Prem Singh is studying industrial engineering in a premier government engineering college in Indore city and is in his final year. He is the youngest son of Aap Singh who is a Barela Adivasi farmer residing in Kanad village of Dewas district. A few days ago in another post I had written about how Aap Singh with the help of his son Prem Singh had put together an aeration system in his home to store onions in the hope of getting a better price later. Prem Singh had put to good use his theoretical studies as an industrial engineer to help his father. However, even though he is a student of science first and that of technology afterwards, so specialised has all education become that his knowledge of basic medicine is poor. So when he was taken ill with a bout of high fever combined with vomiting and diarrhoea he first went to the dispensary in his college where he stays in the hostel. The person in the dispensary too, despite being employed to take care of the health of students neither had the knowledge nor the medicines to treat Prem Singh and so he was shifted to a nearby private hospital. The doctor at the hospital, a senior physician, immediately put him on various antibiotics injected intravenously diluted in normal saline. Various tests were also conducted on him. However, neither the fever nor the diarrhoea was controlled even after two days.
Aap Singh on coming to know of this came rushing to Indore and on seeing his son in bad shape argued with the doctor to discharge him as he did not have any trust in his treatment. He said that even the quacks in his village could treat fever and diarrhoea better and they would do it for a few hundred rupees instead of the thousands he was charging. A heated argument ensued that continued for a few hours but eventually Aap Singh had his way and Prem Singh was released. As it was already evening, Aap Singh called me and asked whether they could spend the night at our house before going home. I told him to come home. I went through all the diagnosis, tests and prescriptions and found that apart from having a low haemoglobin level of 10 mg per litre there was not much else wrong with Prem Singh. True he had fever but it was not very high and he was going frequently to the toilet to relieve himself because of loose motion. The doctor while discharging him had given him antibiotic and antacid tablets and paracetamol. Only an anti-diarrheal was missing. I told him to give him these medicines and gave an anti-diarrheal from our stock. By next morning Prem Singh had recovered and in the afternoon Aap Singh took him home to his village on a motorcycle!!
This whole episode brings out the total disarray in which the health system is in this country. Prem Singh was most probably affected by pathogens in the drinking water in his hostel. Why was he affected while other hostelers were not? It might be because he is anaemic. Anaemia reduces the power of the immune system of the body to resist pathogens. Be that as it may, the illness was not very serious and with proper medication would have subsided within a few days. The dispensary in his college did not have the basic medication for fever and diarrhoea. The specialist doctor of the private hospital that he was taken to administered medicines through intravenous drip despite Prem Singh being fully capable of taking them through the mouth. The two days in the hospital cost him 7000 rupees and even after that he was cured. The administration of medicines through intravenous injections diluted with normal saline had become an irrational bane of treatment in this country as shown in the picture below.
Intravenous injections should be given only when a person is unable to take food or medicines through the mouth due to a serious medical condition. But nowadays these are administered at the drop of a hat and people too demand that they be given these drips as they feel they are more potent!! So powerful is this myth that we find it extremely difficult to convince people to take simple medicines orally. Aap Singh after coming to my home first asked me to get a doctor to come and put his son on an intravenous drip. It took some hard talking to convince him that his son was not seriously ill and that tablets taken orally would cure him as they did within the space of a few hours.
Thus, the poor in this country are caught in a deadly pincers of malnutrition on the one hand which reduces the power of their immune system and makes them vulnerable to disease, an almost non-existent public health system, a rapacious private health system practicing irrational medicine and a lack of knowledge of basic medicine. A student of engineering who has great innovative power in his field does not know anything about basic medicine and that shows how lopsided our education sytem is. With neither health nor education we have a recipe for disaster.
First Published here