What can kill, circa 2005

Someone I know, a health officer for UNICEF in Bhopal, recently forwarded a note she received from one of their district consultants in Madhya Pradesh. It reminded me most of all of her own experiences as a doctor in rural India (i.e. the health officer's), some of which I will post here one of these days.

Meanwhile, here is the note, nearly untouched.

***
Dear Sir,

A large number of T.B. patients are dying everyday in our villages. They are either not identified as T.B. cases or could not reach T.B. Hospitals due to various reasons. A sorry state of affairs. This case however is of a patient who was identified and brought to the District T.B Hospital from a remote village.

Udam Singh Adhivasi an agricultural laborer is a resident of Karmai Chak (a majra) of village Sonaj in Badarwas Block of Shivpuri. On 11th of March, 2005 during a field visit we met him in Karmai. The District Immunization Officer identified him as a likely case of T.B. and advised him to be brought to the District T.B. Hospital. The Cluster Animator (NGO worker) Mr. Mohan Sharma was instructed to bring this man to the T.B. Hospital. On 2nd of April '05 Mohan brought Udam Singh to the Kolaras Block PHC. Dr. P D Gupta referred the patient to the District T.B. Hospital. On the same day Udam Singh was brought to Shivpuri. The District T.B. Hospital nurse refused to admit the patient stating that it's not possible for her to do so without the doctor's permission. No doctor was available in the hospital from 2 pm onwards. A helpless Mohan finally informed me about the state of affairs at around 5 pm. After I called up the doctor (Dr. R K Jain) and got the nurse to talk to him over the phone, the hapless Adhivasi was admitted.

Two days after being admitted, Udam Singh's wife was told something unfathomable. The doctor told her that it was wrong on her part to get her husband admitted in the District T.B. Hospital. He should have been treated in the Block itself, the referral not withstanding. Udam Singh was sent back to his village with a promise that medicines will be sent to him within 4 days. The medicines reached him after 24 days on 28th of April 2005. Udam died on 4th of May 2005. He has left behind a wife, three small children and a big question mark on our civilized health delivery system.

With Regards,
Yours,
Soumya