What gives

I have been in Madhya pradesh for barely a little less than a month.Looking at the spectra of patients who enter my out-patient I must say I am impressed. Seoni district is supposed to be the poorest district in the state.The first thing that I had to face as soon as I started working was predictably in the field of tuberculosis. Anti-tuberculous drugs were just not available over the counter.This was a dream we had been dreaming of all those days when I was working with the tuberculosis programme earlier in Jharkhand and later in HCH and had thought would never happen in India.There have been forums which have waxed eloquent in this but practically I thought it would never happen in India,but this state has done it.Even though grudgingly,I had to give kudos to the government here. However the flipside was when a patient of miliary tb presented to us and would not give a sputum and so apart from the CXR we really did not have anything to fall back on.The bystander had to make the round

Sumitra was thirty five ,gave a history of being four month’s pregnant, came wailing into the casualty with a back pain.She was pointing to her spine ,was more than hundred kilograms in weight. Her husband ,a handicapped person was emphathetic enough while the rest of the family watched the drama from a distance.She had a whole lot of complaints ,a lot of which could be attributed to depression. I was asking her the history and the staff was taking the FHS which could be heard clear and loud through a Doppler.I was talking to the husband and when we asked her for a history of discharge PV she said she had had it for the past two days. We decided to do a PV examination.Much to our chagrin ,she was fully dilated and the membrane was bulging.She had no USG with her but she and her husband were absolutely confident about the dates although her uterus looked almost term. We shared all the possibilities with them. We decided to induce labour with all the necessary warnings that should the

Malti is eighteen .She was reffered in by one of our community nurses as having headache and fever of one month duration.Her feisty uncle and her docile father had brought her in. When she was brought to the casualty,she gave me a blank look ,hardly spoke.She seemed terrified of being examined.She read abuse all over her. When I asked her for the history of fever as written in her referral sheet she shook her head definitely to indicate she had none. It was difficult to get history from her since she looked badly. I diagnosed her as having early schizophrenia but never the less screened her for organic problems. I put in a word to Dr.Rajah our clinical psychologist in Herbertpur.Rajah as helpful as ever was effusive in his response and gave me a detailed guideline as to how I could manage her. I remembered many a day when Dr.Rajah had futilely tried to hammer in psychiatry into our medicinified brains.I had sat through his talks taking in the lighter aspects and thought, had not taken

Meena Bai was nineteen years ,seven months in the family way.She worked as a daily labourer in the road and earned all of one rupee and twenty five paise. She became unwell so came to the mission hospital for treatment. The mission people had an unusual way of treating patients .They not only gave medicines and examined ,they also spent a long time talking to patients. Sister Barbara was one such lady who counselled her for a long time.She specifically remembers being told not to keep too many things in mind or worry too much. Life was difficult.Her husband had an erratic work.When there was work there was enough to eat. The hospital ,when she was about getting discharged ,conducted a camp for surgical patients.The doctor asked her to help out in the camp.She still remembers she was employed for fifteen days at a stretch . They gave her all of sixty-five rupees at the end of it. She had never seen so much of money in her life. That is how she started working in the mission. That was fo