My experiences at the Indraprastha Apollo Hospitals

The other day I landed at the Indraprastha Apollo Hospitals, a stone’s throw away from my residence in New Delhi. My wife needed a test and our doctor at Max Healthcare asked us to get it done at Apollo as the equipment at Max was out of order. The moment I walked in I felt as if I was on a railway platform. The hospital was full of patients as everybody appeared to be in a mad rush. In the OPD area, the ladies at the reception were busy, chatting amongst themselves, while patients and their caregivers waited for their attention. They wore no uniforms and for some strange reason, they were also collecting cash from the patients (apparently for the doctor’s consulting charges) and handing out receipts scribbled on small chits, which did not even have the hospital’s name on it.

Strangely, I was than directed to a cash counter to pay for the tests.

Since my wife needed some injections we were asked to go to the pharmacy and buy them, bring them back to the treatment room in the OPD area, where a nurse would help us with the shots. As we wound our way back to the Pharmacy we discovered that buying medicines is a huge chore. We submitted our prescription at a counter in the pharmacy and were handed over tokens and asked to wait. There was no place where one could even stand, without being pushed around. After being jostled around for 30 mins, we managed to buy the medicines, only to discover that we also needed to buy the disposable syringes, which the doctor had forgotten to mention on the prescription. So lo and behold the charade of the tokens was repeated.

During all this I counted 18 people inside the pharmacy store and the two guys who handed me the medicines and accepted my cash kept chatting with each other in a south Indian tongue, without bothering to pay any attention to me whatsoever.

We returned to the OPD and were directed to room no. 15 for the shots. This room was locked and we were than directed to a paediatric immunisation room full of anxious parents and bawling kids. This is where my wife managed to get the shots she needed. We wasted more than an hour in all this and ran around the hospital OPD trying to get some very basic services. The staff was uniformly disinterested in us, poorly trained and too busy to attend to us. Fortunately, the test my wife needed was routine and she is in good health. I can just about imagine the plight of patients and their care givers flocking to this hospital and being shunted around by a callous system, which barely works.

And now here is what happened when I came to collect her reports two days later.

I called up the hospital to check if the reports were ready. On being informed that I could collect these by 8 PM, I agreed to stop by to pick these up. As I walked in at about quarter to 8 in the evening I discovered a security guard merrily locking up the report collection area. He directed me to take another door into the radiology reception and 5 minutes later, when I walked in I found the lights switched off, the guard had also disappeared and there was not a soul to be found. Perplexed, I walked into another adjacent room and found someone busy on the phone.

As I explained my predicament, this gentleman informed that I was late and that the staff usually left 15-20 minutes earlier than closing time! Amazed and incensed at all this I asked to be directed to someone, whom I could lodge a complaint with. Much to my disbelief I was told to approach the Emergency Medical Officer in the Emergency!

At the reception in the Emergency, I found myself explaining my situation to a young man, who was simultaneously trying to answer questions from an anxious gentleman, whose father had just been brought in with severe chest pain!!! The emergency medical officer, who was supposed to record my complaint was predictably busy with a patient and I was asked to wait. After about 30 minutes of watching the bedlam of a busy Emergency room with no one paying me the slightest attention, I raised my voice (and in the process added to the chaos) and demanded to see the highest ranking hospital official to record my complaint.

I was than informed that the Night Duty Manager will now attend to me soon. Another wait of about 15 minutes followed and yet no one showed up. I again screamed at someone and in another 10 mins a nurse walked out looking for me. She understood my problem, asked me to wait and went to fetch my reports. She returned in a while with my reports and gently admonished me for being so late and irresponsible in collecting my documents.

This is a true story of Delhi’s only JCI accredited hospital. God help us all!!!

The Apathy of Delhi Hospitals Towards the Poor

The Delhi High Court has been after private hospitals in Delhi to honour their commitments regarding the treatment of the poor, but sadly to no avail. The hospitals are just not willing to treat poor for free, a condition that they agreed to while accepting land from the government at hugely subsidised rates. In-spite of the Delhi high court directing the hospitals time and again to fill up the beds for the poor, the hospitals are dragging their feet by hiding behind every legal loophole that they can find.

For the uninitiated here is the story. As many as 38 private hospitals in the city managed to get land at subsidised rates from the government under the condition that they will treat certain number of poor patients free of cost. The list of these hospitals today read the whose who of the hospitals in the city. However, once these hospitals commenced operations, they never honoured their part of the bargain. Thus the poor continue to be unwelcome in these hospitals, while beds reserved for them either remain empty or are filled up with full paying patients. This needless to say is criminal.

The reasons for this, however are not too difficult to fathom. The business of healthcare is a capital intensive business and the cost of real estate in Delhi is a prohibitively high expense. Thus, getting land from the government at very cheap rates against a commitment of treating the poor once the hospital starts, seems to be a good way of grabbing land. I seriously doubt that any of these private hospitals had any intention of treating the poor to begin with. This was just a ploy to grab land to build the hospital.

Now with the hospital up and running they had to find excuses to wriggle out of the commitment made. Here is a sample of what the hospitals have been saying. A large 600 bed hospital sitting on prime land in south Delhi and part of the largest hospital chain in the country claims that they are unable to treat the poor because they can not find them! As per them the government needs to refer poor patients to the hospital, and since there has hardly been any government referrals, they can not fill up the beds reserved for the poor. They further claim that ‘free’ to them means a free bed and the patient has to pay for all other expenses, thus making the hospital out of reach of the poor. (Mercifully, this claim has now been thrown out of the window by the high court). Other hospitals too advance similar claims. Strangely many do not offer any reason for not filling up these beds.

A recent report in The Times of India indicates that 16 of these 38 hospitals have not even bothered to submit details of the status of their free beds to the government. Hospitals like Dharmshila Cancer Hospital and the Jaipur Golden Hospital have submitted that all their free beds are empty. The Times of India report also alludes to a nexus between the health officials of the government and these hospitals. The health officials refer their kith and kin or their political masters to these hospitals and they are treated free against the beds meant for the poor.

While all this has been going on for many years, some public spirited Non Governmental Organisations have moved the courts. The high court has made all the right noises but justice is yet to be done. While the cases against these hospitals meander in our courts, the poor, as always continue to suffer silently.

Pic courtesy http://www.flickr.com/photos/9019392@N08/552358084/

So much for my ‘Indian Hospital Experience’

While trawling the net I came across a blog (http://www.travelblog.org/Asia/India/National-Capital-Territory/Delhi/blog-440604.html) about the travails of an American, getting treated for a mole/wart/skin cancer in New Delhi. The experience narrated in this post is exactly the kind of stuff we do not want. I am amazed at some of the narration and the stereotyping this does of the Indian doctors and medical system.

The blog has a semi mad sardarji (sikh) as a doctor who speaks and understands no English, laughs at his own jokes in Hindi and does not understand the difference between a mole and a pimple. The doctor has never heard of the United States and knows America, a country whose citizens are rich and ripe for fleecing. The doctor prescribes lotions and creams for treating the mole, which are not available at his own pharmacy and the patient (the author) walks out, having parted with Rs. 500 and nothing to show for it. Astoundingly, this gentleman returns to the clinic of the mad sardarji, encounters a ‘wildeyed’ patient on a wheelchair, and asks the doctor to burn off the offending mole in the emergency room next door.

Can you really believe this? A dermatologist who knows no English, does not know what the US is, prescribes lotions for treating moles and does strange surgery in his ER. All this in Delhi. To me this sounds stranger than fiction.

One can not study medicine in India unless one knows English as the language of instruction in medical schools across the country is English. I refuse to believe that there exists a dermatologist, who can’t differentiate between a pimple and a mole and if I ever encountered, will I let him treat me not once but twice! Come to think of it, will I let someone operate on me if their was a serious language barrier, when I am not sure if the doctor/surgeon understands the problem. If I agree to all this, than it is me who is playing with fire and taking completely unacceptable risks.

I am willing to grant that the author might have been lured to a quack’s place by someone. However, his complete gullibility and his willingness to try out this kind of treatment, which one would instinctively recoil from appears to be a product of his imagination. This as I said earlier only reinforces Indian stereotypes of a land of great mystery, faith healing, strange medical practices and half crazy doctors.

I am sure this makes for great reading back home.

However, what it also does is that it mocks at the great advances India has made in medicine. It paints a very distorted picture of Indian healthcare. India has some of the most modern hospitals and qualified medical personnel, which attract thousands of foreign patients every year. While, there is no denying that there are quacks and the like who exist, not going to a qualified dermatologist for the removal of a mole and continuing with the treatment of a doctor/quack who does not understand ones language will be considered foolhardy anywhere in the world.

Let us have none of this kind of crap.

Pic courtesy http://www.flickr.com/photos/robotalphabet/2693142482/