Adventures at a Hospital in India

I spent last week in Jaipur, India because, well, why not?!  My husband was visiting Jaipur for business so naturally I thought I deserved an adventure too.  Jaipur did not disappoint.  I expected to arrive back home in Nashville sick and nauseated, a result of accidentally opening my mouth in the shower and taking a gulp of contaminated water, but instead came back fat and happy.  That's right, no traveler's diarrhea for me!  Rather, I developed an appetite for buttery, garlicky Indian food.  Mmmm.

While in India, I had the unique opportunity to get a firsthand look at the healthcare system.  I visited the 250 bed Fortis Escorts Hospital, one of many hospitals in the vast Fortis network.  First, I toured the hospital then made my way to the emergency department to compare my personal work experience with that in Jaipur.

In India, health insurance is "rudimentary" as I was told and most patients are cash-pay.  So, there are different tiers of healthcare and patients choose a hospital based on their financial situation.  The cheapest hospitals are government hospitals where I am told patients sleep on floors and the nurse to patient ratio is about 1 to 30.  The middle tier hospitals are a bit rustic but offer better care.  Patients share rooms but are still receive adequate attention from staff; this is the type of hospital I had the opportunity to visit.  

I wondered how people could afford medical care in India with a cash pay system.  The patients around me didn't exactly look affluent.  Then, on one unit I saw a few patient's medical bills tacked to a bulletin board (HIPAA laws don't apply in India I assume...).  The cost for a breathing treatment?  100 rupees, about $1.66 in USD.  I'm not sure how much an albuterol treatment costs as an inpatient in the U.S. but I'm sure it's at least 50 times as much.  The total cost for an ER visit including physician fee, CT scan and medication?  About $80 USD.  Next time I anticipate a big hospital bill, I might request admission in another country.  Amazing.

As I talked to the nurses in the emergency department, I realized how medical care in India could be so inexpensive.  Nurses in India earn about $120 USD each month, according the the friends I made.  Understandably, they asked me how to go about taking the NCLEX so they could some to the states and earn something like 500 times their current salary

It's funny how you don't realize some of your habits until you are taken out of your natural environment.  On my hospital tour, I realized how much hand sanitizer I must use at work.  When I go into and out of a room, I sanitize each time.  I sanitize when I just feel dirty, when the hallway smells funny and after I bite my nails (bad habit!).  But not in India.  The lack of hand sanitizing stations had me whirling.  The hospital was overall clean but I couldn't suppress my natural tendency to reach for the wall every time I walked through a doorway.

As I was led through the hospital by a nursing supervisor on my tour, we took the stairs rather than the elevator...up all 8 floors.  The workout was welcome as a 30 plus hour travel time had my legs in need of some stretching.  The stairs also provided additional views of the hospital helping me soak up the experience.  For example, I noticed piles of surgical drapes strewn across the roof drying in the sun.  I guess that's one way to save energy.  I don't think we could get away with sun-dried drapes here in the states.

The hospital floors in India were a bit more rustic than here in the U.S., but I was pleasantly surprised by the level of care this particular hospital in Jaipur offered.  Nurse to patient ratios are similar to what I see in my own workplace, 3 or 4 patients to one nurse on the floor and 1 or 2 patients per nurse in the CCU and ICU.  MRI's and CT scans are available to patients who need them as well as most other medical tests we are accustomed to in the U.S.  My husband noted customer service in the hospital was perhaps better in India as evidenced by a "Money Back Guarantee" poster on the waiting room wall.  "When's the last time you saw a hospital offer a money back guarantee in the states?" he asked me.  Good point.

Once my tour was complete, I stood outside in the sun letting the rays warm my face as I waited for my ride and contemplated my experience.  The hospital I visited was certainly not quite up to the standards of cleanliness we have here at home, but patient care seemed surprisingly good.  One nurse even bragged to me they had zero pressure ulcers among their patients last year.  Not bad. 

More on my Indian ER experience later this week...