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The spin doctors: India’s quacks imperil lives, but are ‘god’ to their patients

One of the women infected by HIV by a quack’s use of a common injection needle in Bangarmau, Uttar Pradesh.

One of the women infected by HIV by a quack’s use of a common injection needle in Bangarmau, Uttar Pradesh.   | Photo Credit: Rajeev Bhatt

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Some 10 lakh quacks ‘practise’ allopathic medicine in the country, according to the Indian Medical Association

It is not even 6.30 a.m. when Kabir Singh’s phone rings. He leaves his pooja midway, changes into a white shirt and trousers, gets on his bike, and sets out. He carries a black Rexine bag with three compartments: the first for a torch, stethoscope and money; the other two for injections and medicines.

The 62-year-old Singh’s destination is Aarti Jatav’s house, 6 km away, in Pura Bhadauriya village in Uttar Pradesh’s Agra district. Aarti’s mother is ill and Singh is the only ‘doctor’ who attends patients at home. Sometimes, he even treats poor patients for free.

In Baah tehsil, on the banks of the Chambal, some 100 km from the home of the Taj, ‘Kabir doctor’, as Singh is called, practises in almost 30 villages. He has been doing this for 40 years now. Only, he has no medical degree or certificate — in fact, he has not studied beyond Class XII.

It does not bother Aarti Jatav in the least. “He has jash (divine power) in his hands,” she says. Her mother has been suffering from diarrhoea ever since she ate gulab jamun at a wedding in the village the previous evening.

Quack knows best

Singh, a farmer by profession, gives her two allopathic pills and five sachets of ORS. He charges ₹40 for the house visit and the medicines. He spends the next 25 minutes talking to Aarti about her father’s health, her marriage plans, and even throws in some home remedies for her acne problem.

“Doctor sahib knows best. Apply it. Can’t you see how young and handsome he looks even at 62,” says Aarti’s father Kishan Jatav. Just then, Singh’s phone, a small Nokia handset, rings again. On the other end is Govind from Samrai village, 5 km away, who says his father Ataveer has been shivering all night and needs immediate help. Singh picks up his bag and heads out.

How did he get into this line of work? Singh’s father was a renowned vaidya (ayurveda doctor), he says. “I have learnt all this from him. I was keen to become a doctor because of the respect people have for them. Otherwise who respects Jatavs in villages.”

“I worked as a medical representative with an agency in New Delhi,” he continues, “that was for two years, 1972 to 1974. I learnt the combination of allopathic medicines to be prescribed from there.”

In the brick house in Samrai village, Ataveer is lying on a string cot and has a high fever. Singh claims he can diagnose a disease from just feeling the pulse. He holds Ataveer’s wrist for over a minute, then concludes that he has heat stroke.

“This is the season of potato harvesting. You must have counted potatoes under the sun and drunk cold water immediately afterwards.” Ataveer nods readily. Singh prescribes five medicines and administers two injections, one a broad-spectrum antibiotic, the other an anti-inflammatory. He charges ₹60.

‘Kabir doctor’ makes a home visit.

‘Kabir doctor’ makes a home visit.   | Photo Credit: SHIV KUMAR PUSHPAKAR

In February this year, Rajesh Yadav, better known as dus-wala doctor or the ₹10 doctor, a quack who ‘treated’ patients in UP’s Bangarmau town (about 300 km from Agra), was arrested for allegedly infecting dozens of people with HIV by using a common syringe. Yadav cycled around villages, where residents described him as polite and accessible. He almost always administered an injection — whether for headache or fever — and people flocked to him.

The incident shone a spotlight once more on the huge influence quacks have over sections of society. According to the Indian Medical Association (IMA), some 10 lakh quacks practise in India. This includes compounders, assistants to doctors, lab technicians, medical store owners and vaidyas. Just in Delhi alone, some 50,000 quacks reportedly practise ‘medicine’, according to the Delhi Medical Council.

Within 30 minutes of the ‘treatment’, Ataveer is up and about. “Kou kachu bhi bole, hum to je janat hain ki jo je daaktar na raho to hum majja jaange,” he says. (Whatever people say, I know for sure I will die if this doctor were not around.)

Nothing but god

In Baah, Singh is the most famous quack. He claims to know every house in the 50 villages. “Can you see the wilderness? This is Chambal country, where dacoits used to live. Whatever tall promises the government makes, one can’t easily survive here. There are no roads, infrastructure, schools or health centres. I am famous because I serve door-to-door. A patient needs first-aid before they reach hospital.” Singh is not ashamed of being a quack; but visibly proud of what he believes he is doing for society. “I don’t make enough even for petrol for my bike,” he says. “I like what I do and people trust me.”

As we prepare to leave, a man called Lalji offers sweets.

“What is this for?” Singh asks.

Bahu ko ladka bhao hai. Sab tumhari kripa hai daktar,” says Lalji. (My daughter-in-law gave birth to a boy. It’s all your blessings.)

I learn from him that Singh also gives men ‘hormone’ pills to ensure that they sire sons.

Lalji turns to me and says, “He is nothing but god.”

***

In the national capital, scores of men, women and children are standing outside a multi-storied building in Basai Darapur, a small suburb near Moti Nagar metro station. They are here to meet an elderly unani doctor famous for treating jaundice. Nearly all the men in his family seem to be medical practitioners of some sort; the board outside lists five with MBBS and Bachelor of Ayurvedic Medicine and Surgery (BAMS) degrees. The old man himself claims to be a Bachelor of Unani Medicine and Surgery.

Inside, the man and two of his sons are sitting around a table, seeing patients. They disperse as they see the camera. We are taken inside a room, and the elderly doctor, who refuses to share his name, asks why we are here. He is clearly nervous.

His eldest son, who has an MBBS degree, says, “I completed my BAMS and then my MBBS. I treat with both systems of medicine. There is nothing wrong in that.”

He is mistaken. In 1998, the Supreme Court made cross-pathy illegal. As Dr. Girish Tyagi, Registrar of Delhi Medical Council says, there are four valid medical degrees in India: allopathy, homeopathy, ayurveda and unani, but “doctors who have studied multiple systems are allowed to practise only one.”

The other problem with this medical family is that even members without an MBBS degree, including the old man, dispense allopathic medicine. And according to a 1996 Supreme Court ruling, anyone who practises allopathy or modern medicine without an allopathic degree is considered a quack.

The family’s ‘clinic’ has a blood collection centre today and even an X-ray machine. Injections and medicines, both allopathic and ayurvedic, are supplied from their medical store located next to the veranda.

“Treatment is all about experience. Degrees hardly help after a point,” says the young doctor. Their ‘clinic’ sees almost 200 patients a day, he says, and patients are charged anything between ₹50 and ₹100. The family claims that patients come from as far away as Kolkata, Kota and Muzaffarnagar for hepatitis cures.

A roadside dentist waits for patients in New Delhi

A roadside dentist waits for patients in New Delhi   | Photo Credit: AP

***

It’s a cold and sunny February afternoon. A crowd mills about outside a small, shabby shop in Naglapadi, a small hamlet in Agra. Inside sits ‘Bengali Doctor’. Every day for over 17 years, from 2 p.m to 10 p.m, the 37-year-old ‘Bengali Doctor’ has been treating patients for all possible illnesses. Only, he is neither Bengali nor a licensed doctor.

Poonam, 23, has been standing outside with her seven-month baby for 15 minutes. When the ‘doctor’ finally emerges, she plonks down with her baby on a stool next to a revolving chair in the room that has all the trappings of a clinic, albeit a rundown one.

‘Bengali Doctor’ has a stethoscope and a medical kit with antibiotics, syringes and torch. A few other allopathic medicines are kept under his table and in the box-cot behind his chair.

Poonam’s baby has a high fever. “Why is he not wearing socks and cap? It’s still cold,” says the ‘doctor’, and prescribes a syrup. He then folds two small packets of white powder kept in his drawer and hands them to the mother. “Mix these in milk and give it to him with the syrup three times a day. Come back in two days.”

Naglapadi is barely a kilometre from New Agra police station, and the colony has a population of a little over 50,000. The daily income of most households is between ₹300 and ₹500, and most people are either domestic helps or daily-wage labourers.

The next patient is Vinita, 19, married two days ago. She complains of a stomach ache and vomiting. The ‘doctor’ makes his diagnosis: “You have eaten too many sweets in the last few days.” He then gives Vinita one pink tablet, two white ones, and one dark brown one, and asks her to take them twice a day. He also adds six tablets from a popular Ayurvedic brand of liver pills.

Stand in line

The queue of patients is getting longer outside. “Why Bengali?” I ask. “I share my clinic with an elderly doctor from Bengal. He hardly comes any more, but his name seems to have been carried forward to me.”

Actually, in Naglapadi, there are four ‘Bengali Doctors’, all quacks, but this one finds the term insulting. “I am a Rural Medical Practitioner,” he says. “I have a degree in Electro-homeopathy. The government doesn’t consider this a degree, but I can beat any MBBS doctor given a chance.”

S.B Zafri, who heads the anti-quackery unit constituted by the Chief Medical Officer in Agra, says there are 48 quacks practising in Naglapadi alone. The frequent crackdowns on their clinics have hardly harmed business.

The ₹40 fee

‘Bengali Doctor’ charges ₹40 as consultation fees and almost nothing for medicines. The government hospital of SN Medical College is just 4 km from his clinic. “I charge ₹40, the OPD fee there is just ₹2. Why do these patients still come to me? If the government has an answer, please let me know,” he says.

Rajneeta, 24, is studying nursing but only comes to ‘Bengali Doctor’ for treatment. “See, the residents of Naglapadi are poor,” she explains earnestly. “A private doctor will charge at least ₹300 to ₹500 for consultation. Then, they ask for tests. Believe me, they are looting patients.”

What about government hospitals? “Have you seen the long lines outside them,” she asks. “One line to meet the doctor, one more for medicines. It costs a labourer an entire day’s wages.”

 

According to a 2017 study that looked at Medical Council of India data, India has just 4.8 practising doctors for every 10,000 people. This ratio, says the paper published in Indian Journal of Public Health, is far lower thanWorld Health Organisation’s earlier claim that there were 7 doctors per 10,000 people in the country.

As ‘Bengali Doctor’ moves to his next patient, he gets a call on his mobile phone. The caller says there’s a crackdown by the health department on quacks, and advises him to shut shop for a few days. “All this has happened because of that Bangarmau case,” he mutters under his breath.

The IMA’s anti-quackery cells keeps tabs on quacks and health malpractices. Dr. R.N. Tandon, Hon. Secretary General, IMA, says he encounters three categories of quacks: “The first have no qualification at all. The second practise modern medicine with degrees in alternative systems like ayurveda or unani. The third practise systems such as ‘electro-homeopathy’ and ‘Indo-allopathy’ which have no validity in India.”

The IMA has been trying to get an anti-quackery bill passed, but it’s been stalled for decades, says Dr. Tandon. The absence of a provision in the Indian Penal Code and Code of Criminal Procedure is a big loophole. Incidents such as the one in Bangarmau would not have happened if the laws had been more stringent, or there was more awareness among people, he says.

I meet Urmila, a domestic help and a regular patient here. Her young son died, she tells me, while he was being treated by ‘Bengali Doctor’. Why does she still come here, I ask.

“But he saved my daughter from a serious illness. He may have killed my son, but he is a saviour too. And above all, life and death are in god’s hands,” she says.

(Some names changed to protect privacy.)

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Printable version | Jan 26, 2020 8:02:02 PM | https://www.thehindu.com/sci-tech/health/the-spin-doctors-indias-quacks-imperil-lives-but-are-god-to-their-patients/article23398980.ece

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