#India – Mentally ill held captive in asylum without licence #WTFnews


Christin Mathew Philip & Pratiksha Ramkumar, TNN Apr 29, 2013,

CHENNAI: Hidden behind 15ft-high compound walls is an 80-bed privately run home for the mentally ill in Urapakkam, 50km from the city. The home, Oxford Charitable Trust, has around 100 patients, but has not renewed its government licence for more than seven years.

“We have not issued a licence to them. They are not registered with us as a private nursing home for the mentally ill,” confirmed Dr C Jayaprakash, director of the government Institute of Mental Health (IMH). As per the law, a private mental health nursing or rehabilitation home needs a licence from the IMH or the state mental health authority. The licence has to be renewed every three years.

While there are 30 licensed private nursing homes for the mentally ill in the city, there are a number of centres that operate without licences or regulation.

Oxford Charitable Trust functions out of a white-washed building. The only entrance is a 6ft high blue gate, which is usually locked. TOI managed to gain entry into the building and found a kitchen with women cutting vegetables and stirring watery sambar. Further inside is a courtyard, surrounded by locked rooms with small windows. On the first floor are women watching television while quietly eating sambar and rice.

It could pass off for an old-age home, but residents of Urapakkam say sounds of “women shouting or crying loudly at odd hours” suggest otherwise. “They hit us if we cry, shout or try to escape,” said former inmate K Rizmiya, who has filed a petition in the Madras high court against her husband who admitted her there.

“The staff would force us to take strong sedatives at night or inject us with medicine to put us to sleep for five days if we shouted,” said Rizmiya. She protested the day she was admitted, and woke up in the same spot five days later drenched in her own urine and feces.

Oxford Charitable Trust does not fulfill the prerequisites for a mental health nursing home as per the State Mental Health Rules, 1990. “They need a psychiatrist on call and a full-time psychologist and registered social workers,” says Dr Sathyanathan, former director, IMH. “They need to have an emergency care unit and an electro-convulsive therapy facility,” he said.

The owners describe Oxford Charitable Trust as a home for the mentally ill. “We charge Rs 6,000 a month without medicines,” says one of the owners, G Ramkumar. “We take care of the patient as long as the guardians want us to.” They require a “medical history report and prescription of medicines” for admission.

Rizmiya said brokers who hang around IMH falsify medical certificates and admit people in to the home.

#India – Medical negligence: Father compensated for daughter’s death #Vaw


New Delhi | Wednesday, 2013 10:06:05 AM IST

The father of a pregnant woman, who died after a negligent doctor treated her for cancer that she did not suffer from, has been awarded compensation of Rs.5 lakh by the apex consumer court.The National Consumer Disputes Redressal Commission held Chennai-based doctor Kurien Joseph and Joseph Nursing Home in the city guilty of medical negligence and upheld the Tamil Nadu Consumer Commission’s decision that “there was medical negligence on their part in giving wrong and irrational medical treatment to the patient for a disease which she did not have”.”The rounds of chemotherapy given to her caused untold damage to her and were also responsible for her death,” said commission president Ashok Bhan and member Vineeta Rai recently, dismissing an appeal filed by the doctor and the nursing home.Joseph and the nursing home were directed to pay by June 2 a sum of Rs.5 lakh as compensation to victim G. Ushanandhini’s father Govindarajan, failing which the amount would carry an interest of 9 percent per annum, together with Rs.3,000 as costs, the commission said.The doctor and the nursing home have the option of challenging the decision in the Supreme Court.Govindarajan, a resident of Jothi Ramalingam Nagar in Perambakkam, sought compensation of Rs.10 lakh in his complaint, which stated that the cancer treatment given to his daughter was not correct since she was not suffering from the disease. Ushanandhini was admitted with complaints of stomach pain and menstural discharge despite being pregnant.The commission held the doctor and the nursing home guilty of ignoring a pathologist’s advice to conduct tests for cancer before starting the treatment.”Despite specific advice of the pathologist to correlate the provisional finding of carcinoma with the clinical picture and conduct biological test in dilutions of the patient, the appellants failed to heed this and did not conduct the required tests nor did they consult an oncologist or get biopsy done, which is the common procedure undertaken in cases of suspected cancer of this nature involving mass in the abdomen and growths,” Bhan said.The doctor and the nursing home took the defence that there were important and more than adequate indicators to confirm that the patient had cancer and that there was no need for other tests, including biopsy, which could have caused her further damage.The commission rejected the contention and said: “We are unable to accept this contention of the appellants.No medical report has been produced to conclude that Ushanandhini was suffering from cancer.”The doctor, not having conclusively established that the deceased was suffering from cancer, should have realised that chemotherapy was ill-advised on the patient. “We, therefore, hold that the opposite parties had been negligent in treating the patient and this had been the cause for the death of the patient,” the judgment said.”We note that appellants had deposited a sum of Rs.2.50 lakh with the state commission, vide this commission’s order of Feb 5, 2008. In that case, this amount be released to Govindarajan with interest accrued thereon and appellants are directed to pay the remaining amount as directed above,” Bhan said.(Rahul Chhabara can be contacted at rahul.c@ians.in)–Indo-Asian News Service rah/vm/tb

After Chhattisgarh its Bihar- illegal hysterectomy on 14-yr-olds #VAW # Reproductiverights


 

In Bihar,

illegal hysterectomy — an operation to remove the uterus.

Numerous cases of forced surgeries came to light in Samastipur district following a probe by district magistrate Kundan Kumar. The victims were sometimes girls as young as 12 to 14-year-olds.

There were a number of fake cases too, and in some of them, the operation was shown to have been conducted on men.https://i2.wp.com/www.hindustantimes.com/Images/Popup/2012/8/09_08_12-metro10.jpg

“It is not only a case of fraud but a gross violation of medical ethics,” said Kumar, who held a health camp as part of the probe. At the camp, ultrasound tests were conducted on over 3,000 women.

The report, which was finalised on Wednesday, indicts 16 nursing homes in Samastipur, all of which have been issued a showcause notice. The matter also found resonance in the state assembly, where the opposition put the Nitish Kumar government on the mat.

The probe was held when the insurance company, ICICI Lombard, raised an alarm after receiving a bill of a whopping Rs. 17 crore from the 16 nursing homes. A claim of Rs. 10,000 can be made for a single hysterectomy.

“At the camp, we received many complaints that the surgeries were forced,” Kumar said. “Private nursing homes even scared women with prognosis of grave medical complications, like cancer, if the uteruses were not removed.”

State labour minister Janardan Singh Sigriwal — whose department is the nodal agency for the scheme — insisted that  there has been no irregularity. It was decided that the call attention committee of the assembly will probe the matte

 

 

Kashmir’s health department cracks whip on private nursing homes


Around 150-180 hysterectomies at Valley’s 40 private nursing homes every month alarms authorities

Riyaz Wani
Srinagar

Rafiqa, 50, from Qamarwari locality of Srinagar has had a massive weight gain and undergoes wild mood swings—a source of constant trouble for her family. The reason for such erratic behaviour, her doctors at the government hospital now tell her, was the hysterectomy surgery she underwent at a private nursing home six years ago. The surgery it turns out, was unnecessary. The consequent complications, she is told, will probably last for the rest of her life.

Rafiqa is not an exceptional case. Around 150-180 hysterectomies—a surgical procedure in which doctors remove the uterus—are performed at Kashmir’s 40 private nursing homes every month. The situation has alarmed the Valley’s health department, which is already battling the incidence of female foeticide in a state where the female sex ratio as per the 2011 census has plummeted to 859 females per 1000 males.

“We didn’t know that the situation is so bad. Then the complaints from the people and public quarters alarmed us,” director of health Dr Salim-ur-Rehman, who has recently taken over the functioning of the department, told TEHELKA. “We found that there was a tendency to prescribe hysterectomies as the only solution.”

According to a recent survey ordered by the health department, the total number of hysterectomies performed in the seven districts of the Valley over the past five years is 14,788. Most of them were done at private hospitals. For example, in Kulgam district, out of a total of 4,196 hysterectomies in five years, 3,546 have been done in the private sector and only 650 in the government sector. Similarly, in Baramulla district, out of a total of 280 such procedures, only one has been done at a government hospital. In Bandipore district, out of a total of 924, around 659 procedures have been performed in the private sector.

The easy recourse to the procedure in private hospitals can be gauged from the fact that a small nursing home in downtown Srinagar, according to the data of health department, has performed 28 hysterectomies in December 2011. As against this, Lal Ded, the Valley’s largest maternity hospital carried out only two hysterectomies in the same period. “The particular nursing home has only two surgeons and sees fewer patients, while Lal Ded with 66 doctors, sees more than one lakh patients at its OPD alone,” said a health official.

Rafiqa has had her hysterectomy at a private hospital in Srinagar. “I didn’t know what I was getting into. Doctors told me I would be all right and I had no choice but to believe them,” says Rafiqa. “Since the surgery, my health has become worse,” she added.

The incidence of the growing number of hysterectomies has forced the health department to crack the whip. Rehman has decided to hold the private nursing homes to account. At a meeting with the Association of Private Hospitals on 12 March, Rehman called on them to exercise a greater restraint in the prescription of the procedure and warned the cancellation of their license in case they didn’t follow the norms of medical practice. There are around 40 private nursing homes in the Valley.

Besides this, the health department is going for a more detailed survey of the incidence of hysterectomies in the Valley. “I have told chief medical officers to gather information on hysterectomies through Ashas. There is one Asha for 1000 people, so we will get a fair assessment,” assures Rehman.

The Federation of Obstetrics and Gynaecological Societies of India in a policy statement sent to the director of health underlined that only a gynaecologist can carry out a hysterectomy. “Surgeons cannot do justice to the removal of uterus since removal of uterus is not just a surgical skill and training for the same is primarily imparted to gynaecologists,” FOGSI says in the statement. “This (hysterectomy) can be done best by gynaecologists and the surgeons can be called in the event of involvement of other organs.”

However, FOGSI president Dr PK Shah, doesn’t think that the large number of hysterectomies in a particular area means they are all unnecessary. “It is very difficult to make a judgement. If there is a reason for hysterectomy, then it is okay,” Shah tells TEHELKA. “Numbers don’t matter much, but there are no two opinions about the fact that the hysterectomy should always be the last resort.”

The Valley’s well known psychiatrist Dr Mushtaq Margoob says he has seen more than many patients in distress following a hysterectomy, over the past several years. “I have seen women in their 30s who have undergone hysterectomy,” Margoob revealed adding that in most cases hysterectomy had not been recommended by a gynaecologist but by other doctors and sometimes even by quacks.

Another psychiatrist Dr Arshid Hussain said the “post-hysterectomy depression” is a familiar phenomenon. “I see a lot of these cases,” Arshid says. “Hysterectomy deprives women of hormones at a crucial stage in their life, which sends them into severe melancholic depression. There is a need for these women to keep replenishing these hormones.”

Pertinently, a study carried out by the Government Medical College has found the incidence of uterine rupture in the Valley at 0.2 per cent. The study, which carried over two years (March 2007-March 2009) studied 100 women and found that the prevalence of the uterine rupture was common in women with low socio-economic status.

Riyaz Wani is a Special Correspondent with Tehelka.
riyaz@tehelka.com

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