Sunday, August 13, 2006

Heart Attack? Don't Bother Calling for an Ambulance

Scott Carney, my friend from Madison who is currently in Chennai, writes about what the U.S. could learn from India about healthcare. He is impressed by the fact that it is possible to walk into a doctor's office and get treated without any fuss. No forms to fill out, no worries about insurance. Even at a private clinic, the treatment is affordable and at government hospitals, it is free. I agree - I've had the experience of coming down with the flu in the U.S. and having to wait for one whole day before I was treated by a nurse practitioner. It is very, very frustrating.

Scott admits that there are other major problems with healthcare in India. To my mind, one of the most serious problems concerns emergency services. My father recently died of a heart attack, and my mom managed to get him to a clinic near home with the help of a neighbor who owns a car. The clinic arranged for an ambulance, and he was taken to a bigger hospital nearby. At the hospital, it took nearly 45 minutes for a cardiologist to arrive.

No ambulance with flashing lights and a shrill alarm speeding past vehicles that move to the side of the road (in an area like Malleswaram, on Sampige Road, there is no side you could move to even if you wanted). No code blue, a la Grey's Anatomy. Too little, too late. Everyone recognizes that my mom did the best she could under the circumstances, but it wasn't enough.

A day before we left Bangalore, I came down with a bad throat infection and went to my mom's doctor, who is also a cardiologist. Minutes after I reached the clinic, a family arrived in a van and out rushed a middle-aged woman. She asked the clinic staff for a wheel chair, took it outside, and with the help of two of her neighbors who had accompanied her in the van, managed to get her husband into the wheelchair. The doctor came out, felt his pulse, and realized right away that he had had a heart attack and was in a critical condition.

But he could do little else. His clinic wasn't equipped to deal with such an emergency. He did not know how to get an ambulance. The receptionist did not know either. She did not even have phone numbers of major hospitals handy. I ended up calling a call-taxi service using my cell phone, and until the taxi arrived, I was out on the road, trying to flag down cars. None stopped. And there wasn't even an auto in sight.

Eventually, the doctor called a friend of his at a nearby hospital who then arranged for an ambulance. Now this ambulance, as we found out a full fifteen minutes later, was a Maruti Van with the back seat taken out and placed lengthwise. That's it. No flashing lights, no oxygen tank. The driver had just woken up, and was still dressed in his lungi and banian, and arrived alone. So the driver, the patient's neighbor, and I somehow managed to get the patient off the wheelchair and into the ambulance. We were clumsy - we had no idea if there was a proper way to handle him. We might have contributed to his worsening condition. And I don't know if he survived.

I went in and asked the doctor if this was par for the course and he nodded. It is very frustrating, he said. This was a doctor who had worked in the U.S. for more than two decades before returning to Bangalore. "Unlike in the U.S., where the county or the city provides emergency care - at least an ambulance which gets you to a hospital - there is nothing like that here," he said. "The Bangalore City Corporation does not provide this service. If you call 102, a number listed in the phone directory, no one picks up. Trust me, I've tried."

If you don't have a car, if you don't have neighbors who own cars and are at home at the time, if you live in a part of the city where autos aren't easy to find, or if you have a medical emergency late at night, you're in trouble. All you will have left is a crushing sense of guilt that you did not/could not do enough to save your loved one's life.

As I said earlier, I had this experience a day before I left Bangalore. So I did not have a chance to make some calls and find out what emergency health services the City of Bangalore or the State of Karnataka provides or are expected to provide. I hope to do this in October, when I'm in Bangalore next.


  • Emergency services are so poor in India that they are almost a joke. I have had a similar experience as you when I got caught in a predicament where a student of mine on an abroad program died and we had to move her body out of Bihar before she began to decompose. The thing was in Gaya, one of the largest cities in Bihar, there were absolutely no ambulences that could accomidate a coffin .They were just converted omni vans with red crosses painted on them. At that, in the whole city there were only two.

    There are a few places where you can find emergency services, and I imagine that Bangalore is one of them. I know that in Chennai that Apollo hospital has a small fleet that can rush you to a first rate medical clinic. But the thing is that you need to know about the service and have the money to pay fo it. Otherwise there really isn't much hope.

    By Blogger Scott Carney, at 8/13/2006 9:30 AM  

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