Ramakrishna Mission Seva Pratishthan (The Hospital)

We have spent the last four weeks on four different rotations in the hospital - Medicine, Surgery, Paediatrics and Obs & Gynae. We went to the hospital every day from nine(ish) until two o'clock. Or one. Sometimes twelve. A couple of times we left at eleven.

The one thing I can say about the hospital is that, although the facilities are fairly poor, the doctors really do know their stuff.

Was that two things?

Anyway...

A feature of a communist government, such as that in West Bengal, is that everywhere ends up overstaffed. The Ramkrishna Mission Hospital is no different. There are loads of doctors, and a lot of them seem to spend a substantial part of the day hanging around. Certainly, when we were doing our Paediatrics rotation, we had to kick the doctors into any sort of teaching, and then they'd tell us that their team only had two patients on the ward. Well then whose are all the other kids? How many paediatric teams does one ward need?

I think the exception is when they do their outpatients clinics. Oh Holy God. Literally thousands of people crammed into the waiting room. A doctor told us, as we were going home one day, that he couldn't meet us the next morning because he had outpatients. He said that even if he only sees thirty patients, it makes a difference to the team's workload.

Sorry? Thirteen patients? No. Thirty. Three zero. Only. Thirty.

Wow.

And the setup is... well... different from that which you may have experienced in the Western World. A team's outpatients clinic consists of maybe four doctors sitting around what looks like a fair sized dining room table, chatting to a patient each. Confidentiality flies out of the window. If a doctor wants a second opinion, he just asks the guy across the table, so that the other patients (both the ones sitting at the table as well as the ones waiting in line around said table), the patients' families, the porter and the bewildered medical student can hear. X-rays and lab reports are passed freely back and forth, so it's a miracle anything ends up back in the right chart. They're big into paper-weights here because the ceiling fans blow a gale and tend to scatter things if they are not pinned down. That is, of course, when the fans are working. If they are not then I leave drips of sweat all over the charts, such that I wonder if it wouldn't be better to laminate it all. I got an almighty slagging from the other doctors for that.

The other curious thing about the hospital, apart from the abundance of doctors, is that it is run by monks who have no medical training. So hand-washing is not a big issue, but one has to change one's shoes when going into the Intensive Care Unit, the Coronary Care Unit, the Labour Ward, the Dialysis Unit and the X-Ray department. We even have to change our shoes a second time from ordinary surgery clogs to special flip-flops when entering the Caesarean Section theatre. And there are many more practices that were never done in the West or were abandoned years ago that are still practised here as a result of policy-making by a religious leader. A big, fat, extremely rude religious leader. And orange really isn't his colour.

I won't have any pictures of the hospital, because we lied to the monks and said we were flying home this morning and that we couldn't come in. So if I turn up in tourist garb with a camera and get spotted, they might take back their certificate.

They gave us a certificate.

In fact, they really like pieces of paper in this country. Bureaucracy creates jobs. Therefore, everything is written in triplicate and signed and countersigned. Only, they don't do today what can be put off until tomorrow. The whole first day was taken up with setting us up in the hospital. Despite the fact that they emailed us and told us that they would accomodate us in a four week elective, they weren't expecting us. But eventually they found the emails they had sent. I could be cynical and imply that the catalyst for their change of heart, after about an hour of not doing very much about us, was the fact that I produced the 3 X 7,000 rupees that was requested before we arrived (and I can tell you that 21,000 rupees in 100 rupee notes looks pretty impressive), but I wouldn't do that. These are holy men after all.

I'd say I was going to hell, but since these Hindus chaps believe in reincarnation, I'll probably just come back as one of the lizards living in our bathroom.

It could be worse. I could be a patient in the Ramakrishna Mission Hospital.

Toby.