Hospitals to Die For

It is sometimes argued that the difference between being 'happy' or being 'sad' is really a physical difference and not physiological. If we are too hot, or too thirsty, or too cold, or too hungry, or sick, or with an injury, it is our 'physical body' which is suffering. Undoubtedly strength of mind can help minimise the extent to which we feel the pain, but if we are in good health then our sufferings are drastically minimized.

Since I have arrived in Kolkata every day produces more questions. My visits to Topsia Clinic was no exception. Likewise, when I walk through Sealdah train station to distribute 15 people lunch, I pass over bodies. Some mutilated with disease, others just mentally mutilated from a life of being 'Just Another Poor Man', or Woman, or Girl, or Boy, or Babu. Sealdah train station rose particular questions for me because it is right next to Nilratan Sarkar Medical College and Hospital; a state hospital. Yet people remained slumbered outside. And if medics or volunteers find someone near to death, they are transported to the Mother House rather than a few meters to the hospital. There are even cases where volunteers find patients in situations of severe neglect inside of the hospital and have had little choice but to carry them out and take them to Kalighat House where at least they are washed, feed and watered. Strange?

And what of the Mother House dispensary at the entrance to the train station which provides basic first aid and bandaging to the poor when the poverty stricken should receive medical care at radically reduced rates from the state government? And what of food rations available for those unable to provide for themselves? And what of free hospital beds for those who need operations? And why the need for Topsia Clinic if there are locals doctor? The State of West Bengal has after all been governed by the Communist Party of India for the past thirty years and one would think that there would be some sort of social safety net for the ill, injured, disabled, single mothers, child mothers, refugees or those still chastised by the remnants of the caste system? The answers my friend? Complicated.

I quizzed the Nurse. I received irate replies. The Nurse spoke passionately and with conviction and left me with little doubt that he is filling a gap out of necessity rather than charity. The doctors he replied are expensive. For the anonymous poor, destitute, refugees, mentally challenged or orphaned, finding the correct paperwork to receive their Right to medical care is not always an option. Without either papers or payment patients are refused treatment. And if they are able to find the papers, bribes might be necessary or waiting lists longer than remaining life energy. Besides, health care is still not free. In the government hospitals there is a ration of free beds, but a diagnosis and operation still needs to be paid for – even if at a radically reduced rate. For the poor, this means that they often wait until they are severely sick before trying to borrow or beg the required money. A blood test costs 30 rupees, which is the equivalent of about 35 British pence, 44 Euro cents, or 70 US cents. 30 rupees could easily feed a poor person for a day.

In regards to the local doctors, the Nurse argued that diagnosis's are given at a distance, and hands-on care is rare. Although many of the doctors have received their full medical training they haven't been able to pay for the final exam. Ironically this is a blessing for the poor who can't afford to go private, as once certified many Indian doctors are either working in private hospitals or overseas, where the conditions are much less challenging. The 'brain drain' is flowing quicker than the education system can refill. As for the hospitals, “corrupt and inefficient” seems to be the general reply when I ask the opinions of locals or medics working here. Patients are often turned away, or must bribe there way in and then once there, although the operations themselves are viewed as sound, there are long waiting lists, piles of paperwork to negotiate your way through, and a shocking lack of basic sanitary care.

Today I accompanied a long term volunteer on a visit two hospitals. This volunteer gave me a blessed icon of 'The Other Mother', is training to be a priest and streaked through the Mother House after Mass the day before yesterday. He is 200 percent committed, equally spontaneous and entirely unconventional. With such a combination he achieves some formidable results. Like the French volunteer I was lucky enough to meet on my first day, it was a privilege to walk next to him. Today helped me to answer many of my practical questions which were still left unanswered. He spoke of carrying a dying man into hospitals to be told the correct paperwork was missing. His response was to find a random stamp, provide a signature and with the appropriate amount the self-confidence return the 'completed' paperwork and have the patient admitted just in time to have save his life. Today I saw that food and drinking water is not provided. Washing sheets, clothes and patients is the role of the family. So what if the patient's family is poor, or far away or does not exist? It should not be presumed that the nurses will clean and dress wounds, and today I saw a young man cleaning his crushed leg with a bottle of savlon. I changed the bedsheets of a man with no family, and Mr Unconventional distributed food and a little money to the select individuals he had helped to help by finding/ buying them a 'free' bed and sponsoring their treatment.

Visiting the hospitals today helped me to understand the demand for free alternatives, and how ventures such as Topsia Clinic are essential for helping the local community to maintain a basic threshold of health care. The denial of essential aftercare and hygiene explained the massive number of post-operation infections which these clinics have to deal with, and which could easily cause repeat infection, amputation or fatality. Once again the conundrum is – how can the health care system be improved if there are non-state ran “free” alternatives, which are preferential in that at least they provide 'care' if not 'medical' care?

More information on the conditions of government hospitals in Kolkata has been complied by the Bengali Human Rights Group People for Better Treatment Prepare to be shocked.