Lack of essentials in JJ Hospital
I worked as an intern in JJ Hospital and despite the name and legacy that JJ Hospital has, I was in shock at the lack of basic medical essentials at the biggest Government Hospital in Mumbai! This is a hospital with a 175+ years of legacy behind it, with probably the most funding of any government hospital in maharashtra and one of the top institutions of the country.
My first posting was in Medicine and during my emergency shifts (we handled any medical emergencies that came during the day for 24 hours, and then the next unit took over). This is where I was taught the basic steps in Medical treatment as I had no exposure before - attending clinics during my 4.5 years of MBBS just provided basic knowledge in understanding patient care and also I was afraid of needles (a whole another story) so I didn't want to go to patient wards. The first steps after history taking and examination, were collection of blood and iv line insertion. For collection of blood, there were hardly any syringes present in the emerg ward (you need atleast a 10 ml syringe for the amount of tests), and the needles that were present were green needles (the widest ones and hurt like crazy). On top of that, there weren't any blood collection bulbs!!!!!!! Not just that, nor were there any iv cannulas, there weren't any bivalves or iv lines. (all of this is required for fluid and antibiotics to be given urgently to patients)
Thus I was told to give a list to every patient is to be admitted for them to go and buy which included needles, syringes (Rs 10 each), bulbs (Rs 10 each), bivalves(Rs 75 each), iv lines, iv cannulas (Rs 150 - Rs 250 each). These might look like small amounts and compared to US or other countries, they are cheaper in India, but these people are the poorest of the poor who come to JJ for treatment. And in a govt hospital, treatment is supposed to be free for people who can't afford it, but that doesn't include these purchases that they have to make from an outside medical shop!!!!!!!!!!!! And no one comes to the emergency with loads of cash, its a freaking emergency!!!!
This isn't the end of it, after getting all the supplies and then when we collect the blood of tests, I have to give the patients another paper with a list of number for medical labs that run tests coz the Biochem / patho lab in JJ isn't running certain tests. And you might wonder if these are some hi-fi tests and that's probably why it isn't being run, but no. It's the most basic tests - CBC (the most basic test that you need to know), ABG (to know if a patient has acidosis / alkalosis / good O2 saturation) and many more aren't run in JJ. And thus they have to give it outside, which again isn't reimbursed. And these tests do add up to the costs of the patient's!!
The same is the case of wards, the medicine wards lacked the same stuff again. I learnt of a barter system that if I could get the medical lab to give me bulbs to use for the patients then I'd give their number of the tests. It provided some (mind you, a very minute) relief for the patient.
After this was casualty posting. This is where we attend to patients first! If anyone comes with any emergency, casualty is the one that gives a preliminary diagnosis and then sends them to the respective department, for eg fracture is sent to orthopaedics, heart attack is sent to medicine and so on. In casualty, I found out that there is no nitroglycerin tablets! This is first line therapy for anyone with a heart attack! Supposed to given immediately if you suspect a heart attack or atleast seen on ecg, but nope. If a patient comes with chest pain and the ecg shows signs of Myocardial Ischemia (heart attack), all we can do is give pain relief and ask the patient's relatives to buy nitroglycerin and come.
Rant over for sometime! Will come back with a part 2, I got too worked up just thinking about this.
