As I sit on a bench with Sekhar, a steady stream of young men approach the open courtyard in front of me. Never from closer than 6 feet away, each one snaps his head forward and -- powerfully and voluminously -- spits into the courtyard, rounding off initial releases with two or three supplementaries. Their prowess explains the even red tone of that corner of the courtyard.
Is this some surreal Olympics of spitting, the young men competitors? No, just another routine day at the medical college hospital in Berhampur, Orissa.
We have brought Sekhar, a tiny three year old suffering from suspected intestinal obstruction, here because the small dispensary his mother took him to didn't have facilities for surgery. I have to look down at Sekhar, or at his bottle of intravenous drip that I am holding, to remember this is a hospital. A teaching hospital, at that. I have been in this building only half an hour, and already I fear for Sekhar's life if we leave him here.
Outside, cows stand in pools of yellowish liquid that has oozed from blocked drains. As you enter the building, the aroma envelops you -- a fruity blend of human and bovine waste. The dingy corridors have not been swept or mopped ever, I'm sure. A pool of something -- vomit? urine? what? -- is a magnet for a horde of flies. I was angry because we were refused a stretcher for Sekhar -- "Why do you need a stretcher for a 11 kg boy?" -- but when I see the stretcher, I'm glad I carried him. It is blotched with large bloodstains. Spit stains too, for all I know. The bars of the window opposite, encrusted with years of spittle, are grown to twice their size.
But it isn't just the filth that makes me fear for Sekhar's life. I am on this bench watching spitters because we are waiting for the Casualty Medical Officer, who has to sign Sekhar's papers so he can get a bed. The CMO is on duty, yes. But he is not here, no. He strolls in after an hour. Before he gets to the papers, he munches a samosa thoughtfully. When he finally does sign, he won't let me take the papers and rush Sekhar to the ward. Only peons are allowed to carry the papers, he says thoughtfully, and there isn't one to be found. Sorry!
Finally in the ward, I do an agile sidestep as a nurse strolls past, the syringe she has just administered an injection with held in front of her like a lance. Sekhar's drip runs out; the same nurse has to restart it. It is an hour before she can spare a minute from lance duty to do it -- an hour that skinny, malnourished, hurting Sekhar is off his only source of vital fluids.
"You can talk to all of them, and they still make it so difficult," says Sekhar's mother. "How could I have managed on my own?"
I don't know. But a prominently displayed sign I see on the way out assures me that Sekhar will survive his stay at the Berhampur hospital. It's signed by Biju Patnaik, the late ex-CM of Orissa, and it says: Take care of your hospital. Keep it clean.