life in a district hospital through the eyes of the CHD

The Institute of Public Health has taken on the responsibility of running a Citizens Help Desk (CHD) in the district hospitals of Bijapur and Bagalkot in North Karnataka. These CHDs are part of the innovations under the National Rural Health Mission.

The following stories are just a glimpse of life in a district hospital.

Money matters

In Bagalkot, an accident case was brought to the hospital. The person who had been hit was carrying a bag with one lakh rupees. As it was a road accident, it automatically became a police case.

When the patient came to hospital, and he was being searched to find out his identity, the money was discovered. The accompanying police constable immediately wanted to keep the money, though he was willing to share it with the others. Luckily for the victim, the CHD manager was present and with the support of the medical officer on duty was able to keep the money safe.

…And the hospital is a cleaner place

Most public places in India these days are characterised by hundreds of tiny plastic cups discarded after the ubiquitous tea has been consumed. This was also the case in both Bijapur and Bagalkot hospitals; till the time the CHDs decided that there was a need for cleaner hospitals. They simply worked with the hospital authorities and banned the chai wallah from entering the hospital premises. Henceforth, whoever wants to drink tea has to go outside to the stall and drink it. The patients get tea inside but out patients and others cannot drink inside the hospital! And the hospital is a much cleaner place.

It is possible to use the toilet now!

One can usually smell a public toilet from quite a distance. If the toilet is in a hospital, then it is much worse. One can go into the sociological reasons of why people do not use toilets the way they have to, but most of the times, it is simply because there isn’t enough water in the toilet to keep it clean.

These district hospitals were also in the same situation, not just the ones for OPD but even in the wards. So much so that the staff nurse used to refuse to sit in one of the wards due to the smell. The patients of course had no such choice.

The CHDs decided that this was yet another issue that needed to be addressed. They raised the issue with the hospital administration and they were able to restore water supply in the toilets making them usable.

And the PHC called us

It was a normal day at the CHD. The telephone rang. It was the doctor from the Jamakandi Community Health Centre calling us for assistance. He had a patient who needed a hernia operation; but the patient was a little worried about being able to manage in the hospital. So the doctor called the help desk to say that he was sending the patient to the hospital with his reports asked the team to help with further treatment. It is on days like this that team feels accepted by the government team.

And we felt helpless here…

It was the middle of the night and a patient came for delivery. She was in a serious condition and had come from far. The duty doctor simply refused to admit the patient and turned her away saying that they did not have the means to do the delivery in the government hospital. The patient’s caretakers took her away to a private hospital. The CHD volunteer tried to intervene but it did not work.

Later, it was learnt that a healthy baby was born, but at a far greater expense.

But, here we managed to help…

It was evening when a rural patient arrived; again a delivery case, again the doctor refused saying there was no blood. The CHD volunteer was better prepared this time; he called the District Surgeon who asked him to intervene and help the patient and contact the blood bank. By the time the district Surgeon arrived, the blood had been arranged for and the patient admitted. Another healthy child born.

The District Surgeon was also appreciative of the CHD work.

No change

The cost of registration at the hospital is Rs 2 and the cost of an X Ray is Rs 50. The persons at the Bijapur counter were over charging – not returning the balance from the registration and keeping the change so that the registration cost became Rs 8 or 18. For an X ray, they would charge upto Rs 100. Several patients complained to the CHD. The CHD manager took the complainants to meet with the District Surgeon who transferred those people.

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