Everyone in the govt is clueless

Our daughter was admitted to the Kasturba Hospital in Mumbai, suspected of swine flu. The experience has been Kafkaesque and Shambolic.

I specifically exempt from these criticisms those knowledgeable and dedicated professionals who smilingly work in our hospitals, private and government, mostly at low pay, and often in hazardous conditions. They try and take care of their patients as best they can, given the tools at hand, while having to kowtow to our political classes and bureaucrats.

Worried by continued high fever, and mindful of the fact that we had recently returned from Europe, we took the kid to see her pediatrician. It was clearly the flu, but the government does not allow the private sector to test for the swine flu virus. Our doctor advised that we take a test that at least lets you know if the virus is type A, of which swine flu is a subset, or type B. The hope is that it would be type B, as it had been for her other patients to date, so we could all relax.

Unfortunately it was type A, and the doctor advised us to visit Kasturba Hospital, the sole provider of swine flu testing in the city. Our GP called the head of the swine flu cell, I suppose you would call it, and he said we had to hurry as everything closed at 5.

Hurry we did, and given the publicity of the day before, were surprised to see just a few people waiting. Perhaps people knew of the 5 pm deadline and knew that it would be observed, hospital or not, people in need or not.

After a difficult form filling procedure (one cannot fill the forms oneself, one has to dictate to someone who was clearly barely literate) we were admitted to the sanctum, where tables of doctors sat around, with three apparently required to examine one patient, and with half the doctors, including the senior doctor, tied up in showing around some visiting troupe of government or political officials.

After a cursory examination of her history and reports, the doctor decided that she had to be admitted because she looked weak.

So one would be, if one had been forced to walk one kilometre with a 103 fever because of road blocks courtesy the Kasab trial (Kasturba is opposite the Arthur Road Jail) and because guards do not allow any but government cars in through the gate.

The doctor said that the swine flu test would be done but that the results would not be available for two days. Why two days? Babudom had decided that for ‘quality control’ (sic) all tests will be done only in Pune, where they have been testing, they say, several hundred per day. There samples wait in line for a test that apparently takes 6 hours and costs Rs10,000. Our (AB) test at Bhatia took 15 minutes and cost Rs900, so I am sure there is a modern method somewhere.

And the doctor said that Tamiflu treatment would start after the test results were received. Our system decreed the wait, not caring that Tamiflu (the only thing that works to shorten the effect of the flu and so reduce its nastier effects) is best given within 48 hours of the onset of symptoms; in fact he seemed clueless about the disease, his role, and supposed government directives on being allowed to send patients home with Tamiflu etc.

I managed to persuade him to start the treatment as a condition of putting the kid in hospital. But, incredibly, apparently there are people in the hospital who are awaiting tests and not getting Tamiflu, but who are sharing rooms with infected patients.
This cluelessness extends to every level of government (but not to the senior health care establishment), and given the prominence that the disease has garnered, and the warning we have had, the ludicrous outcome ought really to be laid at the feet of the PM.

All one needs is simple mathematics to analyse the flu biz and apply the results to the population, extrapolate and compare the result with the infrastructure that has been set up. Nor do babus have a sense of time, suspended as they are in the 19th century.

All information is from recent reports and anyone with an internet connection who follows the same method will arrive at the same result. Try it.

WHO has declared this a level 6 pandemic. This means the spread cannot be stopped and the consequence must instead be to minimise damage. The babu’s have instead tried to enforce old communicable disease laws drafted for the age when TB was called consumption, in an effort to stop what cannot be stopped, and what for all practical purposes need not be stopped because it is for the most part no more virulent or serious than normal flu. Some dummy has even publicly opined on testing intercity travellers and quarantining all foreign arrivals. My daughter is trying to keep herself cheerful in a super crowded room full of people suspected of swine flu, where the worry shifts from swine flu to secondary infections of all sorts. That is a unique way to run an isolation ward and one that none but a bureaucrat, short on time, budget and imagination could design.

At least the poor nurses and doctors are giving their all. But the ones working are far outnumbered by the ones loafing at the diagnosis tables (the strength  apparently dictated by the cumbersome procedures required at government hospitals).

The ones on duty have no way to actually do the work assigned to them at a normal hospital frequency. Overloading them like this will cause a huge breakdown. One doctor and two nurses cannot manage a 12 hour night shift for close on 100 patients.