Speak up for better healthcare within hospitals #AbMontuBolega

Dr Roshan Radhakrishnan
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Over the last few months, we have all been watching a steady increase in the awareness of keeping our country clean. The Swachh Bharat campaign and the subsequent photo-ops by various ministers trying to out-do each other appeared on all our front pages, sadly in some cases, bringing the dirt with them to pour onto the streets. I really could write volumes on what I thought of such deliberate acts by ministers to be relevant but the truth is I do wish to talk on an aspect of our lives that desperately needs to be given priority as far as cleanliness is concerned.

I am referring to the state of hospitals in India. Look beyond the plush tertiary health care centres for a moment. The vast majority of patients (> 85 %) in this country do not have access – either financially or just geographically - to them, after all. India, by and large, walks into primary and secondary health care centres when they have a cold, fever, infection or pain. And it is this section which caters to the majority that I feel has been neglected for too long.

If you recall earlier in November 2014, a state-run hospital in Indore called in exterminators to deal with ‘an infestation’. Only this was no minor bug infestation as it turned out. In two days, over 4,000 rats and mice were killed. The pest and fumigation agency noted with shock that there were at least another 10,000 rodents in the hospital and it would take over a month to get rid of all of them.
This was one of the biggest government run hospitals in Madhya Pradesh and included a medical college. They looked after people of all ages, ranging from 1 day old to a hundred years old all within that single campus which HAS (the extermination is still underway as I type this) more rodents than you and I will ever see in our lives.

The sad part is that this is nothing new.
Image source: here
Maternity ward shifted outdoors due to construction work.
How is this okay in today's India?
Come into a packed government medical college out-patient department on any day of the week. What do you think you will see? Hundreds and hundreds of patients and their relatives, jostling for space to stand as they wait outside cramped corridors. 
There are people groaning in agony and sneezing and coughing all over one another, infecting everyone around them. General wards are usually overflowing, with patients sleeping on the floor after the beds are taken. 
Rats, cats, dogs, frogs, monkeys, snakes… these are all animals I have personally seen inside hospitals.

Cleaning the roads is fine… it is the first step towards fulfilling the ‘prevention is better than cure’ concept. But that concept is at least a decade away (optimistically)  from fruition. Till then, you need to be able to cure those who are ill without allowing them to share illnesses at the very place they come to be cured.

And it is not even a matter of mosquitoes and rodents anymore – even invisible bacteria like Staph aureus and P. aeruginosa are getting in on the act now. It is deeply concerning that in recent years, the lack of adequate hygienic facilities in Indian hospitals has facilitated the arrival of more anti-biotic resistant infections than ever before. This has resulted in longer stays at the hospital, more expensive forms of treatment, loss of not just work-hours but often the partial salary of the affected person and those looking after him as well. Even within ICUs – which are traditionally the most well-maintained and sterile areas in a hospital - the rate of nosocomial infection is now between 11 – 25%.

It is all going downhill and it is time to refocus our goals to arrest this apathy towards healthcare for ‘the mango people’ of the country. The #AbMontuBolega campaign launched by Strepsils (join them here on Facebook and Twitter) asks us to stand up and raise our voice and there is no time like the present to demand changes for the future of the country. You cannot continue to turn a blind eye to this anymore. 

You do not need to keep building new AIIMS centres all across India. You need to invest in the existing hospitals and upgrade their standards. Building these new hospitals will take years… the need of the hour is NOW. Lakhs of people walk into these centres today – you need to ensure that they walk out cured of the disease they came in, instead of adding the infections of the people they were standing next to in the queues.

Primary and secondary health care centres form the largest congregation of morbid people in India. You cannot ignore them. Take time out from inspiring people with statues that reach for the sky and invest money in maintaining the hundreds of hospitals that cater to 85% of India. When those who are ill get treated and return back to work, you automatically boost your chances of running the country more efficiently.

We need to ensure that hospitals do not settle into mediocrity and cut corners where hygiene and sanitation are concerned – Thousands are dying of nosocomial infections; these infections extend beyond the hospital gates to every one of us, even those who have not visited the hospital as a result of secondary contamination and carriers. Every life affected burdens an entire family and that in turn affects the society over a period of time. Improving health care in hospitals is as much a vital cog as cleaning the streets in the goal for a healthy nation. 

If you find yourself dissatisfied with the hygienic standards at hospitals you or your loved ones have been to, let your voice be heard. Do not accept it with a shrug of your shoulder. Forcing the government to invest in hospitals that exist and in turn ensuring that these hospitals raise their standards of health care is a critical step to winning the battle against dozens of transmittable diseases which even today literally cripple our transition from developing to a developed country. 

Or if you are actually okay with sharing your hospital beds with rats and your delivery rooms with cats, frogs and snakes, well... that's up to you.

Authors note:

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10Comments

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  1. Wow! Some of what you share is so mind-blowing like those thousands of rodents IN hospitals: that's pretty appalling! I've heard that if you want to get sick, go to a hospital as it is often more likely that you will end up with an infection of some sort (forget the common one though think it is different from what you mention). And a maternity ward being outside the hospital while construction is going on is downright ludicrous. I can't believe what you all deal with in India though I do believe your suggestion regarding focus is spot on. All the best to you working in hospitals/health centres and those facilities as well. :) And by the way, it makes me appreciate for our health care system and our relatively clean hospital conditions, so thanks for posting Roshan! :) <3

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    1. I agree.. it is really scary... using the excuse of poverty is one thing but the level of poor hygiene is downright insane considering we are opening up a living being and operating under such conditions. Its frightening to me as a doc to see how much apathy people have towards these poor conditions...

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  2. That is so spot on Rohan! I shudder to think what all you must see being on the 'inside'.

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    1. Trust me... there is so much any doc in India can tell you... it would make your blood curdle.

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  3. This is so so important....This is one of the reasons I'm scared of choosing a hospital...Most are unhygienic and those that are don't have good doctors, they only speak the language of money...I was in CMC Vellore this year with my parents... I think it is the best hospital in India in terms of everything....It was surprisingly clean too and not only the private wards....Docs were great too... The condition of hospitals you mention is something that needs to be dealt with utmost priority & urgency!

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    1. I agree.. CMC maintains top notch standards.
      And sadly, you never see any minister talk of upgrading the existing hospitals or making them better... its unbelievable that there were 14,000 rats in a single hospital and this is supposed to be one of the most famous ones in the state, apparently...

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  4. As someone who is seeing it from the inside, I am sure it must be heart breaking for you, Roshan. Let's hope something can be done with the Strepsils initiative.

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    1. I certainly wish more would be done at the ground level. The scary part is that most docs are now used to bad conditions... they accept it as normal.

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  5. Wow that was alarming news for people like us who at least like to believe that hospitals are clean ! I hope this campaign becomes successful and cleanliness and hygiene become a way of life rather than duty.

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    1. There is a big difference between the sanitary conditions in the hospitals abroad and here in general...

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