Naseema Begum has waited a month for her infected kidney to be removed. Her doctor has promised that her surgery will happen ‘tomorrow’, but that tomorrow has still not come. She was told that if the surgery isn’t done soon, it could spread to her right kidney.
When TNM caught up with Naseema, she was on her way to the anaesthetist to check the next available dates for her surgery. “The doctor keeps saying tomorrow,” the 38-year-old daily wager tells TNM. She travels from Kishan Bagh to Osmania and back every day.
"They last fixed the date as August 9 for the surgery and even bought 4 units of blood for the surgery, but it was again postponed," she said. Naseema does not know why her surgery is being postponed, she hopes it will happen soon.
"It's because of overcapacity," said Kavitha, the Civil Assistant Surgeon Resident Medical Officer at Osmania. "If a surgeon has 10 patients scheduled for an operation, they would keep the infectious case for the end, as the operation theatre has to be sterilized after such surgeries. Often, these surgeries take time and hence the schedule changes.”
Osmania Hospital is a tertiary care hospital, but witnesses a high number of referral patients from primary and secondary care hospitals in the districts. So why does a high number of referrals come to tertiary care hospitals like Osmania?
The answer lies in the disparity in the distribution of government medical facilities, suggests data from the Telangana Social Development report 2017. The report finds that the distribution of sub-centres, primary health care centres, community healthcare centres, area hospitals and district hospitals, and the availability of facilities vary sharply across districts in Telangana.
Out of the total of 108 general hospitals, 21 are in Hyderabad and out of the 17 speciality hospitals, 10 are in the city. The general hospitals are concentrated in districts like Warangal, Medak and Nalgonda. Adilabad and Warangal do not have district hospitals.
Aman Gouse is an 11-year-old with a kidney stone problem, who has been living in the waiting area of Osmania Hospital for the past few days. Aman's father, SK Gouse, is unsure about how long the family of four will have to stay at the hospital.
"The OP ward opens at 9 am, but the doctor comes late and leaves early, so if they ask us to get a report of some test, we have to wait until next day to the show the report," said Gouse who works as a truck driver. "We came here because our doctor in Nizamabad General Hospital told us to."
All the medical documents in possession with Gouse are in English, so the family is completely dependant on what the doctor tells them. "We were told there are no kidney doctors in Nizamabad, we did not check with the private hospitals. The child was in pain, so we rushed and came here," said Naeema, Aman's mother.
"The family need not have come all the way here to Hyderabad for kidney stone related problems; there are issues that could have been dealt at a secondary hospital," says Kavitha.
“There is a dire need to strengthen the primary and secondary healthcare systems in the state. Tertiary care hospitals focus on complicated health issues of patients, but all our resources, be it doctors, postgraduate student doctors, house surgeons, nurses and even sanitation workers, are stretched too thin. The focus is towards catering to provide primary and secondary health care for the influx of people who come here," she added.