Indian Hospital

Indian Hospital: Episode 4

Dr Shetty is on a mission to reduce the cost of medical care for India’s poor and to empower the country’s women.

This unique observational documentary series shines a light on Indian society as it is rarely seen. In six one-hour programmes it illuminates the complexities and dilemmas of modern India through the extraordinarily varied lives of patients and medical staff working at the Narayana Hrudayalaya Hospital Complex in Bangalore.

A series by Paul Roy.

Thirty-year-old Prabhu has been suffering from terminal motor neurone disease for half his life. A recent side effect has been the deterioration of his eyesight to such an extent he has had to quit his job.

After an eight-month wait, he has the first of two cornea transplants. It is exacting precision work with no room for error.

His motor neurone disease is untreatable and increasingly affects his mobility and coordination but Prabhu continues to enjoy life to the full.

Meanwhile, 12-year-old Bimesh and his father arrive at the hospital to hear the final decision on whether Bimesh will be offered the spinal surgery that could potentially save his life. If he is not selected for inclusion in the charitable scheme, that would see him treated free of charge, he will probably die before reaching adulthood.

Such a procedure would normally cost several thousand dollars – which is well out of reach of Bimesh’s family. For a child from a poor background, being able to have such an operation is as rare as winning the lottery and across India there are hundreds of other children in Bimesh’s position.

India has traditionally been a country whose population has suffered from diseases of poverty. But as the world’s second-fastest growing economy it is now suffering from the consequences of affluence. Diseases such as diabetes are becoming increasingly common.

Business management student Navya Naidu was diagnosed with a failing kidney three months ago. To survive she must undergo painful and expensive dialysis three times a week for the rest of her life unless she can find a suitable donor for a kidney transplant.

The cost of regular dialysis sessions is a financial burden for Navya’s family. With her father unable to work because of a recent motorbike accident, Navya’s illness has placed her family in a desperate financial position. They have four mouths to feed and their only income comes from selling the milk produced by their two cows.

It is now more important than ever that Navya receive a transplant, finish her degree, and get a job so that she can help support her family.

“We are the diabetic capital of the world. Diabetes leads to kidney failure, heart disease and all kinds of other illnesses,” explains Dr Devi Shetty, the founder of the Narayana Hrudayalaya Health City. “This is going to add significantly to the disease burden.”

At present the hospital has only 27 dialysis beds, which run in three shifts almost 24 hours a day. The aim is to add at least another 280 beds over the next two years.

Shetty has developed an innovative scheme to not only reduce the cost of dialysis but to make it available to thousands more people across India.

“We want to put up 5,000 dialysis machines across the country …. So we have tied up with a Japanese dialysis equipment company which … will put up the infrastructure and they will supply the tubings and the filters and everything. We give them a fixed amount of money per dialysis and we run our infrastructure 24 hours …. They will get a lot more than they would by selling [and] will have a low cost product.”

This plan would see the cost of dialysis treatment reduced from about $20 per session to $9 or $10.

On this episode of Indian Hospital, we follow 53-year-old Venkatesh who has been a diabetic for 20 years and on dialysis for three of those. He and his wife Pushpa have travelled two hours to see Dr Vincent for the first time.

Venkatesh is in very poor health and shows all the signs of a diabetic patient in late stage renal failure.

But, unlike Navya, who at least has the lifeline of a transplant and the chance for a normal life if a donor can be found, Venkatesh is too old to be considered for a kidney transplant and has neither the money nor the insurance to cover the cost of the procedure. So he has no option but dialysis for the rest of his life.

Each uncomfortable four-hour trip to the hospital for dialysis takes a day and a considerable toll on his weakening body. But for Venkatesh to survive, he needs the support of his wife, Pushpa, as this will become a routine for both of them, three times a week, for the foreseeable future.

But the role of women in Indian society as breadwinners, family carers and a source of stability is often underrated. Shetty, however, recognises that they are the bedrock of society.

“I strongly believe that there is no job in this world that a woman cannot do … unless we empower women we will never be able to build a strong nation,” he says.

Shetty’s vision for empowering women extends to the nurses at Narayana Hrudayalaya who are studying to become nurse intensivists. This innovative year-long course will dramatically upgrade their skills to a level where they can work independently of doctors and make diagnoses themselves. If successful, they will earn considerably more money and have better employment prospects.