When Chief Minister Narayan Rane recently visited KEM, Mumbai's premier public hospital, he didn't notice the hospital's esteemed super-speciality units, but its rather rundown structure. Not surprisingly one of the first priorities of KEM's new dean, Dr R G Shirahatti, is to get the entire building repaired.In fact, improvement is the watch-word for Dr Shirahatti, who took over from Dr Pradnya Pai. A general surgeon and associate professor, he was also a professor of surgery at Sion before he was selected to head that hospital in 1996. In an interview with Rajiv Sharma, Shirahatti discusses KEM's problems and his prescription for change.What are your plans for improving the hospital?When I took over as dean of KEM hospital, I was taken aback by the state of disrepair and lack of maintenance of the 75-year-old building. For instance, these heritage buildings are quite old. And because the plaster between the joints has come out, moisture gets absorbed easily.Therefore, I haveinformed the municipal commissioner that Rs 4.5 crore will be needed to repair the entire structure. After all, the appearance of the hospital influences staff as well as patients, who will keep the place clean only if it is maintained properly.What are the medical services in the hospital that require improvement?This is a major area of concern. While the hospital has well-developed super-specialities, it lacks in basic services. Since 50 per cent of indoor patients are emergency cases, they have to be provided with X-rays or blood tests, and the doctor is later called for treatment. Since all these facilities are scattered, it takes time for the patient to get treatment in an emergency. Therefore, we plan to start emergency medical services whereby patients will get treatment the moment they enter the hospital. There will be a 30-35 bed ward, and all tests will be in the vicinity of the ward. The OPD will also need to be modified, some laboratories will have to be relocated, and operationtheatres will need upgradation for major surgeries. This project should take off as soon as possible.Isn't the cost of sophisticated equipment a major problem for the cash-strapped BMC, which runs KEM?It is a fact that the last few years have seen medicine becoming more technology-intensive, and that there is less reliance on skill-based treatment. And since the equipment is expensive, we are exploring the idea of leasing machines. I had, for instance, made a proposal to lease the CT scan at Sion hospital just before I left. However, the fund crunch has not affected basic services and as a rule, the civic health budget is also not supposed to suffer.Is shortage of staff at the hospital a problem?It is not shortage, rather, high absenteeism among the nursing staff that is creating the problem. The ratio of beds to nurses which was 6:1 should be brought down to 4:1 so that the rate of breakdown among nurses is reduced. We have asked to raise the number of nursing staff, and theadministration doesn't seem averse to the idea.KEM is known for rivalry among its two unions, the Municipal Mazdoor Union and the Municipal Kamgar Sena.KEM is a major fort for any union, hence, unionism will always exist. But we will ensure that it does not affect the hospital's functioning, and we have told the unions that confrontation is not the answer. Things have improved; while there were four morchas in the first week after I took over, there have been almost no problems lately.How do you intend to better KEM's academic record?The hospital is already ranked fifth in the country, and we plan to improve on this standing. I have been discussing the problems of each department with the staff so that facilities can be improved. The results will be evident shortly.
