even if they are, I refuse to say anything to them. The strike should have spoken volumes, but since they haven't heard anything till now, I'm sure they're deaf.

To the media - Please, just don't ignore us. Don't write a tiny article hidden inside your newspaper just mentioning our strike somewhere.We are not asking you to support our cause blindly, but go ahead, do your research, dig out the facts, and after that, if and when you realize that we deserve what we're asking for, then you can help us by creating awareness and increasing political pressure.

The outcome of this strike will say a lot about this Government, and it will affect the state of health services in Maharashtra in the future, but more than that, more than anything else, the outcome of this strike will affect my faith and belief in my Nation and it's Democracy. Let's see where that goes from here.