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![Presentations at 3rd National conference on tobacco or Health Mumbai](https://i0.wp.com/iphindia.org/wp-content/uploads/2015/02/IMG_20141216.jpg?resize=1080%2C675&ssl=1)
![Technical assistance to MEMISA and the WBVHA in Darjeeling district](https://i0.wp.com/iphindia.org/wp-content/uploads/2015/02/20150131-e1424059879515.jpg?resize=600%2C450&ssl=1)
Technical assistance to MEMISA and the WBVHA in Darjeeling district
![“If I buy medicine, then I can’t afford to pay my children’s fees”: Story of a diabetes patient from rural India](https://i0.wp.com/iphindia.org/wp-content/uploads/2015/01/Patient-group-meeting-in-Korategere-taluka-Akkirampura-PHC-e1423052938969.jpg?resize=1080%2C675&ssl=1)
“If I buy medicine, then I can’t afford to pay my children’s fees”: Story of a diabetes patient from rural India
It was one of my routine visits to a PHC in rural Karnataka where I facilitate the patient counseling sessions for people with diabetes and hypertension. This PHC is 45km from the district head quarters and covers about 18,000 people. It was a busy day and the medical officer was attending to the patients. I silently headed towards the counseling room; there were about five patients waiting for me. I started my counseling session and explained to the patients about their disease, the importance of regular treatment and lifestyle modification.
Among them was a patient, who was around 45 to 50 years old. He showed me a few prescription slips written by different doctors and from that I figured out that his blood glucose levels were quite high in the last few months. I decided to have an individual conversation with him. When I asked him why his blood glucose levels were not in control, he started narrating his story.
He belongs to the same village; his house is located around 1 km from the PHC. He runs a tea shop for his daily living; he has a small family for which he is the sole bread winner. He comes to the PHC for his regular checkup, but is prescribed medicines from the private pharmacy, which he cannot afford. He said apologetically that he is not able to take medications regularly and that is the reason for his fluctuating blood glucose levels. He is unable to spend money for his regular medicine expenses, so he used to consume medicines whenever he has money. He has completely stopped taking aspirin due to the high medicine cost (each medicine costs 7 rupees) in the last few weeks. When I reminded him that he needs to take care of his health first, his response was, “if I spend the money on the medicine, I would not be able to meet the household expenses, pay my children’s school fees, or celebrate any festival. And for me happiness of my family counts the most”.
After a few minutes of our conversation, he asked me if I could do something so that he can get the same medicine in the PHC at free of cost. I listened carefully and assured him that I will try to speak to the medical officer see if anything can be done. After I finished my conversation with him, I went to the medical officer had a discussion about that patient and also enquired why is he not getting benefited from the PHC. The medical officer told me that the PHC does not have the stock of that particular medicine which he requires; his sugar levels are constantly high and are not getting controlled by the PHC medicines so he was given an outside prescription.
It’s not justa story of one patient whom I came across; there are many more who are suffering in the same way. During my routine visits, I have come across many such patients who have discontinued medicines due to financial difficulties. For people with chronic conditions like diabetes it is all the more difficult, as they need to take lifelong medication. This raises a question in my mind, what is our health system doing to help these poor patients? We hear about many programmes and schemes targeting the poor, but how far these programmes have actually reached out to the poor? I don’t have a solution to offer either, but unless we address these issues, we will not have an answer to the increasing burden and mortality of chronic diseases.
Santosh M Sogal
Research officer
Institute of Public Health
Bangalore, Karnataka
Laboratory Technicians Training
![My Monday musings of being a “Generic”!](https://i0.wp.com/www.iphindia.org/wp-content/uploads/2014/05/my-monday-musings-of-being-a-generic1-300x300.jpg?resize=300%2C300)
My Monday musings of being a “Generic”!
Author: Dr Mrunalini
I am pretty well known in the country and constantly have a presence in news making headlines against the multibillion Pharmaceutical industries. I still struggle on a daily basis convincing people that I’m as good as the BIG BRANDS, and to start including me in their daily lives so to help them keep their diseases under control. This is a series of stories about me and a group of generics when we started our journey in K.G.Halli (Bangalore) through a primary care clinic in January 2014.
Every Monday, I sit there for few hours seeing people scan me with a close eye and have a skeptical look towards me and the idea of taking me home and start including me, to fight their war against the disease.
Along with me there are two doctors, two community health assistants bombarded with questions for being a generic drug, is there even a possibility of me being a generic drug?
The questions they encounter “Why is the color of the packet not green”? , Why do I have to take two medicines instead of one? , Why is it so cheap? Is it cheap because the strength is less? Do I actually help in controlling the disease? How can I be so affordable? Medicines for my disease always cost me a lot, how can the expenses suddenly be so less for a month, why are you people doing this work for the community? What do you get out of this? There are a lot of whys? There is lot of how can this be a real.
A lady sits across me , picks me up and says , this is not the same medicine for my disease, the shape is different, the cover is different, when I get two medicines in one tablet why should I take two separate tablets, will this cheap medicine help me control my disease?
The doctor sitting close by me answers with a comfortable ease and politely, that the packet color is different I agree, so is the shape. But the medicine which is required to cure your disease is inside this packet. Only the cover is different. The patient continues “but why can’t I get the combination?
Out in the community I’m an unspoken truth, or something which is never acknowledged, I’m a shadow amongst the big brands, the family physician when they see me pretend like I’m nobody. While the struggle continues, I choose to embark on a journey of my own in the community along with my dedicated team of doctors and community health assistants. I will introduce myself and promote myself that I too exist amongst the multibillion pharmaceutical industries, barring the fancy covering, huge promotion and marketing strategies.
Every journey begins with one small step, while I have embarked on this long journey, hoping it will be a successful in KG Halli.
Private healthcare providers threatened by the Vajpayee Arogyashree Scheme
There have been some recent newspaper reports that networks of private hospital owners have threatened to stop providing services to patients if the government of Karnataka expands the Vajpayee Arogyashree Scheme (VAS) from the poor to the rest of the population. We look at the reasons for this reaction. To read more – click here