I MET HIM TWICE

She was shaking with fear with every stroke , As the gateman tapped on steel frame of the bed with stick . That fifty plus women hid down herself beneath her husbands bed . It was non-visiting hours of the ward while dinner has been distributed . Her husband was incapable of movement ,could not even talk . As i begin she was afraid of being caught and thrown away , And she invariably would be when senior doctors on round . Most of the time attendant is the only means of communication with the patient . Patients attendant should not be considered merely a person accompanying and facilitating patients visit but one can exert a positive influence on patients medical care1 .

Contrasting scenarios also present . Wards become market place with constant gathering of visitors .There is a strong positive associations between frequencies of hospital acquired infections and increased number of visitors per patients per day . Visitors are additional load for proper hospital management & effective patient care2 .

Again i found myself in a situation when a bed ridden patient asked me where to get medicine .He had none but a six year old son to look after him .They had never been such a big city before .Yesterday he sent his boy to hospital medicine store but came to know this could be found outside only .He was the only earning member of his family & would loose his leg if not properly treated .He was asked to bring medicine by that day .If he would fail to do so he would had to vacant the bed .he had been facing a dilemma as lots of money to be spend & his little boy had to go outside the hospital alone with it . I Never Met Them Anyway .

Though meeting a patient second time on different occasion was not that happy event .At first i met him while i was walking down the stairs .He was sitting on third floor on second step .He had his left lower limb full plastered .Our orthopedic ward is in the fourth floor .This 8-10 years old boy had just drag himself down from fourth to third floor and was attempting all the way down to ground floor .God knows if he could reach him .Its true our hospital does not have enough wheelchair or trolley .One trolley for each 50-60 bed ward & we have inscription 1/a,1/x in both side of the bed on the wall just as to facilitate flooring of the patients .And last of all this boy could not afford to offer some coins for trolley man(ward boy or aya) . Yes i did manage to bring him to the main exit and send him home by local transport .

As i was saying i met him twice weeks later i found him in the emergency with high fever ,swollen leg with greenish blue tinged plaster instead of white .I managed to have few words with him .He told me that he was released last time with fever .He was told that hospital was out of supply of antibiotics required for him ,The boy was simply sent home . Without notice i visited some rural primary health care facilities with our teachers .Though we found no assigned doctors present but there was ample supply of required drugs .So tertiary hospital like ours was out of supply of antibiotics-this is not the story to indulge in .

Once i met a seventy five years old man with gangrenous left toe .He seemed to come from a well to do family .It was quite unlikely to have people like him in the government hospitals .Senior doctors told me we could treat him free of cost with government medical supply but he had a different issue .No one of his family showed up since his admission & he could not mention his address .He just stared at me .Did not know was he searching his beloved grand children in me ? you are my son, please relieve my pain -once an esophageal carcinoma patient cried in anguish .I checked her papers and found her chemotherapy schedule were postponed over & over again .Only a seal was given on admission papers-BED OCCUPIED COME LATER .That was the only facility of both government and non- government sectors for entire division merely over 20 million people .

My favourite ward is neonatal care unit (paediatrics ward) . Every one in this unit mothers ,visitors-attendants all are more or less happy .Mostly in festive mood in post labour unit .It is the only place in the hospital where people present with smiling face .I never felt that sorrow even having seen a lots of pain,tears,death but the smile of two little angels when i came to know they were abandoned child .No government organization or N.G.O were willing to take their responsibility until certain age .Every year there had been one or two such incident & they are mostly female .In the labour ward i once saw a over cautious mother in labor pain .she kept repeatedly asking about the condition of her baby even though she was in tormenting pain .Later i came to know she delivered a still born last time .After delivery the newborn was given onto her chest but she just threw it quietly as it was her third consecutive daughter .

My first day at medical college .I was in the canteen .There i saw a mother with skeletonoid baby in her lap .She was wandering and approached to every student .Some showed interest some remain indifferent .After some time she came up with a request to me .It was not for help-money-food.She just asked me for blood for her child who was a thalassemia patient .We have voluntary blood donation organization that meet her need .But i kept meeting those faces over & over again last five years and we all know these student s voluntary blood donor organization are not sufficient in larger context .

I may learn to avoid such situations or overlook in upcoming years like my seniors .But these probably more terrible would keep coming to me ,my colleague .It is the common people who suffer heavily .If modern health facilities only to offer treatment then i would say we are doing tremendous job ,working round the clock ,putting our best effort .But if it is A question of health care then existing hospitals in the developing country are far behind .A person never return back to his society the same both physically and/or mentally after receiving treatment of any major illness from any health facilities .

for my son you are god to me ,my sons wellbeing depends on you-but why dont you touch my baby?-the mother burst into tears .Last three nights an intern was on duty in neonatal unit .It was a premature baby kept in the incubator .intern explained -mother my hands would be a source of infection that would be rather a curse if i touch your baby But in the absence of that caution today there is high rate of infection in the post operative patients .This is the number one cause of mortality & morbidity in hospitalized patients in surgical wards at present ,leading directly or indirectly to an enormous increase of the cost of hospital care and duration of hospital stay3 .

Probably it is the hospital where people say their earnest prayers ,ask for gods grace .In that case all the hospital stuff ticketmen-doctors-administrators should serve the people with integrity ,conscience ,commitment and competence like priest . God speed . (these events are true)

References [1] Qidwai , Maria K , Javeria R , Azam SI : Patient Attendants views on their role in Doctor Patient Consultation . Hungarian Medical journal,2007;1(1),47-54 . [2] [3] Faruquzzaman : Positive associations of Nosocomial Infections in Surgical Ward with Etiological Clinical factors . Bratisl Lek Listy,2011;112(5), 273-277 .

Correspondence to Mohibur hossain Nirob 5th year MBBS student Chittagong Medical College , Bangladesh . Mohib_nirobb@ovi.com