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Why there is need for good Home-care Health System in Rural Areas?

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Maharashtra, March 30, 2017: Last month, my mother, who is 92, fell in the bathroom and broke her pelvic bone. I live in the rural town of Phaltan in western Maharashtra and to get a simple X-ray done was a nightmare.

We called the local orthopedics hospital and they sent a ramshackle ambulance. How an old Maruti Omni van got permission to ply as an ambulance is anybody’s guess. Even a healthy passenger would feel sick and his/her bones would be rattled in that ambulance while going over the potholed roads of Phaltan. Some of the worst roads in the country are in Maharashtra, especially in rural Maharashtra.

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The driver of the ambulance also doubled up as the paramedic and his callous and non-empathetic attitude almost broke my mother’s heel. He almost threw my mother on the stretcher! Most of the ambulances in rural areas are like that with hardly any facility to help the patient. I had to use an old saree to tie my mother to the stretcher so that her broken pelvis did not shake very much.

At the hospital, after a good deal of arguing, we got her X-ray done quite quickly. Otherwise it takes forever to get it done. Since the pelvic bone was fractured, the doctor advised complete bed rest and told us to take her home. In such cases, there is no surgery needed but just plain bed rest so that the broken bone heals by itself. That is also the reason why I did not take her to Pune for treatment.

We brought her home and were immediately confronted by the stark reality of who will take care of her nursing needs. We tried to locate nursing care in Phaltan but were unsuccessful. Even the hospitals do not provide that facility. The relatives of patients do that in most rural hospitals.

Finally, after great difficulty and searching, we got a 24-hour help (who had almost no training as a nurse) from Pune. This helped relieve our emotional and physical stress.

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Searching the net and talking to my doctor friends, I have finally been able to convert my mother’s room into a home health-care facility. This includes the adjustable hospital bed with an air mattress and a specially fabricated small wheel-chair, which can navigate the narrow passages of the house and can go into the bathroom. I feel I could get all this done because of our resources and ability to spend time searching for solutions on the net. Most of the rural population does not have this luxury.

Another tragedy in rural areas is that no doctor wants to do a home visit. No matter how ill or old the patient is, they insist that he/she should be brought to the hospital or their clinic. I was able to get a person who was not an MBBS doctor but could administer saline or do basic dressing for bed sores. That was a partial relief.

Secondly, I was greatly helped by my brother, who is an orthopaedic surgeon in Australia. He constantly advised us on the basic care and his telemedicine greatly helped us.

Very frequently I have seen that in rural — and also in urban — areas, the missing ingredient in patient care is good nursing facilities. Putting a patient in hospital (whether he or she is terminally ill or suffering from non-life-threatening ailments) means endless headache for relatives, who have to stay in the hospital, undertake the nursing care of the patient and run continuously to get medicines and medical supplies. Besides, the hospitals charge exorbitant amounts for surgeries and for lots of unnecessary tests performed on the patient.

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The government has mooted quite a number of good schemes which provide hospitalisation for below poverty line (BPL) patients and take care of their bills through insurance cover. Yet I have seen these schemes misused by doctors and hospitals where they admit the patients at the slightest pretext and charge them the full amount even for minor ailments. The money is then paid to the hospital by the insurance company.

Our medical care system in rural areas is, therefore, quite broken with very greedy doctors and hospitals that, in collusion with insurance agents, fleece both the patients and the government.

A hospice or home-care health system might alleviate this problem greatly.

This system will rely on specialised agencies that provide trained nurses (at nominal cost) for homes, simple equipment like small wheelchairs, beds, commodes and the like, and qualified doctors on duty who can respond through the internet or mobile phone to the queries from the nurses – and, in an emergency, make home visits. At present there are no such agencies but they are urgently needed.

For the terminally ill, a home-care system which provides nursing care and basic equipment will be extremely helpful. He/she will be surrounded by family and nursing care given by trained nurses will help relieve the pain.

Financially, this system will be much more viable than having a dedicated hospice facility. The financial arrangements on how the government can help organisations in facilitating such a system need to be worked out. A possible solution could be to provide insurance coverage for such a home-care system.

Also such a facility can provide home-care for patients who are discharged from the hospitals. Too often, relatives and the family have to provide prolonged post-operative care –which they are ill-equipped to do. Such a facility could be a boon for those patients.

In urban areas, better medical facilities, including good ambulances, can provide timely care. In rural areas, in the absence of such facilities it is very necessary to have a home-care facility. (IANS)

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10 Indian Sites That Got UNESCO World Heritage Tag

Maharashtra now has a total of five sites – more than any other state in India

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10 Indian sites that got UNESCO World Heritage tag
10 Indian sites that got UNESCO World Heritage tag. IANS

— By Sonali Pimputkar 

Mumbai’s rich bunch of Victorian and Art Deco buildings in the Fort and Marine Drive precinct on Saturday, June 30, got the UNESCO World Heritage tag, giving India its 37th site. The precinct was added to the global list at the 42nd session of the UNESCO World Heritage Committee in Manama, Bahrain. It covers an area of 66 hectares with Oval Maidan at the centre and includes a row of 19th-century Victorian buildings on one side while the 20th-century art deco structures on the other. There has been a universal praise for the team who represented Mumbai’s case to UNESCO. With this Mumbai gets its third UNESCO heritage tag – joining the Elephanta Caves and the Chhatrapati Shivaji Maharaj Terminus (headquarters of the Central Railway). Maharashtra now has a total of five sites – more than any other state in India – including the Ajanta and Ellora caves in Aurangabad. India is home to 37 World Heritage Sites approved by UNESCO which brings cultural and natural glory to the country. Here’s a look at 10 heritage sites of India that got the UNESCO world heritage tag before the Mumbai Art Deco buildings.

  • Capitol Complex of buildings, ChandigarhChandigarh Capital Complex is a government compound designed by the architect Le Corbusier and is spread over an area of around 100 acres. It comprises of three buildings, three monuments and a lake, including the Palace of Assembly, Secretariat, the signature Open Hand Monument, Geometric Hill, Tower of Shadows and Punjab and Haryana High Court building. The site got the UNESCO World Heritage tag in 2016.
  • Rock Shelters at Bhimbetka, Madhya Pradesh

    Located 45 km South of Bhopal at the Southern edge of the Vindhya hills, the area is covered with thick vegetation, natural shelters and rich flora and fauna. The shelters were discovered in 1957 and were added to heritage list in 2003. The name ‘Bhimbetka’ has been associated with ‘Bhima’, the hero-diety of Mahabharata and the name literally means ‘sitting place of Bhima’. The place is a magnificent repository of rock paintings within natural rock shelters. These paintings depict man’s experimentation with creativity and belong to different prehistoric periods, including Late Paleolithic Period i.e. Old Stone Age that consists of large representations of rhinoceroses and bears. Paintings from Mesolithic i.e. Middle Stone Age consists of animals and human activities, Chalcolithic i.e. early Bronze Age consists of agriculture, early historic and medieval consists of religious motifs and tree gods.

    Bhimbetka
    Bhimbetka. IANS
  • Rani ki Vav, Gujarat

    Located on the banks of Saraswati river, Rani ki Vav (Queen’s step well) was built in 11th century AD in memory of King Bhimdev I. Stepwells are a distinctive form of water storage systems that have been in existence since the 3rd millennium BC. Rani ki Vav is designed into seven levels of stairs with more than 500 principle sculptures and over thousand mythological and religious works. The site has also been felicitated with the ‘Cleanest Iconic Place’ title by the Indian Sanitation Conference (INDOSAN) in October 2016.

  • Champaner-Pavagadh Archaeological Park, Gujarat

    Champaner-Pavagadh Archaeological Park is located around the Pavagadh hill and is known for its archaeological, historic and living cultural heritage properties. The history of this site dates back from the 8th to 14th centuries. The park is studded with eleven different types of buildings including temples, mosques, tombs, wells, walls and more.

     

  • Group of Monuments at Pattadakal, Karnataka

    The heritage site is named as ‘Group of Monuments at Pattadakal’ by UNESCO as it houses nine Hindu temples and a Jain sanctuary that portrays an amalgamation of architectural features of Northern (Nagara) and Southern (Dravida) India. Eight among the nine temples are dedicated to Lord Shiva and the ninth is Papanatha Temple, a Shaivite sanctuary. Apart from the major temples, several small Shiva shrines are seen here.

    Group of Monuments at Pattadakal, Karnataka
    Group of Monuments at Pattadakal, Karnataka. IANS
  • Khajuraho Group of Monuments, Madhya PradeshKhajuraho Group of Monuments are popular for its artistic magnificence rather than religious aspects. The site comprises of 22 temples. It is said that initially there were about 82 temples built. The temples belong to the Hindu and Jain community and have an amazing fusion of sculpture and architecture. Every evening the Khajuraho temple complex organises a light and sound show in the open lawns in English and Hindi. Besides, The Khajuraho Dance Festival is held every year in February that features classical Indian dances.
  • Khangchendzonga National Park, SikkimKhangchendzonga National Park (former Kanchenjunga National Park) also known as Kanchenjunga Biosphere Reserve is the first ‘Mixed Heritage’ site of India. Located in the Himalayan range, the park is home to plains, glaciers, lakes, and valleys. Animals like snow leopard, red panda, and musk deer are spotted here regularly. Besides, the park is home to several rare and threatened plants and animals.
  • Archaeological Site of Nalanda Mahavihara, BiharThe ancient Nalanda University or a large Buddhist monastery located in the Southeast of Patna was a centre for learning in the seventh century. The site comprises of stupas, shrines, viharas and several artworks in metal and stone. The site stands out as the most ancient university in the Indian subcontinent. It is also said that the site was an organised mediation of knowledge for over 800 years. The historical development of the site proves the development of Buddhism into a religion and its educational traditions.
  • Nanda Devi and Valley of Flowers National Parks, Uttarakhand

    Nanda Devi and Valley of Flowers National Parks, Uttarakhand
    Nanda Devi and Valley of Flowers National Parks, Uttarakhand. IANS
  • The heritage sites comprise of two core areas -Nanda Devi National Park and the Valley of Flowers National Park -about 20 km apart. The Valley of Flowers is popular for its natural beauty and endemic alpine flowers. While the Nanda Devi National Park is known for its wilderness and spectacular topographical features including glaciers and moraines. Both the parks are blessed with a high diversity of flora and fauna, with a notable number of globally threatened species including Himalayan musk deer and various plant species.

    Also read: Indian Railways Will Promote Heritage Tourism By Preserving Its Metre-Gauge Tracks

 

  • Jantar Mantar, Rajasthan
  • Built by Maharaja Jai Singh II between 1727 and 1734, Jantar Mantar got the World Heritage tag in 2010. The cultural property has been inscribed as ‘an expression of the astronomical skills and cosmological concepts of the court of a scholarly prince at the end of the Mughal period.’ Jai Singh II had constructed five Jantar Mantars at different locations – New Delhi, Jaipur, Mathura, Varanasi, and Ujjain.