Archive for June, 2011

Sleeping sickness is a resident evil

Sanchita Sharma, Hindustan Times
June 26, 2011
Truncated sleep ups your risk of almost every known disease, from heart attacks (by pushing up blood pressure), to the common cold (by lowering immunity). It turns your brain to mush by lowering its ability to learn and store new information. It makes you irritable, impatient and emotionally fragile. It also causes people to nod off while driving, which is the biggest cause of road accidents after speeding and drink driving.Sleeplessness, however, is at its most lethal when the insomniac is a doctor or a surgeon taking decisions that can make or break your fever – or your life.

Working for more than 16 hours without sleep results in resident doctors committing serious, preventable medical errors, reported the journal Nature & Science of Sleep on Saturday. While there is no data for India, the US Health and Human Services reports that 180,000 (1.8 lakh) patients die of medical negligence each year in that country.

Work shifts longer than 16 hours increased medical errors by 35.9 per cent while shorter shifts reduced errors, reported Harvard Medical School researchers in the New England Journal of Medicine (NEJM). Following the report, Harvard Medical School announced a 16-hour limit on the time resident doctors can work at a stretch.

In India, resident doctors live in the doctors’ duty room 24×7, on call at all hours for any length of time. They routinely do 24-hour shifts, which can go up to 36 hours in departments such as neurosurgery, where emergency cases such as accidents and stroke need immediate attention. By the end of a shift, the fatigue is apparent not only in the dramatically shortened fuses but also in cases needing a second opinion for final diagnosis.

Rising patient load and staff shortages are too blame. While patients at teaching hospitals have more than doubled in the past decade, medical staff strength remains the same. Given the easy access to medication and addictive medicines, addictions are a norm. Apart from smoking, most residents take stimulants or “uppers” to see them through the day. “What are we to do? After MBBS, we do 3-5 years of junior residency and another 3 years of senior residency. Most of the time we are too tired to keep our eyes open,” says a senior resident at the All India Institute of Medical Sciences.

The US Institute of Medicine has recommended major changes in residency training programmes, including re-designing training to eliminate dangerously long shifts (over 16 hours without sleep), and reducing residents’ workload by focusing on academic training and transferring a lot of the routine things they do – bandaging, drawing blood, filling out paperwork and starting intravenous lines – to nurses and other health personnel.

“It’s an abuse of patient trust,” says Dr Lucian Leape, adjunct professor of health policy at the Harvard School of Public Health and a co-author of the NEJM report. “Few people enter a hospital expecting that their care and safety are in the hands of someone who has been working a double-shift or more with no sleep. If they knew, and had a choice, the overwhelming majority would demand another doctor or leave.”

Try as they might, teaching hospitals cannot shorten resident work hours because of financial and staffing shortages. If hours for residents are reduced, other staff – such as teaching faculty and consultant physicians – need to step in, who have to be paid overtime. But given that resident doctors are staffing emergency rooms, an urgent overhaul of hospital work policy is needed. For when it comes to medical errors, saying sorry is not enough.

Source:- Hindustan Times

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Letters to The Editors: NEIGRIHMS, Shillong In Distress

Source: The Shillong Times

It was a proud moment when our children joined NEIGRIHMS MBBS course three years ago. It was an upcoming institute of excellence we were told. But now we find that the institute is lacking in several aspects of MBBS teaching. The Institute is highly understaffed, not meeting even minimal faculty strength. Several faculty who have joined from various prestigious institutes, have already left and more are preparing to leave for various reasons. No new faculty have joined since the past two years. Going through the MCI website we learnt that this is a very serious matter and chances are that the Institute will not get full recognition or may even be derecognized.

Construction of basic amenities like proper hostels and dedicated undergraduate classrooms for teaching-learning are yet to start. Some batches of students are in Polo campus from where they have to commute for not less than an hour to attend classes, go back for lunch and return for evening classes wasting precious academic time. Dinner is served in the evening so that the cooks can leave early and food is prepared elsewhere, so no quality check can be done. Every student complains of gastroenteritis soon after joining. And the list goes on!

My question is, if this is the status, then why was the MBBS course started in the first place? At the end of five years will our children get a MBBS degree or a diploma in Medicine & surgery (MDDS) similar to the quasi-medical degrees offered elsewhere to cater to the rural population or will they just be told to “pack off”? Will they be competent enough after training in this facility to treat us and other family members? Will the doctors and other administrative staff of NEIGRIHMS go to him/her for treatment? If NEIGRIHMS is brave enough to introspect then probably little is left to change at this stage and all the medical students should be transferred to “recognized medical colleges” so that their future is not marred. I have learnt that the parents of students selected from CBSE PMT have already made such an appeal. I request the administration to spare our children too.

Yours etc.,
Aggrieved Parents of MBBS Students

“How Much Is A Miracle?” (via Old Sonnie’s Porch)

Indeed!! Dear God, give us a chance to be another Dr. Carlton Armstrong someday. That’s our calling, and it’s one of our goal in pursuit of Happyness. God bless us. 🙂

Tess was a precocious eight-year-old when she heard her Mom and Dad talking about her little brother, Andrew. All she knew was that he was very sick and they were completely out of money. They were moving to an apartment complex next month because Daddy didn't have the money for the doctor's bills and our house. Only a very costly surgery could save him now and it was looking like there was no one to loan them the money. She heard Daddy say to he … Read More

via Old Sonnie's Porch

Monetary assistance extended to children living with HIV/AIDS

Imphal, June 19: Monetary assistance of Rs. 1.25 lakh was given today to 43 children living with HIV/AIDS, all hailing from Uripok Assembly Constituency, in a function held at Epathoukok Shanglen, Naoremthong Bazar.

Manipur Legislative Forum on HIV/AIDS, Uripok MLA L Nandakumar, Y Kesho, former Guidance Officer of Education Directorate, Y Ibempishak, wife of DGP Y Joykumar, were the donors of the monetary assistance.

MLA Nandakumar handed over the amount to SASO general secretary Sushilkumar for onward distribution to the children at the function held as part of constituency level HIV/AIDS convention organized by the Manipur Legislative Forum on HIV/AIDS.

MLA Dr Kh Loken was the chief guest of the opening function of the convention which was presided over by DGP Y Joykumar. MLA L Nandakumar, IMC councilor, Th Baleshwor, L Arunkumar and president Murali Meetei of Epathoukok were guests of honour of the function.

Former project director Dr Kh Pramodkumar, Dr H Diamond Sharma of RIMS, Dr Y Mohen, Dr Bibekananda, were the resource persons of the one day constituency level convention on HIV/AIDS.

In his speech as chief guest, MLA Dr Loken urged upon the people not to stigmatize the people including children infected by HIV/AIDS and treat them with love and care. There is the need for taking care of them for fighting against the dreaded disease, he added.

DGP, Y Joykumar, in his speech as president, asserted that the problem of HIV/AIDS has been faced in the last 30 years or so. This problem is a worrisome and important issue. It should not be taken lightly. If not checked, the spread of this disease will continue and the society will face destruction, he said.

He said that even though effort are there for protection from the dreaded disease, the targeted achievements have not been realised. So, there is a research needed to find out the reasons behind the little success in the efforts.

There is still the habit among the masses, of forgetting the issue after attending an awareness programme. This is indicative that the targeted achievements will be difficult to be realised. He believed that if the issue is discussed frequently, at least once a week, there would come a change.

For holding discussions or awareness programmes, there would be no dearth of funds as it can be availed from the Centre or the state government. The DGP asserted that from his side he is always ready to extend cooperation.

He further stressed the need for setting up a system which would help the people living with HIV/AIDS or helping themselves. This will give them strength to live them in the society.

MLA L Nandakumar said that it is an unfortunate that innocent people are infected or affected by the dreaded disease. The monetary assistance given through SASO will not reveal the identities of the affected people.

State coordinator of UN AIDS, Sushil Huidrom gave the key note address. Y Ibempishak and Y Kesho were also in the podium of the function.

Source: Hueiyen News Service

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No ration supply in Tamenglong District hospital

By From Daniel Kamei

Tamenglong June 20: NO RATION has been supplied for patients for the last one month in the district hospital in Tamenglong. The CMO has been out of station since 11 June. This was stated by Mathiusang Panmei, Coordinator, ZSU while briefing reporters this afternoon. He appealed to the concern authority to look into the matter.

He informed that a NSF team would be coming to Tamenglong on 26 June to interact with the people in Tamenglong. DC Tamenglong, K Panmei said that he did not get any information regarding non supply of ration to patients in the district hospital. CMO incharge, Dr Chambo Gonmei said that non release of funds by the state government the present led to the present crisis.

Source: Hueiyen News Service

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Rural medical assistants: Not Quite The Good Doc, But The Better Bets

June 18, 2011 2 comments

The heated debate over the creation of a rural healthcare cadre is far from over. Opposed by medical practitioners, the health ministry’s plans to start a four-year Bachelors in Rural Health Care course (BRHC) from this year have received a setback. The Medical Council of India (MCI) is now expected to take a fresh view. “We have to take healthcare to rural areas,” MCI board chairman Dr K.K. Talwar told Outlook. “It is an important issue. As I wasn’t involved in the earlier discussions, I need to understand the various issues. Some states have their own rural healthcare programmes and I am trying to get information about what experiences they have had.”

Currently busy clearing approvals for medical colleges before the June 15 deadline, the MCI board plans to review the proposed BRHC plans at a later date. This, when the health ministry had in January got almost all the states to support the move and chart out the BRHC syllabus. “It took a year to convince all political parties and chief ministers to support the proposal as we wanted the syllabus to be recognised,” says health minister Ghulam Nabi Azad. “Unfortunately, the MCI got influenced by medical practitioners and did not give national-level recognition.” Given this wide opposition by medical practitioners to the creation of a rural healthcare cadre, the health minister underlines that while the states are free to start such courses as is being done in some cases, “unless the course gets national-level recognition, it won’t attract good talent”. MCI’s approval is a must for the implementation of a uniform curriculum across the country.

The health minister’s concerns are not unfounded, given the continuing resistance of the Indian Medical Association to accept any alternative cadre of rural health practitioners, which had been in vogue before Independence. The decision to adopt the western model of MBBS to provide better medical care across the country has been to the detriment of large parts of rural India—most doctors shy away from working in areas which offer no career prospects even though some states offer incentives.

That’s why healthcare experts are keen on finding a viable alternative. The idea of a separate cadre of healthcare providers exists in several developed and developing countries. India too, it is felt, needs to seriously explore the concept, considering that, as against the desired ratio of one doctor per thousand population, large parts of rural India currently have just four doctors for 10,000 people.

A decade back, when newly-created Chhattisgarh tried to address the issue by starting a condensed medical course, there was opposition. Yet, despite many legal and political twists and turns, the state went ahead to train and deploy over 700 Rural Medical Assistants (RMAs) in primary health centres and sub-centres. A visit to some of these centres, many miles away from a properly equipped hospital, is an eye-opener.

Driving through lovely, thick forests early in the morning to visit some of the primary health centres in the Manpur, Mohla, Ambagarh Choki blocks of Rajnandgaon district, there’s no mistaking that we’re deep in Maoist-affected territory. From time to time, we see CRPF men scanning the road we are travelling on with landmine detectors and sniffer dogs. With villages 10 or more kilometres apart, only the ploughed fields in some areas give indication of habitation.

Read the rest of the articles here: Rural medical assistants: Not Quite The Good Doc, But The Better Bets


Medical Directorate Transfers Doctor Couple from PHC Lilong

IMPHAL, Jun 16 : Dr Th Somorendro and his wife Dr Anjana, who have worked in Lilong Primary Health Centre for around 10 years, have been transferred to Hiyanglam Primary Health Centre not as a disciplinary step, but to ease the tension and avoid any unwanted incidents,  Director of Medical & Health Dr S Ibomcha has clarified.

Talking to The Sangai Express, Dr Ibomcha said that since their posting at Lilong Primary Health Centre, Dr Somorendro and his wife Dr Anjana have been contributing their service to the people in the capacity of MO in-charge and MO respectively for around 10 years.

The doctor couple, however, was transfered to Hiyanglam Primary Health Centre following an order yesterday. The transfer order was issued  a day ahead of the threat of Muslim Students’ Union of Manipur to call a bandh along Lilong Road of National Highway 39 if the demand for their transfer is not fulfilled. However, transfer of the doctor couple does not  mean that they are guilty.

The transfer has been effected as a precautionary measure in the light of the threat for calling bandh, Dr Ibomcha said. Informing that the Medical Directorate has not received any complaint against the doctor couple over the last 25 years of their service and posting at different places, Dr Ibomcha observed that it would be advisable to all to avoid putting the blame against such doctors who have been performing their duties with sincerity and dedication. In case, any of the doctors working under the Medical Directorate committed some mistakes or have some complaints, the public should come to the Directorate instead of taking the law in their own hands, Dr Ibomcha added.

Sources:- The Sangai Express

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