Vibrations

A 30-year-old lady was brought to us with a “Bilateral hemiplegia”. She had a hysterectomy and appendectomy, done a week prior to this, at a private nursing home. She was running some fever prior to the same, and had completed her family. It was told to them that she needs these surgeries urgently! A week later she ended up with bilateral hemiplegia which turned out to be a Sagittal Sinus Thrombosis. She was anaemic and in severe sepsis. An unwanted surgery done which led to her cortical veins getting thrombosed.

Majority of the women who come to our OPD above the age of 30 do not have a uterus.  Hysterectomy is the mode of current day contraception. When asked about contraception, they will say, bada operation ho gaya. For what? Bacha bandh karnekeliye….For contraception! Changing medical protocols in a part of our nation, when rest of the country is talking about health tourism!

Cortical vein thrombosis which is supposed to be an uncommon disease is quite frequently seen in our centre. Most of these are in women, who have had home deliveries and coming in with seizures and  various neurological deficits in the context of anaemia. Pregnant mothers with anaemia, Hb of 3 and 4 gm/dl is not as uncommon feature in the location where we are…

Recently one of our friends from a nearby health centre send this text “R, this place is horribly poor. The rich are very rich. The poor are dirt poor. I do regular village clinics now. And the fact remains that communities are so so poor. The only succour they have is alcohol which all the more pulls them down. Last 3 years, the drought has been so bad. This year it has rained. But, we don't expect much to change as the poor are landless. Those who are a bit smart emigrate for work. But, that is unskilled work. Yesterday, I was in K. With a registration charge of 10 rs, I saw 270 patients. 70℅ women were severely anaemic. More than 90℅ children more than Grade 2 malnourished. And 95% of men smell alcohol. Feel so so helpless . . .”  Part of our nation, news which would never reach the Delhi based media…because there is no news worthiness for these….

A recent study done in our centre over four months revealed some interesting information. Of 2096 deliveries there were 2000 Live births and 162 Maternal Near misses (MNM)! For every 12.3 live births, there was 1 MNM. Maternal Near Misses is defined in Wikipedia as “an event in which a pregnant woman comes close to maternal death, but does not die – a "near-miss". Traditionally, the analysis of maternal deaths has been the criteria of choice for evaluating women's health and the quality of obstetric care. Due to the success of modern medicine such deaths have become very rare.” Rare where…not in the locations where some of us are. And evaluating the cause of the MNM, it is interesting to note that there were many who needed high end critical care interventions and these lives were saved because they reached in time. For every patient who reaches an institution, how many might be there who have not been able to? How many misses might have happened in the villages? This is anyone’s guess!

Recently our nation celebrated elimination of “Maternal and neonatal tetanus”. Yes, these hasve become  diseased which is no more a public health problem, but what about the few who still get the same. A four months reporting from our center reveals this data. Cholera, Leprosy, Tetanus, Encephalitis still continuing to be issues affecting families. Can we celebrate when people are still dying?

Yet another information – over last few years we have been seeing increasing number of people presenting with attempted suicides. The data given is couple of years old. The numbers are only increasing over last two years. Children as young as 6 and 7, elderly as old as 70s present with attempted suicides. Majority of those who present being in their late teens and early 20s. Reasons being “family conflict”.

Here is a story which is given as it was told to the informant, in the words of the person who told us the same. One stray incident or one of many such? Child trafficking seems to be the latest way of earning a quick buck in these locations. Many families who come tell us – “bacha chalegaya, koi khabar nahi hei”…(actually “le gaya…”)

Why am I writing all these, a common knowledge to our friends who work with us?

Few years back a friend told me “Being wise as serpents and gentle as doves” means – like the serpent, listen to the vibrations from the ground and be wise how you respond to the same, and like the dove, have a bird’s eye perspective of the situation and gently reflect what can be done…

Here are some vibrations from the ground, awaiting some reflective responses from….? Or as the powers that be desire - shall we close our ears to these stories, since it does not fit into the image we want to portray....