Tuesday, December 29, 2015

An inspiring man

I find that my blogs related to health services in rural India have mostly told negative stories, of services not provided, of indifferent or hostile care providers,of difficulties in access and availability of basic services. I have met many cynical or jaded or dishonest health care providers, be it ANMs or doctors, ready to misuse the system, or just be indifferent and do the bare minimum possible. There are any number of excuses - some valid, some not - as to why they are not doing what they are supposed to be doing. There have been a few very good ones of course, and the effect is immediately apparent - a motivated team, or a community that is immunized or gets the services it should. And these people keep the system going.

Dr N Saxena, Civil Surgeon, Rajgarh
Last week I visited Rajgarh district in Madhya Pradesh. It borders Rajasthan and the district headquarters town of Rajgarh is dry and the landscape more akin to desert areas - in complete contrast to the southern part of the district that is forested. My colleague and I visited the district headquarters hospital which is housed in an ancient building. We met the Civil Surgeon Dr Niranjan Saxena who is in charge of the running of the hospital. In the hour we spent talking to him about facilities provided at the hospital, and constraints faced, I watched him process several files. These were of patients who needed more care than the hospital could provide - facilities that were often available only in private facilities, at a cost the patient could not afford. He was instructing his assistant about which scheme could be utilized for which patient, and what amount. For instance, there was one child who had come with headaches, who turned out to have a benign brain tumour. The family could not afford the treatment, and Dr Saxena recommended a grant of Rs. 1 lakh from the State Illness Assistance Fund.

He informed us that he uses this fund, as well as the Chief Minister's Scheme for health assistance, in addition to the Deendayal programme for financial assistance in health care. He is a surgeon by profession, and carries out all kinds of surgeries - general and orthopedic surgeries (including amputations where necessary); obstetric and gynaecological surgery when the obstetrician is on leave; and cancer surgery. They see about 20 cases of oral cancer each month, and 1-2 cases of breast cancer. Post-operative cancer patients are then referred for radiation or chemotherapy to higher centres that have these facilities. Day care for chemotherapy is provided at this hospital, once the regime has been prescribed by a higher centre.

Not many women with cancer of the uterine cervix are seen, he said, probably because too many women have their uterus removed at an early age. A sad commentary of our times.

Dr Saxena was full of energy and enthusiasm, and informed us he retires at the end of the year, when he turns 65. One would not think it, to look at him. An inspiring man and one that the health system could utilize for some more years to come.