The Hindu : MCH departments hedge for prime space

Online edition of India's National Newspaper
Monday, Apr 28, 2003

Southern States

Southern States - Kerala-Thiruvananthapuram

MCH departments hedge for prime space

By M. Dinesh Varma

THIRUVANANTHAPURAM April 27. The long-term development of the Thiruvananthapuram Medical College is being caught up in a development conundrum with various departments hedging for prime space, leaving the expansion potential of the sprawling campus unutilised and unexplored.

The phenomenon of various departments jostling for more space in the highly congested conditions that prevail at the heart of the Medical College campus has left a stamp of lopsidedness in the growth of the premier institution, sources point out. According to sources, it was amid murmurs of dissent among a section of senior clinicians that the Casualty was recently shifted to a new premises as part of a long-term measure to provide improved and better coordinated emergency care.

Though the relocation of the Casualty was linked to an ambitious project to set up a specialised trauma care complex, a section of clinicians still wonder whether the relocation exercise should have been attempted at all if it were only as an interim measure, prior to the shaping up of the trauma care complex. It is another matter that the new Casualty block is at present facing several teething problems, as was borne out in February when as many as 43 accident victims of a bus mishap at Pangappara were brought in a bunch.

According to highly placed sources, dissenting notes have cropped up yet again to the proposal to establish a Kerala Heart Foundation which has been envisaged to provide high-end cardiology services to patients in the State, on the heart of the campus. The Government has already sanctioned Rs. 1 crore of the nearly Rs. 10 crore project to set up the Heart Foundation that would cater to the needs for sophisticated cardiac care on par with services available at any other comparable institution in the country. However, it is the proposed site being sought for the Foundation--opposite the new Casualty block--that has set off a debate among senior clinicians and administrators of the institution.

Even while wholeheartedly welcoming the exciting move to set up a complex that would deliver tertiary-level cardiac care to patients all over Kerala, critics disagree with what they call a myopic outlook in clustering developmental projects with huge investments, within a two sq km radius around the infrastructure established at the inception of the Medical College in 1951.

It is being pointed out that founders of the Medical College had chosen the nearly 140-acre sprawling campus housing one the premier institutions in the State, over and above the option of upgrading the then General Hospital, primarily keeping in mind the future expansion of the institution. From the viewpoint of the institution's evolution, the Medical College, which had set out with a few basic departments, has seen a branching out into a dozen superspecialties. In the process, more and more departments have been established and patient-intake risen manifold.

Critics wonder whether it would be beneficial for the patients, and indeed the Heart Foundation itself, if such an ambitious project were to be cramped up on the space opposite the new Casualty, that is now serving as a parking lot.

Alongside the initiative to equip the Medical College with the levels of sophistication available in the private sector, there is this disparate strand of thought that the developments would eventually place an unaffordable burden on the common man.

In conjunction with policy changes that have sanctioned, as inevitable, the levying of user charges on the basis of the income of patients, there is concern over whether the state-of- the-art services envisaged through projects such as the Heart Foundation would place health care beyond the reach of the common man.

Meanwhile, sources also point out that the critical development needs of several major departments such as General Medicine, Orthopaedics, General Surgery, Paediatrics and Gynaecology, have been left unaddressed over the years leading to a lopsided growth of the Golden Jubilee celebrating institution.

For instance, the Orthopaedics department, one which is easily amongst the most overloaded of the Medical College units, is always facing a handicap. The department, which has been allotted 12 operations tables over three weekdays, has only one operating table for doing emergency surgeries. As things stand, even when the department often doubles the number of surgeries to around 70 a week, it still gets stuck with a backlog.

Another case in point concerns the surgery units which account for an estimated 30,000 procedures annually, in spite of which there is always a mounting backlog, while the Anaesthesiology department, which provides surgical back-up to numerous departments, finds its resources grossly inadequate to cope with the ever-increasing surgery demands at the premier hospital.

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