The Telegraph
Since 1st March, 1999
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Health problem: the who cares attitude
- Govt lines up classes for medics and aides

Tayeb Hussain, Haroona Bibi, Gouri Rani Chakraborty.

Three deaths in the past week ' not to mention the 15-20 allegations of medical negligence every week at hospitals in the city ' is a grim reminder of the state of healthcare here.

Rattled by the deaths, the state health department mandarins have gone into a huddle and begun a process to identify what is actually ailing the health system in the city and across Bengal.

'The attitude of the staff members and accountability of doctors ' we have to do something about this now and immediately,' says Prabhakar Chatterjee, the director of health services, assigned by the government to make drastic changes in the healthcare delivery system.

Gouri Rani's death at Sambhunath Pandit Hospital earlier this week revealed how negligent nurses can be ' they failed to notice ants crawling into her bandaged eye. But very few would know about the great disparity in the number of attending nurses and patients admitted.

While the rules laid down by the Medical Council of India and all international watchdog agencies specify that one nurse should be assigned the task of taking care of three patients only, Bengal has a one-nurse-for-20-patients ratio, which is in direct violation of healthcare norms.

'The government on paper has one nurse taking care of five patients. But in reality, we have one nurse sometimes looking after 40 patients in a ward and it is an impossible task to look after each and every patient in such a situation,' a senior health official in charge of nurses in a city hospital revealed.

Flouting guidelines, most of the city's state-run hospitals do not allot specially trained nurses to emergency operation theatres, intensive care units, outpatient departments and other specialised wings.

'With no alternative left, the hospital authorities shift nurses from the wards to these departments, creating a void in the wards. Incidents such as Gouri Rani's are inevitable if things go on like this,' says Anshuman Mitra, the Calcutta district committee secretary of the city-based healthcare body, Medical Service Centre.

'There are 24,000 vacancies for nurses, but what the government did was induct only 1,000 nurses in two batches of 500 each. In such a situation, nurses can get irritated at nagging patients and their relatives,' Mitra explained.

Not just nurses, city hospitals lack doctors and beds, too.

There are some 5,000 beds in the city's state-run hospitals. 'In the past year and a half, the flow of patients has increased by almost 20 per cent but we have not been able to increase the number of beds. We will have to continue working with whatever resources are at hand as increasing beds is not on the agenda right now,' said Chatterjee.

Across Bengal, about 100 patients are admitted to be placed on hospital floors every day, for whom doctors and nurses, who are far fewer in number than they should be, do not have either time or interest.

Accountability and symp-athetic treatment of patients and their kin is an area giving the authorities sleepless nights. Earlier this year, the government announced amid fanfare that it would try to bring accountability by introducing a diary on which doctors would sign their names and write down what they did that day. Senior Swasthya Bhavan officials were to go through the records.

'The entire plan to reform doctors failed as no one bothers to sign or do their work. There is no accountability and a section of doctors is still more busy with private practice,' said R.D. Dubey, the editor of the Journal of Indian Medical Association.

The health department has now decided to pump in about Rs 10 lakh into orientation programmes for doctors and nurses where tests of communication skills and attitude will be of great importance. The diagnosis of the health system's ailments has revealed that attitude problem is the single largest issue that officials have to deal with. Stress and lack of proper training follow.

'We have decided to focus on making the hospitals stress free and get all the staff to undergo the orientation programmes. Tending to patients with a little care will be our primary concern in the days to come,' said Chatterjee.

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