Danuli had gone to Bageshwar on the pretext of getting medical attention for an inner ear infection, with the trip pre-empted because we had run out of the antibiotics she required. At the Doctors she commented that her stomach had been giving her a little bit of grief with pain off and on and was swollen. This conversation set off a chain of events that led to an ultrasound and the discovery of a tumour mass approximatley 16.7 cms in size.
As a side story .... when we discussed this later she said it had been a problem for nearly three years but like a lot of Indian women she had 'suffered in silence'. The neglect of women's health is a common theme as is the concept of suffering in silence (but more on that at a later date). Time ticked on as the family made a decision on 'what to do?'. Finally it was decided that straight after Holi they would take a trip to the Almora Base hospital to have some follow up tests done. The next thing we know a phonecall came through to say that on the day Danuli arrived at the hospital, another ultrasound was done and the operation completed at lightening speed.
This was actually the moment I had been waiting for... in a perverse way I wanted first hand experience inside a government hospital in the region. This saw us take the infamous trip to the Almora Base hospital. I had only been into an Indian government hospital once before when I was extremely ill in Meghalaya. The hospital was strangely empty, the sheets were more holes than sheet but clean, rooms were clean but spartan and clearly had no resources to speak of. The female Doctor was professional but after treating me for free refused our donation post event citing endemic corruption and claiming that he donation would never reach the intended purpose. However, while the quality of care I received was wonderful and though exceptionally ill no one could convince me to stay overnight! And as there only appeared to be two staff members there wasn't much anyone could do about my decision. I think at the time I imagined I may vanish into the 'black hospital hole' never to come out the other side - but I was delerious!
Despite the stories you hear and the odd expose on televison of various Delhi government hospitals and the associated lack of facilities (um... and essentials like doctors and nurses)nothing adequately prepared me for the experience. Luckily (for us) on our way to the hospital we saw Danuli's father who had also made the long trek to visit her, this simplified our way through he hospital maze. The stray dogs wandering aimlessly around the hallways and wards were the first tip off that maybe all was not well... then in a dilapidated building replete with broken windows stuffed with newspapers in the gaps to stop the cold wind whistling through we found several wards.
In one large room new mums sat smiled on rusted beds - but I can assure you by their surrounds they didn't have a whole lot to smile about (except obviously their newborns). The operating room had no equipment/facilities for patients should anything go wrong. A red shaggy dog crossed my path, baring its teeth as it gave a reproachful glare like I had intruded upon its space.
Then another dismal ward, this one with stains down the walls, debris across the floor, littered with used syringes and six beds full of groaning women and one child with a broken femur that had two bricks dangling from a rope affixed to the rusty cot. Not a nurse in sight. Here we found Danuli (who promptly burst into tears) propped up on some newly purchased blankets, with a clean shawl spread across the bed. Where the shawl had come adrift I realised that it was covered in blood, then I noted the state of the other bed linen and it was all covered with dried blood (unwashed)and I had the sinking realisation that it wasn't from any of the current bed inhabitants. Kusal (Danuli's husband) had purchased the required goods to try and improve the woeful situation and had been sleeping for five nights on a wooden bench next to her bed, primarily because he wasn't game to leave her alone.
There are a few things that you equate with hospitals and the word CARE comes to mind! Here it seemed to be a non existent concept. When a nurse in crisp, starched white finally arrived to deal with the gorgeous girl with the huge liquid brown eyes who had lain in the same position for two days while still in her school uniform (she fell off the balcony during her Class 4 tes) she was 'tardy'. A few terse words exchanged and she disappeared.
A few minutes later a hapless male appeared, unceremoniously dumping a metal stretcher on the floor before making a hasty exit. Patient transferral between hospital wards is left up to family members. In this case grandpa looked at us pleadingly, so while I had a chat to the and held her hand the first attempt to move her was a painful, unsuccessful experience. Then Kusal and Scott jumped in and finally managed to manoeuvre her onto the stretcher and carried her to theatre for plastering. Her mother appeared looking frazzled (as you would expect) non - caring and by the conversation I gathered the child's treatment costs were a financial imposition and another burden of having girls (of which there were at least three). I took one look at the tears welling in her child's eyes (extreme pain) and didn't hang around. Later on mum was sent back to the ward and directed to make the bed for the next patient. No sheet change required.
There is no hospital food. All patients rely on family members to bring in food from the outside. This is difficult when families have often travelled from various parts of the Himalayas to the hospital. As Danuli improved Kusal was purchasing food from the nearest dhaba. Everyone was in the same boat and luckily all present had family members crowded around their beds.However, I shudder to think what would happen if you didn't have anyone you could rely on.
Then the doctor arrived for the patient in the bed next to Danuli, overweight and with betel nut spilling from the sides of his mouth he spent a couple of minutes telling the family that "no she can't eat the food in the tiffin" because she had been operated on only 12 hours before and was on a drip. This was much to the consternation of the woman's father who was far from convinced that the bottle hanging on the rusty frame was life sustaining. With a little verbal tussle he promptly vanished. Patient liaison over.
Kusal proudly explained that the tumour in her uterus weighed in at 5 kilograms... one can only imagine the internal damage caused by its growth. The tumour was sent away for testing in Delhi, as yet no results. Danuli was still in the original clothes that she was wearing when checking into the hospital, so I asked if she had a wash recently but the doctor had told her not to wash for at least a month or more! As we left the hospital past the now prostrate sleeping dogs, I noticed a pond out the back covered in green algae, next to the pond amongst the grazing cows and cow poo 'patties' were some sheets drying on the ground.
No patient care, no id wrist/foot tags, no hospital charts, no cleaning, no food. Drugs to be administered to the patient must be purchased from the pharmacy outside. All this comes with an incredibly hefty price tag. Welcome to the world of Indian government hospitals.