Where Do I Begin (part-2)

Where Do I Begin………….. to tell the stories of urban polity …

the enduring tales of life as it is least meant to be …..

in a just fair world……?

(To be sung to theme tune of Love Story)

Did you read the  where do I begin part-1 ?(click here)

In the afternoon…..

Our next halt takes us to the home of of Anwar bhai, 42 year old dialysis patient. Anwar has been in the business of recycling for many years, he describes Bangalore as a city that has undergone immense changes, none for the better in his opinion, “yeh jabh computer companies aye hei behen, bangalore ki halath bilkul kharab ho gai hei” (Since the computer companies sister, bangalore has gone to the dogs). He outlines how the rich have gone steadily richer, but nothing has improved for the poor. His wife, pleasant faced, cheerful, brings out the ubiquitous chocolate flavoured 3 roses tea in the tiny cups. This hospitality is a hallmark of practically all poor patients who are residents of K.G Halli.

“It all started,” she says, “when in 2008 he visited Ambedkar and Bowring hospitals. He was diagnosed to have a kidney problem and advised dialysis 3 times a week.” They were visiting Mahavir Jain Hospital for treatment when one day, when returning in the auto, he had a stroke. Distraught as one hand and leg no longer moved and he had lost his speech, she rushed him back to the hospital to be told he had a clot in the brain. We need to take a CAT scan they said and this was the beginning of a 9 day hospital stay that cost them 28 thousand rupees. As she talks. I’m leafing through Anwar bhai’s medical files, a testimony to over-investigated defensive practise of medicine. One of the lucky ones, he has some use of his limbs and his speech remains slurred but he is not bedridden. However his kidneys continue to malfunction and so the trips to the hospital continue. They have now been forced to visit Al-Amein hospital which seems to have the cheapest dialysis rates in the area. In contrast to the 1800 rupees quoted in other hospitals, Al-Amein officially charges only 750 rupees. However, the begum says, the total trip comes to 1000 rs per session, including the travel, a snack and sometimes a bribe. When I asked her how they coped with paying these vast sums of money, she said very matter of factly, all her jewellery is gone. In addition, 2 college going suns have been withdrawn and now are apprentices in welding workshops where they are paid a stipend in addition to learning the skill. The third boy, doing his 10th standard has stopped school and now works in a shop on M.G road. The last boy, tired from his roza fasting, lay asleep on the floor. Anwar bhai is perplexed by his condition. “I never smoked, I never drank,” he says, “I wonder why Allah had this in store for me.” And we are brought up short again, remembering hypertension being described as the silent killer. His wife on the other hand, stoic in her narration, breaks down only when she describes the doctors attitudes. “We don’t expect them cure everything and know all,” she says, “but is it too much to expect them to have a kind word and an explanation for patients and relatives who do not know what is happening?”

And we walk back to the centre…….

Jyothi is a middle aged, grey haired lady who trudges up the staircase of our centre, with her little granddaughter of four years, Darshini. Tired after teaching in the local school, classes 6-10 she has forgotten to bring the medical files we requested her to bring along. She has been teaching for 22 years and earns 4000 rupees per month. Extra income comes from tuitions to the occasional student. She describes three medical crises in the family over the last year. Her daughter Shankari (Darshini’s mother) had had an IUCD insertion after Darshini’s birth. A rare complication, she suffered an ectopic pregnancy and complaining of abdominal pain went to a local hospital. She was diagnosed there with appendicitis and when there was no improvement after two days, they took her to Ambedkar hospital, who referred them to Bowring. Jothi describes the stress of travelling with this daughter in autos and finally being referred to KIMS where she was operated for the ectopic pregnancy. This happened 8 months ago. 3 months later Jothi herself has symptoms of vomiting and nausea and visited the local hospital. With no improvement, her husband rushed her in acute pain to Ambedkar where she was told the operation theatre was closed because of some viral infection. They moved on to Bowring where 4-5 scans were taken and finally she had an hysterectomy- she still has low blood pressure and occasional bouts of vomiting. What might be the straw for the camel’s back is her husband who has cirrhosis of the liver. Chronic alcoholic in earlier days, he has been advised today to get admitted in Ambedkar hospital. Jyothi has two sons, Vinod who has passed his tenth and Arish, 2nd PU failed. Neither of these young men feel obliged to contribute to the financial crisis in the family. “When I asked him to go to work, they ask me to get them motorcycles,” she says, shaking her head sadly. “I really don’t know what to do next.” Jothi has spent to the tune of 1.5 lakh rupees ( 150,000) on medical care in the last one year.

And then we take the bus home……..to work on some fledgling ideas of health financing for the poor……