Why make a business out of everything?

Cartoon Credits: Teresa Burns Parkhurst for Reader’s Digest

Medical treatments in India can be a nightmare.

One doesn’t see the gravity of a situation until it affects them personally. Such is the case of medical treatments in India, a country of a billion plus people where an inclusive public healthcare is a dire necessity, yet does not exist. The National Family Health Survey-3 (2005–06) states that the private medical sector is the primary source of health care in urban areas at 70% and 63% in rural areas. The latest survey (2015–16) does not provide any specific information on this trend. Where the medical business is flourishing under no regulated watch, people are being looted out of sheer necessity and often helplessness.

The past few months have taught me this, and not in a very upbeat way.

The saturating point was when a Kenyan man, temporarily renting a place in my family’s community in Delhi and undergoing treatment for blood cancer in a self acclaimed ‘multi specialty and state of the art’ hospital next to our community, died within the hospital premises last week. The cause of the death remains inconclusive but some doctors who were on the patient’s case claim that although his cancer treatment was working, he had contracted an infection and died because of it. And even before the Kenyan family could revoke their right to information, the hospital authorities informed that the family could not retrieve back the body of their loved one before they had compensated the hospital of all the subsequent costs.

Compensation is such an ironical word. The letters of this word dance at the fingertips of those who hold power, those believe that they can use it at their willy-nilly to give it or to receive. To eventually ward off an any inconvenience for themselves.

The Kenyans were a middle class family who had collected an appropriate amount of money through their friends and family, to travel to India and manage the medical and other (housing, food, etc.) expenses in this foreign country. For the parents of the son, the wife and his kids unfortunately, they could not find better treatment for blood cancer in Kenya and thus, traveled all the way to India to make the middle aged man, battling with cancer, survive.

Unfortunately for his family, he succumbed to death. Their hopes of reviving him at any cost could could not survive. The hospital had made sure the family knew what ‘at any cost’ meant for them. The family had already paid over 34 lac INR (Indian rupees) for the treatment and were trying to manage the rest in the meanwhile, in lieu of the foreign exchange issues. And so when they were unable to pay immediately the rest of the 21 lacs INR in cash to the authorities in the event of the sudden death, the hospital authorities refused to return back the dead body. They wouldn’t budge and the family was allowed to hold no grudge.

“There is practically no control over hospitals. That could be one reason why people vandalize hospitals. That (the violence) is not good,” Justices V M Kanade and P D Kode said, referring to case of the Singhania Hospital destruction in Thane (Mumbai) by the supporters of a political leader who died suddenly in 2001. Currently there is no legal mechanism which regulates the recovery of bills by hospitals. In another appalling case, a poor man working in a small weaving factory underwent trauma over not just the loss of his ailing brother but the misery of being unable to retrieve the body from the hospital authorities.

As in this case, many people live with poverty stricken conditions. And while India boasts of world class medical establishments, for many people especially in the rural areas, medical care tends to be bare minimum or even unavailable. The man’s brother was diagnosed with a rare heart problem for which there was no treatment in the village and therefore, he traveled all the way to the city to a specialised hospital where he was hoping to get his brother nursed back to health. While the hospital authorities did acknowledge the right of the patient to know the expenses and the respective contract was legally signed between the two parties, what they did not regard were the spiritual and cultural needs of the dead’s kin. And that the poor cannot amass a figure that big immediately. Eventually, after much harassment the man fled back to his village, fearing police action on his inability to pay back the money.

On the same case criminal lawyer Shyam Keshwani states,

Holding back a dead body is not an offence under the Indian Penal Code or the civil law, but the hospital cannot do that and should immediately hand the body over to the kin. If the kin refuse to pay the medical bill, the hospital can later register a court case against the relatives or friends who brought the patient to the hospital.”

It is as exhausting as it sounds. Not just the sick ail but their families as well. The constant running around, making sure the treatment is right, taking care of the medicines, the expenditures, it is not easy. And yet there is no regulation in India which takes care of those crippling along with the patients.

My mother has been sick for the past many months, being whizzed around by her family from one doctor to the other in search for the right diagnosis, the right treatment. The doctors would identify the symptoms of her, deliriously prescribe ten different medicines (most of which would be antibiotics) in their untidy handwriting on fancy prescription slips. Her case was simple and yet she ended up in an almost fatal heart condition in the hospital. Amidst nervousness and anxiety, we could not comprehend which tests and medicines deemed right for my mother, their patient. The doctors kept testing, the doctors kept prescribing.

She was given the wrong diagnosis. After a few days of coming back home, she was again admitted in the hospital, this time with a severe condition of the lungs. My family and I were overwhelmed with a range of emotions — confusion, anger, concern, fear and helplessness. Every morning I would sit outside the doctor’s room, hoping that he would answer my questions on what was wrong with my mother. They seemed less enthusiastic to listen to my prodding and instead told me what they thought was the best for her.

I was sick with worry. And so was the rest of my family. With less trust in the doctors who were treating her, we wrote to different doctors in Germany, in Ukraine, in different parts of India. There had to be a way out but we were no doctors ourselves. The internet terminologies didn’t help much either. Eventually after spending a lot of money, we ended up in a renowned hospital and were met with the Director of the concerned institute there. A relative helped us in getting in contact with him. My mother is getting treated but we are yet not assured if this is the right treatment. Sleepless nights and anxious days have exhausted all of us and we have only that much faith left in this treatment.

My family along with others know how it feels to be at the receiving end of the hospital ambiguities and treatment, even though they are supposed to provide services to human beings as human beings (Pravat Kumar Mukherjee vs. Ruby General Hospital case). And when people in our community in Delhi came to know about the Kenyan man and his family, they immediately started collecting money to ease their stress. However, 21 lac is a painful sum. Nevertheless, there was a way out. Somebody had a contact in the Ministry of External Affairs (MEA) asking the MEA to request the hospital authorities to return back the body.

After much hue and cry, the body of Kenyan man was finally returned. And even though it could not be taken back to Kenya (again a gregarious sum required by the airline companies), the people in the community helped them bury the son with due respect that the dead would want.

Death is a complex topic. But why should we have complex medical treatments, facilities and services as well? The least, those holding the power to restore one’s health, could do is to responsibly use it to ease the human condition of ill being. To treat human beings as human beings and not a commodity.

Why make a business out of everything?

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