Bloodshot eyes… year after year

We are now a small and a sick family. We have all fallen victim to Conjunctivitis (commonly called “pinkeye” or “Madras Eye” in India). It started off with my dad, and then spread to the entire family, including our little daughter. Newspapers in Mumbai are full of Conjunctivitis news. It is that time of the year, when Conjunctivitis is rampant in the city. When I called up my colleagues in Bangalore, two of them had also fallen ill and had not reported for work. So, if this is so common all over the country, and if people are not reporting for work, and there is say 2- 3 lost working days per person, imagine the gross loss of productivity. Forget the productivity; what is greater is the suffering and pain that one experiences. In an earlier posting,  I had written about the cost of treatment for diarrhoea in children. Now, treatment of Conjunctivitis is not cheap either. I think more than the medicine cost is the cost of consulting an eye specialist. So, in addition to the lost work days and pain and suffering, is the cost of treatment.

Conjunctivitis is highly contagious and quickly spreads from one to the other, so, just like in our family, the whole household usually gets infected very soon. We were very careful about not touching our eye and then touching each other, washing our hands often, not sharing towels and pillow cases, and so on; yet we all fell ill. So, one can only imagine in the slums where living spaces are so crammed and people have no other option but to share common resources, how easily it can spread.

The fact that Mumbaikars and people in other places around India suffer due to Conjunctivitis EVERY YEAR, around this time of the year (monsoon and post-monsoon) is almost like a foregone conclusion. Nobody even bats an eyelid (no pun intended) when hordes of people fall prey to this infection. In spite of having enough knowledge about the infection and knowing precisely when it strikes, we are unable to do anything to prevent it from happening year after year. So much for public health in our country! 

I had an interesting experience during the treatment of this infection. A drug which is commonly used in Mumbai (and other places also I presume) as first-line treatment for Conjunctivitis is a drug which contains corticosteroids, while the recommended treatment for bacterial Conjunctivitis (the most common, I think) is non-steroidal anti-inflammatory medications and antibiotic eye drops or ointments  I was told that schools here routinely stock the drug containing corticosteroids during monsoons, because of the high number of children who go to school with the infection. In fact, even I was advised by a friend to get this particular drug for Conjunctivitis. I did not not know about its contents. He said that anybody with Conjunctivitis vouches for the efficiency of this drug, and in fact this was most commonly prescribed drug by doctors everywhere. So, I went to the nearest chemist and asked for the drug. He laughed and said, that this drug was out-of-stock and I would have to procure it in black (paying almost double the cost) since there was huge demand for the drug. I walked away from the chemist in anger and went to another one. There, the same story was repeated. Finally, I decided to buy this drug, by paying that extra cost because my eye was hurting badly and I could not walk any further in the hot sun. Just after I had bought the drug, my wife called me to say that I should not use the drug as it contained corticosteroids and that it was usually used in the worst cases to reduce the discomfort from inflammation. On reading the label, I found that drug contained corticosteroids, and the warning said “indiscriminate and prolonged use of the drug could lead to glaucoma, cataract and fungal infections”. In fact, it can even cause permanent eye damage by inducing central serous retinopathy (CSR). Needles to say, the drug was a Schedule H drug (which was to be sold only on the prescription of a Registered Medical Practitioner), but I got it without even a single piece of paper. What is even more shocking is that, it is being used indiscriminately in schools and slums where people go and buy this from the Chemist across the counter at a price that the Chemist decides, because for most of the slum-dwellers, the Chemist also doubles up as their only “doctor”. 

I have uploaded some snaps of my Conjunctivitis-ridden eyes to show you the signs and symptoms. The first one shows the redness and watering from both the eyes, while the second one shows the swelling around the eyes, especially in the mornings. For more snaps, click here.

The mystique of medicine and the cost of treatment

How much does it cost to treat diarrhoea in children? A lot, as we realised when we came face-to-face with diarrhoea and the medical establishment, twice in the span of less than a month. I had written earlier about the water in our neighbourhood. Needless to say, our little one was down with her second bout of diarrhoea, in less than a month. We started out with homeopathy on both occasions. Our resolve to be patient and wait out until the infection dies out, was quickly overcome when we saw the condition of the child not improving.

The second time was worse than the first episode. A visit to the local doctor, not yielding any visible benefits, saw us rush for a consultation with a specialist pediatrician, who filled in two long sides of a prescription sheet with medicines and powders of different kinds. Banish any thought of rational medicines and good old home remedies! In fact, when we asked the doctor about some of the specifications of the medicines (more in the nature of clarification, rather than confrontation), he lost his cool and said “then why do you come to me?” – the arrogance of knowledge being mystified and given into a few hands!!! Anyway, we visited at least three different medical stores to get the array of powders and medicines – the hocus-pocus of modern medicines. The whole exercise in ignorance, set us back by about Rs.1000 (the second time). On closer examination, we realised that one of the costly powders was a substitute for its poor (but effective) and distant cousin – kanji (rice gruel), while another was a substitute for home-made ORS, and yet another was a replacement for milk (to not aggravate the loosies). As a parting shot, he also said that we need to get her stool tested, (but of course, the clinic also had a lab attached) and that in case she did not improve and pass urine in the next few hours, we had to get her admitted (and yes, he runs a children’s hospital also). No tips on how to take care of the child at home, or how to avoid hospitalisation – purely a “pill for every ill” or rather “a load of pills for every ill” approach.

 For more photos, click here.

Just opposite the housing colony where we live is a large slum. The children there, not only have access to the same (if not worse) water, but also have poor living conditions and all other typical features which characterise slums in cities. It was especially with reference to this slum, that the doctor has said “oh, diarrhoea, everybody gets it here”. If everybody gets it, and spends so much of their hard-earned money on the doctors and medicines, and syrups and tonics and lost wages, then why is nothing being done about it? One reason is definitely the mystique of modern medicine carefully preserved and crafted and refined by the practioners of the art, to keep common people from taking health in to their own hands. After all, if they do that, where will they make their living from? That’s the tragedy of commercialisation of medicine and medical education. Wither health for all???