Tottering healthcare in Punjab

Mohit Khanna in Nurpur Bedi/Chandigarh

If you want to see how Punjab’s healthcare — pegged at Rs 1,358 crore (2017-18) and claimed to be 14.21% higher than the previous year's — crawl, take a close look at buses parked outside PGI Chandigarh: these have patients and their attendants from about 200 villages located around Nangal Dam, Habowal town near Garhshanker and Nurpur Bedi. These people would tell you how a free bus service has become synonymous with 'cancer train' ferrying cancer patients from Bathinda and adjoining districts to Bikaner in Rajasthan.

These patients from the Kandi area have come this far — around 90km — braving rickety roads and government apathy. Their condition is defined by a total lack of health infrastructure and, in many cases, contaminated water that they are forced to drink. Meet Makhan Singh (45), who has a serious heart condition. He is a founder-member of the Guru Ram Das Samaj Sewa Society and has got like-minded people together to get a donation-driven bus service started. All this is because the government has failed to provide quality healthcare at their doorstep. And even if there are certain facilities, the specialist doctors have played truant from posting in rural areas, preferring cities.

The Tribune accompanies these patients on a one-day journey:

3.30pm: Three buses are parked outside Gol Market in PGI waiting for the patients to arrive. Jaswinder Singh, driver of the new 50-seat bus purchased by the society for Rs 18 lakh, says: “Fortunately, there are fewer patients. The long weekend around Holi was difficult; there was a sudden rush.” Telu Ram (33) is a cancer survivor from Tibba village. He is returning home after his first post-operative chemotherapy. He says many like him don't find specialists in the area. Around two years back, when he lost appetite and had fever, the doctor at the local government hospital in Singhpur started tuberculosis (TB) treatment. The treatment went on for nearly a year, but his condition deteriorated. The PGI diagnosed him with cancer. 

“Continuing the treatment was tough because I had to change buses to reach Chandigarh: first I would travel all the way to Nurpur Bedi, nearly 20km away from my village. I came to know about the free bus service about a year back. This came as a boon. I board it from my village at 5 am and reach PGI by 7am,” says Telu. 

4pm: The journey begins. Gurpreet Kuar is detected with breast cancer and is seeking some advice from Telu. Pritam Das (70), a resident of Golni village located near Nangal, has diabetes and hypertension, which has further caused heart and liver issues. He is tightly clutching a bag in which he carries the medical reports. 

Karnail Singh (63) is from Bhallari village and is diagnosed with a clot in the head. He is returning home after an operation. He says private doctors take Rs 500 per visit, but at PGI, the best doctors conduct a checkup for Rs 10! 

The bus crosses Ropar, the bumpy ride starts to Bains village. “Imagine the suffering of a woman in labour as she is rushed to a hospital in the middle of the night,” says Gurpreet Singh of Haibowal village.

Mohar Singh (45) from Sekhowal village near Garshanker, rues the day when he visited a private hospital for treatment of his abdominal pain. “The medicine led to side-effects. I was told my veins had shrunk. This caused psychiatric problems. I lost all my savings.” 

The conversation veers to the thriving sand mafia. The rampant scooping of the riverbed has led to approach roads being blocked. It has also caused water table depletion and contamination of potable water. “My brother is gastroenteritis patient,” says Parampreet. 

The Kandi area has many quacks. Joginderpal Singh from Bains village says his mother is a victim. “She was suffering from glaucoma and visited an eye check-up camp in Tedewal village where a doctor performed the operation. The operation went wrong, and since then she has a searing pain in the head. We are following a treatment from PGI. The pain has receded; but we have to visit PGI frequently,” says Joginderpal.

6pm:  As the bus reaches Nurpur Bedi, the passengers are requested to offer any amount as donation. The amount varies between Rs 10 and Rs 100. At Nurpur Bedi the donation box is handed to Makhan Singh, founder-member of the society. He says he and other members of the society visit several villages each day, requesting people to contribute for the cause. “The bus service started on Feb 8, 2016. Since then the three buses have ferried over 45,000 patients to the PGI,” says Makhan. 

He took the idea from the train service that ferries cancer patients from Bathinda to Bikaner. Makhan himself is a cardiac patient. Before he returned to Nurpur Bedi, he ran a bus service in Delhi. He was diagnosed with a rare ailment last year and had to visit PGI frequently. That was when he along with others thought of hiring a bus. The society maintains a register of the patients. “People don't have regular bus or train services. Government medical facilities are pathetic as private medical institutes make a killing,” says Makhan. 

“It was after the patients started visiting the PGI that we learnt that many among them were suffering from cancer, heart diseases, renal failure, high blood pressure and diabetes,” says Makhan. The society pays Rs 4,500 each day to the bus owner for ferrying the patients.

After maintaining the register of patients, who have sought booking for the next day, it is time for Makhan to switch duty with Lakhwinder Singh (54).

A well-established businessman, Lakhwinder wakes up at 3am, visits the gurdwara of Peer Zinda Shaheed, cleans the premises and gets to work with the ailing patients and their attendants queuing up to board the bus. 

Meanwhile, the buses from Nangal and Haibowal also arrive at the gurdwara. He asks everyone to show their identity and OPD cards. After verifying the documents, the bus starts its onward journey. 

“I believe god has chosen me to work for the people. I feel sad that so many people have to cover a long distance for a check-up. Had Makhan Singh along with others not taken the initiative, many people would have died in the absence of treatment,” says Lakhwinder.

No specialists, only politics

• 'Percheyawala' hospital: The Government Community Health Centre (CHC) in Singhpur village, barely 5km from Nurpur Bedi, presents a gloomy picture of neglect. The hospital is known for medico legal reports (MLR). The duty doctor remains absent for most of the time. The foundation stone at the civil hospital says the hospital building was constructed in 1977 by the then CM Gyani Zail Singh. 
• Politics continues: AAP MLA from Ropar, Amarjit Singh Sandoa, says he has met health minister Brahm Mohindra seven times requesting him to depute some specialists at the hospital. “I have also requested for setting up a lab and imaging centres in the nearby hospitals. The district administration is sitting on the funds being offered at the shrine of Peer Baba Jinda Shaheed Nurpur Bedi. These funds could be put to best use for affordable treatment.”