We drove from the Bhubaneswar train station directly to the Hospital. We were planning on spending one day at Puri beach to kind of acclimatize after the 24-hour train trip across India but Govinda told me Sunday was the busiest day at the hospital and we had several visiting doctors there for the day. We arrived after dark and the next morning the patients started to show up early. There were around 60 patients waiting in and around the hospital entrance and due to the visit of a gynecologist, Dr. Tappan, there were many female patients waiting.
There was an operation today at the hospital in Juanga that is worth noting. It was a 40-year-old woman from a village around 15-20 kms. Away! Her mother accompanied her to the hospital. She was suffering from an ovarian tumor. The family was extremely poor and her husband had abandoned the women with two children. The husband was a labor worker and just never came home. She moved back in with her widowed mother in the village of Galadhari. They are landless and get their food by one son who is doing labor work as well. Labor workers gets around 60 rupees a day (1.50 USD) and the rest of the family eat from this. It’s hardly enough to survive. So the mother was hesitant to seek medical attention for the growing tumor for fear of throwing the family into a debt that would ruin all their lives for at least this generation.
The tumor had grown to 4.2 kilos and needed to be removed for her to lead a tolerable life. The operation was a great success and everyone was amazed at the tumor sitting there outside the Operating theatre. But Dr. Tappan said he had seen far, far worse cases in these regions of persons living in poverty leaving them to extremely advanced stages.
After the procedure was over, I entered the office and the discussion of payment between Govinda (the Managing Trustee), Dr. Tappan, and a few other staff. This same procedure would have cost the family around 20,000 rupees (500.00 USD) in any other nursing home or hospital in the nearest cities. But do to the visiting Specialists charge and the rate of medicines we would usually have to charge at least 5,500 rupees (137.00 USD) But due to knowing her condition and after a long heated discussion about villagers having to pay something for the work, we all agreed on charging her 500 rupees (12.50 USD). Most village women, out of pride, wear a sari that was gifted to them at a wedding and tucked away in their mud huts in a plastic bag as a prized possession, only to be worn when they need to enter an official engagement like a government interaction or a hospital visit. This old frail women, dressed in nothing more then a tired thread bare sari, reached for a knot and small lump in the cloth holding all the money they could borrow to visit the hospital. I watched her hands trembling and the anguish on her face as she desperately untied the knot to reveal the waded up bills hidden in her sari. She handed the 500 rupees to the clerk in the office and then sat curled up on the bench in the entrance hall, quietly with a blank stare. I found this very unusual since her daughter was just operated on and Indian villagers can’t bare to be alone or leave others alone, especially at times of crisis. I knew what weighed on her mind was that even the 500 rupees would place an incredible burden on the families future and stability. I went up to my room and took out 300 rupees (7.50 USD) and reached around the corner and tapped her on the knee. She looked up and I handed her the rolled up notes and she gave back both combination of a smile, a look of shock and confusion. I placed my finger over my mouth and gestured for her not to tell anyone. She peered around to see if anyone was looking, then turned back to me and shook her head in agreement with a more confident smile.
I realize why the hospital wanted the patient to pay at least some of the costs. We can’t possibly afford to give everyone free care (presently, we barely raise enough funds for salaries). Also in some cases, villagers need to feel responsible for their care and take their medicines properly and understand what we tell them they need to do to get well. Many times if they pay something they are more apt to do this. But I do feel in the future it would be good to have some funds available for just such cases as this when they arise. As it is, I don’t know how Govinda and the staff deal with and function in such a poverty-stricken region and continue to maintain a stable healthcare for the villagers.
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