Inadequate medical infrastructure across North India and poverty, which restricts access to whatever health facilities that do exist, force tens of thousands of patients to leave their homes in states across the region and beyond and come to Chandigarh’s Post-Graduate Institute of Medical Education and Research. When they come here, the condition of some is already beyond treatment; many wait for years just to arrange money for the treatment, all the while their condition deteriorating; mostly they are all poor and in dire financial straits, and by the time they arrive at PGI, they are already deep in debt over medical expenses.
The patients who come to PGI provide a snapshot of how difficult it is to find affordable and reliable health care away from the metros and urban centres, and how medical expenses can send even some in the large middle class hurtling back into poverty. Starting today, Chandigarh Newsline will bring you stories of some of the patients at PGI, mapping their journey here, their extreme financial vulnerability and their crashed dreams.
It all began with a minor infection in 1994. Today, Pawan Kumar, 44, from Jammu is fighting a difficult battle against kidney failure. For the past four years, Pawan along with his family members has been staying at the Sarai in the PGI campus gurdwara. Each day for them is spent visiting doctors and arranging money for Pawan’s treatment.
Jammu has one big hospital, Jammu Medical College, besides two others. Pawan underwent several surgeries there after the infection was discovered, and later a stone in his kidney. “His condition took a turn for the worse in 2010, and we took him to Jammu Medical College again for treatment,” says his son Honey. But dissatisfied with the treatment and the lack of facilities at the college, the family turned to PGI on the advice of a private doctor.
It was the same doctor who broke the bad news to them — both his kidneys were not functioning. “We were not aware of the problem and no one in Jammu Medical College told us this,” says Honey, who left his studies while he was in class X to take care of his father. “Then doctor sahib told us about it.”
Pawan is one of thousands of patients who come from Jammu & Kashmir to PGI every year. The inadequate health infrastructure in that state forces those with serious illnesses to look outside for treatment. Chandigarh’s relative proximity brings many to PGI. As per PGI statistics, 42,319 patients visited the hospital in 2014, while the hospital has recorded 39,832 arrivals from the state in the current year until October-end.
PGI’s Advanced Trauma Centre nodal officer Dr Sameer Aggarwal believes that rush at the hospital can be reduced, if better health facilities are provided to the people in northern states. “We can reduce the rush of patients up to 30 per cent if better health facilities are provided to the people in northern states and then we can devote more time to the complicated cases,” he says. “There are places where you don’t have facilities like X-ray after 2 pm and the patients come to the PGI.”
The gurdwara inside the PGI is now home to Pawan, his wife and son. Another son lives and works in Doda as a shop assistant, saving money for his father’s treatment, which includes three-times-a-week dialysis.
“I am waiting for someone who can donate me a kidney,” says Pawan, now totally dependent on his belief in God. “I am sure God would send someone, because I don’t have any money to arrange a kidney for myself.”
The son and mother, both are still angry at the Jammu hospital. “If initially, the doctors had informed us about the problem, the situation would have been different today,” says Rani, Pawan’s wife. “For 12 months, we visited the hospital for treatment.”
With no source of income and completely dependent on what his son sends from
Doda, Pawan and his family are a classic example of what countless studies have shown — a “health shock” has disastrous consequences for low-income households, especially where most people are forced to cope with medical needs through out-of-pocket expenditure. Pawan’s financial difficulties are already telling on his family and are likely to have a long-term effect.
“My son in Doda sends us money sometimes, but we have a debt of around Rs 2 lakh with his employer,” Rani says. “He is a nice man and he still gives [my son] money.”
She recalls with nostalgia their life in Jammu, where the family led “a good life” with the money Pawan earned. “But now everything has finished,” she says.
But it is Honey who is likely to be most affected by the family’s “health shock”. He is crushed at having had to abandon his studies. “For 10 years, I had been studying in a private school despite my father being a daily labourer. Today, I am taking care of my father,” Honey says. Back then, his aim was to become a marketing executive, a dream that he says “doesn’t exist anymore”.
What is giving sleepless nights to his son and wife is the cost of the medicines. “We couldn’t provide him injections as we don’t have sufficient money. We have now been asked to arrange blood packets for my husband,” says Rani.
They have no other option except to stay on at the PGI and hope for the best. “We have been here for the last four years, because we know how difficult it is to treat patients in our hometown. Today, if anything happens, we can immediately go to the doctor and get him checked, but in Jammu, the case is different,” Rani says.
And while Honey is speaking to this reporter, he gets a call from Babaji, the in-charge of the gurdwara. “I need to go out to fetch something,” he says, pointing to the message written on the wall.
The message reads: “No one is allowed to stay here, without doing any work.”