Wednesday, February 16, 2011

PHC continued......

Wandering is not new to me, but searching some address in a completely strange environment, at a place not given in details in google maps was a bit challenging. With some anxiety and some fear and tons of loneliness and kilotons of curiosity, I reached Walsang- The village of the PHC which has been allotted to me by the DHO. I was walking like a fool, looking at any slightly big house as the PHC… and people were looking at me as if a strange funny fast cartoon character was marching before them. The village was the same as where I’ve spent my childhood, with only few houses with more than one floor and the school and some little private clinics, and open gutters and garbage and pigs. But I encountered about three medical stores which was a bit surprising to me.

And when my legs were about to give up walking, after asking few times to the locals, and after spending almost one hour in searching, I reached a place they were calling as PHC. It was open, and crowded… “Who’s that girl,” I heard a woman asking to a man…

I work in a tertiary care hospital, that too aligned to a medical college- Govt. hospital Solapur… so my idea of primary health centre was something with a standard far below than that of my hospital. And that’s why I got shocked to enter it- the PHC at Walsang… in contrary to my hospital, it’s computerized, and is extremely clean and webcams are recording the behavior of doctors and nurses with the patients… and finger print machines are used for attendance recording… I was pinching myself repeatedly to examine whether whatever I was seeing was true. And I was to have a heart attack or may be a stroke due to excitement when I visited the drug store…

Along with Amox and cipro here septran and tetracyclines like tetracycline and doxycycline, cephalosporins like cefalaxine and cefixime are also available. Of course, higher antibiotics are not always necessary and can cause resistance and toxicity is high especially with the tetracycline group… but they are must when strains resistant to routine antibiotics are encountered. Here in my hospital we pray that the strain shouldn’t be resistant and if it is, we are left with no other choice than telling the patient to purchase it from nearby private medical.

Antihistaminic drugs like cetrizine are also there… but chlorpheniramine maleate stock is in abundance. I don’t understand why they go for CPM when cetrizine has far less CNS side effects… diclofenac and paracetamol are available in my setting also… but diclofenac is sometimes out of stock, here that’s not the case. I almost shouted to see Diclofenac gel in their cupboard. I never see such things in Solapur. I wondered to see a tablet with serratiopeptidase as a constituent… but the other constituent of it- nimesulide disappointed me. Why the hell government is providing something as toxic as nimesulide when it is banned in many countries? One more thing that bothered me was the needles… according to new agenda we use a new needle for every patient, but here the needles are used in ancient manner repeatedly for many patients after boiling it for sterilization. This seems dangerous, when I remember the long queues of patients and relatives waiting for ART drugs in my hospital. And yes, vitamin B tablets are out of stock here, same as in my hospital…

But I liked this PHC… at least the first impression is good. It would be an ideal health center if only few drawbacks it has were removed. It’s as if it’s very close to the health service in my dream world… of course higher facilities like x rays and CT are not available… but still it’s good as it’s just a primary health center. Why my hospital lacks these things like the webcams and the attendance recorders and the cleanliness and the friendliness, why so many drugs are not available here? How can a tertiary health center lag behind some primary one in many things? Why other PHCs are not like this one… why are many of them closed for almost all the time?

I don’t know management much and economics was a big challenge before me when I was a high school student… but it would be very pleasing if I could answer my own questions… I’m here to learn and to use whatever knowledge I have for the patients over here and I’ll do it. But I can’t stop myself dreaming an ideal health service serving the whole world… I want my dream to come true.

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