Independent Goa Observer

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When healers turn killers

THE FOCUS OF our cover story this time is the Goa Medical College Hospital. The immediate provocation focussing on the GMC is a young man who walked into our office. He had gone to the GMC following an epileptic seizure. When he left the GMC his hand had been infected because of an act of criminal negligence. The hand had to be subsequently amputated. Privately all the senior doctors in the GMC admit that young David D’ Sa is a victim of negligence. Phenomena all too common in the GMC. But of course nobody will take responsibility. The GMC is perfect in the art of passing the buck. Not surprisingly the discharge papers do not bear any signature. And nobody seems to be particularly agitated or surprised that the young man in the prime of his life lost his hand because of the callousness of butchers masquerading as healers.

I am no stranger to the GMC. In fact because of the GMC I lost almost five years of my life. In 1989 I was admitted to the GMC after I was assaulted by some hired thugs presumably at the instance of the then speaker of the Legislative Assembly, Dayanand Narvekar. I had incurred his wrath because I had run a campaign demanding his resignation after a young lady employed at the secretariat complained that he had attempted to molest her. Even more dangerous than the indifference of the doctors in the GMC is their anxiety to please VIP patients. I was under considerable pain when I was admitted to the GMC way back in 1989. The Head of the Department of Medicine, Dr N G K Sharma, pumped me with steroids.

When I developed steroid toxicity he panicked and instead of gently tapering the steroids off he withdrew them abruptly. Which plunged me into an even worse crisis. The worse part about steroids is that they mask the symptoms. Doctors also have a herd mentality and subsequent doctors inevitably go by the diagnosis, right or wrong, of previous doctors. The crux of the problem was the former Head of the Department of Medicine, N G K Sharma, did not know what was wrong with me. And it was this that aggravated matters and cost me five years of my life. When a doctor uses the phrase “differential diagnosis” run for your life. It means he does not know what is wrong with you and is experimenting at your cost.

The GMC has the best medical infrastructure in the State. The problem with the GMC is that it has deteriorated into a highly politicised soulless bureaucratic machine where human limbs or for that matter even human lives don’t matter. The doctors couldn’t care less about what happens to a patient. Particularly poor patients who have no voice. The doctors in the GMC can afford to be callous and uncaring and criminally negligent because they cannot be taken to the Consumer Court and cannot be held accountable. This is because public hospitals, which on paper do not charge any fees, do not fall under the preview of the Consumer Courts. Never mind that the GMC is free only in theory. And the patient has to pay for everything from disposable syringes to even the sutures used in an operation.

The GMC has become a nightmare for patients. But unfortunately private hospitals in Goa with some honourable exceptions are even worse than the GMC. Private hospitals are totally mercenary. Private maternity homes for instance will always advise a caesarean because there is far more money in caesareans than normal deliveries. Private nursing homes will inevitably ask you to undergo a dozen diagnostic tests. At the slightest excuse they will suggest you have a CT scan or an MRI. Because there is an elaborate kickback system and the private hospital gets a cut on every CT scan performed by a private imaging system. The same holds for X-rays and sonography. I have known of private hospitals which insist on unnecessary operations. The appendix is a major source of revenue for most private nursing homes. Nobody objects to private hospitals making money. But the quality of medicare is so pathetic that private nursing homes are even more injurious to a patient’s health than government hospitals. And private hospitals are merciless in collecting their bills even from the dead. I understand that a well known private hospital in the South submitted a bill of Rs.5,000 after the patient was dead.

The most dangerous private nursing homes in Goa are the insurance specialists. Hospitals which sprang up for the benefit of foreign tourists. Most foreign tourists are heavily insured. They are an enormous source of revenue to many private nursing homes in Goa. Not surprisingly the insurance hospitals are more concerned with the medical insurance papers than the health papers of their patients. Apparently there is also a nice little racket that has been going on. A conspiracy between the foreign charter tourist and the nursing home to take the insurance company for a ride. The nursing home goes through the motions of treating a heavily insured tourist for some imaginary disease. Some even go to the extent of performing a dummy operation and the loot is shared between the doctor and the patient.

I do not want to scare both residents and visitors to Goa. The scene is not totally bleak. There are several honourable doctors and ethical nursing homes. But you have to look through the haystack of racketeers to locate the uninfected needle. You need to do some research before you place yourself at the mercy of a private nursing home. And as a general rule of the thumb the greater the hype about the hospital or a nursing home the more injurious it is likely to be to your health. Do not be taken in by the PR. If the receptionist is pretty and smiles at you and the nursing home has a more elaborate lobby than an OT you should run for your life. And my personal experience is that hospital run by old-timers are safer than all the Johnny-come-latelies with their hi-tech equipment. The India Today in its survey claimed that Goa had the best health services in the country. Obviously none of the India Today staff had ever to use the medical services in Goa. We are appalled by what has happened in the GMC. But at the end of the day it is the only hospital in the state which has the infrastructure and, in the case of many departments, reliable experienced medical professionals. So what we need to do is to bring pressure to stem the rot in the GMC. And make it work as a caring, compassionate hospital.