We reached our Kerpai health center at around noon. This time we could not come to clinic on Monday so we were late by 3 days. By the evening patient started coming to center. As patients were more than usual and that too at unusual time, our 3 days gap was evident. One of our Swasthya Sathi (female health worker) from very nearby village also had come accompanying a patient. While in conversation she told about another patient from her village and he is very sick since 2-3 days. I ensured that I shall come to village to see him after seeing these patients. I took one of our field staff Jayshankar with me and drove bike to that village.

There were few people outside of patient’s house and we exchanged greetings with them. Some of them were familiar to me. I entered the typical low height, mud, adivasi house. Few women and men, young & old and some children were sitting around patient in central room. Children had nothing to do with the situation but all other were looking tense. To me, all were looking equally tense which made it difficult for me to find his family members among them. His wife and son were actually sitting at some random and unusual places. A bulb was lighten unlike other far off villages and that helped us to see patient well. He is about 50-55 year old man, lying on a mat completely unconscious with lots of breath sound filled with airway secretion and that is making him breathing more laborious. Patient had fever and seizures since last 4-5 days and now non responsive for two days. He had been given medicines but condition got worsen. I asked why not you took him to PHC. This PHC is 13 km with poor road and almost no transport facility on other days except on Thursday which is a weekly market day. There was no point in asking that question because that PHC do not have doctor and it is nonfunctioning. While I was asking, patient had an episode of seizure and none of them sitting near to patient tried to hold him. This was not very common. I made him lie on one side. His wife said “he is having Hapud (seizure in Kui language) many times a day, we tried initially to hold him and did Guruguniya (traditional healing) but all in vain and what is the point in taking to PHC, they do nothing, we shall try to go to Raygada (district hospital) once our son reaches here”. Where is your son, I asked. “He works in Kerala, he has been informed day before yesterday and it may take another two day to him to come here, he has to borrow money also for treatment.” I asked to take him to our clinic. She asked “is it going to help? Will he be better? If yes then we shall come”. I said, I cannot assure you but I shall try my best. Somehow they agreed. Because of road our vehicle could not come up to house. I advised to carry him on a cot. Four people got ready and carried him on a wooden cot for about ½ km before reaching up to our jeep.

What will happen if similar kind of situation arises at our home in any town or cities? We turn sky upside down. There will be vehicles to take patient to hospitals not any PHC but a tertiary center. Doctors will be available and every diagnostic facility is made accessible. At no cost we would be awaiting the death of our loved ones. But at these places you cannot do anything for your diseased loved ones. You cannot do anything if you are old enough and your son is working at thousands of kilometer away from you. Here people do it, they wait for death to come and take their loved ones without much suffering. They know they cannot do anything beyond this and there is no system to take care of their sufferings, so they surrender. They surrender in front of the nature, in front of their god and in front of the situation for which we are equally responsible. Unless we come out of our comfortable confinement the situation is not going to change, it will worsen.

-Dr. Abhijit Gadewar