055. Who Will Catch Fake DMOs Who Catch Fake Doctors?

Who Will Catch Fake DMOs Who Catch Fake Doctors?

By Special Correspondent
Kerala Health Research Online

A District Medical Officer of Kerala caught a fake doctor in the private sector. But who will catch fake DMOs in the Kerala State Health Services Department? Justice M P Menon Commission that enquired into the fake mark list and MBBS certificate cases in the 1980s concluded its report by saying that the Commission, with its limited resources, time and staff, could only catch and expose a few fake doctors and the majority of them might still be working in the Health Services Department as Assistant Surgeons and Civil Surgeons. No follow up action was ever ordered and undertaken by the Chief Ministers, Health Ministers, Health Secretaries or the Directors of Health Services of Kerala. Most of them were duly promoted and some may have eventually become DMOs and other key Programme Officers. And it is, was, not the end of faking certificates and bribing for appointments. Things became only easier since then with the advent of computers, laser printers and other advancements available to those who want to fake things. Where do they actually verify the certificates a person claiming to be a doctor produces? There are three major recruiters in government sector- the Kerala Health Services Department, the Kerala Medical Education Department and the new, free, liberal and open route, National Rural Health Mission. In the last, anything is possible with its non-accountability. In the first two, there is no initial verification before appointment; everything is taken as gentleman’s word. After appointment, when the supposed doctor goes to the concerned institution to join is the SSLC Certificate and MBBS Certificate physically verified for proof of age and entry qualification, by a lowly clerk. They rarely hand over these to the clerks but just ask them to prepare a covering letter to the Accountant General without seeing them. A clerk in Trivandrum District once reported this to his superintendent and the superintendent said: ‘this person, from Sooranad, did not show them to even me, then how would to you? Anyway, give him the covering letter.’ SSLC Book of another doctor from Karunagappalli revealed that she secured 5 marks for English I Paper and 8 marks for English II Paper in Eighth standard. How will she ever become a doctor? When these facts were reported to higher authorities, the then Deputy DMO, DMO and DHS were very, very, very eager to suppress news; after decades, they sent this clerk away without four higher grades, promotion as UD Clerk on attainment of 50 years age, gratuity or even a pension, even though he had a corruption-less service of 32 years and was recruited through PSC. (Documentations are available online). They are such long-remembering and spiteful. So, before arresting others for faking, every doctor in the Kerala Health Services Department in Kerala, including the Director, has to prove before the public that they are not fakes. Let them put relevant details with scan copies of certificates in their official website and let people verify. Let IMA and KGMOA officials do it first.

Link to news article:

കൊച്ചിയില്‍ 20 വര്‍ഷമായി ചികിത്സ നടത്തുന്ന വ്യാജ ഡോക്ടര്‍ അറസ്റ്റില്‍

http://www.indiavisiontv.com/2014/09/18/353814.html?fb_action_ids=531725000290925&fb_action_types=og.comments&fb_source=aggregation&fb_aggregation_id=288381481237582


Tags: Kerala, Kerala Health News, Health Research Online, Kerala Public Health, Health News, Health Corruption, Fake Doctors, Illegal Medical Practice, Kerala Health Department, DMO, DHS, IMA, KGMOA, MBBS,

054. Kasaragode Hospital Spends Lavishly For Artists, Not For Pediatric Equipments.

Kasaragode Hospital Spends Lavishly For Artists, Not For Pediatric Equipments

'Kasaragode General Hospital spent 50,000 rupees for drawing 30 pictures of Micky Mouse, Tom & Jerry and Donald Duck in the walls of the children’s ward. The hospital superintendent Dr. Narayana Naik told Indian Vision Channel that this was made possible with the help of Hospital Development Committee, and as the next step, every wall in the hospital would be painted and filled with colourful pictures.' (News reported by India Vision Channel Live on 14th September 2014)

Special Correspondent
Kerala Health Research Online

According to health and revenue authorities, Hospital Development Committees in Kerala are outdated and long due for reconstitution. No one cared to regularize and develop them as societies fit enough to hold enormous sums in custody. Kasaragode District Hospital’s HDC is no exception. The District Collector of Kasaragode has full responsibility for the money-spending of this HDC which seems to have unlimited funds accumulated through years but no sense of destination. The politicians in this retired committee are spending money lavishly and foolishly. Indian hospital rooms have their long-approved colour patterns- green below and white above- to create pacifying, soothing effect. Nobody will paint them in red, pink and violet- angry colours. Normal stay for a child in hospital is three days. On the first and second days, the children won’t see practically anything for they would be in pains. On the third day, the day of their discharge, they do not need see anything; they just wish to go home. If they have to stay for more than three days in Kasaragode District Hospital, this hospital is bad in administration, cross-infectious, useless and risky. Because there is money, we cannot spend it; it is our reserves. When large amounts of money needed for a pediatric ward cannot be obtained from government, then, and then alone, can we spend HDC funds. Somebody must tell the Hospital Superintendent and the District Collector of this truth. Does this hospital have enough Pediatric Exam Tables and Scale Tables? Do they have Neonatal Infant Care Infant Warmers? How many working Transportable Infant Incubators do they have? How many Portable Vital Signs Monitors, Hand-Held Pediatric Vital Signs Monitors and Oximeters? How many Baby Finger Print Pulse Oximeters? Do they have Automated External Defibrillators, Fetal Monitors and Fiber-optic Phototherapy Systems? Have they ever demanded these from the Director of Health Services or Medical Services Corporation or have ever written to government requesting these. Have this committee ever discussed these basic necessities of children’s ward in meetings and recorded in minutes? There is a limit to ignorance, negligence and incompetence. Either leave decisions to doctors and other medically-qualified professionals or resign decently from this ornamental committee. Only in hospitals would this cheap political power play become possible. Will Kasaragode District Collector allow and tolerate a politically constituted Collectorate Development Committee imposed upon him, making him a puppet in taking decisions? If this committee, which knows nothing about children’s treatment other than how to make children, want to know about what are needed in pediatric wards, come down from the skies and ask the B.Sc. and M.Sc. Nursing-qualified staff who will tell them to purchase Electric Cots, Mobile Aneroid Stand With Cuffs (Rs.20000/-), Hand-Held Oximeters (Rs.60000/-), Portable Pulse Oximeters With Finger Sensors (Rs.80000/-), Gamma XL Patient Monitor (Rs.300000/-) or even a Da Vinci Robotic Surgical System which will cost only £500,000. Let this HDC prove their mettle.

Mobile Aneroid Stand With Cuffs is a Blood Pressure Machine with reusable blood pressure cuffs of varying sizes to suit any child. Hand-Held Oximeters are used to monitor oxygen levels in babies to prevent damage to vital organs due to lack of oxygen. Portable Pulse Oximeters With Finger Sensors are hand-held devises to monitor pulse and oxygen level while child patients are moved from place to place. Respiratory Humidifiers heat and moisturize the oxygen that is being delivered to children during mechanical ventilation, to prevent them from becoming cold, thick airway secretions from building up, breathing tubes from blocking up and the little lungs from collapsing, based on the principle that humidified and heated oxygen will make children recover faster. Vital Signs Monitors in pediatric and neo natal wards and emergency wards reads, registers and provides all necessary vital signs of the sick child. Gamma XL Patient Monitor can be purchased for Rs.300000/- which will watch all vital signs including Pulse Rate, Temperature, Blood Pressure and Cardiac and Pulmonary functions, replace all other equipments and prevent children from being moved to different monitoring levels, floors or rooms. The latest thing to present a children’s ward in a hospital with is the Da-Vinci Robotic Surgical System which ensures more accuracy in surgery, lesser pain, smaller scars and quicker discharge. The surgeon at the console sees 3D images of internal organs, makes tiny incisions, manipulates miniature instruments and performs surgery. These are becoming popular now- U.S. has 300 0f them and U.K. 1. Why don’t Kasaragode try? Anything is possible, and do not tighten purses where children are concerned. Also take care of a few other things. How many High Dependency Unit Beds, Electric Cots, Pediatric Nurses, Consultant Pediatricians and Anesthetists trained in Pediatric Care are there? Is there a Children’s Ambulatory Care Ward, so that children needn’t stay even a day for surgery? Are cots, waiting room chairs, and equipments including thermometers and birthing-baths beyond or with in Accepted Infection Control Parameters and Standards? Are all beds provided with oxygen space and access to oxygen outlets? What about prevention of cross-infection? Are medical and surgical patients separated? What about cleanliness in children’s baths, toilets and closets?

Link to News Article:

ചികിത്സക്കെത്തുന്ന കുരുന്നുകള്‍ക്ക് കൂട്ടായി കാര്‍ട്ടൂണ്‍ കഥാപാത്രങ്ങളും

http://www.indiavisiontv.com/2014/09/13/352453.html?fb_action_ids=530039403792818&fb_action_types=og.comments&fb_source=aggregation&fb_aggregation_id=288381481237582


Tags: Kerala, Kerala Health News, Health Research Online, Kerala Public Health, Health News, Health Corruption, Kasaragode, Pediatric Equipments, Pediatric Wards, District Hospitals, Hospital Funds, HDC

053. What Does This Minister Harsh Vardhan Know About Horrible Kerala Health?

What Does This Minister Harsh Vardhan Know About Horrible Kerala Health?

By Special Correspondent,

Kerala Health Research Online

Can Government of India’s Union Health Minister be this much ignorant about a state? Can he repeat what his speech-writer scribbles this much blindly? What does this Mr. Harsh Vardhan actually know about Kerala’s health?

From India Today News 21 September 2014:

‘The Union Health Minister was full of praise for the Kerala Health Sector who maintained that the achievements of Kerala in the health sector are a model for the country and the state has been maintaining quality right from the primary health sector to the medical college sector. The minister was inaugurating the 13th Annual Conference of the Association of Otolaryngologists of India, Kerala branch. He admitted it was quite alarming that India occupied the top spot globally in suicide of youths' in the 15 to 35 age group, and it was most unfortunate that 75,455 persons committed suicide in Kerala in the 10 years between 2003 and 2013. Kerala health minister V. S. Sivakumar said Kerala was aiming for comprehensive health protection by including modern scientific technologies in the medical treatment.’ (Reported by PTI)

Note From Editor, Kerala Health Research Online:

The Union Minister's observations cannot be based on statistics collected in their Kerala Health Survey because the Director of Health Services Dr. P. K. Jameela pointed out that these union statistics is erring and differs much from Kerala health department statistics. Mr. Harsh Vardhan’s and Mr. V. S. Siva Kumar’s yelping do not deserve comments. But these two ministers need read some good articles evaluating Kerala’s health. Kerala Health Research Online would like to quote here for their use an article written in February 2007 by Dr. C. R. Soman, Former Professor and Head of the Department at Medical College, Trivandrum, Kerala’s Health Activist and noted Nutritionist. We regret this learned doctor is no more with us; he left us in 2009. Had he lived, he would not have hesitated to make reply to these two ignorant politicians. 

Kerala's Crisis in Public Health. By Dr. C. R. Soman.

Kerala is on the brink of a public health crisis. The state, which set an example for the rest of India and third world countries in providing primary health care, now gropes in the dark and is fast losing the edge. The great achievements in the fields of mortality and fertility have reached a plateau, and the near-universal immunization coverage achieved in the nineties has fallen. 

The state is regularly visited by emerging outbreaks of leptospirosis, dengue fever and other insect-borne viral fevers; the latest entrant is chickungunya. Natural ecology has been tampered with and the once-famous backwaters of the state are polluted and weed-infested. Waste disposal in the municipalities and corporations still remains a formidable challenge. Conventional methods like land-fill evoke furious protests from local inhabitants. Critics have re-christened 'God's Own Country' as 'God's Own Junkyard'. 

The state health department is no longer the prime mover of health development. With less than a third of physicians, beds and institutions under the government, the state health services department is a mute spectator to the rapid decay of health services, particularly primary healthcare. Many primary health centers are unmanned. Drug procurement and distribution systems are outmoded and complaints of drug unavailability appear frequently in the media. The state-run medical colleges have no longer bright young academics to work for. They opt for more lucrative placement in the burgeoning private sector instead. Many super-specialty departments face the threat of closure in the absence of new recruitments. 

There are worse problems. Recent studies suggest that Kerala has the highest burden of coronary heart disease, stroke, hypertension, diabetes and over-nutrition. Conservative estimates put the number of people with diabetes at three million; people with hypertension at 4.5 million and those with overweight and obesity at 10 million. 

Every year in Kerala, between 45,000 and 50,000 people die of heart attacks, while stroke kills over 20,000. In comparison, the annual death toll from HIV/AIDS is just over 200. But the government perceives HIV control as a greater priority. 

It is the healthcare industry that benefits from this sordid state of affairs in Kerala. Private hospitals offering sophisticated tertiary care are mushrooming, even in villages. By-pass surgery and coronary artery stenting are buzzwords familiar even to the children. One would be lucky if an MRI scan is not ordered if you reach a physician with a headache. The doctors prescribe laboratory tests even for minor ailments. 

They may argue that a variety of investigation is necessary for complete profiling of the disease in modern medical practice. According to the Indian Medical Association, the doctor would be in trouble if the diagnosis goes wrong. It argues that they practice defensive medicine. But defensive against whom? Implied in this approach is the assumption that people, individually and collectively, are enemies of the medical profession. The IMA cites stories of attacks against doctors and increasing trend towards litigation against hospitals to buttress their arguments. 

These are convincing arguments for the naive. The sad truth is such arguments are alibis offered to mislead and misinform. The over-use of technology and drugs is driven by greed - a greed that is fuelled and perpetuated by an unholy nexus between doctors, the drug industry and the diagnostic sector. Huge rewards are offered to the physicians for prescribing expensive investigations. Anywhere between Rs.2000 and 2500 is offered as commission for an MRI scan; 40 percent of the fee levied from laboratory investigations reach the doctor as commission. 

Private hospitals make more money through over-investigating patients in their own laboratories than from providing care to the patient. Profit at any cost is the watchword. Doctors in the government sector also gain through the nexus between the industry and the profession. The government has made no attempt to regulate the healthcare industry, and often goes out of the way to provide them with more concessions and soaps. 

Naturally, the victims are common men. Falling sick has become a reason for one to be pushed into debts. The Kerala Sasthra Sahithya Parishad's (KSSP's) studies revealed that at least 15 percent families spend over 30 percent of their income on healthcare alone. While private healthcare costs exceed Rs.55 billion per annum, the government expenditure is falling steadily. The government's failure in providing affordable healthcare is likely to fuel public anger. Hospitals and doctors are likely to be targets of public attacks. Facilities for medical education are being auctioned off to the highest bidders. 

To complete undergraduate course in a private medical college requires Rs. 3-5 million. Naturally, they would expect quick returns for the investment. Fleecing the people would be the only choice! Those who get state-funded medical education are only too eager to fly abroad. And those who choose to stay home prefer to work in cities and towns, leaving primary health centers unattended. 

Medical care in the state has become dehumanized and privatized. Commodifying healthcare- increasingly driven by profit- will demolish all that the state had achieved in the health sector during the last decades of the 20th century. The future looks bleak for Kerala.

Tribute to Late Dr. C. R. Soman.

  

052. Save Health From Shamans of Ayurveda And Shehanshas Of Allopathy

Save Health From Shamans of Ayurveda And Shehanshas Of Allopathy 

By P.S.Remesh Chandran
Editor-in-Chief
Kerala Health Research Online

Ayurveda, Siddha and Unani are the three Indian systems of medicine used widely in Kerala. Before two centuries, there were only these three systems in Kerala. There was no allopathy. The control of these three was put under the Director of Health Services and control of the drugs belonging to these three indigenous systems of treatment was put under the State Drug Control Administration. The variety of plants and herbs relating to these systems were to be cultivated and promoted by the Medicinal Plant Board OF Kerala. In short, under the British and under the post-British governments in Kerala, ayurveda, siddha and unani had no identity. For government, health meant, and still means allopathy. Kerala’s Chief Minister, Health Minister and Health Secretary, if and when they become sick, will only go to an allopathic hospital, that too a large private one, only. 

Doctors, staff and the treatment technology of native systems suffered much and had to compromise much under the allopathic strong hands who controlled them in the health services department of Kerala. They were considered pariahs by those in the department and in the government and allopathic personnel were considered like Brahmins! Hospitals, beds, staff, medicines, equipments and vehicles would only be provided for the allopathic system. Leave, increment, higher grade, promotion and pension applied for by native systems’ staff would be ignored by the staff of the DHS, or kept pending or go missing altogether in the health directorate and the various district medical offices. These systems with more than 2000 years’ tradition were condemned, laughed at, ignored and disparaged by arrogant medical and clerical officers in the health services department, while they catered everyway to the whims of the proponents of a system which was only 200 years old. This neglect and hatred of officers towards these three time-tested and cheap systems of medicine gradually created such a fury and uproar among people who could not afford costly allopathic treatment and medicines, reflected well in the popularity of the few remaining ayurveda, siddha and unani physicians in the state reached a stage where unless these native systems were not separated from the state health services, people will see to it that the allopathic drug industry in the state collapse. At last bifurcation came, against the wishes of the health department. A separate Department of Indigenous Systems of Medicine (Ayurveda) was created, under a new director and staff. Still the question and state of siddha and unani systems remained the same. Like ayurveda suffered under the allopathic directorate, they continued to suffer under the control of the new Ayurveda Directorate. No separate departments and directorates for them were ever created, bi-furcating them from Ayurveda Department. 

The Government of India and people in the health sector of India had by then come to believe that only the creation of an exclusive Ayush Department for catering to the needs of native systems of medicine in India would hold them and save them from the immensely rich and strong allopathic industry. India turned this line and several states including Maharashtra, Madhya Pradesh and Bihar began to bifurcate them from the mainstream of allopathic health services and create separate Ayush Departments for their protection and rescue. Many states in India which are long being ruled and exploited by the allopathic industry, due to politicians and bureaucrats on the payroll of this behemoth industry, still oppose formation of separate Ayush Departments. These states include Kerala which is thought to be one of the most progressive states in India, literally and culturally. The fact is, the State Health Services Department, Directorate and Ministry is heavily bribed by the allopathic industry to make creation of Ayush Department impossible. 

Will creating a separate new department for Ayush solve the problems of indigenous systems of medicine in Kerala and save them is another question. Did the attempts of the health services department save allopathy in Kerala? More hospitals, staff, medicines and equipments came to be built, employed and procured but more number of people became sick and sought treatment each year. Population did not increase much but number of sick people increased unbelievably. Without thousands and thousands of large private hospitals coming into commissioning, the health department could not have contained this situation. Like traitors and cowards, they permitted opening up and privatization of everything in medicine and treatment. 

The problem, when viewed from the people’s side, is enough government hospitals to give free treatment in indigenous systems not being there. Sick people wreck the economy. When they become sick they cannot work; unless they are treated back to well being, they will perish, economy will collapse and country will ruin. That is why state has to provide free treatment. That is the concept of free hospitals system. We may ask, cannot the sick person pay for the treatment? Learn that we become sick only when the last rupee has left our purse. Diseases will not come to us when we are ready with money. Remember that a sick person is a person without money, almost always. So the problem, as far as people are concerned, is setting up new training centres for indigenous systems, creating more doctors and staff, teaching them new techniques, making available new hospitals, staff, medicines and equipments and provide infrastructure. But, for the Ayurveda doctors in Kerala, representing the Ayurveda Medical Association of India, it is only a problem of setting up a new Ayush Department in line with what the central government did in New Delhi and creating a few posts of Joint Directors for them in the Government Secretariate, which was just what they requested to the health minister of Kerala in February 2013. There is a standard phrase in government dealings which every desperate post-seeker uses: ‘this would make no additional financial commitment for the government’, and they used it. In a country where MLAs sit in state assemblies and vote unanimously for their own pay rise instead of conducting public referendum, what else can we expect from ambitious doctors? 

The arguments of the Ayurveda Medical Association of India can be read here: http://www.pharmabiz.com/NewsDetails.aspx?aid=73654&sid=1


Tags: Health, Kerala Health, Indian Health, Health Research, Health News, Health Service, Indian Systems Of Medicine, Indigenous Systems Of Medicine, Allopathy, Ayurveda, Siddha, Unani, Ayush Department,