Remember ME - You Me and Dementia

Friday, November 23, 2007

Medical Bank: a good option for Community medicine

On an autumn afternoon, a motley group of people file into the courtyard of a decrepit old house in Hatkhola, a neighbourhood in the city's deep north.

They were hoping for a heart.

In one corner of the courtyard in a small cubbyhole, D. Ashis holds the key. He is the man behind Medical Bank, a unique experiment in community medicine that delivers pacemakers and medicines with equal aplomb to those who can barely afford it.
"Most of them are (here) to collect free medicines, though some are also looking for a heart," says Ashis, eyes twinkling. "D stands for Datta, my surname, but I have followed the college roll-call system of surname first," says the man, who goes about by his first name. And that's not his only break with tradition.

Ashis, born into a family of businessmen, had quite a pampered childhood and cocooned existence. The Medical Bank was not really on the road map, until he chanced upon a slum. "I was appalled to see people throwing away unused medicines, while in the slums people died because they couldn't afford medicines," says Ashis, who was all of 17 when he first noticed life in a slum in North Kolkata.

To bridge the gap, Ashis and a few of his friends embarked on a drive to collect unused pills and potions from houses in their neighbourhood. That initiative, in 1980, marked the beginning of Medical Bank.

Today, 27 years on, Medical Bank not only takes medicines to those who cannot afford them, but has also extended the model to spectacles and pacemakers, which it collects from those who don't need them anymore.

"We also have an arrangement with eminent doctors, hospitals and clinics by which patients referred by us get treated either free of cost or at a discounted rate," says Ashis.

As part of the bank's pacemaker project, 300 secondhand pacemakers have been implanted in hearts, which would otherwise have stopped beating.

"While a new pacemaker costs Rs30,000-1,00,000 in the market, we have them taken out of bodies lying in hospitals or crematoriums, refitted and sterilized before they are listed in our register," says Ashis.

The Medical Bank maintains a database of patients who need a pacemaker, but are not in a position to buy one. "When their requirements match the specifications (make, model, weight) of the machines we have, they are handed over to them," says Ashis.

Before they are handed over, the pacemakers have to be refitted and sterilized. Refitting means replacing the lead wire of a pacemaker, which is cut before taking it out and costs Rs10,000-12,000. Sterilization costs about Rs500.

"Those who can bear this cost do so, otherwise we step in to the extent help is required," says Ashis. "We do not receive any aid from the government or any organization.

Public donations have kept us going, from ambulances to medical equipment, all have been donated." Apart from such donations, Medical Bank also receives funds from local legislators though not on any sustained basis. "None of us draws any salary for working in Medical Bank and we're truly a voluntary organization," he notes.

Ashis, however, rues the fact that large pharmaceutical and medical appliance companies hardly make any concessions, let alone provide pacemakers free of cost. The supply line of pacemakers is kept open thanks to Medical Bank's network among crematoria and hospitals who tip it off the moment a patient with a pacemaker dies.

"A body with a pacemaker inside cannot be cremated in an electric furnace due to technical reasons. Therefore, family members of the patient or the crematorium authorities call us to take out the pacemaker," he says.

Among Ashis' recent initiatives are Footpath Hospital, which provides treatment to hundreds of slum dwellers, and Negative Blood Group Club, possibly the first of its kind in the country.

"Footpath Hospital consists of an ambulance and a team of medics who go out, on alternate weeks, to the river bank slums and provides basic medical assistance," Ashis says.

"Those in need of advanced care are referred to hospitals and subsidies arranged." Negative Blood Group Club, which has 250 members, has only one criterion for membership: a negative blood group.

"By becoming a member, you can not only save lives of others, but also your own," Ashis says. "Anyone who avails of the services of the club must be ready to give blood when asked for." According to Ashis, Medical Bank decided to set up the club after seeing the insecurity among people with negative blood groups. "Negative blood groups are rare com- pared to positive ones. Hence, people with a negative blood group and their relatives live in fear," he explains.

Members of the club campaign in the districts to collect negative blood. "We have got a good response in South and North 24-Parganas, East and West Midnapore and Hooghly. Relatives of patients from Bangladesh and Nepal are also contacting us for negative group blood. Whenever relatives of patients face problems in procuring negative blood, the hospitals refer them to us," says Ashis.

The patients and relatives in Bangladesh and Nepal are asked to send names and contact details of people with a negative blood group in their countries. "We are also issuing identity cards to people of negative blood groups so that they can easily get help in case of an emergency," he adds.

The man behind Medical Bank is a bachelor and an avowed disciple of Swami Vivekananda.

Ashis makes it clear that his is not a nongovernmental organization, which he waves off for working for the poor, but from behind glass doors in air-conditioned offices.

But the road ahead seems rough.

Medicine collections have halved in the past few years after drug companies cut down on free sample supplies to doctors. Says Ashis: "This has forced us to increase our open market purchases and spend valuable cash on them."

Source: www.livemint.com

Forget yourself for others, and others will never forget you.

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