Obvious oblivion...

India is a developing country and no governmental structure that I know of meets the standard of perfection. Period. After working in the E-ward and EMS of Sion hospital, this observation of mine was only more strenghthened. Its understandable to an extent in the context of the first sentence of this post. But yet there are certain changes that can be brought about in both these facilities which are at present well above the average emergency facilities that most other government hospitals provide.
Firstly, talking about the medical side, Sion hospital is grossly overloaded with patients. Anyone who's ever been here would agree to that. Its location may be a prime factor. But an equally important factor are its under-equipped peripheral hospitals. Not all patients having fever with chills need to be admitted in the most advanced (well, at least theoretically) set-up of the Indian health-care delivery system. These uncomplicated cases who only need close monitoring for a few days should be admitted in the peripheral hospitals. Even if for some reason they don't directly go to the secondaries,they should be referred from here to them after may be administrating any immediate management that may be required.
This has to be accompanied by up-gradation of peripheral centres. Basic investigation facilities like X-ray, pathology labs, USG are a must. This would need funds. Also, in the wake of seasonal viral epidemics, an easy access to fully equipped blood banks is necessary. If a patient dies due to timely unavailability of life-fluid, then all other resources spent on him/her would go to waste. Patient's recovery is resources' recovery. This attitude among medics and paramedics is as essential as it is rare.
Although I haven't done my obs-gyn post yet, I know from my fellow-interns the problems faced there. There are many maternity homes run by the BMC and government but they obviously aren't enough. They ought to cater to a larger population and only complicated cases should deliver in tertiary centres. Also, there should be blood-banks meant exclusively for obs patients. Patients' blood may be grouped in advance and cross-matched later if need be. This opportunity should also be utilized to encourage patients' relatives to donate blood.
I have seen the E-ward of Sion hospital in its best days. While I was posted there, the unfortunate Mumbai bomb blasts had happened. That was the time when for a change, supplies were unlimited. The expertise is flawless. But there is an immediate need of something extremely important in E-ward.
An 8 year old boy had been run-over by a dumper. He had lost his left limb upto hips and had a deep perineal wound. The wound was so extensive that further amputation with rehab wasn't possible in the provided setting. So people just waited. His elder sister who was in tenth standard came to visit him one day against her parents will. She was so disturbed to see her brother in this condition that she committed suicide later that day. The child was transferred to wards later. Thats the last I know of him.
Trauma is an acute illness. The patients and their relatives are never prepared for it. Its foolish to expect them to be. There is a counselor's room just outside E-ward but it is perpetually locked. Someone had the vision but no one has the sense. If they did, perhaps those poor parents would have had at least one healthy living child. Psychiatric/ psychological counselling is very important in the trauma ward, especially for the relatives. They need to be told by professionals that it is indeed a tough situation but they cannot break down now. Appropriate guidance can be provided. Its almost impossible for the surgeons or other staff people to do so as they are really busy trying to save the next one.
These steps that I've mentioned are the suggestions of an intern who has worked hardly for a
month in these places. Obviously a more thorough assessment of the situation is needed if at all any plans are planned to be drawn to improve these situations. But these flaws in the health system are so obvious that it surprises me that till now nothing has been done even remotely similar to the even more obvious solutions.
India spends too little on its health system. If lakhs of rupees can be spent in three days during college festivals, even several times more money can be simply converted to smoke and sound during other festivals, then why can't we purchase a sonography machine of a few thousand bucks for Shatabdi hospital? Or why can't we provide better stains to UHC Dharavi's path lab? No wonder no PS for MP comes positive there.
We have just adapted ourselves to work under inappropriate conditions. We find that easier as our time is limited in these hospitals. Those who stay here for ever learn to pass the responsibilty on to others, never stimulating a single nerve fibre to bring about any change whatsoever.
Meanwhile, I just keep getting surprised by people. Perhaps I'd act someday...