Manikram came to us with a rotting leg.There were ulcers down the front of the shank to the dorsum of the foot.Maggots were having a field day feeding off his flesh.
My junior did a good debridement along with the senior nurse.
I saw Manik Ram in the ward accompanied by his wife they were simple village folks.They had come from a faraway place and there was no way they could have managed to come for dressings so they decided to stay back in the hospital.
Anticipating a big bill, we decided to discharge the patient in our software but never the less keep him back in the hospital free of charge while we did his dressing.
At the end of the second week his perky daughter-in law appeared out of nowhere. Maniklal seemed to have made up his mind to go home.
I thought he might have been home-sick so I agreed to let him go and offered to teach the bystanders how to do the dressing at home They could come back to us for further management.
Meena bai,our nurse assistant , matter of factly enlightened me as to why Manikram was to go home.
Apparently in their society whenever someone has maggots growing in any part of the body,their society's norm is that the person has to feed the whole community to a meal or else they are ostracized from the community.
His daughter-in-law had come all the way to take the father-in-law to fulfill that bit of formality back home.
They had no money to foot the hospital bill,they had no relatives or the people from their village visiting them while he was sick .To be accepted back into their community ,none of whom had showed up when he was sick, he had to buy his way back with a meal.What kind of poverty is this?
in the meantime India's mission on mars has just been successfully launched.
Monda suggested we go hunting. Dressed up to beat the rains and the unpredictable weather we ventured out at night with the two Dawas. Annie had baked a cake for Rumpanol.It started pouring in spurts but nothing could beat the enthusiasm.The junior Dawa was to drive us to a place around fifteen kilometres up the north Sikkim highway.We would come across three rivulets of sort where we could possibly find the edible frog.The senior Dawa was already at the spot making a pathway in the jungle for us to proceed. We reached the spot at around eight at night.in the pitch dark one could hear the sound of frogs of all variety and we started seeing quite a few but none of edible variety.We shuffled around in the rain with an umbrella,raincoat and torches like Nancy drew exploring the grasses and having eye contacts with stunned frogs which seemed to have lost the ability to run .The two boys did a Tarzen and was lost in the jungle with a sling bag ,a torch sans any cover from the rain.While
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This is, of course, an extreme case, but I wonder how many patients have to similarly spend money on so many other 'indirect expenses related to hospitalisation.' Ultimately, all these direct and indirect expenses combine to push them below the poverty line.....
Those who have less might actually be more blessed....