Mercy mission to Punjab's poorest

THEY were greeted almost like heroes, says Vijay Bangar reminiscing on his recent trip to a small charitable hospital in north western Punjab.

Speeches, garlands and gratitude were the order of the day when Dr Bangar - a general physician at Calderdale Royal Hospital - arrived with fellow volunteers at the Sant Sarwan Dass Charitable Hospital.

Named after a saintly guru, the three storey hospital depends on charitable subscriptions. Dr Bangar, a specialist in diabetes, first visited four years ago. And had been troubled then by its lack of resources.

Built in 1982, the 250 bed hospital was, he says, little more than a dispensary. “The most senior doctors there have about four years postgraduate experience, which is registrar level in British terms”, he says.

They do great work, he added, but he and other British medics felt they could share some of their expertise and help improve healthcare for the thousands of mostly very poor people who use the hospital.

After two more self-financed visits, Dr Bangar decided to make a longer trip and persuaded other volunteers to come with him. Two colleagues from Calderdale Royal were fired up by the idea.

Dr Ashwin Verma, consultant gastro-enterologist and Craig Woods, A&E co-ordinator, volunteered. So did two specialist nurses from Coventry and Dewsbury and an A&E doctor from Leicester.

“Last year I went on my own for just three days. That’s what gave me the idea. Our team, two senior doctors, one junior doctor and three nurses saw over 600 patients in 10 working days”, says Dr Bangar.

All the volunteers, he adds, had to be prepared to give up two to three weeks holiday and pay their own travel and accommodation costs. Calderdale Royal, however, let the volunteers have study leave.

And as it turned out, he says “we were all given free lodgings”. And the use of a car. A bit of an embarrassment because, as honoured guests, their hosts weren’t keen they should walk anywhere, even on sightseeing trips.

Hospitals like the Sant Sarwan Dass are starved of many things, from medical specialists - who tend to work in big city hospitals - to funds to pay for free medicines for those that need them.

Eight hours by road from Delhi, the hospital sees a vast range of conditions. Some are life-threatening, some have remained undiagnosed for years even from early childhood.

Craig Wood, A&E co-ordinator at Calderdale Royal, has volunteered before: last year he used holidays to work in Guyana. Working in the developing world is “ a real eye-opener”, he says.

The first day or so was chaotic with hundreds of patients milling about. So Craig set up a triage system to sort and funnel patients to the right doctor or specialists.

“People are very grateful for whatever you can do for them and you get great positive feedback. But you do encounter a lot of end-stage disease, like untreated cancers and heart disease”, he adds.

One patient was a 40 year old woman whose cervical cancer had spread. “You do the best you can but such cases were very frustrating”.

Dr Bangar saw one boy in his early teens who had a diabetic condition undiagnosed since he was seven years old. “Expectations about medicine are less and people have been less exposed to doctors”, he says.

It is that which makes such work so attractive: “It is very gratifying, very good for the side of you, as a doctor, that wants to do good - whatever that really is”, he says wryly.

And no, he explains, diabetes may be associated mostly with obesity in the West but that doesn’t mean it is rare among the poor of Asia. And though it is often treatable, poverty can frustrate that.

“Many of the patients who attended my diabetes clinics presented aspects of the disease I had never seen before in the UK. Some would almost certainly have died without the treatment they received”.

After correct diagnosis there are plenty of generic drugs available but charitable hospitals are often strapped for cash and cannot afford to give medicines for free to every single patient who needs them.

Which was why, says Dr Bangar in a throwaway line, that he and his team gave their 2,000 travel bursary from the BMA to the dispensary at the hospital before they returned to Britain last month.