FROM THE PRESS
What’s the magic cure?
The Indian Medical Association (IMA) has filed a writ petition in the Hyderabad High Court, asking the government to take action against the administration of a highly publicised, government-supported, traditional remedy for asthma. The composition of the paste, which is inserted into a live fish and placed in the patient’s mouth, is a family secret. Thousands of asthma patients come to Hyderabad for the annual ritual. The IMA has asked that the contents of the medicine be made public, the family be prosecuted for violating the provisions of the Drugs and Magical Remedies Act, and the government not promote this treatment.
Sanjay Kumar. Traditional Indian remedy for asthma challenged in court. BMJ June 19, 2004.
Doctor accused of molesting patient
The arrest of a Mumbai infertility specialist on charges that he molested a patient raises questions about the medical protocol in a gynaecological examination. A couple complained to the police that Dr Anoop Gupta had asked them to have intercourse in front of him in his clinic, and then tried to molest the woman. Most specialists dub the alleged incident as ‘too bizarre to be true’. ‘Only a mentally unstable person would do such things,’ said one doctor.
The couple also went to the Shiv Sena, whose members assaulted Dr Gupta. About 500 doctors supported by the Indian Medical Association went on strike in protest.
Times News Network. Chaperones must be present during gynaecological exam. 500 docs to stir over manhandling of gynae. The Times of India. June 19, 2004.
Buy your way to an MD
Medical students are guaranteed a seat at a top medical college if they approach the right people and have money. Educational consultants sell seats for a commission. Marks do not count, money does. ‘We take about Rs 5 lakh as advance and keep the original marksheets and certificates so that they do not approach others,’ says one agent. Extract from a conversation between a reporter and an ‘education consultant’: ‘What’s your preference?’ ‘A Bangalore college.’ ‘The rates vary from Rs 23 lakh to Rs 27 lakh.’
Seethalakshmi S and Hemali Chhapia. Medical, dental seats on sale. The Times of India. June 26, 2004.
Insanity certificates for a fee
The Uttar Pradesh government suspended Dr S K Gupta, a psychiatrist at the Agra Mental Hospital, filmed taking bribes from men for certifying their wives mentally ill so that they could get an easy divorce. Dr Gupta was shown taking a wad of notes, writing a statement that a woman (who he has never met) is under treatment for mental illness. He also admitted that he had done the same for 10 other husbands who wanted to leave their wives.
IANS. Tehelka sting catches doctor certifying women ‘mad’. New Indian Express. July 1, 2004.www.newindpress.com
Medical debt
Janreddy’s daughter-in-law is in bonded labour to pay off Rs 5 lakh in family debts. Of this, Rs 3 lakh are her late father-in-law’s medical expenses. Health spending is among the fastest growing components of rural family debt, especially in Andhra Pradesh where the state has destroyed the public sector health care system, boosted the private sector and promoted corporate hospitals. A common thread running through the farmers’ suicides plaguing the state has been high medical spending, all borrowed at absurd rates of interest.
P Sainath. Anatomy of a health disaster. The Hindu. July 1, 2004.
Doctors and Abdul Karim Telgi
Two doctors were arrested for providing Abdul Karim Telgi (accused of running a scam in government stamp papers) false medical certificates so that he could get bail. Dr Jnanendrappa, professor of medicine at Victoria Hospital, Bangalore, apparently shared the Rs 25,000 he received with administrative officer Channa Keshava. Dr Jnanendrappa initially evaded arrest—by getting admitted to hospital. Earlier, the press reported that doctors at the Karnataka State Forensic Laboratory injected Telgi with sodium pentothal or ‘truth serum’, a practice that constitutes torture according to the UN.
Staff reporter. Another doctor held for helping Telgi. The Hindu. July 29, 2004.
Scientific curiosity or bravado?
Dr Pradeep Seth, head of microbiology at the All India Institute of Medical Sciences, New Delhi, injected himself with a candidate HIV vaccine that he had developed but which had not been approved for human use—to see how the human body would react to it. Colleagues and policy-makers describe his action as bravado and unethical. The vaccine must undergo animal trials before it can be tested on humans.
Ganapati Mudur. Indian doctor’s decision to “self test” AIDS vaccine decried as unethical. BMJ July 31, 2004.
Hospitals attacked for patients’ deaths
The death of 18-year-old Sunil Avasarmor in Rajawadi municipal hospital in Ghatkopar, Mumbai, triggered off an attack on the hospital and staff, and a strike by the staff. Sunil’s mother stated that they were made to wait and then sent away. The authorities claim he was examined on August 9 and told to return the next day but did not till August 11.
Less than a month later, residents of Kurla, Mumbai, ransacked the Bhabha municipal hospital when 15-year-old Harsha Nathani died a few hours after she was admitted for accidental poisoning. A family friend said Harsha was treated by untrained interns.
Prachi Jatania. Boy dies, hospital trashed. Ramabai Nagar livid, docs go on strike. Indian Express Newsline. August 13, 2004.
Express News Service. Another hospital faces ire. Indian Express Newsline, September 4, 2004.
Government supports spiritual AIDS research
On the instructions from project director Salina Singh, the staff of the Madhya Pradesh State AIDS Control Society are trying to locate AIDS patients to be treated through spiritual methods by Baba Shree Nirvikar Path. The baba lives at the home of BJP MLA Jalam Singh Patel. The treatment apparently includes giving up non-vegetarian food, liquor, garlic and onions, and praying in certain poses.
Singh admitted that she had sent an officer to bring AIDS patients to Patel’s residence. ‘There is no harm in sending patients to someone who claims to cure them by meditation and without charging anything for food and stay. We should help a social cause like this,’ she said. ‘I directed my staff on the basis of talks held among some ministers.’
Kumar Shakti Shekhar. ‘Baba’ claims AIDS cure, govt supports. Hindustan Times. August 17, 2004.
Patients slapped
Twenty-seven-year-old Sandhya Mondol was in labour at the NRS Medical College and Hospital in Kolkata when an attending doctor slapped her to ‘induce labour’ and make her ‘cooperate’. She went deaf temporarily. Hospital staff call this a standard practice when a woman’s labour is delayed. A few weeks later, a plastic surgeon at the same hospital slapped a 14-year-old girl when she refused to take an injection before surgery. As complaints against ill-mannered doctors come in regularly, the West Bengal government has asked its medical officers to change their attitude or face action. Udalak Mukherjee. Is there a chance of recovery? The Telegraph. August 24, 2004.
Bappa Majumdar. Ethics rein on slap-happy doctors: government warns medicine men to mend their ways. The Telegraph. August 23, 2004
Sexual harassment
Women’s organisations demonstrated outside the BYL Nair Municipal Dental College in Mumbai, calling for action on a complaint of sexual harassment filed three months earlier. Dr Vatsala Shetty had filed a police complaint and a departmental complaint against Dr B S Banga, a professor at the college. Dr Banga denies the charges. Dr Shetty says she has since been threatened by Dr Banga’s friends.
Prachi Jatania. ‘If I bless someone, how is that sexual harassment?’ Indian Express Mumbai Newsline. September 10, 2004.
Moonlighting
A doctor at the All India Institute of Medical Sciences, Delhi, apparently markets nutritional supplements manufactured by a multinational company, for Rs 1,500 for 60 doses, to patients. Patients are given directions to a store selling the supplement, along with a prescription signed by a faculty member.
Kalpana Jain. MNC using AIIMS to plug its protein supplement. The Times of India. September 10, 2004.
And now pathology tourism?
The UK government is considering shipping blood and urine samples of patients of the National Health Services to India for clinical tests to cut costs. SRL Ranbaxy started with trials in some private hospitals there, and is now targeting the public sector. The samples would be flown to the company’s main laboratories in Mumbai, which already conduct clinical trials for large drug firms. The laboratories are open around the clock.
Heather Tomlinson. Scheme to process NHS clinical tests in India. The Guardian. July 9, 2004.
A glimpse of Nepali health workers’ lives
Inadequately funded, understaffed and caught between guerrillas and soldiers, hospital staff at the only government-run facility in Rukum, mid-western Nepal, struggle to do the best they can. Some patients are direct victims of conflict, wounded by explosives or bullets. Thousands of others are indirectly affected by under-nourishment, a lack of vaccines and unsafe drinking water. Many more are beyond the reach of basic health care.
Set up 16 years ago, the hospital is partly supported by Médecins Sans Frontières. Its 15 beds are always occupied, with a long waiting list.
‘The Maoists leave us alone,’ says Bhabani Sharma, an ayurvedic doctor who heads the hospital. The rebels take away up to half the supplies sent to outlying health posts. Health workers say the Maoists also organise health camps and since only they can enter interior districts, they are actually taking health care to the villages.
Most health posts in Nepal don’t have personnel, and some health workers in others have gone over to the rebels, impressed by their dedication.
Kishore Nepal. War is bad for health. Nepali Times. August 6-12, 2004.
Doctors arrested for treating criminals
The Joint Doctors Action Committee staged a demonstration outside the Karachi Press Club demanding that Dr Akmal Waheed and Dr Arshad Waheed receive due process, with the right to legal assistance and an open trial. The doctors were accused of providing medical treatment to the perpetrators of an attack on the Karachi Corps Commander’s motorcade.
Dr Shershah Syed, Secretary of the Pakistan Medical Association, said the doctors were recorded as arrested after 15 days of illegal confinement at an undisclosed location and produced before the court in a hush-hush manner. They were denied their right to see their legal counsel and relatives.
‘It is doctors’ duty to treat patients regardless of their biases and prejudices,’ he said.
Correspondent. JDAC asks authorities to allow doctor brothers meet counsel. The News, Pakistan. July 15, 2004.
The organ trade in Pakistan
With no laws restricting the sale of organs, Pakistan is fast becoming a trading centre for foreigners and wealthy Pakistanis. Many hospitals even advertise on the internet, offering a transplant to anyone who can pay.
The buying and selling of kidneys is a regular practice at Pakistan’s busiest transplant hospital near Islamabad. The hospital’s founder, Colonel Mukhtar Hamid Shah, insists that while most donors are paid, the transactions are ethical. ‘Their economical problems can also be solved. They are encouraged to donate their organs.’
Transplant surgeon Adib-ul Hassan Rizvi calls this the worst form of exploitation. ‘The only beneficiaries are the middleman and the doctors involved,’ he says. The vendor at the end of the day is in the same place he was earlier-minus a kidney. Dr Rizvi heads the Sindh Institute of Urology and Transplantation in Karachi, the only transplant centre in the country providing treatment and transplantation free of cost. He is pushing for legislation to outlaw the sale of live organs and for the government to allow doctors to use cadaveric organs for transplant-currently not an accepted practice in Pakistan.
Ash-har Quraishi. Pakistan’s lucrative kidney trade. CNN. August 4, 2004.
Ethics course for prison doctors
US health personnel conspired in the abuse of prisoners in US-controlled prisons in Iraq, Afghanistan and Guantanamo Bay, Cuba. A survey recently reported that those working at Abu Ghraib falsified death certificates to cover up the killing of detainees, hid evidence of beatings, and, on one occasion, revived a prisoner so that he could be tortured later.
In this context, the World Medical Association’s announcement of a web-based course to help prison doctors detect torture and treat victims, is timely. The 12-hour course designed for prison doctors includes guidelines on ethics and human rights based on international declarations. The course is available free of cost at http://lupin-nma.net.
Fiona Fleck. WMA launches course to help prison doctors confronted with torture. BMJ. September 11, 2004.
Registration of clinical trials
The International Committee of Medical Journal Editors announced that trials that begin enrolment of patients after July 1, 2005 must register in a public trials registry at or before the onset of enrolment to be considered for publication in those journals. The British Medical Journal has announced a similar policy, with some differences in the criteria for the registry. Registration of clinical trials would prevent the non-publication of inconvenient trial results, a practice that distorts the body of knowledge available for intelligent decisions on health care.
Catherine De Angelis et al. Clinical trial registration: A statement from the International Committee of Medical Journal Editors. N Engl J Med. September 16, 2004.
Kamran Abbasi. Compulsory registration of clinical trials. BMJ. September 18, 2004.
International kidney sale scandal
South African doctors are in an international kidney sale scandal involving mostly Brazilians (as donors) and Israelis (as recipients), with the surgery conducted in South Africa. Senior nephrologist Jeff Kallmeyer faces charges under South African law forbidding the sale of organs for transplantation. Other surgeons and medical staff have also been arrested.
