Chennai, the evolving medical destination

Sonam Choki

Chennai, Feb 28: The city is increasingly becoming a center of medical tourism with inbound tourists both from abroad and from different States.

According to a study by Confederation of Indian Industries(CII), Chennai draws in about 40 percent of the nation’s medical tourists and receives about 150 foreign patients every day. The inflow of medical tourists increased by 23 percent and Chennai is continuing to be the favorite medical destination among foreigners.

People mostly from Bangladesh, Iraq, Nigeria, and Oman come here for treatment for several ailments such as cancer, cardiac surgery, diabetes, spine surgery, urology, nephrology, as well as medical check-ups.

According to the Export of Health services survey conducted by the Director-General of Commercial in Intelligence and Statistics of India, from fiscal year 2017 to 2018, India saw 4, 60,000 inbound patients at its different hospitals. The largest group of foreign medical tourists was from Bangladesh, around 1, 65,000.

Devtosh Ghosh (26), a man from Bangladesh who came with his ailing mother at Apollo Hospital said, “My mother was suffering from cardiovascular disease. We consulted lot of doctors who said that there was no treatment for this disease. Thus, this made us to come here. After getting treatment here, she is now in a better condition with significant improvement in her health.”

Maruf Elahi (49), also from Bangladesh, who came here recently with his wife said, “My wife is suffering from skin cancer. I heard that Apollo Hospital gives best treatment and I came with the full hope that my wife will be cured.”

Moudud Ahmed (55) from Iraq who will be soon undergo kidney transplant said, “I am now ready to undergo transplant as I trust the hospital because one of my friends also got treatment from here and this builds my confidence.”

He said that staff here takes good care of patients unlike his country.

Ms. Jhansi Lakshmi, General Manager of Apollo Hospital at Greams Road said, “Every month we receive around 40 to 50 foreign patients. Patients mainly come here for organ transplant and various cardiac and neurosurgery treatments.”

Beside overseas patients, a lot of native people also come for treatment in the city. While some come here on doctors’ advice and most of the people come due to low cost surgery, qualified and experienced specialist and good quality nursing care.

Bipin Sharma from Lucknow came here at Apollo for cataract operation said, “You will never feel cheated here. In my area they take a lot of money but fail to give proper treatment.”

Destigmatisation: Mentally ill patients to receive formal documentation

by Akshara Srivastava, Bharat Sharma

Chennai, Feb 22: The Institute of Mental Health (IMH) in Kilpauk is slowly inducting its patients into the Voters List before the upcoming Lok Sabha elections. With assistance from Disability Rights Alliance (DRA), they have enrolled more than 129 people as of now, including 62 men and 67 women.

Most government schemes and services can only be availed with a valid proof of identity. In lieu of this, the Institute intends to extend access to formal documentation to people with mental illnesses. This will include getting them Aadhar cards.

This is the Institute’s first initiative that involves patient participation. “This is the most progressive step we’ve ever taken… our society has never fully accepted mentally ill people as our own”, said Poorna Chandrika, Director of the institute.

Most of their patients were destitute or abandoned by their families. Owing to this, there are no documents proving their citizenship.

After screening their 900 patients, they figured out that 150-160 of them are mentally equipped to make a rational decision while casting their vote. According to D. Sumethi, Head of Voters Department and Social Welfare Officer at IMH, the voter patients are those who have been in recovery for a long time and continue to show signs of improvement.

“Only the improved patients will vote this time… We have many patients who have shown significant improvement over years. We’re starting with them”, she said.

129 patients have been registered with the Election Commission as of now. | The Hindu

Equipping patients with the right to vote is not enough. Awareness about politics is intrinsic to exercising one’s right responsibly. “We’re teaching them our political scenario and the history of Indian politics to help them choose their leaders wisely”, said D. Sumethi.

Out of the 129 people who have been enrolled until now, six are patients with a history of crime. According to her, their improvement warrants inclusion in the list.

Besides this, all patients have access to television and regularly watch the news. “Someone will read the newspaper to them in the recreational hall so they can understand clearly”, added D. Sumethi.

Within the ambit of Representation of People Act, a person with an ‘unsound mind’ can be disqualified from registering and voting.

The Institute, with help from DRA intends to multiply the number of enrolled patients by three times next year.

The institute is curating a list of people below 60 who will be slowly registered over the next year. | Bharat Sharma

Providing a family like environment remains IHM’s priority. “We have always and continue to treat them as normal people who need extra care and medical attention”, said P. Chandrika. Asserting that voting is every citizen’s birth right she said that “this is why we’re doing this for them”.

Metro stations offer healthy beverage choices

Akshara Srivastava, Bharat Sharma

Chennai, Feb 15: Orange juice vending machines have started showing up at metro stations across the city, as part of Chennai Metro Rail Corporation’s (CMRL) efforts to make station food and beverage offerings diverse and healthier.

O. Jooz, at the Corporation’s ambitious machine squeezes fresh juice with no human intervention in less than 40 seconds.

At Rs. 100 a glass, it is not the cheapest alternative. However, unlike most vendors who use traditional juicers and fruit concentrate, the machine is entirely waste-free and has no additives.

A fairly new technology, it is the first of its kind in India and is imported from Singapore.

The vending machine cum juicer is designed to allow a transparent view of the juicing process. From skinning to squeezing, one can witness every step of the preparation.

According to Karuppusamy Andi, who works for O. Jooz, there are currently 20 juice machines across the Metro line.”These machines are located at stations like Central and Vadapalani. The feedback has been positive so we are looking to expand slowly but surely”, he said. The machines are washed and topped up every day.

The juice remains consumable if stored between 3-6 degree Celsius. It has no added sugar or preservatives, which is usually the case with packaged juices.

According to Rathinam Devendrar a daily Metro commuter, the machine has eradicated his dependence on carbonated cola drinks. “I drink this juice every day. It is a little pricey, but better than Pepsi which is simply unhealthy… It refreshes me but also makes me feel healthy…”, he said.

The Chennai Metro Rail Corporation (CMRL) has vending machines that sell carbonated drinks at every platform. However, this venture is part of its attempts to make stations offer instant healthy beverage alternatives.

Shruthi, Assistant Public Relations Manager, CMRL claimed that more healthy options will start showing up at stations soon. “This is just the start. Soon, one will be able to find mega chains like Subway and local chains like A2B at stations… However, we prefer more mechanised options… whereby vending machine technology is utilised to the max”, she said. They’re in talks to procure coconut water and salad vending machines soon.

Toilet built near temple lies unused

CHIYA AHUJA

CHENNAI, Feb 8: Residents of Urur Olcott Kuppam, located on the periphery of the affluent neighborhood of Besant Nagar, in Chennai do not use the public toilet as it is built near Selvavinayagar Temple and because of the lack of proper water supply.

The area is home to a fishing community. “Our families have been living here and have been involved in the fishing business for seven generations” says Monika Anand, a 52-year-old fisherwoman.

The stench from the garbage strewn around renders the toilets useless. | CHIYA AHUJA

The kuppam (fishing hamlet) houses 600 people, including fishermen, businessmen and migrant workers from Andhra Pradesh, Maharshtra and Odisha.

The locals of this area did not receive any money to build private toilets and some have created broken-down roofless structures that are used for bathing, washing and laundry. These make-shift structures cost them around Rs. 5000, which they spent from their own pockets.

Washrooms serve as abandoned storehouses. | CHIYA AHUJA

The community toilet, which was built 20 years ago, consists of 10 cubicles, five for women and five for men. It is maintained by Minalkodi (52), who has been living here for 15 years, and is paid no salary. She earns through the pay-and-use facility, which amounts to Rs.2 per use.

She explains that the toilet is not used by many people as it remains dirty and water comes only for an hour every day.

For daily-wage labourers and fisherfolk, a charge for a basic necessity as this is high. Rupak Ranjan Raut, a 23-year-old migrant worker from Odisha, who works as a security guard at the National Stock Exchange office in Kotturpuram said,“Money is spent, but what can we do when everyone has to pay.”

Dilip Raut (25), another migrant worker from Odisha, states that migrants in the area use the facility more often the than locals.This is because they have settled here recently, and do not have access to toilets in their homes like some local dwellers do.

There are no toilet seats inside the washrooms and these roofless structures are only used for bathing, washing and laundry. | CHIYA AHUJA

Since the drainage system became fucntional only as recently as last month, those few who have toilets in their houses, have been unable to use them. Moreover, there is no water to clean and maintain the toilets and thus, it stinks of garbage piled up nearby and has become home to insects.

“The water motor is not working and there is a water problem,” Minalkodi explains. The tank used to store water is also jammed, she adds.

Most of them, then, defecate out in the open which becomes a health hazard. The area by the beach is littered with garbage and is cleaned only once in three days.

Another reason why toilets are not in use is that it is adjacent to a temple. “I can’t join my hands in prayer on one side, and go on and relieve myself at the other,” says Sushila (70), who sells dried fish in the market.

“The toilet built by the corporation is barely used by any of us. It lacks maintenance and is cleaned only once in 60 days. With the temple next to the toilet, it violates our religious beliefs to use the toilet. Hence, it lies abandoned. The area gets water supply through the tankers and when there is excessive water, the tank in the public bathroom is flooded. Otherwise, it lies empty, ” says K Saravanan, a fisherman.

The motor remains jammed and water is available for only an hour a day. | CHIYA AHUJA

Satyarupa Shekhar, Head of the Government Outreach and Advisory team at the Citizen consumer and civic Action Group (CAG), says, “If we look at it from the planning perspective, we need to question what the local government did before they built the toilet. If they are building a toilet near a temple, they should think of the cultural restrictions. The problem is, toilets are built where land is readily available and the sanitation need of the community is ignored.”

Looking at the case of UrurOlcottKuppam, she explains, “There are no private toilets or a sewer line. The rainwater carries feces and dirt to the river, where the water is untreated. The government needs to make decisions based on the right information. They have addressed the sanitation need, but not built support infrastructure for the same like water supply, drainage system and electricity.”

The consequences of such neglect include personal and public hygiene problems. It proves to be unsafe for women to openly defecate at night. “The plans need to be culturally contextualized and made after due consultation from the local residents,” she added.

Rise in leprosy cases in the city

BHAVINI MISHRA, LEAH THOMAS

CHENNAI: Leprosy seems to be back in the spotlight with a rise in new cases in the city alone. Out of the 4,109 cases detected in Tamil Nadu in 2018-19 so far, 294 cases were reported from the city, according to statistics shared to the New Indian Express from the State Health Department.

In 2017-18, 264 cases were reported by the department. “A major reason for an increase is the intensive screening that is taking place to detect early onset and the presence of a number of hidden cases in Chennai. This count has only been done till December 2018 and is bound to increase,” said Dr. G. Sridevi, Medical Officer at the Medical and Rural Health Services (Leprosy) Department, Tamil Nadu.

Leprosy, also known as Hansen’s disease (HD), is a long term infection by the bacterium Mycobacterium lepare. Symptoms include granulomas of the nerves, respiratory tracts, skin, and eyes.

In 2005, the Central Government announced that leprosy had been eliminated as a public health concern. Despite such claims, the Central Leprosy Division of the Health Ministry reported that 1, 35,485 new cases were detected in 2017. There should be a distinction made between elimination and eradication, said Dr. Sridevi. “Elimination is not eradication. By elimination, it is meant that the disease has reached a rate of 0.01%, that is, 1 per 10,000 cases is reported. We have a long way to go before we eradicate it completely.”

The lack of a vaccination also affects the spread of the disease. “At the moment, patients come to us during the later stages of the disease, making it harder for us to treat it. Research to develop a vaccine is underway. For now, only early treatment can control the disease,” Dr. Sridevi said.

A doctor examining the skin patches on a patient |Bombay Leprosy Project

Chennai is among the 18 districts identified with relatively higher cases where the Division started a detection campaign. “The Centre wants to completely do away with leprosy by 2019, so they have allocated funds. But the problem is too widespread and embedded in the country for it to be completely eliminated by 2019. A long-term plan is necessary to tackle the disease,” said Dr. Sridevi.

Renovated IMH shop sells vegetables cultivated by patients

Home grown: Vegetables on sale at the Industrial Therapy Centre outlet at IMH, Chennai on Monday. — **Home grown vegetables being sold at Industrial Therapy Centre outlet**
| **The Hindu**

DEEPIKA AGRAWAL

CHENNAI: Patients at the Industrial Therapy Centre of the Institute (ITC) of Mental Health cultivate and sell vegetables at a new outlet located in the centre of the outpatient building in the hospital premises. It faces the Medavakkam Tank Road. For 18 months after Cyclone Vardah, the shop operated out of a room in the outpatient wing, a hospital worker said.

Dr. Venkatesh, a senior doctor at the IHM said, “Once the patients recover from their illness, they are put into rehabilitation activities. Patients who are able to work in the gardening section are made to practice cultivation of vegetables.” He said that a gardener has been appointed to train the patients. He guides them with harvesting and planting the vegetables.

The main vegetables grown here are brinjals, lady’s fingers, varieties of snake gourds and bananas. After harvesting, these vegetables are sent to the ITC shop where they are sold with the items from other sections. Notebooks, gunny bags, handicrafts and cardboard files are among the earliest items sold at the outlet.

“The other sections of the ITC include a bakery unit where the patients make breads. The breads are sold both at ITC shop and to other hospitals. A special ITC unit for female patients trains them to make bangles and small toys,” said Dr. Venkatesh.

He said that special tokens are given to the patients working in these ITC units so they can get food, water and other essentials. The tokens are substitutes for money and can be used in the IMH canteen or other ITC shops. “The tokens have special discounts. Patients can get things for half the price. A Dosa worth Rs 15 can be purchased for Rs 7 using the token, Dr. Venkatesh said.

The ITC shops are run by the hospital staff from the social work department. Trained patients can also run the shops. “The stock is purchased by people from within the hospital as well as outsiders. Whoever crosses the outpatient building can see the shop. In fact, the day before yesterday, a man from Madipakkam, around 8 kms away from the hospital, came to purchase the vegetables from our shop,” Dr. Venkatesh said.