Wednesday, October 17, 2007

Government General Hospital - I (Before the surgery)

Manjula is one of our employees. She is a teacher at a school AID India runs in Vembakkam block of Thiruvannamalai district, had to undergo an Open Heart Surgery (OHS). She is from a very poor family.We started enquiring about the charges, we got her cardiogram done,and showed it to Dr.Rex Sargunam, a doctor we knew. He referred us to the HOD of Cardio-Thoracic block of Government General Hospital(attached to Madras Medical College). He told us that it was a simple surgery and asked her to get admitted. At that time, we were told that normally patients have to wait for 2 months to get this surgery done,but since we were referred here by Dr.Rex, the HOD told us that this will be done in one month. We got her admitted around the 17th ofAugust. She was admitted, but once we entered the ward, we saw that many of the patients there did not have beds. They just had to buy a mat on their own and get a place somewhere on the floor. This surprised us. So we went to check when Manjula will get a bed. We were told, that we will get one as soon as one becomes empty. That too,after all those who were already on the floor before us, got the beds.With not much option she settled down on a spot on the floor. Then wewaited and waited. Nothing happened for almost 3 weeks. Forget thesurgery, there was no sign of getting a bed. Then Manjula was asked to take a test. Which she did. After that a couple of more tests. Again waiting. Then again no activity for 1 more week. So we went and met the HOD again around mid September, asking him when the surgery will be done. He said that before the end of october the surgery will definitely be done. We again waited.

All through these 4-5 weeks we kept visiting manjula almost once everyweek. We heard a lot of stories that she picked up from others. We were told that patients were waiting for 6-7 months to get their surgery done. She also once told us, how a single death, resulting from an unsuccessful operation, casts a gloom on the whole ward. We also once heard, that a lady fell off from her bed during the night and hence she died. Since then, the nurses there did not allow patients to sleep on the beds at night. She also told us, that the toilets had to be cleaned by patients themselevs since the ayahs there refused to do it. Apparently, they tell the patients that since they are the ones using the toilets, they should clean it themselves.

Normally a list is prepared for each day on which surgeries for this ward happens. The list is announced the day before the date of the surgery. The first date on which her name came on such a list was 5thSeptember. She was taken to a room outside the operation theatre,where she was asked to wait. We reached there before 8 AM. She was taken to the waiting room outside the theatre at 8.30. We were waiting. There we learnt a thing. Normally the number of patients listed for the surgery will be greater than the actual capacity. This is to ensure that just in case, a surgery cant be done to one patient due to change in their body parameters, then one of the waiting patients can be operated upon. Though this is a pretty good idea, it becomes very tough for patients who are taken to the theatre and brought back without doing the surgery. We can understand if this happens once or twice, but what if it happens 6-7 times. We learnt of a lady who had been to the theatre and back 7 times. Manjula herself had her 4th unsuccessful visit to the operation theatre on 19th October.Out of these 4 visits, on 3 occasions she was asked to get some medicines or some devices needed for the surgery. We are yet to investigate whether it is right on their part to ask us to buy medicines, since it is supposed to be free for the poor. But the doctor doesn’t write the medicines as a formal prescription. He writes them on small bits of paper (which are slightly bigger than stamps) and gives it to Manjula. The first time we spent about 1500 rupees. The second time 75 rupees and 1800 Rs for the third time. What we didn’t understand was, each time they were a different set of medicines or other devices. Assuming the ones that we were asked to buy the second and third time, what would they have done without these if the surgery had happened the first time itself.

Try to imagine this. Everytime she is called for the operation theatre she has to stay on empty stomach from 9 PM the night before (not even water should be consumed). She will be taken to the theatre at 8.30 AM and made to wait for 1.5-3 hours in a white cloth draped around,sitting along with 8-9 other patients. At the end of all this, she is asked to go back to the ward.

It has already been more than 2 months since she was admitted. And this is after, they telling us that it will happen quickly since we have a reference from Dr.Rex. The Madras Medical College claims that the Average Length of Stay was 10 days in 2004, 2005 and then reduced to 9days in 2006. (Source: On that page click on Hospital Statistics tab on the left hand side).

Of course there are other usual complaints of every low level employee asking for bribes at every possible chance. On Oct 17th, when we were waiting, while Manjula was waiting outside the operation theatre, we were talking to a lady whose husband had to undergo a surgery and was presently in the ICU. She expected them to move her husband to the post operative ward soon, but she was telling us, that she has paid Rs 500 to each of the ayahs and attenders there.Her husband has a textile company in Tiruppur. She told us, that they had to wait for 4 months, during which they lost their regular income.More than that, she had to shell out money at every turn. And she had to live in the GH along with her husband for 4 months.

We are mentioning the above meeting with the woman, only to tell you,that the time taken for Manjula is not an isolated case. Talk to anybody in the ward, or to anybody who has had his surgery done, and everybody would say that it would have taken a minimum of 2-3 months.In the face of this, the numbers given on the website is a lie. We understand that the numbers on the website is the average of all the patients in the hospital. But the scenario in this block is entirely different.

The hospital’s maintenance is also generally bad. You can always find waste dumped here and there. There are places which stink of urine, areas where cobwebs have not been cleared for months. And we were shocked to see that there are no dustbins in any of the floors. Those who come to the hospital to visit patients are forced either to leave the garbage (like used paper cups, plastic plates, covers, leftovers etc) in some corner, or throw them out of a window. People generally spit in all the corners and on the stairs. There are no spittoons available. No wash basins for people to wash their hands. But considering the fact that patients don’t get even beds to lie on, expecting all this is probably too much from the Government Hospital.

1 comment:

suneel said...

very much moved by your post
what can we do to avoid or prevent situations like this. its quite depressing to think : where the fault really lies,who is responsible for this?. are the people responsible for this or the government.instead of spending crores on developing int. tech parks, it corridors,try to improve basic facilities for common man, basic needs like proper medication, roads and sanitation facilities.the post depicts the scenario in a metro like chennai and its quite unimaginable to think off a situation in rural s and semiurbans
where r we heading to? it seems the world now a days needs only Information tech but nothing else
some part of the blame shud be taken by public too, v people never follow traffic rules or civic duties of a citizen, ex look at the post instead of craving for dustbins we can carry the scrap with us till we find a dustbin or wait until u reach home.may b v can think along these lines to improve civic sense among us and in fact it can make our country a better place if not the best