The fire swept through AMRI, a 180-bed, state-of-the-art facility regarded as one of the best hospitals in India. There were no exit doors or evacuation plan, the windows were sealed, and the local fire department took more than 90 minutes to arrive. Trapped, many of the patients died from smoke inhalation, according to a report in Christian Science Monitor. Most died in their beds, unable to escape the inferno that raged for hours. Residents living in the neighborhood accused the hospital guards of not taking any measures to control the fire and of even preventing others from rushing to the rescue of the victims who were abandoned by the hospital staff. The hospital is known to attract many foreign patients. However, it's too early to tell if any foreigners died in the blaze because most of the charred remains have yet to be identified.
“Large numbers of hospitals are coming up in a big way across India. What we need to look into when issuing the licenses for running the hospitals is that building construction has complied to safety building codes and a safety plan is in place in case of fire,” said Dr. Muzzafer Ahmed, a member of the country's National Disaster Management Authority, speaking to the media.
Though Indians remain among the most under-served in the world in terms of health care, growing for-profit Indian hospital industry has been promoting itself as an inexpensive alternative to high-cost surgery in the United States and Europe. There are a large number of foreign-trained highly-skilled physicians and surgeons in India. And the heart bypass surgery that costs $6,000 in India costs more than $20,000 in the US, according to Yaleglobal. There are similar deep discounts available for joint replacement, in vitro fertilization (IVF), and surrogate mothers' womb rental services.
Many Indians are expecting exponential growth in foreign demand to take advantage of the opportunity to combine medical treatment with vacations at significantly lower costs. "With health care costs going north," says Dr Alok Roy of Fortis Hospital, one of the leading service providers in the medical tourism sector, "patients are compelled to look at cost-effective destinations for medical treatments. And what could be better if they can combine that with sightseeing at scenic locations?"
The safety concerns about India go beyond the fear of being burned in a fire. Other major concerns include:
1. Fake pharmaceuticals are a big worry. In fact, 75 percent of counterfeit drugs supplied world over have origins in India, according to a report released by the Organization for Economic Co-operation and Development (OECD).
2. Lack of proper hygiene contributes to a large number of infections in hospital settings. A recent investigation into the death of 13 women in a Rajasthan hospital found that the poor hygiene standard in the hospital were flagrantly overlooked, according to Times of India.
Will the latest incident at AMRI in Kolkatta, combined with general concerns about unhygienic practices and widespread use of fake pharmaceuticals, hurt India's efforts at growing its medical tourism industry? The short answer is yes. However, the growth prospects could improve in the future when the Indian government and the hospital industry begin to improve the safety situation to regain the trust of prospective foreign customers.
Related Links:
Haq's Musings
Indians Carry Heavy Disease Burdens
India Leads the World in Open Defecation
WHO Says India Leads the World in TB Cases
Infectious Diseases Kill Millions in South Asia
Infectious Diseases Cause Low IQ
Malnutrition Challenge in India and Pakistan
Hunger: India's Growth Story
Google Baby Boom in India
WHO Report on Medical Tourism in India
11 comments:
Loss of life is a very sad event. Watch out soon they will blame Pakistan for this disaster.
@khalid
Not a bad idea to raise a report to state that it is subotage of pakistan and divert the attention toward the enemy. Generally that is the style of pakistan and not india.
@riaz
NO medical tourist comes to the government hospital. They go to private sector hospital which has five star comfort with seven star bills. But from their perspective it is still cheaper. You could read here and there even Pakistani coming over to India for treatment.
http://sociologyindex.com/medical_tourism_in_india.htm
Nothing will happen after this fire as government hospital are place for the mp / mla to loot the fund by supplying substandard equipments and infrastructure.
http://www.economist.com/blogs/freeexchange/2011/12/india%E2%80%99s-economy
India’s economy
Slip-sliding away
EXPECTATIONS for India’s economic growth rate have been sliding inexorably. In the early spring there was still heady talk about 9-10% being the new natural rate of expansion, a trajectory which if maintained would make the country an economic superpower in a couple of decades. Now things look very different. The latest GDP growth figure slipped to 6.9% and industrial production numbers just released, on December 12th, showed a decline of 5.1% compared with the previous period, a miserable state of affairs. The slump looks broadly based, from mining to capital goods, and in severity compares with that experienced at the height of the financial crisis, in February 2009, when a drop of 7.2% took place. Bombast is turning to panic.
Here's a National newspaper report on UAE funding hospitals and clinics in Pakistan:
Seven UAE-funded hospitals and clinics will be built in Pakistan at a cost of nearly Dh63 million, Wam, the state news agency, reported yesterday.
After a signing ceremony between Abdullah Khalifa Al Ghafli, director of Emirati projects to assist Pakistan, and Maj Gen Zahir Shah, commander of the GOC 45th Engineers Division of the Pakistani Armed Forces, it was announced that two hospitals will be built under the names of Sheikh Khalifa and Sheikha Fatima.
Mr Al Ghafli said the UAE would also fund medical equipment for both hospitals and all of the clinics.
The increasing number of healthcare projects in Pakistan was a sign of the strong co-operation between Pakistan and the Emirates, said Sheikha Fatima bint Mubarak, chairwoman of the General Women's Union and of the Family Development Foundation.
"Pakistan was one of the first three countries in the world to recognise the UAE, following the declaration of the Union on December 2, 1971," she said.
Sheikha Fatima said the active role the UAE plays in places of crisis was due to the generosity of the president, Sheikh Khalifa.
"We thank Allah that when humanitarian work anywhere worldwide is mentioned, the name of the UAE comes up, thanks to its generosity and its strong commitment to shoulder its responsibilities and to preserve human dignity," she said....
--------
In February of this year, a medical team from the RCA and 400 local volunteers initiated a programme to provide measles and polio vaccines to Pakistani children.
The Campaign to Cure One Million Children, sponsored by Sheikha Fatima, also provided free medical treatment to more than five million children who suffered from malnutrition and digestive and respiratory diseases as a result of the flooding.
The UAE ambassador to Pakistan, Eissa Abdullah Al Nuaimi, noted that last month a UAE-funded school for 400 pupils was completed.
It will take 18 months to build the hospitals.
http://www.thenational.ae/news/uae-news/health/uae-to-fund-hospitals-in-pakistan
A Bangladeshi is among the dead at Kolkatta's AMRI hospital, according The Independent of Bangladesh:
DHAKA: Bangladeshi patient is among the 73 killed so far in the massive fire at AMRI private hospital in Kolkata, the foreign ministry says.
However, a number of foreign and Indian media put the death toll at 90 in the hospital inferno, saying nearby hospitals were providing emergency treatment to the seriously wounded AMRI hospital victims.
The process to bring back the body of Gauranga Mandal through the Bangladesh Deputy High Commission in Kolkata is underway, the South Asia Department director general Mashfi Binte Shams told the reporters.
Family members had identified the body, Shams said.
She, however, did not have Gauranga's address or other information about him immediately.
Nearly 160 patients were admitted in the facility, The Times Of India said quoting hospital sources.
Additional director general, Fire Services, D Biswas was quoted as saying that patients who died were admitted in the critical care and orthopaedic units and were unable to move.
Only 85 patients were rescued and removed to two other units of the same hospital located at Mukundapur and Saltlake, they told the Indian daily. It said the hospital authority could not confirm the condition of remaining 75 patients....
http://www.theindependentbd.com/international/asia/83826-20-killed-in-kolkata-hospital-fire.html
Here's an excerpt of Businessweek story on medical tourism:
Convincing Americans to jet off to third-world India is a bit of a harder sell, though. By buying a 23.9% stake in Parkway from U.S. private equity firm TPG for $687 million, Fortis has now positioned itself to become the regional leader in medical tourism, with a strong presence in India (where it has 46 hospitals) for the most price-sensitive patients and a new base in Singapore for higher-end customers aiming for more luxury. Investors are pretty upbeat about the deal: Fortis shares today hit a twelve-month high of 187.4 rupees and are up 35% so far this year. Parkway investors are happy, too. The Singapore company hit a 52-week high of 3.3 Singapore dollars today.
http://www.businessweek.com/blogs/eyeonasia/archives/2010/03/india_hospital.html
Here's an APP report on the use of technology by US to teach and treat in Pakistan:
U.S. Ambassador to Pakistan Cameron Munter Thursday highlighting Pak-US cooperation in science and technology said that it has trained more than 100 doctors nationwide, and treated more than 2,000 patients remotely through the use of cutting-edge technology. During his visit here Thursday the Ambassador and his wife Marilyn Wyatt met with the faculty and students of the Rawalpindi Medical College at Holy Family Hospital’s telemedicine facility, working together with U.S. hospitals.
He said Pak-US cooperation in science and technology focused on many elements, including innovations in Pakistan’s public health sector. During a tour of the hospital with the hospital’s Telemedicine E-Health Training Center Project Director Dr. Asif Zafar, Ambassador Munter stated, “Holy Family’s partnership with American hospitals is an example of the true spirit of our people, who work together, across oceans, to improve access to healthcare in remote areas of Pakistan and treat the sick.” He said, “We commend Dr. Asif Zafar and the Holy Family Hospital team for its efforts to strengthen the health sector in Pakistan, and look forward to more shared successes that bring Pakistanis and Americans closer together.”
http://pakobserver.net/detailnews.asp?id=134092
Here's a Businessweek story on fake medicines in Pakistan:
In Pakistan’s biggest market for wholesale medicines, it pays to be observant.
More than 2,500 stalls wedged along dirt lanes in Karachi’s busiest trading district offer everything from Pfizer Inc. (PFE) (PFE)’s cholesterol pill Lipitor to GlaxoSmithKline Plc (GSK)’s painkiller Panadol. Closer study of the remedies lining rickety shelves reveals the source of an unfolding medical crisis: Lipitor sold in obsolete packaging, Panadol packets missing tell-tale ribbing, and allergy medicine Zyrtec mislabeled as Zytrec.
Now, the free flow of fake medications channeled through the market for decades may soon be slowed. Lawmakers are poised to pass legislation in June creating an agency to quash the trade after 107 heart patients were killed this year by pills tainted with lethal amounts of an anti-malarial agent. That may help break the ring of counterfeiters in Pakistan, part of a wider network supplying what the World Health Organization estimates is a $431 billion global market for spurious drugs.
“The issue is serious, demanding serious steps,” said Salman Burney, chief executive of GlaxoSmithKline Pakistan Ltd. (GLAXO) in Karachi. “Better regulation will generate more investment in the pharmaceutical industry, which will mean better quality medicines.”
The problem spans national borders. Pakistan was one of the 10 largest sources of counterfeit goods seized in the U.S. last year, U.S. Customs and Border Protection said in January. Medicines accounted for 85 percent of the value of the Pakistani items obtained.
At least 30 percent of medicines bought in the country are either counterfeits or substandard, said Kulsoom Parveen, a lawmaker who chairs a Senate health committee. Pharmacies nationwide sell drugs without a doctor’s prescription, enabling the treatments to be taken without medical supervision.
’Exploiting Weaknesses’
Pakistan has 4,000 registered pharmacists and 25 times more merchants dispensing medicines illegally, the Pakistan Pharmacists Association said.
It’s no coincidence that fake and substandard drugs are flourishing in Pakistan, said Laurie Garrett, senior fellow for global health at the Council on Foreign Relations. The New York- based think-tank prepared six recommendations to fight the drug- safety crisis for consideration by the Group of Eight summit at Camp David, Maryland, today and tomorrow.
“Individuals that are exploiting weaknesses in global drug safety and regulation will base themselves in places where they know the system is fragile or nonexistent,” Garrett said in a telephone interview. “Pakistan is really struggling to keep its entire public health infrastructure alive.”
Damaging Brands
Protecting product integrity would also benefit makers of brand-name medicines. Pharmaceutical sales in Pakistan, with a population of 196 million, total $2 billion annually, compared with $12.4 billion in neighboring India, with 1.2 billion people.
GlaxoSmithKline Pakistan, based in Karachi, made 1.14 billion Pakistani rupees ($12 million) in profit on sales of 21.75 billion rupees last year. In India, Mumbai-based GlaxoSmithKline Pharmaceuticals Ltd. (GLXO) had net income of 6.3 billion Indian rupees ($118 million) and revenue of 23.9 billion rupees.
Prime Minister Syed Yousuf Raza Gilani’s government hasn’t had a federal health minister or a central drug regulatory agency since powers were handed to the country’s four provinces last year. A new bill, to be voted on by Pakistan’s senate next month, will strive to fill the void....
http://www.businessweek.com/news/2012-05-17/stopping-fake-drugs-from-pakistan-is-too-late-for-victims#p1
Here's a Reuters' piece on absence of hygiene in India:
My Indian friends and I joke around a lot about me as the typical white American guy visiting India. Cows! Con men! Colors! Most people I’ve met in India have restricted their reactions to my westerner-in-the-east experiences to gentle teasing. When I stuck a picture of a man urinating in public on my Facebook page, calling it one more picture of what you see everywhere you go in India, people weren’t as patient. What was I doing? Insulting the nation? Focusing on the ugly because it’s what all the westerners do when they visit India? Why does India provoke such visceral reactions in visitors?
Public urination, public defecation, dirt, garbage, filth, the poor living on the street — talking about these things, even acknowledging that they’re in front of your face, risks making your hosts unhappy, and possibly angry. It’s the third rail of India, and the voltage can be lethal. That’s why I was surprised when B.S. Raghavan decided to touch it with all 10 fingers.
Raghavan’s column in The Hindu Business Line newspaper begins with this headline: Are Indians by nature unhygienic?
Consider these excerpts:
From time to time, in their unguarded moments, highly placed persons in advanced industrial countries have burst out against Indians for being filthy and dirty in their ways of life. A majority of visitors to India from those countries complain of “Delhi belly” within a few hours of arrival, and some fall seriously ill.
There is no point in getting infuriated or defensive about this. The general lack of cleanliness and hygiene hits the eye wherever one goes in India — hotels, hospitals, households, work places, railway trains, airplanes and, yes, temples. Indians think nothing of spitting whenever they like and wherever they choose, and living in surroundings which they themselves make unliveable by their dirty habits. …
Open defecation has become so rooted in India that even when toilet facilities are provided, the spaces round temple complexes, temple tanks, beaches, parks, pavements, and indeed, any open area are covered with faecal matter. …
Even as Indians, we are forced to recoil with horror at the infinite tolerance of fellow Indians to pile-ups of garbage, overflowing sewage, open drains and generally foul-smelling environs.
There’s plenty more that you can read in that story, but I’ll direct you to the article. I’ll also ask you some questions:
Some people say you shouldn’t point out these problems, and that every country has problems. Do you agree with this statement? Why?
Does anyone disagree with Raghavan’s descriptions of these sights and smells?
Is this even a problem? Or should people get used to it?
Should visitors, especially ones from countries where people are generally wealthier, say nothing, and pretend that they don’t see unpleasant things?
As for me, I can say this: I got used to it, but I would be lying if I said I didn’t notice it. Indians notice it too. Otherwise, people wouldn’t suggest public shaming campaigns against people urinating in public, they wouldn’t threaten fines for doing it, and they wouldn’t respond with relief to plans to finally make sure that toilets on India’s trains don’t open directly onto the tracks. Of course, these are people in India. It’s a family, taking care of business the family way.
As for me, the message usually seems to be: “If you don’t love it, leave it.” It would be nice if there were some other answer. Acknowledging problems, even ones that are almost impossible to solve, makes them easier to confront.
http://blogs.reuters.com/india/2012/11/17/indians-inherently-unhygienic-indian-writer-touches-third-rail/
Here's TOI on dangers to foreign women visitors to India:
On January 7, Japanese actor Yu Asada took a cab from the IGI Airport in Delhi to her hotel in Mahipalpur. It was her maiden trip to India, and she had come to Delhi to meet the cast and crew of My Japanese Niece, a film by Manipuri director Mohen Naorem. That taxi ride was the worst she ever had.
"The cabbie charged me Rs 4,800. When I told him I couldn't pay so much, he talked about the recent gang rape in Delhi and insinuated that I might meet the same fate. I was numb with fear," she told TOI.
American Michelle Tanner (name changed) didn't have to part with her money when she came to India on a backpacking trip in 2010, but she did become a victim of sexual harassment. "Someone pinched my bottom when I went to Chandni Chowk; when I turned around to see who it was, I felt a hand grab my breast. I felt so humiliated that I immediately returned to my hotel, shut myself in my room, and broke down," she said.
Both Asada and Tanner did not approach cops. Neither do the hordes of foreign travellers who face sexual harassment in varying degrees in India. Their reason is simple: when local women with all their familiarity with the law and advantage of language have such a tough time reporting a sexual offence or getting an FIR lodged, what chance do they have as foreigners?
British woman Kaya Enrich, 27, learnt this the hard way when she was molested by a plumber in Gujarat in 2009 and decided to lodge a case. She was allegedly humiliated in a metropolitan court in Ahmedabad. "The questioning was aggressive, and it seemed to be aimed at demeaning me as far as possible so as to weaken the case. I was asked everything in Gujarati and told to answer in Gujarati even though I had asked for an interpreter," she had said back then.
At an even greater disadvantage are those women who don't come from the English-speaking world and, therefore, do not dare move an inch without help from their foreign offices. India doesn't have an enviable reputation for dispensing quick justice; and tourists with their tight itineraries don't want to go through the rigmarole of procedure, never-ending investigations and sanity-defying questions that promise very little comfort.
According to statistics shared by the market research division of the ministry of tourism, 6.65 million tourists came to India last year. Of them, roughly 40% (2.66 million) were women. This figure is likely to go up with India setting a target of increasing its share of arrivals from the current 0.6% to 1% by the end of the 12th plan. This simply means more and more women will come to India, either for work or pleasure, and quite likely, carry home sordid tales of harassment: tales that would eventually find vent in blogs and websites and dent the India story....
http://timesofindia.indiatimes.com/india/India-no-place-for-foreign-women/articleshow/18094603.cms
Here's an excerpt from Fortune Mag on drug safety in India:
Thakur left Kumar's office stunned. He returned home that evening to find his 3-year-old son playing on the front lawn. The previous year in India, the boy had developed a serious ear infection. A pediatrician prescribed Ranbaxy's version of amoxiclav, a powerful antibiotic. For three scary days, his son's 102° fever persisted, despite the medicine. Finally, the pediatrician changed the prescription to the brand-name antibiotic made by GlaxoSmithKline (GSK). Within a day, his fever disappeared. Thakur hadn't thought about it much before. Now he took the boy in his arms and resolved not to give his family any more Ranbaxy drugs until he knew the truth.
What Thakur unearthed over the next months would form some of the most devastating allegations ever made about the conduct of a drug company. His information would lead Ranbaxy into a multiyear regulatory battle with the FDA, and into the crosshairs of a Justice Department investigation that, almost nine years later, has finally come to a resolution.
On May 13, Ranbaxy pleaded guilty to seven federal criminal counts of selling adulterated drugs with intent to defraud, failing to report that its drugs didn't meet specifications, and making intentionally false statements to the government. Ranbaxy agreed to pay $500 million in fines, forfeitures, and penalties -- the most ever levied against a generic-drug company. (No current or former Ranbaxy executives were charged with crimes.) Thakur's confidential whistleblower complaint, which he filed in 2007 and which describes how the company fabricated and falsified data to win FDA approvals, was also unsealed. Under federal whistleblower law, Thakur will receive more than $48 million as part of the resolution of the case.
Fortune's account of what occurred inside Ranbaxy and how the FDA responded to it raises serious questions about whether our government can effectively safeguard a drug supply that last year was 84% generic, according to the IMS Institute for Healthcare Informatics, much of that manufactured in distant places. More than 80% of active pharmaceutical ingredients for all U.S. drugs now come from overseas, as do 40% of finished pills and capsules. (Click here for a list of Ranbaxy products in the U.S.)
2. The dark side of the generics boom
Today's global market for generic drugs is $242 billion and growing. In America we have embraced generics as a vital way to control costs, a trend likely only to accelerate as health reform extends treatment to millions and our population ages.
Ranbaxy was the first foreign generics manufacturer to sell drugs in the U.S. and rose rapidly to become, today, the sixth-largest generic-drug maker in the country, with more than $1 billion in U.S. sales last year (and $2.3 billion worldwide). The company, now majority owned by Japanese drugmaker Daiichi Sankyo, sells its products in more than 150 countries and has 14,600 employees.
http://features.blogs.fortune.cnn.com/2013/05/15/ranbaxy-fraud-lipitor/
Post a Comment