Lack of planning and arbitrary referrals from smaller hospitals result in a chaotic rush of patients in tertiary care hospitals and declining quality of medical care in government-run health facilities. Syed Asma witnesses what happens when an oncologist has to see a patient for treatment of a common cold.
Hundreds of people holding coloured tickets in their hands are waiting in the corridor.Some are standing, some sitting and a few others pretend to be in a queue. People get irritated and yell at each other whenever someone tries to sneak in the queue or by pass it.
As the seats in the corridor can accommodate only a few people, others rest uncomfortably on the cemented floor. Few stretchers are occupying the space in the corridor too. Amidst this rush, patients find it difficult even to walk through the corridor.This is the Out Patient’s Department (OPD) of SKIMS hospital.
Amidst this chaos, a conversation begins in one of the corners of the corridor.“Just see how people are stuck to that door as if there is a treasure inside,” says a patient.“We should stand in a proper queue, so that inconveniences will be minimized,” says another.
One more attendant adds,“Does this look like a hospital? I feel I am at Patna railway station This is so chaotic and irritating, I regret why I brought my mother here.”The man has come from Baramulla. The old lady, who has a kidney disorder, is holding a bottle of water in her hands. She complains of back pain as she has been sitting on the floor for three hours.
Her OPD ticket displays number 115 and so far the doctors have seen only 25 patients. She still has to wait for a long time.
A few shouts come from the other end. “A bit louder”, yells a young man satirically. It turns out to be a quarrel between an old man and a doctor (senior resident). It began when the doctor was struggling to ‘penetrate’ through the jam-packed corridor to enter the doctor’s room.
“O! Rich fellow where are you heading. Are you getting late for your flight? What do you think we are doing from last three hours here?” says an aged patient. The doctor without giving any attention to the old man tries to make his way into the room. The old man holds the young doctor by his collar. A fight starts. “Do you have any idea who I am? I am a doctor and you are behaving with me like this,” the doctor says. “I do not care whether you are a doctor or what,you can’t go inside….” The argument gets more intense and the patient leaves the corridor in a fury.
The doctor starts making an announcement, “If any of you think you are the only ill persons here, you are wrong. Nobody is roaming about for pleasure. Stop giving yourself a priority and believe me, we all are at your service but please maintain discipline.”
Amid these fights and empathizing notes, a woman is crying. She is not wailing because of pain but for her son who was lost. “I can’t find him anywhere for the last three hours. I was holding his hand, we were standing near this door,” she breaks into tears. Her son, Ibrahim, is five years old.
Most of the patients waiting here have come from far away places and have to wait for a long time to see the doctor. A boy, 10, is asleep in the lap of his father on the floor of the corridor. They have boarded a train from Sopore to reach in time but there seems no chance of getting a consultation in the next few hours. The kid has undergone a neurosurgery the previous month. He is now complaining of continuous headache since a few weeks.
Another patient from Anantnag who was hit by a vehicle a day before was referred from Bone and Joints hospital to SKIMS for a general check up is also waiting for her turn.
After waiting hours, patients complain that doctors do not give them proper attention. “We wait for hours to see a doctor but in the consultation they hardly spend five minutes with us. Here doctors are always in a hurry,” complains Mohammed Yusuf, a diabetic.
In the meantime, Ibrahim was finally found after five hours, and his mother heaved a sigh of relief.
The doctors too have their explanations. “If I spend more time with a patient others waiting outside make a hue and cry. They would say that I do not think about them and am wasting time with only one patient,” says Dr Abdul Rashid Lone. “We have to make sure that we attend each and every patient who is waiting for his turn outside.”
Doctors feel they are over-burdened. Lesser number of consultants and a little movement in peripheral hospitals increase their trouble. A super specialty OPD should ideally not receive more than 15 or 25 patients in a single day but they have to attend 100 or more every day.
“We lack proper referral system in the Valley. I am an oncologist specialist but patients with trivial issues like cold and throat infection also come to me for treatment (though most of them are cancer patient or have been at some time) and waste the doctors as well as the other genuine patients’ time also,” adds Dr Lone.
The doctors suggest that if the peripheral health centers do their job seriously the rush in the city hospitals will be lesser and the quality will be improve.
“We have a significant infrastructure in most of the district hospitals but due to lack of knowledge we fail to use that. Proper training and regular updates should be given to the Paramedical staff in all the hospitals so that the efficiency of the health sector increases considerably,” says a senior consultant who wished not to be named.