Geriatric Hospitals Are Essential

Subhas Chandra Pattanayak

Six months!

Six months without her because of whom, after passing away of my father in 1988, I was not an orphan.

My mother passed away at Bhubaneswar six months ago on December 16, 2011.

After igniting her pyre in “Swargadwar” crematorium, Puri, while waiting for the Malabhai (group of my brotherhood who performed the cremation) to come with her ashes, on the beach of Mahodadhi, my sobs had taken the following form:

(These two pages are from Dahana Daha, published on her Dwadashah)

And, while jotting down the above stanzas, I was consoling myself that the fire would immortalize my mother with the elements and make her omnipresent for me to feel her presence every moment, everywhere.

All these six months, in every moment of solitude, I have felt her presence in her omnipresent form, have taken my sleep as if in her lap, have welcomed the wee hours everyday to see how the sleeping world wakes up to her eternal call to work apace.

Working apace was my mother’s celebrated habit all her life. She was always busy in works after waking up in the wee hours till retiring around midnight. Her loving care was not limited only to the family members but also was fabulously available to the plants on our soil, to the pets in our house as well as to our relations and family friends, including the friends of the friends and to casual visitors. Everybody in our extended family, in our immediate neighborhood and of my clan in the village, was of unreserved reverence and utmost affection for her. When the news of her illness had reached them, they were as anxious for her recovery as they were in tears on getting the sad news of her demise. She was really unique. Not a moment of her life was spent in idleness. When no specific work was to be done, she was reading books and browsing through newspapers and keeping herself abreast of developments in socio-political and economic fields.

I was in USA for six months. On return, to meet her, I went to my native place Tigiria, where I had left her with my brothers before going abroad. She told me that she was having some pain in the abdomen sometimes. I brought her back to Bhubaneswar, my professional place of living. And, consulted the Capital Hospital. It is the State headquarters hospital of Orissa Government conceived originally to be what AIIMS is to government of India. But self-centric persons taking over political reign of the State since 1960, the idea was abandoned. Yet, senior specialists in different disciplines are being posted here and Professors of super-specialty departments of SCB Medical College are conducting outdoor treatment everyday in weekly rotations under orders of the Government. Under their advice I admitted my mother in the nursing home of this hospital. After a week, under their advice again, I took her to Kalinga Hospital for an endoscopic investigation. I shudder to write what happened thereafter. I am sure, had I not taken my mother to Kalinga Hospital, she would certainly have been alive as yet. Recalling that experience is so painful and frustrating that I am yet unable to find words to make a report on that. Someday, when time shall, to manageable extent, heal up the wounds of my soul, I will narrate my mother’s Kalinga Hospital phase and how brutally that shortened her life.

However, as the first six months of her passing away have passed away, I feel it necessary to say that I could have given her proper treatment if any hospital in Orissa (in hope against hope, I had to contact and consult all who mattered in respect to her health in all the government and private hospitals in my State under reference and cross-references), could have any scope for geriatric treatment.

There is no geriatric care specialties in any of its medical colleges and in the private hospitals that are making money under brand names.

The general impression is being given to the elderly / aged patient is that his/her suffering is caused by old age, sans any concern for what impact such statements from the treating physician should be putting on the psyche of the affected.

I feel, we all will fail in our duties to our elders if we fail to force the governments to put priority on establishment of geriatric hospitals with super-specialty departments addressed to diseases that are expected to afflict the parents and the grandparents in course of time.

With massive majority in Orissa perishing below the poverty line, because of mismanagement of the mineral-rich State by commission agents in power, the geriatric problems are more menacing in rural areas, where, the available medical practitioners have no training at all in geriatric care.

No Doctor in Orissa has any training in geriatric medicines. No Nurse has any training in geriatric care.

Old persons are admitted in general wards and treated generally, with open suggestions that their diseases are “old-age-diseases”, which precipitates their debacle, as they feel they cannot be cured. This has to be stopped.

My family being a big joint family, my mother was in no dearth of caring hands. Yet, I feel, had we in the family have enough awareness in geriatric problems, and orientation in physical and psychological care of the elderly, my mother could have received more defined and desirable nursing than that she got in the hospitals. So, it is necessary that the general public be made aware of geriatric necessities.

The Panchayats and urban civic bodies need be instructed and enforced to orientalize the people within their jurisdictions on locating geriatric problems, on dealing with the elderly, on how to keep them in better health.

The MLAs and MPs Local Area Development Funds are being mostly misused and cycled into their private pockets, a small part of the booty distributed amongst their followers and false bill preparers. The funds necessary for geriatric programs can be obtained officially from the LAD funds given to MLAs and MPs.

But unless geriatric hospitals are specifically established, and super-specialty departments to deal with geriatric problems are created in Medical Colleges and Doctors as well as Nurses are given orientation training in geriatric treatment and care, the general awareness cannot be sharpened on this issue.

So, instead of squandering away Orissa’s natural resources for benefit of private capitalists, even foreign industries, shouldn’t the State Government take steps to ensure better health care for elder generations, by establishing geriatric hospitals, at least one in every district?

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Overcoming the Trying Tricks of Time

For the last three weeks, my mother Asharani Pattanayak, at the age of 91, has been trying to overcome the trying tricks, the ‘age’ is playing upon her.

She is trying to foil the design of time, of course, with the able advice of the competent doctors of the Capital Hospital of Bhubaneswar, particularly the treating physician, Dr. Sudarsan Dash (Gynecology), Dr. B.C.Panigrahi (Medicine), Dr. Ashok Panda (Nephrology) and the Chief Medical Officer Dr. Nirmala Dei.

Age plays havoc with senior persons everywhere.

Medical science and its practitioners try to stand by their side.

But determination and willpower of the patient are essential to make the medical endeavor successful.

My mother is an epitome of both these noble qualities. She has been co-operating with Dr. Dash and his colleagues to make medical science triumph over the cruelties of Time. And, hopefully, within a week, she shall come back home with her revived old self.

I confess, I am not as strong as is she. If this is not true, I wonder as I look at these pages, why have I not been able to come up with what should have been presented to my esteemed subscribers and readers up till now since her hospitalization?

Capital Hospital is the largest Government Hospital in the Capital City of Orissa (recently changed into Odisha by the idiots in politics under a law created by them under sheer misconception).

The number of patients it daily treats is as massive as that the well-known S.C.B.Medical College Hospital of Cuttack attends to.

It has a number of suites styled as Nursing Homes that are allotted to indoor patients on payment of rent. But, like age ruins the human body, the Nursing Homes are showing signs of physical decay.

The stained toilets attached to these suites are indicative of acute lack of maintenance.

The air-conditioner machines are indicative of how rotten could be the instruments if the essential necessity thereof for patient management is forgotten by officials after installation.

The junked and damaged legs of the beds as well as of the steel wardrobes with nonfunctioning doors are indicative of how the authorities are negligent to the essential safety of the patients.

Yet, for people like us who stand for and subscribe to public sector, the Doctors and the Nursing Staff of the Capital Hospital are humans whose humane qualities have not yet collapsed under disastrous designs of the plutocratic government that willfully neglects the essential infrastructural necessities of government hospitals.

And, therefore, in Nursing Home No.8, despite threatening indoor environment, my mother is taking a turn towards the better.

From the core of my heart I thank the Doctors, the Nurses, the authorities of the Red Cross Blood Bank attached to this hospital for the nice, efficient, alert, timely and tireless support they have given to my mother in her determination to survive the cruel attack that the Time in the guise of ‘age’ has perpetrated on her.

She belongs to the generation of freedom fighters whose love and sacrifice for the motherland had forced the British to quit. Their dreams of freedom were woven around fair living environment. Now those dreams are destroyed by the agents of capitalism – the hybrids of post-independence opportunism – who in power, have thus dragged the public sector hospitals to deplorable condition of dilapidation in order to help the corporate houses hijack the most essential sector of health care. Yet, there are Doctors in the public hospitals, who, despite the capitalist design, are doing their best to save human lives using every available means within their rich.

And my mother, despite her age, is co-operating with the Doctors to overcome the disadvantage of not having a proper health-care environment in even the largest public sector hospital in the Capital City of the State.

She is trying to overcome the trying tricks of ‘Age’. And, in her, anyone of India of my age, aptitude, orientation and situation can see his/her own mother and think of how to protect and save the government hospitals from official negligence and subterfuge.

Cholera is caused by Misrule, Admits even the Health Minister

Subhas Chandra Pattanayak

We have in these pages shown repeatedly how slow starvation has destroyed common man’s immunity and because of that how cholera has taken toll of the poor persons in unprecedented numbers in post-independence Orissa. No rich man, despite presence of the deadly virus, has died so far in the affected area. This proves that only the poorest of the poor, who have lost their vitality due to slow starvation, are succumbing to cholera.

After a delayed visit to affected districts, the Health Minister of Navin Patnaik’s government, Prasanna Kumar Acharya, has admitted that people are dieing because of two factors. The first factor, according to him, is dependence of the poor villagers on unclean ponds and streams for drinking water and the second factor is unavailability of medical services to majority of villages due to total absence of negotiable roads.

Navin Patnaik is ruling the State as chief Minister for three terms. His father Biju, whose footsteps he claims to be following was the CM for two terms and the remote controller of administration for one term when his protégé Nilamani Rautray was commissioned by him as the CM. Now Navin’s Minister of Health admits that the people are succumbing to unrelenting cholera due to want of potable water and basic health care worsened by non-existence of negotiable roads. This is how the father and the son and their factotums in politics have ruined Orissa.

It must have been very difficult for the Health Minister to have admitted the misrule that has culminated in cholera. But here, the misrule is such a discernible reality that the man in the Minister has has at last risen to admit it.

Navin Brand of Administration: Cholera Kills the Common Man

Subhas Chandra Pattanayak

All of the one hundred and forty persons who have died due to Cholera and other water-borne diseases in Orissa and the 667 persons that are hospitalized being affected by the unrelenting epidemic are wretchedly poor fellows belonging to the undeveloped districts of Rayagada, Nabarangpur, Nuapada, Koraput, Kalahandi and Malkangiri, where welfare funds are habitually hijacked by ruling party hoodlums and bureaucrats who share their booty with politicians in power leaving people in the grip of continuous slow starvation.

Continuous slow starvation has destroyed their body immunity though health department officials hold that dependence on village streams for drinking water is the root cause of the epidemic. Even the administrative authorities of the affected districts admit that the infected villages have no dependable dug well whereas tube wells, wherever installed, are so sub-standard that they not functioning as a result of which people are forced to drink from the streams ignorant of how contaminated is their water.

Were the doctors and the administrative executives been honest, steps could have been taken to ascertain as to whether or not loss of people’s physical immunity due to continuous slow starvation has helped Cholera takes its toll. But the confession of the authorities that the epidemic is caused by contaminated stream water confirms that Navin Patnaik’s government has not paid attention to drinking water needs in the undeveloped districts.

Navin Patnaik brand of development has caused shift of priority from people’s welfare to benefit of POSCO and Vedanta and the likes. Consequently it has made administration so apathetic to needs of the common man that people in slow starvation are dieing due to want of potable water.

Cabinet Resolution Would Ruin Health Care: Cancel It

Subhas Chandra Pattanayak

Chief Minister Navin Patnaik, marked for onrush of anarchy to which his government has subjected Orissa’s health care time and again, has allowed his Cabinet pass a resolution on July 6 to bypass the Orissa Public Service Commission, the constitutional authority to select appropriately qualified Doctors for posting under the State Government, in appointment of doctors on ad hoc basis so that privately run dubious medical colleges gain seat selling environment for themselves by getting their alumni appointed in health care jobs in the public sector.

The resolution is cunningly crafted to help persons educated in dubious medical colleges, who, in OPSC exams, may never qualify for appointment as Government doctors.

Havoc played upon Health System

Loot of health-care funds brought on loans from the World Bank for implementation of Orissa Health Systems Development Project (OHSDP) is well on records. But Chief Minister Navin Patnaik, instead of taking steps to punish the culprits, had rewarded the two persons in charge of the health department when the loot was going on – the then Health Minister Prafulla Ghadei and Health Secretary R.N.Senapati – with the Finance portfolio that controls audits or investigations in the matters of financial offences and improprieties with inbuilt command over the administrative mechanism to initiate penal action against the offences or to render them inconsequential.

Environment created for misappropriation

The administration under Patnaik has forced poor patients to pay for treatment in Govt. Hospitals in the name of use of essential funds in health care. But in fact it is a trap to get more money for unbound misappropriation. On 17 January 2007, in these pages, we had shown how government auditors had unveiled misuse and misappropriation of at least Rs.2,09,79,509.00 within a period of around two years in a single Hospital, i.e. S.C.B.Medical College Hospital, Cuttack. The Government is yet not able to tell the people as to what action is taken for recovery of the involved amount and against the culprits involved.

Aborted official conspiracy

Looters of public exchequer, who operate under the guise of NGO, had used the Patnaik Government to take over Government Hospitals. The conspiracy, first resented to by Loksabha member and editor of Dharitri Tathagat Satpathy, was exposed in these pages on 1 February 2007. Government was put on leash; but the modus operandi remained undismissed.

Post fixing

We have often exposed, as for example our posting on 24 January 2009, in these pages, how posting of Doctors are fixed on extraneous and illicit consideration in stark disregard to administrative propriety and essential necessities in health care sector. The practice is going on even now as Notification No.1702 and No1707 of 29 June 2010 shamelessly breathe.

Incorrigibly corrupt

So, despite change of persons in the chair of the Health Minister, the Government continuing under Chief Minister Navin Patnaik, continues to be incorrigibly corrupt in matters of health care.

Phenomenal rise of private Hospitals in Orissa during this period is because Navin Patnaik administration has ruined public sector Hospitals through continuous corruption as sampled above. Some of these private Hospitals have established Medical Colleges whereinto admissions are given on open secret bids to aspirants that are considered too deficient to get seats in Government Medical Colleges. How dubiously many private Medical Colleges run by purchasing corrupt officials of Medical Council of India doesn’t need any elaboration after arrest of Ketan Desai, then its President and his associates in a Rs.2-crore bribery case, by the CBI on 23 April, 2010. Desai had struck a deal for this amount with a single private institute called Gian Sagar Medical College in Patiala of Punjab.

Private Medical Colleges running in Orissa use Doctors retired on superannuation. No authority has ever examined whether or not they are of impaired faculty. No authority has placed before the public details of their infrastructure and facilities against expected minimum so that qualitative study of suitability of medicos graduating from there, may somewhat be possible to help the people decide if health care could be safely left in their hands.

But now the Government in shape of resolution in the Cabinet has created the environment of handing over health care to medical graduates from private colleges.

The Cabinet resolution is equipped with a cunningly crafted escape method. And, that is the method of ad hoc appointment with provision of regularization later.

Dubious method of ad hoc appointment

Ad hoc appointment is the ploy in practice in Orissa to settle deficient persons in government jobs behind the back of the Orissa Public Service Commission.

The OPSC has been crying in vain against this. This is being reflected in its annual reports. The Governor is the statutory authority to take action on reports of the OPSC. But such is the clout that no action is ever taken against any wrongdoer even after notes on how ad hoc appointments have been kept hidden from the OPSC for several years.
I will site two cases pertaining to department of Higher education. There was an IAS officer whose wife was a lecturer appointed on ad hoc basis. She had the requisite class in her Masters degree. But in the interview before the OPSC she miserably failed. She failed also for the second time. There was an official stipulation that if an ad hoc appointee fails to pass the OPSC test consecutively for three times, he or she should be permanently disqualified for the government job. The lady had no chance to pass the test in the third chance. So, she never appeared for the third time. She continued on ad hoc basis till regularized behind back of the OPSC. She is now a senior faculty and her husband is in a prestigious post. There was yet another case where the concerned person was a third class MA, which was below the requisite qualification for lecturership. The OPSC had refused to approve her ad hoc appointment on the ground of deficiency in qualification. Behind back of the OPSC she was allowed for a decade to continue as a lecturer till the Utkal University was tamed to condone her deficiency to create new grounds for the OPSC to allow her fresh appointment with effect from the date the University condoned her deficiency. But, in blatant disregard to OPSC advice, she was regularized with retrospective effect from the date of her first ad hoc appointment and was helped to supersede hundreds of properly qualified College teachers in bagging promotion to Senior Administrative Grade in Orissa Education Service. This was because, she was the sister of the wife of an IAS officer who retired as the State’s Chief Secretary.

Against this background, with IAS officers ruling the roost in Orissa administration with expertise in hoodwinking Laws and with self-centric politicians habituated in serving the interest of whosoever can afford to pay, ready to cooperate, there is no difficulty in understanding what for the Cabinet has resolved to bypass the OPSC in appointment of Doctors.

There should be no difficulty in understanding that unless the proposal to appoint Doctors on ad hoc basis is not instantly withdrawn, health care in public sector would be in total ruin.

Cancel the anti-people resolution

If Chief Minister Navin Patnaik himself is not involved with this foul play, he should review the Cabinet decision in this particular matter and use his prerogative to cancel the resolution for ad hoc appointment of Doctors.

State Appears Rudely Repressive: Patients under Shadow of Death

Subhas Chandra Pattanayak

In yet another display of its rude reaction, the Government of Orissa has asked the District Collectors to use ESMA against the Doctors who go on strike on and with effect from April 18 in protest against official repression.

Health Secretary-in-charge Suresh Chandra Mohapatra has declared that if the Doctors go on strike, the State would run the Hospitals with trained quacks who are branded as Ayush Doctors. They comprise persons practicing Ayurved, Unani and Homeopathy.

Government Hospitals in Orissa are Allopathic Hospitals. Just imagine what is going to happen in Orissa when Ayush Doctors take over.

The Secretary-in-charge has also declared that if the quacks fail to tackle or contribute to acuteness of any illness, the affected patients would be shifted to selected private Hospitals. This is nonsense. The government knows that beds in private Hospitals are too marginal in number to shoulder the number of patients taking treatment in and depending on Government Hospitals. So, it is evident that the assurance to provide the patients with treatment in private Hospitals is impossible. But possible is that the design is drawn to provide a bonanza to private operators of medical care. In that case, the present impasse might have been promoted by the private Hospitals through their commission agents in occupation of political and official posts.

Might be, therefore, the Doctors’ demand for Dynamic Assured Career Progression (DACP), even though it would have acted a correct incentive, is not being heeded to by the Government. Undoubtedly, anarchy is engulfing the health care sector.

Patients, no doubt, are under the shadow of death.

WHERE HAS NAVIN LANDED ORISSA!

Subhas Chandra Pattanayak

Engrossed in contriving methods to help POSCO and similar other mine mongers, Chief Minister Navin Patnaik has thrown Orissa to such a ruin that in the eyes of the United Nation’s World Food Programme (WFP) four of its districts – Kandhamal, Malkangiri, Gajpati and Rayagada – have been thrown into the ‘geography of hunger’ even as three of them, Kandhamal, Gajapati and Rayagada as well as the district of Nabarangpur are found ‘extremely insecure’ in the matter of food.

When serving the non-Oriya capitalists has remained the priority agenda of the CM Orissa has become a symbol of economic ruin.

More than 15 million people in rural Orissa live below the official poverty line, which constitute 47 per cent of the State’s rural population, says the report prepared by the Institute of Human Development on behalf of the WFP termed Food Security Atlas of Rural Orissa. No other State of India is so wretched.

Noting that the people in Koraput, Nabarangpur, Rayagada and Malkangir have the lowest access to food, the survey exposes that more than five million persons in these districts suffer from calorie undernourishment whereas protein consumption in the State is as low as 48 gm a day per person.

When parents are so pathetically undernourished its impact is bound to play havoc with the children. And it is happening. Before reaching the age of five 90 out of every 1000 children are dieing due to slow starvation in the State.

The report shows, the districts of Kandhamal, Gajapati, Rayagada and Malkangiri have under-five-mortality higher than 160 per 1000 births with more than half of their children being underweight. Similarly, 46 per cent of children under three in the State are underweight, 40 per cent are stunted when 20 per cent children are wasted.

Had health care network of the state not been subjected to subterfuge and corrupt practices by the State administration itself, chances were that the children below five would have a little more hope of excepting death in more numbers. But Navin has been giving an administration that swindles the funds obtained as loans from the World Health Organization and no prompt action is taken against the swindlers when the scams are exposed through audits and intelligence.

Such a Government has given birth to an environment where Less than half of the population has access to primary health facilities. The survey says that the situation is still worse in most of the northern districts and in the southern districts of Rayagada, Malakangiri, Kandhamal and Gajapati where less than 20 per cent of inhabitants have access to primary health cares.

One-third of Orissa’s rural households do not have access to safe drinking water as a result of which water borne diseases such as Cholera and diarrhea are rampant in these areas.

The well known reality is that lakhs of working people from different parts of Orissa are being forced to leave their soil in search of avenues to earn their food and end up as bonded labors out side Orissa. The WPF report has now confirmed the cause. The rate of wages for rural causal labor is very low in the State, it has said indicating that it is further lower in the northern districts, where the rate is often less than Rs.30 a day, which is less than half of the national minimum wages. The Minimum Wages Act is applicable to Orissa; but Navin’s Government never enforces it. The Labor department, which is the administrative department, is most inadequately manned and habitually lethargic. It never serves the workers in right earnest.

Where has Navin landed Orissa!