Unsuspecting, poor women become victims of medical avarice

This hamlet is no exception with an approximate population of 2,000, situated 21 km from Ranebennur (which is taluk headquarters of Haveri district) on ‘Ranebennur — Guttal’ road. Thandas are generally dominated by the Lambani community, just as this one is.

The village is quiet and peaceful, but the stories emanating from it recently speak of horrendous cases of medical avarice. During the last six months, a dozen young women from this thanda have undergone hysterectomy (removal of uterus or womb) and all of them at the taluka government health centre at Ranebennur by the government surgeon. There was no medical justification for these surgeries, at such a young age, and that too on so many in such a short period.

Among the women who have been operated, half of them simultanously underwent operation for the removal of appendix as well. This is an accomplishment almost unheard of in medical history! 

The mostly poor Lambanis are known for their colourful clothes and traditional ornaments. But one needs to look beyond these colours for the painful scars that these women now carry because of these unwarranted operations.   

Renuka Ransoot a resident of Nukapur thanda, aged 22 years, who earns livelihood by daily wages, developed pain in the groin and white-discharge for about eight months. She approached a private doctor in Ranebunnur. But as the cost was high, she approached Dr Shantha, the surgeon at the government hospital.

After an ultrasound at a private clinic the next day, she underwent hysterectomy on  June 24, 2011. She had to pay for the surgery at the government hospital, but not directly to Dr Shantha.

She paid Rs 9,000 to the pharmacist at the government hospital. The pharmacist in turn gave medicines and also delivered the money to the surgeon. The patient was not given any receipt.

But importantly, most medicines he delivered carried the label ‘Not for sale. Government of Karnataka supply.’ A couple of days after the surgery, Renuka was discharged without any medical reference sheet. Now three month since the surgery, her health problems have only worsened and she continues to suffer and live in pain.

It is surprising as to how a decision was taken to operate upon her without taking a biopsy. A biopsy is a must when a surgeon wants to confirm the diagnosis of cancer. After the biopsy report, if found positive for cancer, she should have been given due counselling before taking a decision to operate on her for hysterectomy.

The worst example is that of Gangavva Rathod aged 55, who underwent a similar course as others and got operated on June 2, 2011. Her condition got worse and she had to be treated for a major psychiatric problem. Her discharge card at the psychiatric centre at KIMS, Hubli reads, ‘Severe depression, secondary to gynaecology surgery’. 
 
Dr Sanjeev Kulkarni, a consulting gynaecologist says, “Hysterectomy is a racket by itself. But what I saw and heard at Nukapur thanda on my visit in September was absolutely outrageous and is a matter of shame. It needs to be deplored by every section of our society including the medical bodies.

A committee should be set up by the state government to look into it. The government should issue strict guidelines so that such barbaric acts are not repeated again.” He further adds “I am surprised that the concerned doctor has done incisions that are vertical. They can cause hernia, whereas transverse incisions heal fast. It is a shame that no discharge card has been given to the patients after undertaking such a major surgery.”

As the women who underwent surgeries continued to complain of pain, Karibassappa, a member of Jana Arogya Andolan — Karnataka, a state level network of civil society, took all the operated women to Dr Shantha, the surgeon at the government health centre at Ranebennur, and asked as to why he undertook the surgery at all.

The doctor reportedly replied, “Because of lack of hygiene, most of them had cervicitis”. And further, the surgeon denied having taken any money as the same was collected by the pharmacist at the hospital.

When S D Baligar Ranebennur, another member of JAAK, went to the nearest primary health centre at Honnati, which is around 4 km from Nukapur thanda and spoke to  N N Makarabbi, a block health educator, he was told,  “We have no idea about this incident, but we will speak to our superiors”.

Baligar says, “This outrageous manifestation is the ugly face of the private health care which is slowly but surely trying to creep into the public health system. We need to strengthen the public health care system as it is visited by the most vulnerable sections in the society”.

The Nukapur thanda episode underscores the point that there is an urgent need to strengthen and revamp the public health system by increasing the budget and bringing in good managerial skills and thus make free, universal health care system accessible to all the poor people.

 What is really needed is commitment and involvement of policy makers to address these issues without loss of time. Will the state show its concern for the poor?