HEALTH

Why workers shun ESI hospitals
From Manoj Kumar
Tribune News Service

LUDHIANA, Oct 18 — Workers of industrial units contribute crores of rupees towards the ESI fund. Under the law, workers are entitled to use this fund to get family pension, insurance cover and medical facilities whenever they need these. However, in the city, most workers and employers do not seem to be interested in using the medical infrastructure set up under the scheme. The reason is not far to seek.

“The ESI scheme has become a burden on workers as well as employers. We contribute our hard-earned money towards this scheme. However, what we get in return is not the facilities, but a sheer wastage of time in getting small benefits,” says Avtar Singh, General Secretary of the Chamber of Industrial and Commercial Undertakings (CICU).

Persons who come from distant places to avail themselves of the medical facilities under the scheme are harassed physically and mentally. Mr Mohamand Nathuni, a Bihari labourer, whose leg had been fractured in a factory, was treated in the ESI hospital here for about a year. He said, “The treatment and doctors were good, but I always had to go out of the hospital to get most laboratory tests done.”

His wife, Lalbai, said doctors were good, but all the required medicines were not available in the hospital. “We wasted so much money on buying medicines from outside the hospital. The medical expenses were reimbursed, but after such harassment.” she said.

Workers have to contribute 1.75 per cent of their wages towards the scheme. Employers contribute 4.75 per cent of the gross salaries of the workers, excluding the conveyance allowance, to the scheme.

There are 11 ESI dispensaries and one ESI hospital in the city. There are four local offices of the ESIC that have 13 inspectors to monitor and coordinate the services of the corporation. The offices give cash benefits like wage sickness, maternity, dependence and funeral allowances. Medical facilities are given to workers in collaboration with the state government. The corporation pays Rs 600 per worker to the state for this service. The state also contributes about one-seventh of the expenditure.

“There is no dearth of funds in the corporation. The necessary funds are received through the Finance Department of the state. The department often delays the release of these funds,” says Dr S.P. Jagat, Medical Superintendent of the ESI hospital here. He says that the grants have been sparse in the past few years.

“If the funds are directly released by the corporation to the Health Department, the situation can improve a lot. There are more than 20 doctors, including specialists, in the hospital who are highly motivated and even ready to buy medicines for the hospital out of their pockets. We will not let any patient die because of the scarcity of medicines,” he says.

A new building has been built to expand the services of the hospital, but it has not been used for the past six months. There were some deficiencies in the structure that were removed later. However, the authorities concerned have not granted the permission to use the building. As a result, services like that of a blood bank cannot be provided to patients. The blood bank was closed down in the early 90s.

Persons like Dr Jagat are making lot of effort to bring the hospital back on rails. He said a number of voluntary organisations were providing free milk, diet and other facilities to patients. “Employers may be spending a huge amount of money on the scheme, but they do not approach us due to their preconceived notions about us. If they come here, they will get the same service as anywhere else without having to pay more for it. The amount spent by workers is also reimbursed sooner or later. There are a number of big industrial units who use our services and are rather satisfied,” says Dr Jagat.

Depression is no slur
From A Correspondent

LUDHIANA, Oct 18 — Ashima was a clever girl. She was preparing for a competitive examination and her parents and friends expected her to do well. To everybody’s surprise, however, Ashima suffered a nervous breakdown while preparing for the examination.

Ashima says, “First my parents thought that I was behaving oddly, but when I continued to be listless, they took me to a doctor. They were shocked when the doctor suggested that they should take me to a psychiatrist. They thought it would attach a stigma to their family.”

Ashima’s parents took one year and a lot of coaxing by friends and relatives to take her to a psychiatrist. She was found suffering from depression. She took the treatment and was soon her normal self. “I had to waste one year because of my parents’ reluctance to take me to a psychiatrist, but thank God, I can now move ahead in life.”

Depression is a term used to describe “disappointment”, “short periods of feeling low” and “mild psychological upsets”. It is a curable illness and complications such as suicidal thoughts can be avoided if one consults a qualified psychiatrist in time. In India, a large number of cases remain unreported and very few patients seek professional help to overcome depression.

According to Dr Atul Shetty, a psychiatrist from Mumbai, “broadly there are three main causes of depression: biological, social and psychological factors. Heredity and harmonal balance also play an important role. Those who have personality traits like unassertiveness and dependency are more likely to develop depression. According to health experts, depression is expected to become the second most prevalent illness in the world by 2030. A study conducted by the World Health Organisation (WHO) showed a large number of patients visiting primary health doctors in many countries, including India, were suffering from diagnosable mental illnesses and depression was detected to be most prevalent among them.

“Depression should be dealt with in the same manner as other diseases. There is no shame attached to it. Nothing could be farther from truth that people who consult psychiatrists are mad. We should treat the mind just as we treat other organs of the body,” says Dr Ashok Vatswani, a psychiatrist from Mumbai.

Leprosy is mainly a rural disease
Tribune News Service

LUDHIANA, Oct 18 — Leprosy is believed to be a rural disease only. The latest research and various studies on the disease have revealed that leprosy was mainly a rural disease and was transmitted much less in the cities than in villages.

According to Dr M Z Mani, Professor and Head of the Dermatology Department, Christian Medical College and Hospital here, a few decades ago some South American leprologists had emphasised that leprosy was mainly a rural disease and was transmitted more in rural areas than in urban areas. This is primarily attributed to some unknown factors which are present in rural areas but are absent in urban areas.

Dr Mani disclosed that this theory was corroborated in his study and interviews of various leprosy patients. He said in his study almost all the leprosy patients from endemic states belonged to the rural areas and a large proportion of them actually contracted leprosy in the rural areas only. Explaining his findings, he said those patients who developed leprosy while residing in the city could also have contracted it in their native villages as they used to visit their villages regularly.

He disclosed that most of patients in Punjab also belonged to the rural areas or those living in the slums adjoining the towns and cities. He further revealed that careful questioning of leprosy patients living in urban areas revealed that they had migrated from some village or slums in towns and cities.

The reputed dermatologist has forwarded a new hypothesis on the transmission of leprosy. He disclosed that leprosy was mainly transmitted under poor sanitary conditions prevailing in the houses and surroundings of people. In rural areas the livestock which is usually kept beside the house, is also believed to be a contributing factor.

Arguing that the spread was mainly because of environmental factors, Dr Mani and other leprologists said, the usual spread of leprosy was not direct from person to person like in the case of tuberculosis. They pointed out doctors nurses and other paramedical staff who are regularly exposed to infectious cases of leprosy, hardly get infection. This is in sharp contrast to tuberculosis which spreads among hospital staff also.

Supporting the argument about the relation of sanitary conditions with the transmission of leprosy, Dr Mani revealed that some leprosy patients from endemic countries have migrated to Northern European countries. However, this did not lead to any further infection to other people there, primarily because better sanitary conditions prevailed there. He said, besides good rural sanitation in developed countries the livestock is segregated and isolated in livestock sheds and kept in enclosed pastures. However, when leprosy was endemic in Europe, the rural sanitation was poor and the livestock was in close contact with the village population as they were not segregated in those days.

He has been emphasising that the minimum measure of cleaning up the environment in villages and cities would be a good measure by itself and would also help a great deal in reducing the chances of transmission of leprosy.

Dr Mani said one thing needed to be emphasised was that leprosy was a disease of low infectivity. Once the patients are treated they become non-infectious. He asserted that leprosy was curable and with early treatment deformities can also be cured. Leprosy patients no longer need to be isolated an they can be treated at home only. Early detection helps a great deal in the treatment.

Dr Mani has already presented his hypothesis at a few national and international conferences on leprosy held at different places in and outside the country. He has also published a brief report based on the same study in the Indian Journal of Leprosy.

SPORT

Champion swimmer of PU
From Kamal Kishore Shankar

LUDHIANA, Oct 18 — Madhav Sund of the Ludhiana Government College for Men broke a 13-year-old record in the Panjab University Inter-College Swimming Competition that was held recently in Chandigarh. He broke Sukhiwinder Singh’s record of 1.08 minutes in the 100 m backstroke event by clocking 1.06 minutes. He created records in the 200 m freestyle, 400 m freestyle, 1,500 m freestyle, 100 m backstroke, 200 m individual medley and 400 m individual medley events.

Madhav won nine gold, one silver and one bronze medals, besides the title of the Best Swimmer of Panjab University, at the meet. He had won the title past year as well after creating four records and winning one silver and seven gold medals in the process.

Madhav began his career as swimmer in 1987 in the local Rakh Bagh pool. He has represented the state 19 times in various tournaments, including prestigious national meets.

He said his family supported his decision to choose sport as a career. He received inspiration from his grandfather, Kewal Krishan Sund, who had represented the state in many National Games as an athlete. His grandfather was also an avid swimmer who could not become a champion because the sport was not popular then. His uncle, Arvind Sund, was an international water polo player. His cousin, Sumit Sund, had also won the title of the Best Swimmer of Panjab University about five years ago.

Madhav said his performance had improved due to the guidance of Ajay Sharma, a swimming coach of Panjab Agricultural University. He will represent the university in the All-India Inter-University Aquatics Championship. The meet is to be held from October 21 to 25 at Gwalior.

Madhav said, “The main reason for the failure of our swimmers in international events is a lack of facilities and international exposure. There are only a few states that have all-season swimming pools. Our swimmers should be sent abroad for trainnig. The government should identify talented swimmers and give them incentives to do well,” he said.

Soccer trials:
Trials to select the boys’ team of the district for the Punjab Junior Football Championship will be held on October 24 in Guru Nanak Stadium here at 10.30 am. The tournament is to be held from October 28 to 31. This was said by Mr Tara Singh Lotey, Honorary Secretary of the District Football Association (DFA), in a press note issued here.

Death condoled:
The District Football Association (DFA) condoled the death of a former Indian football player Jarnail Singh. Mr Tara Singh Lotey, Honorary Secretary of the body, in a press note issued here today, urged the Chief Minister of Punjab to do something to keep the memory of Jarnail Singh alive.