Grief hung heavily in a minor house with her bare floor and uncontrolled walls. Outside, some anxious faces saw as 20 -year -old Navami, 20, stepped out, hoisted her old grandmother Sethma. Her father, Vrathan, quietly sitting on a chair nearby, was bouncing her eyes.
With a heavy heart, Navami bid a quiet goodbye and drove the flight of steps leading to the road, where a car was waiting for him to take him to Government Medical College Hospital, Kottayam. He looked at his house before coming into the waiting vehicle, as his mother’s memories refused to leave their house.
Navami, one final year B.Sc. Nursing student is going for surgery. And this is his second attempt. The first visit on 1 July, his mother, D. She was with Bindu, from her side. But staying in that hospital was sadly reduced. Just three days later, on the morning of 3 July, a dilapidated bathroom block fell in the hospital. Bindu, who was taking care of his daughter, was trapped under the rubble. It took two hours to recover his body. By then she was dead.
The tragedy triggers a political firearms as the building was considered unsafe for more than a decade. Opposition parties pointed to the roads, saying that patients were forced to use it due to lack of facilities. After the incident, the bulldozer could not reach the spot on time to save the point; He said that a confrontation with the police demanding the resignation of Kerala Health Minister Veena George.
The allegations flew thick and fast, with equally strong protests. But in Navami’s house, there was no hunger for the defect game. For the family, nothing more than the destructive truth was that the point was not.
“They all came. Minister, party leader and district collector. He consoled us and assured us. This means something, yes … but we have lost it,” futile, “he is called, his voice is heavy with sorrow.
Before returning to the hospital, a team of doctors visited Navami to provide consultation. The young woman, already evaluated by neurologist and orthopedics, will soon go under the knife.
Between the resentment and questions that emerges on administrative failures, the questioning question emerges is what does the famous Kerala model of the state of health care. A fresh question is being asked about the patient’s safety, health care quality, infrastructure of aging and lack of manpower in the Government Medical College Hospitals (MC) across the state.
Public health experts are afraid that the underworcement in the field of infrastructure and human resources is finally taking its toll. The recent social media post Haris Chirkal, the head of the Urology Department of Euruvananthapuram Medical College Hospital, on the lack of facilities in the hospital and the resulting sufferings of patients caught the headlines.
His post, raw, hit a nerve with his colleagues across the state, with helplessness. The first MCH of the hospital, Kerala, has increased well beyond its current infrastructure and human resource availability. The departments expand, new equipment are added annually, but the strength of the employees remains frozen in time.
“It is ridiculous that equipment cumbersome and chronic procedures for maintenance and procurement that are usually applied to all government departments are also brought to tolerate on MCHS, as these are hospitals that run the clock round, handle a huge patient load. To ensure that it reaches its destination to ensure that it reaches a file through various administrative classes. MCH accepts one of the heads of the department.
He said, “Instead of going on construction and purchase of fancy equipment, the government should focus on the timely maintenance of existing buildings, equipment and features to improve health care quality,” they say.
Rosenara Begum, Professor of Atomic Medicine and Chairman of Kerala Government Medical College Teachers Association, states that health care is a resource-intensive and technology-operated today. “But the government only invests in infrastructure and not in people. What is a catheterization laboratory (a special medical facility equipped with advanced imaging and monitoring techniques) without anyone to run anyone in a clock time)?”
Departments such as gynecology, orthopedics and surgery with high patient load have not seen post creation over the years. Repeated transfer prevents doctors from investing in departments and bureaucracy obstacles make basic maintenance a bad dream, she explains.
Even stopgap funding options are drying up. The development societies of the hospital are now in cash for reimbursement of delay from Karunya Arogya Surksha Dhar (KASP) of the state’s major health insurance scheme. Public health experts say that public health experts say that public hospitals are owed to public hospitals as KASP reimbursement.
The only source of income for hospital development societies is a small user fee collected from the payment category of some procedures or CT and MRI scans.
“Hospitals can no longer walk on government money alone. We need functional autonomy and self-reliant model,” KV Vishwanathan, called director of medical education in-charge.
“Funds are never enough because people hate any type of user fee. Recently a proposal to introduce a outpatient ticket fee of ₹ 10 was congratulated with harsh resistance. HDS has to find funds for waste management and annual maintenance contracts,” they explain.
“We can’t overcome anyone,” Dr. Vishwanathan says. “Medical colleges will flow until secondary hospitals are strengthened.”
Manpower Crunch has barely hit Alappuzha MCH. The posts of 80 Assistant Professors, 10 Associate Professors and two professors are vacant, including on leave. This is a MCH in the state without a payment.
Um Kabir, a member of HDS, says that patients have to wait for six months for heart surgery. They say that immediate steps should be taken to fill the vacant posts of doctors.
A hospital administrator says, “More than 1,500 patients pass through medical treatment in the form of inpetors daily, which exceeds the 1,050 bed power of the hospital. Purds are underway. We soon expect to fill the vacancies,” says a hospital administrator.
The story is very similar in Kozhikode MCH. Serving five northern districts of Kerala, the hospital handles 2,000 to 3,000 people in its outpatient department a day. But the staff level was stuck in the 1960s. Distributors of drugs and surgical devices stopped their supply at least twice in the last two years due to payment of bills. Even though the supply was resumed, the arrears have not been completely cleaned.
In Kottayam MCH, however, immediate concern is the future of old buildings. Will they be retained or dropped down? A security audit by the Public Works Department is running to determine the answer.
Official sources believe that the existing block, which had collapsed, was constructed in 1964. “Existing building safety rules set a sufficient route to bring to the rescue machinery around the structure. Without a route, an earth cannot be brought in time to start the rescue mission,” accepts a top officer.
With the increasing number of patients, aging infrastructure and lack of funds and lack of manpower, the major public health institutions of the state are showing symptoms of serious stress. Experts suggested measures such as administrative reforms, updating procurement rules, financial autonomy for institutional heads and investment in human resources to revive the system.
Jose Chathukulam, a public health expert and director, Center for Rural Management, Kottayam, notes that MCHS are struggling with a proficiency crisis, filled with restrictive practices and are protected by an iron shield of public affection.
“Even when the post of Principal and Superintendent goes to the seniors, they should be supported by a professional team of administrators. Kerala will raise funds to invest in the health sector, health administration and human resources,” they suggest.
Minister’s stance
Health Minister Veena George says that during the last five years, medical colleges got more than 3,500 crore to improve infrastructure. “Upgradation of treatment facilities in the period, introduction of modern equipment, improvement of quality in medical education, and opening super-specialty blocks and departments in various colleges were also seen. MCHS is ready for a big jump in terms of quality and high-end treatment. We are constantly trying to meet people’s growing needs, which say.
“If the annual OP registration in government hospitals including MCHS was eight crores in 2015, it is now 13.5 crores, which shows people alone that people have repeated in MCHS. However, MCHS is considered a referral hospital, where any patient can provide to all. Skins in hospitals.
“We are currently handling a large number of patients compared to the current capacity of all MCHs taken together.
Solatium declared by the government may give Navami some relief, which lost his mother in the accident. Thousands of patients like Navami are looking at the government and medical college hospitals to get health and bounce back into life.
