State of our Health Care: Infrastructure or Culture

In these times, when there is Oxygen Crisis in India, I choose to direct my attention on “Care” because it predates and precedes the ongoing happenings and is also a cause of the present crisis.

This is very plain in India that if one member of the house is hospitalized, every member of the house are hospitalized too. The other members need not occupy the bed, they occupy the adjoining sofa, or the floor. It’s become a tradition in India that attending to sick person is the job of the family member. The hospital attendants, nurses, who are supposed to take care, do not show any inclination to do so and their apathetic behavior are something every hospital borne person has to contend with.

If the patient is asleep and the family or the relative is elsewhere, the hospital attendant who arrives with snacks or food, will just drop it on a table nearby, not even bothering to wake the patient or even roll the table so that the food is near at hand for the sick to eat.

The same applies to nurses who are supposed to administer medicine. The nurse, if they show some little concern, just punch out the required dose of tablets and capsules and drop in a tray. It’s the patient’s family who then gets the patients up to feed the medicine. Or mostly, this happens. The nurse enters and says – take this and this and this – and thereafter are in a hurry to scurry out. If the relative of the patient is old or unable to grasp the instructions properly and asks to repeat the instructions; just notice the facial expression of exasperation and hardness in their voice.

Okay, we understand that hospital environment is stressful and the people working there are “doing a great job” and we have all beaten our own share of utensils, but, – it’s their job – isn’t it. If the Health Care workers don’t like the job and can’ take the stress, they should quit and search for another compatible occupation. But the health care workers do not become “great and vital” just by the virtue of their position and sans the service required.

I’ve seen these abject state of affairs in good hospitals and even in a good class of that hospital accommodation.

My sister was hospitalized in 2018 for Dengue in Kokilaben. It was a decent two bed accommodation. But the service was far short of expected. Being weak with dengue, my sister had not enough strength to reach for the table on which snacks or food used to be dropped. Me, who is a bit of a roving kind, chose to wander the hospital and in a starbucks cafe on the ground floor. Innumerable times, the tea or snacks or food grew cold on the table and no one alerted my bedridden sister. Yes, she should have called the nurse. But when the patient is sick, firstly they don’t have much desire to eat. Also, just like a “tradition in Indian Hospitals,” the patient thinks it’s best to call the relative where food and other attendance are concerned.

Now lets see this “tradition in Indian Hospital” in the light of a new kind of malady, which basically changed the way patients are looked after. Before covid, the relatives were there for administering medicine, food and help to go to the toilet. After covid, no nobody is there to attend the patient. No One.

One cannot change culture overnight. “New Culture” cannot start on 24th March 2020, with “Lock-down.” So, you see, India is dealing with this new crisis with old methods and mindset.

I will tell you how. I was afflicted with covid last year June 2020. Here is a link of my experiences. I was admitted in Holy Family for 10 days isolation. I’m attaching my hospital bills just to give you an idea of what it could be for anyone facing similarly.

The bill has many interesting facts.

Each time the doctor showed up there was a charge. Well, that’s fair. But each time the doctor showed up, he/she wore PPE (personal protective equipments) and the hospital charged me for every equipment they wore. PPE and the Masks were charged separately.

The most all the doctors visits did was; they stood at a distance from me, near the door and sent forth one of their junior doctors or the nurse with oximeter. That’s all. They are wearing attire for which I had paid and not even venture close to me.

With no family member with me, in quarantine, I stayed alone. My snacks and food were dumped periodically on a table on the far side of the bed. No one woke me ever, or even offered to roll the table upto my bed. They entered, dumped, and out. And this is happening to someone who is paying Rs. 5000 per day for the room plus also what they are wearing.

Now, I take my scenario and regress downwards. Consider a situation when people, not affording the expenditure which I had shelled, also encounter the similar situation. I was healthy, mobile and for me, staying alone, isolated is not a problem at all. But think of those, who are old, invalid or handicapped due to covid, has to stay alone, and with hospital services all around tuned to total apathy. It does not surprise me at all, when there are news which says, “Patient disappeared from ICU, Hospital says he died 15 days back.” Covid-19 apathy is another subject on its own. We only read what’s little that’s reported. There may be vast numbers existing out there in desperate and dire states.

Even if our infrastructure is weak and the logistics broken, if this – “care” – is in the “culture” of our people – two things will happen.

1) The Hospitals and Health care establishments, which is, in India, is a multi-billion dollar enterprise, will be proactive to provide the inmates with a quality of care suitable for convalescence. If nurses and other attendants have care in their hearts, they will pressure the higher ups and demand the tools that will help them to provide service.

Instead what is happening now. “Social Media-Fication,” show-offs, crocodile tears of the modern age. These are happening. The hospital care staffs are armed with pics and twitter updates to all helter-skelter, to show, as evidence, when asked – what have you done? They all say – Look, this is what I’m doing, updating every moment our state of affairs, tweeting for Oxygen, and posting on Facebook, to demand the wherewithal.

Besides, and these may not be even reported – the hospital attendants, in times of covid care, are busy to be as far from the affected patients as possible. I saw this myself when in hospital.

2) The life and lifestyle of the people of India, of the lower rungs, not particularly poor but not well to do either, is the cause of much distress in hospital care. You might wonder how? Let me explain.

The majority of Indian population live is small houses and pretty beat down living. They live like 10 in one room, and two, or even three, in one bed. No ventilation and of-course with poor hygiene. If one keeps this context in picture, imagine, a patient going to the hospital and asking for better care. It is not surprising that in states like UP and Bihar, there are two or three people on a bed. Well, they sleep at home like that, why should they demand any better in the hospital.

Now, covid comes – tell me who will provide social distance to people, who never experienced any social distance in their lives. Why would a hospital provide hygiene to people who never aspired for hygiene ever in there lives. For people of our class, if we see a dirty toilet, we may stop shitting for a week. Why would a hospital clean their toilet for people who never aspired for a clean toilet.

Incidentally, I’ve also had experience with subsidized hospitals too. My father who is a great believer in “simple living and high thinking,” (another name for poor taste) got admitted to Navneet Hi-tech Hospital near Dahisar in 2019 for Hernia Operation. While attending to him, I realised, he must of chosen the lowest of the low grade of bed, despite having a good insurance plan. For a week, I was living with people who were virtually from SRA (Slum Rehabilitation Authority.) There were two beds side-by-side in that pigeon hole, with barely two metal stools to sit on, one for me and the other for the attendant of the next bed, who never stopped looking at me for all the four days I was there.

There, in that hovel of a Hospital ward, I came face to face with “real India.” My many philosophies changed. In those four days I knew the true nature of man, the rudeness, the abjectness, the total non-care of the doctors and nurses and attendants, contemptible and degrading.

The investment in Hospital care, and with this covid type of disease which will be a new norm from now on, our hospital care has to change. There should be investment in such endeavors where people in hospital care jobs should go through re-education and sensitization on the quality of help that has a proper standard. We take “Care” as a given, as voluntary act of human being. No, it is not. The “Care” should not call for “Emotion.” “Care” should call for “Duty.” The carer “choose” to be “moved” when “camera shines” or taking “pictures” for Social Media, crying for 5 minutes of fame. This Ad-Hoc behaviour should be outright rejected or trolled and laughed “out of social media.”

Medical and Health care has never been a priority for any government and will never will be. Ayushman Bharat and other types of Health Insurances are just legislative. They provide the people with some mitigation but again, health insurance is a milking cow for the hospitals. But, let’s consider that people of India are “paying now or every year” for “Milk” to avail future “Hospital care,” either via tax or premium, aren’t people of India entitled for comensumerate Hospital Care. Should it not be an agenda for IRDAI (Insurance Regulatory and Development Authority) to for their attention to legislate the requirement for “Proper Care” so that, anyone, or bachelors like me, can get admitted to any hospital, stay alone, be attended to, get assisted, and not just disappear from the bed or die in the toilet and be discovered after 14 days.

Covid-19, 20,21, … Our Tryst

I’m recounting my experience with covid so that people will get aware of this malady if they unfortunately face this fact. There is a wide range of symptoms which people report, pre covid, during covid, and post covid. I hope what I recount will aid others to get aware and be on a look out, for themselves, for their loved ones and for their relatives and friends.

Towards the end of June last year, 2020 I was hit by covid. Prior to this, I had the following symptoms;

  1. Loose motions with froth or foam-like substance which accompanied the stool. The usual/normal motion takes time and effort (and leisure) but a covid-shit takes no time. It’s shit-in-a-minute. Meaning, I used to go, sit on the pot and baam! It’s over. All clear. The look of the stool was like Goats droppings with shampoo or soap froth. You know what I mean.
  2. Another symptom was, my tailbone, the butt on which I sit, started to ache a few weeks prior to my diagnosis. I’ve been sitting cross legged since childhood, and since May 2017, I’ve become a regular butt-sitter. My bed is my regular work place where I sit or sleep, as I desire. I was never afflicted with Tailbone pain before and after covid, but the weeks leading up to my final “fall,” I had tremendous discomfort in that region. I cursed myself for never having a regular work table, etc., etc.. Here is another one recounting similar happenings.
  3. The third symptoms, which initially I blamed on my obesity and lack of exercise, was my complete and utter exhaustion. If I even walked up to my toilet and peed and came back, I used to lie down with total tiredness.
  4. Then finally, I developed a fever and and I used to have two paracetamol 500 tabs ever two hours just to keep the fever below 103 deg and to 99 or 100. I finished all Crocin whatever was lying at home, got my sister to get stock from her house, finished that too, then my sister went out to get some more and finished that too. Finally, due to COVID warnings or whatever, the medical shop started refusing to sell paracetamol without any covid negative test report. The medicine was finally procured from elsewhere but by that time everyone in the house knew that there was something wrong with me. No one, not even me, suspected covid.

I was suspected of Dengue. The reason being; since 24th March 2020 till my final fall to COVID in last week of June 2020, I may be the only person in this world to have followed the covid protocol strictly. I never stepped a foot outside the house. I don’t even remember opening the main door. Seclusion and solitary confinement is no problem to me and here I can beat Nelson Mandela. After few days of Dengue tests, I finally took the covid test and within two days thereafter, I was honored with covid Positive report.

Also, along with covid test, my doctor advised me to also take HRCT (High-resolution computed tomography). The LINK HERE is my report and this will give an idea as to the destruction this virus can wreak on a human body. No wonder I used to get extremely tired walking just a few steps. I’ve had breathing problems since birth and being allergic to many things, I was adviced hospitalization, just to have the oxygen handy, if need be.

5. In the hospital I had two strange occurrence.

a. The calf muscle on my right feet suddenly developed pain, and the pain travelled up and down the calf muscle. I just couldn’t make out what could have triggered this “cramp” as I was prone on the hospital bed most of the time watching non-stop Hindi movie songs. At home, I never see these but in the hospital, there was no Netflix. I heard this song so many times, that it became my favorite. Particularly the dance.

Then those medicines started coming in and I was surprised that corona had medicines. Most of them were Vit C, Vit D, anti Acid – but one of them was called – “Clopilet.” Armed with my iPad, which is my another appendage, I google the medicine and found that it’s a sort of “blood thinner.” And later, it may have been instrumental is curing my right calf muscle cramp. Now, I can say, I did have a blood clot and I was fortunate to have been attended to.

b. Around the same time, in the hospital, a largish circular “Goosebump” kind of a Skin Eruption occurred on the back side of my right thigh. It was not painful in the beginning. Over the course of next three to four months, that skin-eruption developed into a pussy boil with no discernable “head.” Gradually it subsided.

When I was in the hospital, my father, mother and sister all were diagnosed covid positive but they were all asymptomatic and quarantined at home. After the quarantine period, our family doctor advised “Venous Doppler” tests on both limbs to all. This was to find any blood clot which may develop as a result of covid and which can travel to the brain or heart and cause fatality.

Thus the malady. Hope this helps, to be aware of the things that may happen, leading to, during and after covid.

In my opinion, the covid test is just an indication. The damage the virus does can be determined by HRCT and “Venous Doppler” tests and also the use of “Blood Thinners.”

HRCT saved me as I became aware of my lung deterioration which made me go to the hospital prior to emergency. In the hospital, I was never on oxygen but my room had oxygen saturation increased.

The “Blood Thinner” was a boon to me inadvertently. Had I not being hospitalised, I wouldn’t have known or taken this medicine.

Post covid, Venous Doppler is important, just to be safe and not let a grain of blood clot which if undiagnosed and untreated, may travel from limbs to the heart and brain. If it doesn’t cause death, it may cause something more disastrous – paralysis.

Even if your immunity saves you from covid, there are other things you should take care of. I’ve listed my own experience.

On Privacy and Surveillance-05

I’ve written on this topic, here, here, here and here. And here is a play I wrote long time back which typifies an office environment.

After writing some on “manual surveillance” I’m veering towards surveillance of the “Tech-Kind.” These are not opinions only but my experiences too; things that happened to me. And if you are not careful, it’ll happen to you, too.

Recently, Apple launched “Airtag” and (frankly) I did not have a clue of what it is. Then when I knew it, after watching YouTube videos, I found Apple is not the first one to make such a device and there are others in the market, and these are pretty popular – “in the western world.”

But who the hell will buy “Airtag” or other “tag” like devices in India?

Imagine, losing your bag and with an airtag attached to it. I’m hundred percent sure, in India, your phone “may” guide you to the “tag” sans the “bag.” Besides, I still doubt you’ll get the “Airtag” too.

Here is my story about “tagging” of another kind.

A decade back (2011), after a drinking binge I walked up to my car and before opening the door I decided to have a smoke. I deposited my iPad and iPhone on the roof of my car. Having finished smoking, I entered the car and drove off. The devices on the roof may have clattered and clanged on the road near my usual bar.

Upon realising what I had done, I went to icloud.com/find to locate my devices. Obviously, anyone who may have picked my phone and pad, did the first important thing. They switched it off. On the browser, I put both my Apple devices on “Lost Mode,” and “Erase Mode,” with message and phone number for any generous angels. I had also remotely password locked those devices so that if any one even tries a password for once, the device will self erase and me getting an SMS with location. Or so I believed.

Then I did the next best thing ever expected out of only me in this world. Next day I went back to the bar and told everyone what all I have done to trap the person who, by now, was my culprit.

A guy like me, in that bar, and who tips pretty good left, right and centre, is always trailed and watched. I know this for sure. I’m pretty certain that many known eyes would have seen me take off and also seen those devices fall of the car-roof. And my next days idiotic brag would have tipped off the culprit for certain.

My two devices probably was never switched on, or, if its SIMs were removed, never got a whiff of any Wi-Fi. Well, why would anyone interested to steal would enter a Wifi password. Yes, the SIM’s were blocked later when no angels showed up.

It must be added here (and it must not be missed) that on the day, or rather the night, when I lost my devices by placing it atop my car, I was not alone. I was with my colleagues, one of them was from my previous company. This “previous-company colleague” had made a career out of “Khabaree-giri,” (snooping and informing higher management). I know this guy since the day I started my career.

After the above incident, only a day or two may have passed, and I was standing beside my car on my office parking – with my “new iPad and iPhone” atop my car roof. At the same time, another car rolled in and stopped beside me, and out peeked a Higher Management and remarked – “Don’t put it on the roof, you’ll again lose it.” I was struck; I literally had my mouth wide open. I immediately knew who reported it and the utter shamelessness of it all. It had not taken him much time to let the news to flow; I can imagine him not sleeping the night and divulge it to the management “first thing next morning.”

So, some tagging don’t work. But some do. Tagging literally means Labelling, for identification. And in this world, this #tag, is an important function.

“Airtag” as is feared, can be used as surveillance. This has been disputed as “Airtag” cannot be used as tracking device on others as their iPhone will alert them. What’s been left unsaid is that if the technology is there, who prevents a third party to devise such a useful device?

In these days of smart devices, there are many more ways to know what people are doing with their time. Such information is important. If you are not doing the work of the company, you are doing the work against the company and this information in your colleagues hands will be used against you in the first meeting everyday with higher management. Any crap information will do. The higher management love entourage, a crowd of yapping sycophants in their cabin, to feel important. In this world, sycophancy to any power is free because it feeds on scraps of promises. Even the bosses smile will do for that day.

In the beginning of my career, I used to go to work with a book in my hands. I realised after a few days, that this was one undesirable behaviour in the world of corporate illiterates. “You know, he reads books,” such expressions started to make rounds till I stopped carrying it. But by that time my reputation was tainted.

In my last company too, there has been numerous occasions when, with my attention is engaged elsewhere, I’ve noticed colleagues fiddling with my iPad. Many of them act ignorant of the device but they exactly know where to go in the ipad and which options to click to know the history of your net-whereabouts.

Smart Devices these days have made it very easy to get information on anyones engagement of his days. Take iDevices. Screen Time has made it easy for anyone to know how the owner of the device is spending his days. And if you cannot access Screen Time, if it’s turned off, then GOTO>Setting>Battery. You’ll get all information at a glance with statistics.

What one does with his days, what app one is accessing, what website one is exploring, what is posted on ones Facebook and Twitter etc., are precious raw metals for adversaries. Picture a run-down African country and their run-down hungry looking kids with porus baskets filtering muck and dirt. They are looking for diamonds and gold. They do it all day looking for just a speck to sell. Your colleagues will scour your life the same way for what you have, and what you consider dirt, is diamond and gold for them.

Along with smartphone, start carrying a Basic Phone too. If anyone asks for your phone, for whatever reasons, give them the Basic Phone. And see the fun!

The Florida Project, Movie, Amazon Prime

The Florida Project is daintily constructed subtle movie. What makes this movie interesting is how it is approached and framed – shot by shot and scene by scene. It’s a story of a six year old girl going about her daily life. It’s as simple as that. But screenplay captures moments of her life and strings it into an interesting episodic story.

There are other actors too in the movie and they assist the child and are pretty main to the story, or to the snippets of stories. It’s important for the viewer to remain with the scenes and with the main actor. After a while the viewer will find himself traveling with the child and accompanying her in her various adventures.

The Florida Project is the movie of the innocent age. The parents are having a hard time yet the children are oblivious. They are living off charity, begging on the streets for one ice-cream cone, and sharing it among themselves, running around here and there and just being children. The color tones, the sound of the movie is bright and boisterous. Besides, there are lots of compassion.

The approach of the story – The Florida Project – is worth noticing. The point of view is through a child, and other children. Though the adults have their own problems, yet, their story is dealt through the eyes and expressions of a child. This consistency is maintained with every hard-luck families and neighbors. There are some poignant moments where a viewer will get engrossed watching the antics of the child and later realise what the adults may be doing in the other room.

The six year old actress, Brooklynn Prince as Moonee, along with her equally accomplished playmates, will take you on an adventure. The viewer just needs to hold their hands.

Nomadland, Movie, Hotstar

This award winning movie is an acquired taste. Meaning – “you’ll have to like it to like it.” Part of your labor will be to adamantly remain with the movie till the very end, just to find out exactly why the Academy of Motion Pictures Arts and Science, better known as Oscars, chose this as their best picture of 2021.

How the Oscar jury work, is known. Here is a link which show their method to choose winners. But what are the KRA, the key result areas on which the performance of the movie are appraised? Are there other aspects too, that are deciding? Like Geopolitics. Or Commercial interests.

For example, India, which had never much featured in the world of Beauty, suddenly, in 1994, won both Miss World and Miss Universe awards. With 1991 economic liberalization in India, a crowd of multinationals had entered Indian market and they all needed models. Well, what best way, than to create some nice well known faces for the media. In 6 years, from 1994 till 2000, India won 4 Miss World awards and in 1996, Bangalore itself hosted Miss World Beauty pageant. That’s two decades back. Since then, except 2012, beauty has escaped India. India not winning anything in the world indicates that the world just aren’t interested in India.

China has always been hot. The western world loves the Chinese (read) – the Chinese Market. And they do all the media tricks to signal their love. And China knows that its market is their power. And they are not shy to use that as a leverage. China have censored movies which does not support their politics and their narratives and it has forced changes in movie scripts and screen depictions. And Hollywood has complied.

Any which way, a message has gone across to China that Americans love them, even their multi-international-award-winning expats’ movie, which has pace, look, and feel like an amateur documentary.

To successfully watch Nomadland till the end, the viewer has to latch themselves, with chains and locks, to the chief protagonist, Fern (Frances McDormand) and stay with her for One Hour Fifty Minutes. The movie will never invite you. Instead, the viewer has to behave like an uninvited guest, rummaging garbage in every scene for tidbits of souvenirs.

If you pursue Nomadland till the end, you’ll get it. Or you won’t. It’s a matter of taste.