The meteoric growth of a neglected government hospital in a nondescript town in Kerala’s Kollam district owes immensely to the perseverance of a group of dedicated staff, led by a visionary doctor driven by the desire for change. The Punalur Government Taluk Hospital is reaffirming the role of primary sector hospitals in the state with its efforts in countering the COVID-19 pandemic.
It was after Dr Shahir Shah took over as the Superintendent of the hospital in 2010 that the government hospital, which had glaring inadequacies, gained public attention. The hospital handles 3,000 patients and 14,000 to 15,000 visitors every day. Thousands of people from the backward regions of Kollam, including a vast majority of the tribal population of the district, are dependent on the hospital.
Dr Shahir, who earlier worked at the primary health centre in Karavalur, joined the Punalur Taluk hospital in 2010. “First, I established an administrative block and then formed a speciality cadre of doctors. The hospital was lacking by all yardsticks and I wanted to bring a change,” Dr Shahir tells TNM.
From very basic facilities, the team established departments such as ophthalmology, dermatology, ENT, orthopaedics, paediatrics, gynaecology and cosmetology, which taluk level government hospitals rarely achieve. A cardiologist and a nephrologist were appointed using hospital funds. A dialysis unit was established in 2013, a first for any taluk hospital. Today, the hospital offers as many as 40 advanced cosmetology procedures, including skin platelet-rich plasma administration, follicle transplantation, squint correction and dental jewellery.
The hospital has round-the-clock facilities for X-ray, ECG and other laboratory tests, and conducts approximately 80,000 tests a month at subsidised rates. The hospital charges Rs 40 for an ECG whereas the same costs Rs 150 to 200 in private laboratories, and Rs 50 for an X-ray which costs around Rs 400 in private hospitals. A knee replacement surgery at the hospital costs Rs 80,000, which costs Rs 4 lakh outside. The hospital also provides free treatment to patients with funds sponsored by certain organisations.
Among the 23 tribal hamlets in the district, 21 come under the jurisdiction of the taluk hospital. The tribal population belonging to Piravanthoor, Achankovil and Kulathupuzha immensely benefit from the hospital. The tribals are given a treatment diary and get subsidised treatment from funds allocated by the Kerala government. The hospital also has a mobile unit to cater to the needs of tribals.
“The merit of a hospital can be gauged by how it caters to the requirements of the backward segments of society. In that regard, we were able to serve the marginalised sections, including tribals and those from economically weaker backgrounds,” Dr Shahir adds.
With free medicines, treatments and other benefits, at least 2,000 of the tribal population of the region have benefitted from the hospital.
The hospital has received many laurels in the past for its efficient functioning, even bagging four awards of excellence from the Kerala State Pollution Control Board (KSPCB). The hospital is fully run on solar power, including the lighting facilities. The awards were received for maintaining the cleanliness yardsticks and for being an eco-friendly hospital for 2014-15, 2015-16, 2016-17 and 2017-18. In the years 2011-12, 2012-13 and 2013-14, the hospital secured first price from the KSPCB (the excellence award was not instituted then). The award also took into account that the hospital has a waste processing unit with aerobic compost, a waste water treatment plant and a plastic recycling plant.
To counter COVID-19, the hospital has put in place a special team for case detection, isolation and testing. Patients are segregated into three waiting areas – primary, secondary and tertiary. Another team helps to sanitise the hands of every person entering the hospital. There is also a 24-hour help desk to cater to the needs of the patients.
Every staff member of the hospital has been given a three-tier training of handwashing, waste management and floor cleaning. A mobile unit has been set up to take throat swabs of patients residing in the interior parts of the district.
Dr Shahir says that none of the hospital staff has been infected with COVID-19 so far nor has anyone needed to go into quarantine.
Dr Shahir says that the ongoing coronavirus crisis highlights the need to strengthen primary sector hospitals. “The primary healthcare system has come to the forefront with the COVID-19 infection. In my opinion, a majority of the doctors in the country should be allowed to work in primary sector hospitals as that will enrich their experience,” he says.
It was after the Punalur hospital received recognition that many of the government hospitals emulated its path of success.
Dr Shahir says that there is a lot of scope for tertiary care treatment in a remote region like Punalur, where people are deprived of good medical facilities. People have to commute to places as far as Thiruvananthapuram to avail specialist healthcare, which might prove too late for the patient. Dr Shahir says his dream is to start new specialist departments as part of the hospital.
The Superintendent says that his staff members supported him enormously, but that he is in need of further manpower. The hospital presently has 109 staff members but more need to be appointed to cater to growing needs.
Dr Shahir’s popularity became evident when he was transferred in 2014 and another doctor was appointed as the Superintendent of the Punalur Taluk Hospital. “Many local residents staged a full-day fasting protest against the transfer, this was during Onam 2014. However, I challenged the decision and approached the tribunal, and was reinstated as the Superintendent,” Dr Shahir recalls.
The hospital is getting ready to shift to a new building being constructed at a cost of Rs 68 crore. Now in the final phase of construction, the building will be a marvel in terms of facilities compared to similar government hospitals in the state. The 10-storied building will even have a children’s amusement park and fully centralised air-conditioned facilities, a rare amenity in any government sector hospital in the state. The new building will have 300 beds compared to the current 144 beds.
Punalur MLA and state Forest Minister K Raju told TNM that the inauguration date of the new hospital will be decided after the construction is completed.
Abhish K Bose is a journalist based in Kerala.