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Safdarjung Hospital, New Delhi

By Naren Karunakaran

Nanhe Singh of Sheikhpura village near Bulandshahr in Uttar Pradesh has cancer of the pharynx. He has been undergoing radiation therapy at Safdarjung Hospital. A marginal farmer with just four bighas of land, Nanhe visits the hospital for sessions of radiation therapy. There is no facility for cancer treatment anywhere near his town.

Nanhe has no one in Delhi to stay with and cannot afford private lodging. He wasn't lucky enough to get a bed at the hospital dharamshala and therefore spends his nights under a tree on the grounds of the hospital in the biting 4-5 degrees Celsius Delhi winter. "I came prepared," he says, patting his sack stuffed with a quilt.

Didn't someone accompany him to Delhi ? "I make do with Rs 15 or so everyday for food, which I eat at the dhaba outside the hospital. An attendant will mean more expenses. We cannot afford it," says Nanhe. Both his sons are farm labourers and their earnings of Rs 50 a day (each) provide for the large family. They get work only in the harvest season.

***

Abdul's is a harrowing tale of neglect. A fruit vendor at Nizamuddin Station in Delhi , Abdul was travelling home to Bharaich on the Kalinga Utkal Express on November 12, 2004 . He lost his balance and only saved himself from falling off the train by hanging onto a railing. In the process he hit his legs against a girder and fractured both lower limbs. It was around 2 pm .

At the next station, Abdul was taken off the train and carried to the general hospital in Palwal, a small Haryana town. "I was in terrible pain and couldn't move my legs. At the hospital, they supported my limbs with wooden strips/bandages and gave me an injection, perhaps a painkiller, which didn't have much effect," he recalls.

The Palwal general hospital was not equipped to handle a fracture of that nature. It was suggested that the next best option would be to move him to the government hospital in Faridabad . An ambulance had to be arranged. "The hospital attendants reached into my pocket, in the presence of the doctor, and removed Rs 250. They claimed it was towards ambulance charges," he says.

By the time Abdul reached the government-run BK Hospital in Faridabad , it was around 10 pm . There was no one to attend to him and he insists no doctor even examined him. He lay there unattended for a long time; then he started howling for water and attention. After much deliberation by hospital staff, it was decided that there was little they could do for him and that he should be shifted to Safdarjung Hospital in Delhi .

Again the question of hiring an ambulance came up. Charges would be Rs 350, he was told. Abdul had no money on him but promised he would borrow from relatives and pay up as soon as he reached Delhi . The hospital would have none of it and he was forced to plead with private ambulance operators, who subsequently extracted Rs 650 from him.

It was past midnight when he reached Safdarjung Hospital and medical attention, a full 10 hours after the accident. Abdul was operated on, on November 14; he stayed on till the 29th. He then went back to his village and returned to the hospital on December 17 as advised.

But the hospital refused to admit him. Instead, they banished him to the dharamshala . "My condition has only worsened after coming here. I am made to go around in circles to dress my wounds. Infection has set in and, worse, the antibiotic drug (cefuroxine) prescribed to control the infection is not issued to me. The supply is erratic, forcing me to buy it from the market," says Abdul.

He brandishes the day's newspaper as he goes on about the appalling neglect and indignity he has had to suffer. The newspaper carries a news item about the organised racket unearthed at Safdarjung's sister hospital, the All India Institute of Medical Sciences (AIIMS). Three employees of the hospital, including the chief pharmacist, have been arrested for siphoning off life-saving hospital drugs worth lakhs to private dispensaries!

Abdul is worried. "Will I ever recover? Can I walk again?" he asks. He has been told to vacate the dharamshala by the end of the month. He has no clue what he will do then.

***

Debilitating asthma and painful spasms prevented Mohammed Fayaz Khan, 60, from labouring in his small workshop in Agra , an inheritance from his forebears, all leather craftsmen. Flagging business, and the need to support his family, forced him to down shutters a few years ago.

The only job he could get was that of a parking lot attendant at a cinema hall. "My daily earning of Rs 30 keeps the family from going hungry," says Fayaz.

A sizeable portion of his earnings goes towards buying medication. "Every time we visit a doctor, a private practitioner close to our house in Naik Mandi, we spend over Rs 15-20. We cannot afford this, but we have no choice," says Shahnaz Banoo, Fayaz's wife.

Last year, Fayaz's condition got worse. He had constant irritation in the throat, trouble swallowing and no appetite. The neighbourhood doctor suspected cancer of the pharynx. A biopsy would cost around Rs 1,200.

"We didn't have the money and therefore kept delaying the tests," says Shahnaz. Agra has six government-run hospitals including three specialty facilities. But the couple never considered visiting them, convinced they would receive no attention without sifarish , or patronage. Some well-meaning relatives suggested they head for Safdarjung Hospital in New Delhi.

In May 2004, a sceptical Fayaz made it to Safdarjung Hospital . He was admitted for three days, and a biopsy was done. The hospital bore all the expenses, except for injectible drugs, which cost him Rs 350. On returning to Agra , he had to spend considerable amounts on the drugs prescribed. "We had to dip into our small savings, set aside for our daughter's wedding," says Shahnaz.

Fayaz is now back at Safdarjung Hospital . The couple are camping at the hospital's dharamshala while Fayaz undergoes radiation therapy. This short-term residential facility for patients from outside the city is free. Patients are also provided weekly provisions for meals. "We are quite happy with the turn of events," says Fayaz.

-- Naren Karunakaran

(Naren Karunakaran is a journalist based in New Delhi. Contact: This email address is being protected from spambots. You need JavaScript enabled to view it. )

Calcutta Medical College and Hospital

The Kolkata newspapers regularly carry stories of babies being found in garbage bins, of seriously ill patients dying because the electricity went off in the intensive care unit for hours on end. While there have been arguments that such stories are motivated and based on careless research, to visit a public hospital in this city is to witness despair.

In the weary crowd at the HIV department of the Calcutta Medical College and Hospital, a premier government institution, Shanti Yadav's piercing, kohl-rimmed eyes stand out. “For the last four years my husband has been very sick, in and out of hospitals. I have spent thousands of rupees to save him. Hospitals, medicines, tests, hospitals. Now I am reduced to being a servant in people's homes to take care of my daughter. If it weren't for her I would have gone mad.” Shanti, 32, keeps a watchful eye on her husband Kamal who is barely able to sit up on the bench because of his incessant wheezing.

The Calcutta Medical College in central Kolkata is the oldest in South East Asia , built in 1835. It is a teaching hospital; its maternity ward,  Eden Hospital , was once one of the best and had the highest number of deliveries. Its maternity management was cited by doctors all over the country as the “ Eden Hospital protocol”.

Four years ago, Kamal, a taxi driver, fell ill with high fever and nausea. He was admitted for tests to a well-known private hospital run by a religious trust. Shanti was confident about the hospital because she had delivered her daughter there. After 10 days and numerous tests Kamal was released undiagnosed. He was re-admitted to the same hospital after a few months when he almost collapsed; this time the doctors diagnosed tuberculosis and jaundice and began treatment.

For a few months, Kamal felt better and resumed driving his taxi for a few hours every day. By then Shanti had sold off her jewellery and brass utensils to pay Rs 70,000 for her husband's hospitalisation, medical tests and medicines, besides the household expenses.

A year ago, Kamal was very sick. This time Shanti's brother, also a taxi driver, told Kamal to visit Medical College 's HIV department. He knew about the disease because his friend's illness had gone undetected for years till the blood test proved him positive. Tests proved that Kamal had full-blown AIDS.

Today, Shanti works as a maid in three houses and earns Rs 1,200 a month. She brings her husband to the hospital each time his condition worsens, or to consult a doctor for his fever and diarrhoea. She is grateful that the doctors finally succeeded in diagnosing her husband's illness and that she had to spend only Rs 1,000 for his medical tests. But she is disgusted at the behaviour of the staff. “They are unhelpful and rude. I wonder if they are human beings at all.”

-- Rajashri Dasgupta

(Rajashri Dasgupta is a freelance journalist working on gender, health and development issues. Contact: This email address is being protected from spambots. You need JavaScript enabled to view it. )

InfoChange News & Features, June 2005