In Need Of An Overhaul: Institute Health Centre Review
Abhay woke up on a cool Tuesday morning, with stinging discomfort in his body and a head scorching hot from fever. With his classes lined up from 8 a.m., he asked his roommate for some arbitrary medicine. The wise roommate advised him to visit the dispensary which opens at 9 a.m. instead. Not wanting to miss his classes, he decided to go to the health centre after classes. Unable to attend his classes in the second half, he reached the centre around 4:15 p.m. After seeing the long column in front of the doctor’s chamber, he sat on the bench feeling exhausted. On asking for medical rest for the second half, the doctor replied that he should have visited the health centre in the morning. He left with a fatigued body wondering there should be a proper way to get to know about the working of the health centre.
This is not an instance that just Abhay had to deal with, this is among the few common glitches which the NITR junta confronts in their quotidian schedule. Thus, Monday Morning brings you a complete breakdown of every aspect of the Health Centre along with its extracts from its meeting with the HOD of Health Centre, Prof. C. Bhattacharya.
The dilapidated stone sign points towards the two-storeyed edifice that is located in front of REC campus school and behind the K.M.S Hall of Residence. Catering to the medical needs of over 6000 students and staff members, the Health Center aims at maintaining proper health for the habitants of NITR. Apart from having an Apollo pharmacy situated within the perimeter of the health centre, the ground floor of the building has three chambers for the unit of doctors available for consultation, one dressing room, a reception and benches in the corridor for the patients. The team of doctors present during the working hours includes Dr C. Bhattacharya, Dr Anindita Debata and Dr Sameer Patnaik. According to the Annual Report, last academic year, there had been 54500 visits by the Students excluding those who came in only for tests (approx.20% more). However, in spite of the increase in the intake of students and other working units, the health centre lacks the workforce for smooth functioning since there have been only three doctors available since 2013. The health centre also provides with ambulance service( contact no-8280468609).
The health centre is open all weekdays except Sundays and national holidays with working hours from 9 a.m. to 11:30 a.m. and 4 p.m. to 7 p.m.The time slot for the Health Centre on ordinary holidays is 9:00 a.m to 11:30 a.m. Certain appointments to the specialists can be made in case of need. However, the Apollo Pharmacy remains open for 24*7.
Dr G.C. Patri
Thursday (4:30 p.m.-6:00 p.m.)
Dr S. Mohapatra
Senior consultant in Medicine
Tuesday (5:00 p.m.- 7:00p.m.)
Dr Rupali Biswas
Saturday (4:00 p.m.-6:30 p.m.)
The hitches faced by students concerning timings of the Health centre are that the morning slot clashes with the classes and the evening slot witnesses long queues of students waiting for their turn. Commenting on the situation, Prof. C Bhattacharya, the HOD of Health centre said-
Without increasing manpower, there is nothing much to be done. In this working structure, the lack of manpower makes it difficult for us to function. The change of timings cannot be carried forth as this time has been not only decided for students but also all the staff and working units. Thus, changing the time slots is not possible.
The scholars in NITR face a lot of confusion concerning medical leaves. If a student appears in front of a doctor with genuine health issues where it seems that the individual is unable to attend the classes, the leave is granted by the doctor and updated in the database of the health centre. However, the doctors seem reluctant to sanctioning the leave in the second half. Talking about his opinion about granting leave in the second half, Prof. C. Bhattacharya said-
Getting a leave is not anybody’s right. If a student reports at around 6 p.m., I cannot grant him leave as I am unaware of his whereabouts of the entire day. However, in cases where the student at the time of reporting is suffering from a certain severe condition and I am convinced that in such a state it would not have been possible for him/her to go the classes then I would grant the leave. According to the general rules, a sick person should immediately report to the health center, if he/she is unable to come, they should call the institute ambulance to come to the dispensary.
For treatment in hospitals that are not recognized by the institution, medical leave is sanctioned if the doctors at the health centre refer the patient to that facility. The reimbursement can be received if the bills are submitted to the respective authority within one month of completion of the treatment process. However, in case of a lack of referral, the institution does not consider it as the case for medical leave. The procedure for procuring Medical rest for treatment in hospitals (not approved by the institution)-
Filling out the form no-NITR/AC/110 (available on the official website) and then presenting the required documents such as-
- prescription or case history of the patient
- hospital registration, administration or discharge slip
- proof of medicines purchased
- the investigation report and proof of payment.
For students receiving treatment outside Rourkela, the institute should be conveyed within 48 hours of initiation of treatment and the bills should be submitted within a month after discharge for reimbursement and Medical leaves.
Addressing the controversy that broke out related to his comments on leave granted to female students for menstrual pain, Prof C. Bhattacharya said-
There is a difference in the perception from person to person. Menstrual pain varies from female to female and there is no means for me to quantify the pain. In my opinion, taking painkillers can help the individual, however, if the current procedure is so problematic for students, then you should request the administration to amend the rules and remove my authority from the process, in that case, whoever comes to the dispensary asking for medical leave would be granted one without any questioning.
The Med-Kit of the Institute: Apollo Pharmacy
Attached to the Institute Health Centre is the Apollo pharmacy which has a tie-up with the institute and gives a 13% discount on medicines to the institute. For students, most of the medicines are not charged by Apollo but two major concerns raised by students regarding medicine were the non-availability of some medicines in the store and the fact that students have to pay for some medicines in spite of paying the medical fees every semester. We clarified both of these issues with the HOD, medical centre Dr C. Bhattacharya-
MM: Why doesn’t the institute have tie-ups with other pharmacies (for example- CWS pharmacy) to facilitate the immediate supply of medicines in case the medicine is not available in the Apollo pharmacy?
Dr C. Bhattacharya: The advantage with Apollo pharmacy is that it provides a 13% discount to the institute, tie-up with other pharmacies is an administrative issue and I cannot comment on it. Moreover, if a medicine is not available they get the medicine within a day or two so it’s not a big issue.
MM: Why are some medicines (with star marks) to be bought by students and are not covered by the institute. For Example- In case of dehydration, even ORS is not covered by the institute.
Dr C. Bhattacharya: The Medical rules of the institute mention all the categories of medicine which are not covered by the institute. As far as ORS is concerned, one can always make a solution of salt and sugar-free of cost in their respective hostels, so there is no need for the packaged ORS.
The medicines which are not disbursed from the institute Dispensary are:
- Baby foods, Sanitary napkins, Diapers, Cosmetic & non-allopathic preparations.
- Vitamins/ Minerals (reimbursable only in case of pregnant women).
- Antioxidants /tonics /appetite stimulants/ probiotics/ ORS/ digestive enzyme preparations/carminatives/genito urinary wash/urine alkaliser/anti hemorrhoids preparation used locally.
- Hair vitalizes or hair tonic/cleansers/mouth wash/medicated kinds of toothpaste.
- Adhesive plasters, Crepe bandages & other surgical/orthopaedics disposables.
- Gauge, Cotton & other dressing materials, anti-bacterial (Dettol/Savlon, etc).
- Disposables syringes are not issued to OPD patients.
- Anti-ageing skin creams and cosmetic skin products.
Where our watch ends, their’s starts- The Procedure for Referrals
The Institute Health centre lacks a lot of facilities, especially in emergency cases, as a result, the institute has tie-ups with hospitals like CWS and IGH where the patients are referred to. In case of an emergency where the patient needs to be taken directly to CWS or IGH (for example- Road accidents), the patient can be admitted there but one of his friends needs to report to the Institute Health Center with appropriate documents to get the referral. In special cases where a patient is referred to some other hospital by CWS or IGH, the bills can be reimbursed by submitting the appropriate proof of referral.
In addition to this, the institute has tie-ups with hospitals like Care hospital (Bhubaneswar), Amri (Bhubaneswar), Birla hospital (Kolkata) and Rai Clinic (Rourkela). Dr C. Bhattacharya had the following to say regarding the benefits of these tie-ups-
If treatment isn’t possible in Rourkela, then we will refer patients to these tie-up hospitals. The benefit of going through our referral as compared to going directly to these hospitals is that in the former case Central Government Health Scheme (CGHS) rates will be applicable, which is almost 40% of the normal rates. Given that students have a ceiling of Rs.50000 per annum; these tie-ups have made the value of these 50000 rupees even higher.
The main stakeholder when it comes to the institute dispensary services is the NITR Junta and it is their opinion which matters the most. We contacted a few students to narrate their experience with the NITR health centre-
Patibanda Sriram, a fresher reported the following experience in a mail addressed to Monday Morning:
Recently, I got affected by viral fever. So I went to the dispensary to get a health checkup, but it turns out that the dispensary is closed as it's Sunday. So, on the advice of the person in the pharmacy, I went to CWS hospital though I was in very bad shape and was not even able to walk properly. When I reached cws, the doctor present there denied to admit me as I don't have the due permission of the doctor from the dispensary. I had to go back to the doctor's quarter near the dispensary i.e. D/4 to get a form from him. But he behaved in a very rude manner with me. He didn't even bother to look at me. He just denied to give permission and moreover yelled at me quoting "Even I have a fever, so what? It's not a big problem at all".I felt very bad after this incident. I had to pay for the medicines I took from the pharmacy and I returned to my dormitories. Due to the lack of proper intake of medicines at the right intervals of time at the beginning stage of the issue, I had to suffer from illness for a long period of time. When a person is suffering due to illness, how can he roam everywhere and get permissions for much-needed health checkup? I hope that you have understood what I wanted to convey.
Satyajit Raiguru, a second-year student had the following to say:
I went to the dispensary yesterday at 10:00 am because I had a severe headache and was suffering from cold. I asked the doctor to change the medicine he was giving me because that was not effective for me. But the doctor didn't change it and gave the medicine again. My health was getting serious day by day, and then I consulted my family doctor for medicine and bought it.
Swagatika Biswal, a second-year student had the following incident to share:
I was admitted to CWS and needed an ultrasound, but it was not possible in CWS because of the timing. As I was in severe pain, I had to do it outside and it cost me Rs.1000 but that money was not given by the institute. This issue needs attention as they refer without knowing the availability of doctors and equipment which creates inconvenience.
Rishi Dakarapu, a Pre-Final year student faced the following difficulty:
I was literally going to fall one day so I went there for ORS and for some reason ORS is not covered under the scheme. They asked me to pay and I had not taken my purse, luckily a Professor who was present there paid for me.
When asked about specific complaints and the absence of a complaint box in the dispensary, Dr C. Bhattacharya had the following to say-
It is mentioned in the prescription that if anyone has any complaint or suggestion with regards to the Institute Dispensary Services, then they can report it to the Asst. Registrar (Establishment).
The Psychological illness: An Alarming trend
MM: You meet so many students in a day; do you see any alarming trend in the health condition of the students?
Dr C. Bhattacharya: Nutrition-wise I see no problem in the students; most of the cases that I encounter are either infections or bacterial. In my opinion, the biggest problem with the students nowadays is frustration. Many students think that they are physically unfit or weak but the main problem is with mental health.
MM: For such cases, the dispensary lacks a full-time psychiatrist or counsellor (SCS does provide a part-time counsellor and psychiatrist). Are there any plans to recruit one?
Dr C. Bhattacharya: Recruiting new staff is an administrative issue and I can’t comment on it but we need to understand that even a psychiatrist cannot solve this problem on his own; students need to start sharing things among their peers. We cannot hire enough number of psychiatrists for 6000 students unless the students create such an environment in the campus where everyone can share their feelings, the feelings that a student can share with another student is not possible with any doctor or psychiatrist.
In my college days, we had a group of five who could do anything and everything for each other and we share that bond even today. But with changing times, everyone has become more self-centered as result factors like pressure and competition are having an adverse side effect on the mental health of students. Friends play a major role in this case and if the student is not recovering even after counseling from friends, then they should be reported to the counselor.
As per the annual report of last year, the dispensary had 54500 (+15-20%) visits in between 1 July 2018 to 30 June 2019 and with the number of admissions increasing every year, the number of doctors has remained a constant, ie, three since 2013. The effort of the staff and doctors of the Health Centre is commendable considering the workload they have but it is high time the institute recruits more doctors to ensure a more efficient and reliable healthcare system in the institute. It is also imperative that the students utilize the health care system wisely and be aware of all the rules and regulations of the health centre.
Team MM hopes that the functioning of the Institute Health services is smooth in the years to come and wishes the best for it.