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Yesterday was revelation day. I met an old friend. Dr Suresh graduated from the same medical school as me. When I was a student, I was always envious of people like Suresh: his father ran a busy practice in his village and when Suresh completed medicine he would naturally join and later on fully take over daddy’s clinic. For students like us future was always uncertain and Sureshs and Rameshs who were doctors’ children left few opportunities of pointing this difference.


Things turned out a little different I guess. We sat together for dinner last night and I realized what medical practice is like in rural India. Suresh had a clinic in the village where he worked between 10 AM and 8 PM. He could walk home for lunch and coffee breaks etc., but only when he had no patients. There was no appointment system which meant whether or not there were patients he would have to sit in the clinic throughout the day. On an average he saw about 20 patients from within his village and the surrounding ones. I thought that was a good deal, till I heard how much he charged. He would charge each patient between 10 and 20 rupees! Some of the cab drivers in Bangalore earn more than that! But then, if he charges more, the patient will never return.


What about lab tests? What about pharmacy? Are these available nearby?


In the village clinic, Suresh explained, asking for a lab test is not practical because there is no lab in the vicinity. Also, the patient never had the money for the tests. If you advice a lab test, the patient simply moved to a different doctor. This means that practically all diseases are diagnosed presumptively and we all know how flimsy and dangerous such practice can be.


As far as the pharmacy is concerned, Suresh explained that he cannot prescribe medicines most of the time for two reasons: prescription medicines are costly and patients will not buy them. So, for the same fees that Suresh has collected, he is expected to dispense cheap, generic drugs to patients!


The other practical problem is if one patient in a family gets a prescription for, let’s say cough and cold, that prescription is never thrown away: anyone in that family has cough and cold next time, the same prescription is followed. Loss of revenue for the doctor! And if a child falls ill, half or one-fourth of the dose is administered out of the same prescription: can be dangerous too!


Medical practice in rural setting in India doesn’t seem as romantic and adventurous as James Herriot’s veterinary practice; or as humorous as Richard Gordon’s experiences amongst humans. Lack of doctors, paramedics, medicines, facility for safe surgery and child-birth, awareness of preventive healthcare all pose a humongous problem. Villagers, both patients and doctors seem to get a raw deal because of poor infrastructure, while plush corporate hospitals in the metros are trying to attract medical tourism.


Yet another irony of independent India!






security1After the chilling incidents in Mumbai during the last few days, we are all ‘limping’ back to normalcy. Meaning, we are now turning away from page One to the sports columns and page 3s faster than the last couple of days. For a change, ‘important’ heads have already rolled or on the block this time, but honestly the pessimists amongst us do not expect major changes except that after all the political chess moves, I think finally India will be under lot of pressure, ironically!


Which is not the point of the blog: this is about two incidents that left me with no doubts that we are a nation of fools.


Incident One: My boss went to a very reputed scientific organization in Bangalore on Friday to give a lecture on how to prevent heart diseases. The august audience consisted of some of their top scientists. This organization was recently in the news for carrying out successfully a very prestigious mission, thus enabling India to join an exclusive club of nations who have carried out similar feat.


On reaching the gate in his private car, my boss’ driver lowered the glass and the security guard peeped inside and asked the driver who deing driven. He was told that so-and-so doctor from such-and-such hospital was there to deliver a lecture. The guard must have had this info earlier and must have been expecting the good doctor, who incidentally is very reputed. But still, no identification papers were asked for and the car was allowed to pass without even a symbolic security check of the boot and the undercarriage!


The doctor was then accompanied by some scientists to the director’s office. The director was very courteous and they both had coffee together. All this while my boss was carrying his laptop which remained unchecked. Later on when he finished off the lecture at a hall below, my boss suddenly remembered that another leather bag which he had carried was accidentally left behind in the director’s office and it remained there during the entire time of the lecture!


I shudder to imagine the security consequences if at all this visitor were a turncoat or someone in disguise or simply a different guy. And this monumental negligence was on Friday when we were still fighting the terrorists holed up in the hotels.


Incident Two: I drove to a reputed hospital in town to visit a sick relative admitted there on Sunday. The security guy handed me a parking ticket and waved me in. I asked if there is going to be any security check. The guy’s face was blank and I instantly realized two things: one, there is going to be no increase in security at many such places. Two, it struck me that this security guard was probably not even aware of what had happened in Mumbai, and why I had asked him if there was going to be a security check of the car!


Just after such an attack on my motherland, half of us don’t seem to care and the other half is not even aware. Do we still expect 26/11 to bring about a change in our attitude? Forget about it..