Government hospitals in Delhi are heaving with patients each morning. Doctors finish at 1pm to have lunch, so the pressure is on to get seen before then. Visiting hospital is a family affair. The ratio of family supporters to a patient might be as high as five to one. This adds up to hordes of people.
The local hospital looked run down and in need of general refurbishment. It was very hot and there were not many overhead fans stirring the stifling air. Security staff corralled the patients into queues. If they had not been policing the lines, everyone would just crowd in, as they do in the Metro or at the supermarket checkout. Some people clutched scarves over their faces to keep out any airborne pathogens and noxious odours.
Away from the outpatients’ department, there were lots of corridors, linking hospital wards, departments and buildings which have been tacked onto the original design. The walls were splattered with red-brown stains. This wasn’t blood, but spittle from paan chewers. The dirt looked ingrained. I thought that even deep cleaning would never get the place pristine.
Family members provide a lot of the nursing care, but they are turfed out of the ward to allow the patients to get some rest or food. I saw small groups of people picnicking in the corridors. Meanwhile, orderlies wheeled large stainless steel food trolleys containing lunch to the wards, just like the NHS when I was a junior doctor, before the era of chilled snack foods.
There were very few wheelchairs, I noticed. Some patients had their own vintage three-wheelers, powered by hand cranking. There were no children’s buggies or pushchairs. Children walked or were carried. I saw hardly any porters. Family members helped patients to move around in the hospital.
I was visiting the obstetric department. As a male, I was not allowed to enter. I had to stand outside with the other expectant fathers-to-be. They all wanted to know about me. Who was my wife? Was she Indian or a foreigner?
The security guard on the door looked like a bouncer at a nightclub. He let me into the ante-room when I found out that I was a doctor. He apologised for keeping me waiting outside with the other men and we got chatting. He told me that not only was he a bouncer, but he trained people to be security guards. He didn’t have to do this job, he said.
I squatted down on a broken steel bench which tilted me forward over my knees. To my left was the labour ward, which was remarkably quiet. To my right, behind a screen, was the postnatal area. Female family members could attend their relatives who had just delivered. There was a pedal bin situated between the room I was in and the postnatal area. Some women were fascinated how this worked. They put their foot on the pedal and spat paan juice into the bin before the flip top lid closed. They also put blood-stained rags into the bin.
Two men tried to bluff their way past the security guard to see their new family member, but their bluster didn’t work. They tried begging and eventually, grannie came out with the newborn baby to the ante-room for the child’s first smartphone photographs.
Another delighted granny came out with a large box of Indian sweets which she offered to everyone, even me. Cynically, I thought her latest grandchild must be a boy.
Outside in the hospital grounds, freshly laundered sheets were laid out on the ground to dry in the sunshine. I glanced to one side and saw a poster advertising free cardiac ultrasounds as a special offer, this week only. Priorities are different, here in Delhi.
In contrast, the private hospitals flourish. These can be small affairs, the size of a townhouse or huge state-of-the-art institutions, fully computerised, air-conditioned and spotlessly clean. 80% of all healthcare expenditure in India is private (The Indian Government spends just a paltry 1% of GDP on healthcare).