A PHC in a remote corner of Karnataka. My colleague and I drive past dry forest and 50 km of non-existent road to reach this PHC. There is a crowd waiting in a nicely painted building. The young lady doctor is seeing the patients, one by one, in her chamber. Others patiently wait for their turn in the waiting hall. I casually flip through the OP register; she sees an average of 100 patients every day. All the details, including name and diagnosis are written legibly in the register. More important, it is obvious that she is present in the PHC every single day, barring the days for meetings.
She completes seeing a few patients, ensures that there are no serious patients in the waiting hall and then sits to talk to us. She listens to our requests and answers our questions patiently. She shares a recent experience when she went to the field for the polio mop-up visits. She saw a two week postnatal lying by the street in a makeshift hut. “The Golla community does not allow post-natals inside the house,” she explained. She then arranged to transfer this woman to the nearby hospital, so that the mother and baby get food at least. “The JSSK programme is a boon. At least we can look after such people.”
Our talk is interrupted by a phone call. A doctor informs her that the patient she has referred is better and will be discharged soon. She negotiates with the doctor to reduce the bill. “A case of incomplete abortion,” she explains. “I wish that I had some equipment and a Group D staff here. Then I could have managed it myself. And it would have cost the patient only 200 to 300 rupees. Just for the medicines. But because I do not have a group D who will sterilize the equipment and clean up the labour room after the procedure, I cannot do these simple procedures. I have to refer them out and they pay so much to the private sector.”
I ask about the 100 patients and the fact that she sees them one by one, not in a herd, as is the practice of most PHC medical officers. She explains that these are patients and need privacy and care. Yes it takes time and most of the days she is in the PHC from 10 to 5 pm. No, she does not stay in the PHC as there are no quarters. And her husband lives in the district headquarters and her child studies in a school in the district headquarters. So she commutes every day by driving in her own car. She explains that this way, she is not at the mercy of the bus (that plies just twice up and down) and can ensure that she sees all the patients before leaving.
My colleague and I leave the PHC wondering why there are not more such MOs. A few hundreds more and the health scene in Karnataka could change. It is obvious that she cares for her patients, cares for them enough to drive every day on bad roads for 180 minutes; cares for them enough to ensure that her PHC is well stocked with medicines, cares for them enough to make regular Anganwadi visits, house visits and school health visits. Does it matter that she takes Rs 10 from each patient, so that she can buy the fuel for her car? I don’t know; for me things are not so black and white anymore.
N Devadasan
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