While a good majority of people in urban India are tending to turn towards holistic living practices, alternative therapies and traditional medicines, much of the rural migrant populations living in our sprawling urban slums seem to have become obsessed with allopathic medicines. I am aghast at how my domestic help from Uttar Pradesh who had once taught me the efficacy of mustard oil and turmeric in treating many an ailment, now finds little relief for her aches and pains unless she swallows a cocktail of multi-coloured pills. Down south they are just a couple of steps ahead. A slight pain, fever and slack sends them rushing not just for a paracetamol but to a neighbourhood doctor for an injection shot or worse still, an intra-venous drip. To date I haven’t figured out how such a drip can be given as a one-time pep-up and how it can be given without the proper tests being done.
Much to the irritation of all the medical professionals I have had chance to visit, I ask questions. I am very particular in extracting details from them on what my affliction is, what has caused it to manifest and most particularly what his or her line of treatment is going to be. Though vexed, never has any one of them ever refused to answer my questions. Considering it is my body and my health, I maintain that it is my right to know what is happening. More often than not, even educated people are extremely reticent to ask a doctor any questions and will invariably come home with a plethora of pills, not knowing what they are ingesting. This despite the fact that most middle class homes today have the luxury of Internet connectivity and the details of almost every medical condition and associated medications can be cross-checked on the net.
Unfortunately, with people from lower income groups they rarely know what questions to ask the doctor. And even when they do muster up the courage to ask, their questions are neither entertained nor appreciated. The sad consequence of this is that in the absence of a clear enunciation of symptoms by the patient, there is rampant misdiagnosis and even mistreatment.
My young helper in Bengaluru has a skin condition on her foot that was diagnosed as an allergy. She has no clue why it was declared an allergy, what the allergen was or why she was not given simple anti-allergy medication with a topical corticosteroid cream for external application. Instead she was pumped with steroids and is now suffering an endless set of metabolic consequences but with the skin condition still unhealed. She also blissfully consumes an Erythromycin tablet every time she has a headache — an antibiotic instead of an analgesic. She insists that her doctor prescribed it thus and that her chemist supplies it as and when required.
After spending a lot of money at private clinics, the urban poor invariably land up at large government hospitals hoping to get expert advice at low cost. My household help of 25 years in Delhi has been frequenting one of the biggest government-run hospitals for the last many years – driven by her aches and pains and cankerous mouth sores. While my general practitioner warned her that these could turn cancerous, she still returns time and again to the government hospital where though she has never been examined she is happy to receive a handful of pain killers and vitamins for free. She is clueless what they are for.
The apathy of many medical practitioners and the ignorance of patients makes for a lethal combination. A quack infecting 150-plus people with HIV by reusing unsterilised needles should, therefore, come as no surprise. Despite huge sums of tax payers’ money being spent in subsidising health care for the poor, doctors are rarely ever brought to book for mistreatment or even gross negligence. Unfortunately, this will continue till people take charge of their own health and lives and start demanding answers and accountability.
Driving home the message of good health and sound medical practices, through Swachch Bharat and various health missions, to both medical staff and patients is now an imperative. As things stand, the cost of any medical condition is well beyond what the poor can bear or the state can cope with. The onus for an individual’s health, fortunately or unfortunately, lies with the individual, but helping them make a priority remains the duty of the state. Preventive health care even for an ever-burgeoning population may still work out to be a lesser burden on the exchequer.
nalini.srinivasan88@gmail.com
