Thursday 11 August 2011

Encounters With Indian Healthcare

A couple weeks ago I contracted some sort of skin infection. At first I thought nothing of it. But within a week the large, painful, red, bulges in my underarms could no longer be ignored. Initially, I was overwhelmed at the prospect of seeking medical attention in this foreign and intimidating country. Should I go to the hospital? How do I get into an Indian hospital? How will I find a reputable doctor, and not a quack that uses unsterilized needles? How will I pay for it? Do I call my travel insurance company? 
After a few minutes of panicked deliberation, a thought came into my head: isn’t there a doctor on the ground-level of my apartment, just a few feet away?

After a quick consult with Lauren, we agreed that I would go, but I would bolt at the first sign of a scalpel or needle. I set off downstairs to see the doc.

This is the sign that greeted me:



I was not comforted by the claim of “surgeon.” Ah yes, I know the cure for a skin infection, SURGERY. 

The pain was quite bad, so I told myself it was worth a try. Bizarrely, less than ten minutes after stepping into the office, I was back in my apartment having been examined, diagnosed, and provided with a full antibiotic regime. The price tag: 200 rupees, or about 4 dollars. So much for insurance, I thought. You would have to have open heart-surgery just to make the deductible worthwhile.

After some skeptical googling of the diagnosis and drugs, and a skype consult with Dr. Dad, I conceded that the doctor had probably nailed the diagnosis and prescription.    
But the story does not end here. After making initial improvements on the antibiotics, about three days into my course, the infection rebounded. What!? Apparently, Indian health-care professionals go a little light on the antibiotics. 

I decided I needed to up my dose, however, Doctor Downstairs was adamant that twice a day was sufficient. C'mon, the Internet and my Dad say three times a day. What more do you want?  I decided to undermine the doctor’s medical opinion and headed off to the pharmacy in search of more antibiotics. I was worried they would want a prescription, but nobody even raised an eyebrow. I probably could have loaded up with Oxytocin. 

I again made progress on the upped dose, but when new boils were still popping up ten days into my antibiotic course, I started to get worried again. Maybe the bug wasn’t sensitive to these antibiotics? Maybe I had contracted an Indian super-bug?

I asked fellow interns what to do. One guy gave me the info for a dermatologist he’d seen. 

“So, I go back to the family doctor and get a referral to get on the dermatologist’s waitlist,” I asked, thinking I might not even get in before we left India.

“Um, no. You just call her.”

So we called up the skin specialist, and she was able to see both me and Lauren (who had other skin stuff) that night. I don’t even want to know how long it would take to see a dermatologist in Canada. 

And so begins our encounter with Dr. Pramila, our neighborhood dermatologist. 
Dr. Pramila turned out to be rather amazing. Very professional, great bed-side manner, perfect English, and very thorough. We both left with multiple-step regimes for curing our ailments, and prescriptions for a whole wack of ointments and creams (that ran us about $25 combined). Lauren, who has bad allergies, and has struggled to find quality, accessible, skin-care in Canada, contemplated setting up a standing weekly appointment to take full advantage of this find.


The funniest part, however, was when Dr. Pramila told me that I was on the ‘right’ drug, but the wrong ‘brand.’

“Oh, yes, this drug will work, but I would recommend the one made by GlaxoSmithKline. The brand you have doesn’t really work.”

Apparently, I was taking a generic. And there is no guarantee that generic drugs will actually work here. About the efficacy of a tic-tac, in many cases. It’s not that they’re fake – they’re just not manufactured properly. Fake drugs are a whole different problem. An enormous and highly disconcerting problem. Some studies that tested drugs in Indian pharmacies found as many as 20% to be completely fake. But I digress.

So, in the end, I am happy to report that I am now infection free. My encounter with Indian healthcare was, on the whole, not all that bad. Some interns seem to have fared much worse. But for me, despite much trepidation, it did the trick.


-Mark

5 comments:

  1. That sounds really efficient overall. Maybe I should go to India to cure my foot condition.

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  2. I think the big thing is that it's very efficient if you have a bit of money. I suppose it's like most private health care systems in that way. Apparently, if you want 1st class care in a hospital it is pretty much like staying at a resort.

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  3. Glad to hear this all turned out for the best. Continuing to pray for your safety...

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  4. Glad to hear you were able to access the care you needed. I'm not sure you'll want a truck-load of Oxytocin from the pharmacy though (unless you are planning on delivering a whole lot of babies)...maybe Oxycontin?

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