My last post was a product of immense frustration i am feeling these days while working as a resident in a trust hospital in Delhi which caters mostly to middle to lower income groups. And i have come across some 12-15 patients, in their middle ages with diabetic nephropathy with CKD stage IV to V in just a period of 2 months of my new job. And the element of surprise is that they were diagnosed to be diabetic only recently after coming in delayed contact with Healthcare. Adding to frustration was – some of them telling me “Sir jub se is hospital mein aaye hein tabhi se yeh sab kuch hua hai … nahi to mein kabhi beemar hee nahi hua !!!“.

I mean…How would you react to such kind of statement ??

Anyways, now that the problem has raised its ugly head, what are the ways available to fix it ?
The answer i get is : “Comprehensive conservative management and initiation of Renal Replacement Therapy”.
Renal Replacement Therapy !!! If i am right that implies :either a dialysis or a transplant.

As we all know Renal Transplant is a rare commodity available only to a lucky few (read lucky as rich).
So in short, how many dialysis can a lower to middle class family afford equates to the amount of life they can buy.

I also feel that each and every step of disease management is restricted by limiting resources especially in India with most of the healthcare bills being paid out of the pocket. Whether the treatment to a ailment is available or not, sometimes seems to be irrelevant.

I am clueless about whom to blame : The Naive attitude of People towards there own health or The Economic System or The Incapability of Medicine as a science !!
Or may be its like a three headed monster trying to eat you and you are trying to figure out which head is smaller…

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