Sunday 6 January 2013

SORRY STORY OF HEALTH SYSTEM

A few days ago, a watchman at my apartment community in Mysore consulted me on his son's illness. He wanted me to refer him to a good physician. I immediately told him to to go to a doctor I know in the government-run K R Hospital. He did not appear convinced, and politely asked me if I knew any doctor in the private sector. My assurances that the government hospital was as good or better than many private hospitals did not seem to impress him.
This is not an isolated instance, I'm sure. Most of us today have lost faith in public systems - whether schools or hospitals. We are convinced that we cannot expect 'quality' in the government system and that 'private' always means better. But is this always true? By way of answering that, let me narrate a few incidents that left me convinced that we not only need an efficient public delivery system, but in the Indian context, they serve a valuable societal function as well.
Dinesh (name changed) was a young 20-year-old living with his parents, brother and sister in Mysore. Coming from a poor family, he had no choice but to discontinue his studies after completing his pre-university course, and found work as a waiter in a hotel to support his family. One day, while traveling with two of his friends on a two-wheeler, he unfortunately met with a accident. He had not been wearing a helmet, and suffered a severe head injury; his skull was damaged and badly fractured.
He was admitted to a private hospital in Mysore, and was kept there for more than two months. After getting his family to spend more than Rs. 8 lakhs, the hospital authorities informed them that the treatment was still incomplete and that they would need another 1.5 lakhs to continue attending to him. The poor family felt cheated, angry, let down and helpless. Not only did they not have the money, but they had also not received the complete and appropriate treatment.
The family turned to everyone for help and the CM's Relief fund granted them Rs.30,000. The hospital, however, was adamant that no treatment could be initiated with partial payment, and insisted on receiving the full amount before restarting their services. A local NGO provided palliative care to Dinesh who was by now bed-ridden and at home. As his condition worsened, the family took him to a teaching hospital locally, where they were advised that he would not live more than a few weeks.
Dinesh died in October this year, a victim of poverty, callous attitude of medical personnel and the indifference of a heartless private health care system that is not regulated, nor held accountable for delivering quality care.
Raghu (name changed) a 32-year-old poor farmer had an altogether different experience. He had fallen from his bullock cart in his village in Mysore district and suffered a spinal injury. He was bed-ridden for three years and was also receiving palliative care from the same NGO that helped Dinesh. A year ago, the staff of the NGO noticed that he was developing very deep bedsores, and they took him to K R Hospital. The nursing and medical staff at the KR Hospital provided full support and took care of this patient with compassion and with no expectation of any 'out of pocket' fees.
Having worked in the Lokayukta investigating complaints of corruption and mal-administration in the Government health care system, I did not believe that this could be possible. I decided to dig deeper, and understand what was happening. I realized, pleasantly, that the patient had been in the hospital for the past seven months, and had four surgeries in that time. The doctors felt that he would fully recover after one more surgery. Most of his sores had healed after the plastic surgery that was done on him. The NGO had trained his wife in making small handicraft articles and the hospital authorities did not mind her preparing them beside the bed of her husband itself.
Raghu is now more confident that he can return home fully recovered from his sores, and the rehabilitation therapy that he is now getting will make his life more livable. All this would not have been possible without the constant support, treatment and compassion that he and his family have been receiving from all the staff at this government-run hospital.
There are other examples. Many years ago, I had referred an eight-year-old tribal child with a treatable heart condition to a famous private hospital in Bangalore. They were claiming to offer free heart surgerirs to poor and deserving children. Hopeful of getting high quality care at no cost, I sent this child to this hospital. Sadly, they sent the child back to the tribal hamlet without any surgery, and I never really learned why. All I know is that this child died untreated a couple of months later.
Last year, the field staff of Swami Vivekananda Youth Movement (SVYM), identified six tribal children who needed surgery to correct their heart anomalies. Having been bitten once, I decided that I needed to explore other equally good and cheaper options. I spoke to Dr Manjunath, the Director of the Jayadeva Institute of Cardiology. He asked me to send these children to his center at Bangalore. Within 10 days all these children were back after receiving the highest possible care and not a single rupee had been spent.
One only needs to visit this hospital at Bangalore to be convinced that it is no different from any of the other private hospitals offering similar services. Only difference is that it is very affordable and even free for poor and derserving patients. This hospital in my view is truly a 'heart hospital with a heart in the right place'. It is such hospitals that lend credibility to Government hospitals across the state, and one must recognize the silent work that they do for the millions of poor who approach them for care.
I am not claiming that all government hospitals are good, or that they meet the required standards of care. Nor am I saying that all private hospitals are bad or heartless. I am sure that there are good government and private hospitals across the state as much as there are poorly run hospitals in both these sectors. What I am trying to point out is that we cannot carry a stereotypical impression that all government hospitals do not deliver quality care as much as private hospitals are providing it.
This is important because often it is the public's perception - and not the facts - about quality of care in government hospitals that leads them to choose private care. Surveys show that in Karnataka, more than 80 per cent of the health infrastructure is in the public sector, but only 34 per cent of the patients use them. This gross under-utilisation of public facilities needs attention.
At the same time, there is also the mirror problem - how can private hospitals, with a mere 20 per cent of the total health infrastructure in the state, cater to 66 per cent of the state's population?
Government-run institutions hire and appoint only qualified personnel, unlike the private sector where personnel need not be appropriately qualified. There are several nursing homes that run with nursing and labarotory personnel not having the requied qualifications. Merely wearing a white saree or an apron does not bestow the required qualification!
Very few private hospitals have a rational and well defined pricing policy. Many of them do not provide and disclose information about the services that they are expected to render to patients. Most patients are not aware of their rights and very few of them demand to know all this. Despite the enactment of the Karnataka Private Medical Establishments Act in 2009, there is no regulation of cost or enforcement of quality in many of these private hospitals.
People need to understand that quality is not always directly proportional to the money we spend. As Dr Noshir Antia, the famous doctor remarked, "Things expensive, need not necessarily mean the best." Patients have their rights, and they need to be more discerning and empowered with the information that can help them make the right and appropriate choices.
The government, which is also supposed to play the role of the regulator, sees its function as merely registering these establishments and collecting the required fees. This means many private hospitals get away with poor and unethical practices, and charge exorbitant sums of money for services that need not cost so much. This severely restricts access to the middle class and the poor who have no recourse but to seek out government faciltiies.
The opposite is also true. Many government facilities that do not meet the standards prescribed for them are nonetheless allowed to go scot free, because the government applies different standards of enforcement to its own institutions, compared to private ones. An honest regulator, however, must hold both the public and private sector to the same standards.
We need a government that not only ensures that standards in the private sector are followed, but also enforces them on its own hospitals. This will help build faith among the public in the government health care system. Only when the government walks this talk can it demand accountability and performance from the poorly regulated private health sector too. And only then will the interests of the patient be protected.

Thursday 10 May 2012

STEEl FRAME OF IAS IS ON RUST IN CHHATTISGARH


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 STEEl FRAME OF IAS IS ON RUST IN CHHATTISGARH
In  the early days IAS is considered as the steel frame of the Indian constitution but cloely observing the case of abduction Alex Paul Menon it seems the steel in the frame has started getting rust. Because collectors or District Magistrete  used to protect the poorest of the poor and downtrodden of the specific district he is posted on, but on chhattisgarh the locals and villagers are fighting to protect the collector inturn situation cleary indicates the state government must do something to re-established the steel frame. It was a time when the cops were running after the naxalites and now they are keen to get the release order. The story of abduction Alex paul Menon is so much complicated yet as a political party Bhartiya Janta Party has got new equation which would be very profitable for mission 2013. Although Government has failed to gain new stage or to establish a new principle.Few men said after the realising of naxals or the softcorner of the government towards naxal front would ink the face of Government. Actually after great effort intelligance catched the hardcore Naxal and after put them behind the bar. In new circumstances suprem court granted Nayan Sanyal bail and he will be free soon. According police FIR Mr. Narayan Sanyal is a hardcore Naxali and he was the mastermind of the jahanabad jail break accident. Now Meena choudhy has moved her bail petion on the High court. Police officers consider that she watered the urban network of the Naxals. Now time has changed. Police Officers are engaged these days to shortout the tribes men who are still in jail an alliged roll. There is new story arises before the police officers. The story has new line- who were cetched by the police now government is ready to free them. possiblly it is not the fare game. State has a complicated charector and the body of government is feeling so much tirdness. Although as a political party  the packet of BJP will remain in profit. At least freemen will become his admirer.
 

Tuesday 10 April 2012

Friday 3 February 2012

BASTAR

SEEING THE CRUCIAL SITUATION OF BASTAR, NOW I AM GOING TO ASK ONE QUESTION- WHO SHOULD BE ACCOUNTABLE ? THE TRP RATE OF BASTAR IS VERY HIGH. EVERY JOURNALIST WANTS TO WRITE ABOUT THE BASTAR. THE LIFE STYLE , NAXAL PROBLEMS AND FOLK-DANCE OF BASTAR HAVE MORE SPACE IN THE NATIONAL MEDIA. BUT THE PROBLEM OF BASTAR IS AS IT IS. WHY? CAN YOU GIVE AN ANSWER THIS - WHY? BASTAR IS VERY RICH  IN  MANY ASPECT . TODAY I AM IN BASTAR BUT I AM NOT ABLE TO SEE THE REAL BASTAR .

Wednesday 28 December 2011

HAPPY NEW YEAR 2012

HAI.. EVERYBODY.... AND CONGRATULATION   FOR THE NEW YEAR 2012. NOW I THINK AS HUMAN BEING WE ARE THE PART OF NATURE AND NATURE CONTROLS  US. I AM HEAR WITH THE CONSENT OF THE NATURE. 
 NATURE PLAYS THE GREAT ROLL..... MY ONE FRIEND RAY WRITES ABOUT SO MUCH ABOUT THE MERITS OF CRY. IT IS ALSO THE GIFT OF NATURE. I DO NOT THINK SO MUCH  ABOUT THE BLACK AND WHITE . I THINK WHAT IS GOING ON....... AND MY CONDUCT IS CLEAR. IT IS THE ARTIFICIAL QUESTION WHAT SHOULD BE... ACTUALLY TO BE OR  NOT TO BE THE THE QUESTION
                                          

Monday 14 November 2011

IS IT RIGHT

BEING A JOURNALIST  I HAVE LITTLE UNDERSTANDING ABOUT THE JOURNALISM. I CAN WRITE ABOUT BAD THING AND PROVE SOMEONE IS WRONG. BUT I DO NOT KNOW ABOUT MYSELF. ACTUALLY LIFE IS THE SERIES OF COMPROMISES . NOW OUR COUNTRY  IS FACING SO MUCH PROBLEMS . JUST LIKE  NAXAL...OR  ULTRA VIOLENCE . IT IS SAID THEY ARE DOING GOOD THING IN WRONG WAY BUT I DO NOT  FOLLOW THAT VIEW. THEY BOMEDOWN INNOCENT PEOPLE.

Sunday 6 November 2011

AROUND FLORA AND FAUNA

 A RICH FLORA AND FAUNA IS THE SIGN OF PROSPERTY OF A COUNTRY.DESPITE THE FACT  THAT FOREST IS NECESRARY FOR THE LONGLASTING JOY OF LIFE ONE CAN OPT FOR DWELLING  IN FOREST. 
  SO  SAID THAT  IT IS A PROBLEM TO MAKE THE FOREST A STAY WHILE SOMETIMES FOREST ITSELF IS A PROBLEM. NOW IT IS NO MORE SYMBOL OF SCARCITY AND LONELINESS. NOW IT HAS BEEN TURNED TO BE LAVISH. PEOPLE ENJOY. PROBABLY THE FOREST DWELLERS IN SOME CASES MAY BE SAID TO BE RICH BUT SINCE THEIR REQUIREMENTS ARE LIMITED, THEY DO NOT LOOK TO BE A RICH MAN. SUDDENLY ONE DAY I FOUND MYSELF AMIDST FALORA  AND FANA. AND I FOUND THE CONFLICT BETWEEN HAVES AND HAVES NOT.  I FOUND THE FREEDOM IS EVERYWHERE AND VERY NATURAL AND LIFE IS PEACEFUL AND FULL OF PASSION ALL AROUND ME . NEVER FOUND IN THE URBAN SOCIETY . MOST OF THE TRIBES ARE NOT ACQUAINTED TO THE GLAMOUR OF THE CITY LIFE BUT THEIR HEARTS ARE VERY PURE ...NEVER THINK OF HARMING ANYBODY AS ALWAYS SEEN IN THE CITY LIFE.  THE FOREST MAY SAID TO BE SYNONYM  TO MINES , THE EXPLORATION , EXCAVATION CONSTANTLY BRING PROSPERITY FOLLOWED BY URBAN LIFE, INSIDE THE DENSE FOREST. FOR AT LEAST THE ALMIGHTY THERE IS NO DIFFERENCE BETWEEN THE HAVES AND HAVES NOT. THE FOREST CHILDREN OUT OF THE LIMITED FACILITIES IN THE AREA ADJACENT TO THE FOREST. ARE NOT SURE TO ACQUIRE A GOOD JOB OR PEACEFUL FAMILY  LIFE, EVERYTHING IS COSTLY. THE RURAL CHILDREN ARE DESIROUS TO GO AHEAD , TO FLY HIGH , TO SATISFY THEIR NEEDS, THE VERY SAME WAY THE BABY OF RICH PEOPLE GET . WHAT IS THE FAULT OF THE RURAL CHILDREN? IN FACT , THE MODERN WORLD  NOT FIT FOR THE CHILDREN LONGING FOR EVERYTHING. THE POOR CHILDREN NEED NOT BE BORN IN THIS LAND . WE HAVE  THOUGHT THE ALMIGHTY AS MAN BUT THE STARVING  CHILDREN ARE SCARED OF THE ALMIGHTY. THE ALMIGHTY MUST AS GENEROUS AS WOMAN.
     THE CITY PEOPLE  ARE SO MUCH FADE-UP WITH THE SELFISH LIFE THAT EVERY ADMINISTRATION IS THINKING  ON DEVELOPING URBAN FORESTRY . THE EXAMPLE CAN BE SEEN IN EVERY BIG HOUSE ,CARRYING LANDSCAPE OF FLORA AND FAUNA.