Life has its unique ways of showing you what you might be looking for. As a purely logistic decision, it made more sense for me to stay overnight in the community centre and this gave opportunity to observe a different side to KGHalli….after dusk. Suddenly “urban” lifestyle took on new meaning for me in the context of health planning.
A walk down Tannery road at 10 pm is like walking down any other big street in Bangalore at 7pm. Like the jaws of a aging man, dark gaps where the bike workshops punctuate the shining rows of shops, many with brightly lit interiors, the city seems to swallow one up. I notice most of the people walking the street are men; the rare family, but as a single unaccompanied woman, I do not draw many glances. This is a world where anonymity is the norm. People are very occupied, earning their living. Every street corner has a hole in the wall eatery with the owner dishing out hot chicken wings from a frying hot ‘kadhai’. Large neon signs in every colour advertise “goodies” of all kinds, from clothes to shoes to accessories to ….and here we have it…. to medicines. As I strolled along, three large, glass- fronted pharmacies caught my attention, the window displays abundantly showcasing expensive and (to my mind), unnecessary products. The vitamins of old have been successfully replaced by “sugar-free” and equivalent products meant to lull the obese patient into the ‘soft’ pill option.
It is well known that many hospitals have their own pharmacies – convenience for the patient being the supposed rationale. By extension, the small clinics often have a drugstore next door. However, by a strange twist, the unstated, unpalatable truth is that the drugstore has the clinic and therefore the doctor. So it was with a great sense of curiosity that I wandered into the newly built 15 bedded hospital adjacent to the large glass fronted pharmacy. I had met the Managing Director , a twenties- something doctor when the hospital opened an hour ago, but community feedback was that it had not really take off. So I was surprised to see three patients in the ’emergency’ ward, all on ‘glucose drips’ , two of these being children. I caught sight of two ‘duty doctors’ identifiable by their stethoscopes and slightly preoccupied air. Evidently the beds are slowly filling up, although there is no permanent staff in place.
As I continued down the road I greeted an older homeopathy doctor known to me. When our team did a survey of existing service providers he had said he comes only once a week. Now, he sheepishly told me ,he comes every night between 9 and 10 pm, this is clear understanding with his regular patients.
And as I continue to walk down Tannery road, every clinic locked in the daylight hours when we have been visiting has been magically opened…with functioning health service providers. It appears they have each created their little niche with specific timings and patient profiles.
When we sit and plan the number of doctors required to serve a particular population ….24/7 services and continuity of care, my lesson from this night would be “Beware the oversimplifying standardisations…..you need to factor in the ingenuity of the human being in his need for survival, where he will not just meet a demand, but unblinkingly create it!’
So one more challenge to the complexity of local health systems……
Take a walk, my friend, take a walk……..
