THIS CAN HAPPEN: VOLUME XXXII & XXXIV

Dr. Gangadhar Sahoo

This can Happen vol. XXXIV:-

(2nd tubectomy camp experience)

In the previous edition I had described my helpless situation in my 1st tubectomy camp in a remote rural area. No doubt, being a specialist I had failed doing a tubectomy operation in a rural camp setup, but  I had not given up . I tried to learn the techniques from my health assistant Mr. Garnaik. I had also heard the story of my predecessor Dr.Gachhayat, a gynaecologist passed from my institute who had gone through the same stages like me. Because of his perseverance he rose from stage zero to hero. He was awarded as the best surgeon, operating maximum number of cases in the district of Sambalpur. His success story motivated me to be a good tubectomy surgeon. So I got mentally and technically prepared to face the challenge.   

The second female sterilization camp was fixed at Jharbandh, the block headquarters of Padmapur subdivision. Jharbandh was only 12km away from my Dava PHC.  Dr. Prakash Mohapatra was the in charge medical officer of Jharbandh hospital. He is one year junior to me in SCB Medical College Cuttack. He had completed his post graduation in Biochemistry. We were very much known to each other from our MBBS carrier. In that camp only 10 cases were kept. I reached there at 10 am in my Govt. Jeep with my operating staff and office staff. After taking a cup of tea we started the camp at 11 am . As per our plan we can finish the cases by 1pm and take lunch at 2 pm . The lunch at campus had a unique specialty. The PHC cook Nanu always accompanied me to the camp . Rice, dal and deshi chicken curry with special flavor were the fixed items. That lunch was not only too tasty but also enjoyable when all the staff had it together irrespective of status .

I was operating the last case . She was too obese a lady and nervous. She was straining, the moment I put my fingers into the peritoneal cavity . All the intestines were coming out through the small surgical hole. Again these were pushed back in place. In this push and pull struggle , I tried to catch the tube . The tube invariably slipped from my fingers. Next time I tried, the result was the same. I tried to catch the tube with my specially designed Allis forceps and it managed to slip also . That time I thought I might have injured the tube . I was feeling shaky and a bit nervous. The patient's attendants and my staff were anxiously waiting. Anticipating problems of exploring the tube to find if it was injured and bleeding , I thought to refer the case to the Subdivisional Hospital, Padmapur.

I didn't dare to explore the abdominal cavity . Praying Lord Jagannath I closed the abdominal cavity. I kept the patient under conservative management. By that time it was 2pm . I asked all the staff to take their lunch. I counseled the husband of the patient that we were going to observe the patient because we were  suspecting some problem inside the abdomen. If required she might be transferred to the Subdivisional Headquarters.

He could understand our problem and agreed to our plan of management. We anticipated a few problems in worst situations.

1.How to communicate to the SDMO, Padmapur? Only land line trunk call  facility was available at that time in specific stations. That facility was available at the police station of Jharbandh only. We entrusted our pharmacist the responsibility of communicating and send him to  the police station .

The second problem we were anticipating that if the condition of the patient deteriorated, what to do ? There was neither any facility to shift the patient nor treat the patient. Our only hope was PRAYER and PRAYER . At 10 pm the pharmacist returned back helpless and hopeless.

So alternatively Dr. Mohapatra and I observed the patient throughout the night.

When dawn climbed down to the earth our hope gradually rose up. The patient had not deteriorated. She was conscious. Her vitals were normal. She had passed urine. We made her ambulatory. At around 10 am we discharged the patient. Her husband touched our feet and said, " Doctor! You are our God . I will remain indebted to you."

I realized at that point of time that our patients are guinepigs and we are butchers. Being pressurized by the higher authorities we had turned inhumane to achieve our targets. If anything goes wrong nobody will come to our rescue. Lord Jagannath is only our savior. Our prayer was our panacea.