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The doctor's dilemma
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All's not well with the Thiruvananthapuram Medical College Hospital. The house surgeons and the PGs are a discontented lot. The recent three-day strike of junior doctors points to the skeletons in the MCH cupboard, writes SMITHA SADANANDAN
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The recent three-day strike by the Medical College junior doctors ended with the Government agreeing to retain the prevalent stipend scale of the junior doctors. The decision to hike the tuition fee of PG and DM courses, by 10 per cent has also been revoked. The PGs and house surgeons in the Thiruvananathapuram Medical College Hospital (MCH) refrained from attending patients during the strike.
Says Mathew Thomas, MCH superintendent, "During the three-day strike, the patients in the Casualty, Out-patient and In-patient wards were examined by senior doctors, who were on 24-hour duty."
Dr. A. S. Prakash, a house surgeon with MCH, says, "We know the hospital will take time to improve, but the authorities concerned have always turned a blind eye to the problems of both the doctors as well as the patients."
Dr. Vishad Vishwananth, secretary, House Surgeon's Association, says, "The PGs are paid a monthly stipend of about Rs. 5000 each, which the Government wanted to cut. The doctors are put on ward duties for long hours, often for 36 hours at a stretch. Though we have had these problems for long, we have never let it affect our duty."
The Medical-ICU is said to have only one ventilator (respiratory aid) in working condition. When more than one patient needs the respiratory aid, the staff has no choice but to refer them to other private hospitals. Recently, a patient suffering from Guillanbarre syndrome (which affects the diaphragm and obstructs respiration) was referred to a well-known private hospital in the city.
Some of the wards are congested. Some others do not have enough number of beds. Garbage is piled up and burned near Ward 16. "This aggravates the condition of patients suffering from Chronic Obstructive Pulmonary Diseases (COPD), causing breathing problems," points out a house surgeon.
Walk along any of the highly congested wards and peer into the toilets; chances are that you will `puke' even before you reach your destination. Fortunately some toilets are bearably - clean, while some have flushes that get stuck and fail to work for two or three days. The outcome: stench and lack of hygiene. The patients and the bystanders have no choice but to use these toilets.
Dr. S. Anup, a house surgeon, says, "The clinical pathology (clip) lab and bio-chemistry lab function from 9 a.m. to 12 noon. It becomes very difficult to send and procure investigation reports to the clip -lab where the routine blood and urine tests are done. These tests are a must for any diagnosis. This causes a lot of problems to the poor patients. Those who can afford the expense involved get the tests done in labs elsewhere. If the working time of the labs were increased to 1-30 p.m., it would make things easier for the doctors, for by the time the doctors complete their daily- rounds of the wards it would almost be 12 noon."
A few PG's (who did not wish to disclose their names) said the library facility at MCH was in need of improvement as the books were outdated. The library timings too needed to be re-scheduled. A junior doctor said that the hospital authorities did not have enough B.P. apparatus and the ones that are available are taken from one ward to the other whenever required. She did not wish to disclose her identity "for fear of repercussions that could lead to my failing in the examination papers". She also added, "We are given a monthly stipend but a single set of texts on a specific topic costs at least three times this amount. So if this stipend is reduced, what do we do? I wish we had a 24-hour library facility; we just can't leave our patients and go and pound over the books in the library. We can leave the hospital only after the duty hours, but by then the library closes. There are days when we stay back even after the duty hours, because the work load is so much."
"Insulin injections and latest broad-spectrum antibiotics such as third and fourth-generation cephalosporin are unavailable in the hospital," complain doctors. "Even the common medicines are not available. We have only outdated medicines here, we are forced to tell our patients that we are helpless and cannot administer the required ones."
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