Status of emergency response at ECHS and Command hospital

You might be interested in the following letter written to the Commandant, Command Hospital, Kolkata.

To, The Commandant, 

Command Hospital, 

Alipur, Kolkata 

 Sub: Failure of the ECHS empaneled hospital system and Refusal of admission to Command Hospital ICU, Kolkata in an emergency case relating to a retired Air Force Officer 

 Dear Sir, 

With regard to the above, I would like to draw your kind attention to the following: 

1. My father, Gp. Capt Arun Kanti Mukherjee, VRC, VM (retd), aged 84 years, service No.4416, ECHS registration no. DL0011776, has been ailing for some time. On 2nd May 2016 morning his health took a turn for the worse. Since we live in Salt Lake, my immediate thought was to take him to the ECHS empaneled hospital, AMRI, Salt Lake since all ECHS centers have large notices displaying the process to be followed in case of an emergency. However, before doing so, I personally went to ECHS Polyclinic at Sector 5, Salt Lake to find out the status of empanelment of AMRI, Salt Lake. The Medical Officer heard me out and told me that even though AMRI Hospital is having some problems with ECHS, I should immediately take him to their emergency department and get him admitted. However, I should keep the ambulance on stand by incase a shift to Command Hospital is necessary. 

2. By 9 AM, I had moved my father to AMRI Salt Lake, Emergency. However, upon showing them the ECHS card, they sent me to their Corporate desk to find out if admission is possible or not. After waiting for 20 minutes, I was told that since there are bill payment problems between AMRI and ECHS, they will not be able to admit the patient without the requisite permission letter from ECHS, Salt Lake.

 3. Once again I went back to ECHS, Sector 5 Salt Lake. This time I met the OIC of the poly clinic. I explained the problem and he assured me that if I were to take my father to Command Hospital, he would be attended to immediately and Command Hospital is the best place to take such patients. He had been assured by the Command Hospital top brass that even if patients have to be placed on the floor, no one would be turned away. The OIC even took the trouble to ring up the Dy. Commandant, Command Hospital and alerted them to my father’s imminent arrival.

 4. I returned to AMRI, Salt Lake, got him released and took him to Command Hospital in an ambulance, a distance of about 20 kms negotiated in peak time traffic and in the searing 40 C temperatures currently prevailing in Kolkata. I reached Command Hospital by about 11-11.15 AM. 

5. There was no one to help to unload the stretcher. Finally a Jawan (wearing a ‘may I help you’ sash) was deputed. My father was unloaded onto a trolley and as I was paying off the ambulance, I was given a mouthful by him for not properly helping to push the trolley to emergency. Anyhow, this letter is not about this, I mention this only as a precursor to what followed. 

6. In emergency, a chest x-ray was advised. 2 signatures and several rubber stamps later (for which I was doing the running around), me pushing the trolley with the assistance of one other person from emergency, my father was sent to radiology. After waiting for more than half an hour, an x-ray was done. Once again, my father’s trolley was maneuvered back to emergency (this time by me alone as the man who had helped to push it to radiology had disappeared). Incidentally, the x-ray was not a digital one. 

7. After looking at the x-ray, and other clinical symptoms the doctor on duty said that ‘right sided pneumonia’ has been detected and ICU admission is advised. However there is no bed available in ICU in Command Hospital. 

8. Shortly thereafter, the pulmonary specialist also came in and said that “if you want, we can recommend an ECHS empaneled hospital”, In other words, back to square one and run the merry go-round again and again till we give up or the patient dies. 

9. I then went to the Dy. Commandant’s office to meet him personally. He was away in a meeting. I met his PA, reminded him about OIC, ECHS Salt Lake’s phone call earlier in the morning. The PA was kind enough to send a note into the meeting room asking for guidance. Word was sent back to the effect that “the patient can be taken away”. 

10. Finally, after giving up all hope of getting any treatment in Command Hospital, sometime after 2 PM, my father was reloaded into the ambulance and taken away from Command Hospital. It may be noted that in this entire duration, my father was not given even a sip of water (let alone any medication or oxygen), while the catheter attached to a urine bag showed his urine turning a bright yellow-orange. I am no doctor but as a lay person even I know that bright yellow-orange urine indicates dehydration at dangerous levels. 

Sir, I neither require nor expect a reply from you because I am reasonably certain that all I will get are platitudes. However, I would request you to introspect and ask yourselves the following: - 

 Do bureaucratic processes take precedence over attending to the needs of a critically ill patient? - Is the brotherhood of the Defence forces, the humanity and the Hippocratic oath of doctors in the Army, a carefully constructed myth? - Is this the response to be expected for a veteran of 3 wars (’62, ’65 and ’71) and an awardee of one of the highest military awards, the Vir Chakra? (A simple google search on his name will tell you his credentials) - Is this the reward for my father who risked his life for the country during his service career? - Are you putting into practice the old proverb that old soldiers never die, they just fade away? Sir, it is quite alright if you feel that the Army Hospitals have no place for old soldiers who have lived honourably and not used ‘connections and contacts’ to get what medical treatment is due to them (on paper). I understand that the pressures of population, concerns about budgets and demands of VIPs constrain your actions. My only humble request is please (please) tell us this upfront. Have some human feeling for an ailing old man who has been unbearably harassed. Please inform us that the so called ECHS tie-up with hospitals is non-functional and we should fend for ourselves. Don’t treat an old soldier like a mangy street dog. Please allow us (civilians) to continue to believe that the Defence forces look after their own and we can send our sons and daughters to emulate the brave old man they call grandfather. Thanking you, Yours sincerely, -- -- KN Sardana __._,_.___ Posted by: YOGISH CHANDER