21 occupational Risks to doctors and nurses, while performing their duties https://extinctdoctorgood.com/2017/11/07/21-occupational-risks-to-doctors-and-nurses-while-performing-their-duties/
Risk to health workers working in remote areas (specially-Women; Doctors & Nurses) https://extinctdoctorgood.com/2019/12/04/risk-to-health-workers-working-in-remote-areas-specially-women-doctors-nurses/
Often an issue is raised that doctors and nurses are hesitant to go to remote places. Brutal rape and murder of Hyderabad vet doctor is an evidence of the dangers lurking because of preying eyes and lack of security, specially to women health workers (doctors and nurses).
A ghastly incident that highlights the dangers associated with entering unfamiliar places, unsecured environment and a dark world with no one to listen to heart wrenching cries of the unassuming victim. With no serious policing activities, it may turn out to be unthinkable nightmare.
But the lady doctor went to a place where transport was difficult and paid the price. A women is being posted to an area where transport and security were not provided and thereby assigned an unsafe posting.
Doctor should consider these factors before joining at unsafe places.
Problem is that the system does not take into account the risk to health workers, their convenience and family obligations. Their difficulty in transport, the security issues, providing basic amenities are not considered important by administrators.
The system that failed to provide proper transport and security is the real culprit.
Till some one puts a question to the system and makes them accountable, there will be more cases of this kind.
Had the deceased not been a doctor, or from some other profession, there was no compulsion for her to go to remote areas.
Lack of medical facilities and infrastructure add to the risk, as the health workers are held responsible for all the short comings. Not infrequently they become the punching bags for the inept system and infra structure deficiencies. Females doctors and nurses are at greater risk for obvious reasons and strangely there are no special provisions made for their security. Usually they are allotted a place where they have to fend for themselves. If one thinks it seriously, risk is even greater than anticipated.
Women -Doctors & Nurses- need to take precautions and save themselves in view of system insensitivity.
A vet doctor was subjected to brutal rape and death in Hyderabad. An incident that filled our hearts with grief and pain.
Who are culprits? The four men, caught and will be given punishment. But are they alone the culprits?
No; there are culprits who will not be even named. Our system is the biggest culprit.
Often an issue is raised that doctors do not go to remote places.
But the lady doctor went to a place where transport was difficult and paid the price. A female is posted to an area where transport and security were not provided. She was given an unsafe posting with no security and no transport. The person who gave her such posting is also the culprit
The system that failed to provide proper transport and security is the real culprit. Till some one puts a question to the system and makes them accountable, there will be more cases of this kind.
May the departed soul rest in peace.
Doctor should consider these factors before joining at unsafe places.
The victim, who had left her house in Shadnagar for Kolluru village to attend her duties at a veterinary hospital, called her sister on Wednesday night to inform that her two-wheeler had broken down while returning home.
A young veterinarian has been murdered by unknown persons, while her burnt body was found on Thursday in Shadnagar town close to the Telangana state capital, police said.The charred body of the victim was found at Chatanpally bridge near Shadnagar town in the Ranga Reddy district.The victim, who had left her house in Shadnagar for Kolluru village to attend her duties at a veterinary hospital, called her sister on Wednesday night to inform that her two-wheeler had broken down while returning home.She told her sister that she was feeling scared and that somebody had offered to help her and taken her vehicle for repair. When her family members tried to contact her later, her mobile phone was found to be switched off.Police said the charred body of a female, aged between 20-25 years, was found near the bridge. Sridhar Reddy identified victim’s body as being that of his daughter.Senior police officers rushed to the scene for launching their investigations and were scanning CCTV footage from a nearby toll gate for clues.It may be recalled that in another gruesome incident earlier this month in the same district a man burnt alive a woman revenue official inside her office near here, but in the process also suffered critical burn injuries himself. The shocking incident occurred in the Abdullapurmet Tahsil Office in Ranga Reddy district on the outskirts of Hyderabad.
Danger of stray dogs is increasing every day around us. As the strays population in increasing, now they are grouped and see vulnerable humans as easy prey. Packs of dogs have become dangerous and difficult to control. Protected by Dog lovers and animal right laws, the danger to normal people of being hunted even around their homes is real. Human right of being in a safe environment is being ignored. Is it not hypocritical that you care for a violent stray who is a threat to the society? Problem is not about loving and feeding dogs, but simultaneous apathy towards safety of humans. Such dog lovers most of the time, totally ignore the fact that these dogs are a threat to children and older people. An immediate sense of hatred towards such dog lovers is a consequence and a natural thought.
Just one of uncountable examples. An 80-year-old woman was attacked by stray dogs while she was going to a temple in Ludhiana city on Tuesday. She was admitted to DMC Hospital for treatment. Residents claimed that a group of 15-20 stray dogs has created terror in the area. The pack of dogs often attacks people including children. The said despite their repeated complaints to the authorities they have not got any kind of relief from this problem.
It is not uncommon dogs chasing children and older people. In a recent incident and a common one , the loud barking sounds were intermixed with cries of a child, who was running and screaming for his life. Two stray dogs were near him, trying to hunt him as a prey. As they got nearer to him, I somehow managed to get some stick from a plant and managed to save the child and shoo away the dogs. The nine year old child just clung to me, almost pale, dizzy and his eyes closed with fear. His football was in his lap, which he was trying to use as shield. A shield which society, government, courts and so called “dog-lovers” failed to provide. This child must be the life for his parents and could have been in a great trouble that day because of apathy of few “Animal Lovers”. For whom animal love is like a hobby to be projected for hollow public applause. I looked around, a gentleman was comfortably sitting with his small dog and reading newspaper. He did not even bother to look at what was happening. He was the person, who used to feed these stray dogs and claimed himself to be a “Dog lover”. He was totally unperturbed by the fact that a child was about to lose his life because of these wolf like dogs roaming freely. Similar apathy has been displayed by government and courts with a result that thousand suffer from dog bite every day.
Apart from the injury part, Rabies is a disease spread by dog bite, which is not treatable. Getting anti-Rabies serum becomes another Herculean task.
Courts have also upheld animal rights. That is right but they did not formulate policies to ensure safety of humans from these violent strays.
Government has not made out any policy to safeguard public from such attacks nor have courts come up with any solid guidelines, which can save public, children, women and older people from such bites.
Animal lovers while pretending of “dog love” have formed NGOs and have donations and accumulate money. But have failed to create shelters for stray dogs. Neither have any steps been taken to save people from dog bites. So consequently, people especially vulnerable are children and older people who are mauled and eaten alive by stray dogs. What responsibility and accountability these animal lovers and NGO bear towards such incidents? Why people who collect money in name of animals do not take care and form shelters for these strays? every single death from such preventable cause raise a question on this issue.
Apathy of these so called dog lovers towards humans is appalling.
Besides dog bite and injuries, animal and dog poop is an health hazard. Following are the diseases which occur in community because of animal poop.
Problem of animal poop with dust : It is all around us. It is actually even a bigger health problem than open defecation by humans. Humans defecate in country side and in open fields. But stray animals and dogs are everywhere. Even owner of pet dogs make them defecate outside their own houses and on the roads and wherever their dogs chooses. This poop dried and mixed with dust, acts a source of infection to the community.
| Life threatening infections : dog’s and animal faeces is a big health hazard. It is even worse than a dog bite since it spreads infection in entire community. A dog’s digestive system can handle just about anything that it eats and this makes its poop very toxic. Animal faeces contain pathogens, which are known to cause severe diseases, infections and organ failure. These heavy loads of bacteria increase the risk of infections in the community. But pregnant women, children and people with suppressed immune systems may are more prone to these infections. Many diseases may be spread by millions of these dogs and other animals like pigs, cattle as their faeces contain parasites, bacteria and viruses. These include life threatening bacterial infections by E. coli, MRSA, Leptospira, Salmonellosis, Campylobacteriosis, brucellosis, Rickettsia and parasitic infections like Giardiasis, Whipworm, Hookworm, Roundworms, Tapeworms, Cryptosporidiosis, Echinococcosis, Leishmaniasis etc. Viral infections like rabies, influenza and other viruses may also spread through these animals.
Environmental health Hazard: Storm water runoff due to extensive rainfall can wash off all these droppings into drains, many of which are connected to river systems and water sources in our country. This can lead to a widespread source of waterborne illnesses. Dry poop on the roads is mixed with dust particles and in the air. So everyone is living in a highly infectious environment. This may be an important cause of high rates of community acquired infections among our population.
SUGGESTION: the Government, NGOs and people who claim to be “animal lovers” should create shelters to save strays “as well as people”. It should be mandatory that all the dog and animal (stray or pet) droppings are properly collected and disposed off. This single step can do wonders as it will reduce infections, people’s suffering, save lives and eventually reduce use of antibiotics. A rationale mind will definitely appreciate the danger due to strays, and can initiate proper steps rather criticizing above said facts in the name of animal rights. An animal has no sense of responsibility, so rights should be limited accordingly.
Crosspathy is dangerous to human race and potential global catastrophe because of antibiotic resistance. All allopathic medicines are hazardous chemicals in inexperienced hands. Incorrect and massive use of antibiotics will cause antibiotic resistance, which has global ramifications. From this angle, it is a retrograde step. When all over the world, need is being felt that there has to be better control of antibiotic prescription. We are entering an era, where antibiotics are getting useless and more so because of rampant misuse of antibiotics. Rather than exercising a better control, it will be a catastrophic to human race world over by causing antibiotic resistance.
Will thousands or lac of alternate medicine graduate will dispense all antibiotics, anticancer , anti diabetic , cardiac medications? It is hard to think about hundreds of potentially dangerous medicines being given without structured training and proper exams in this system of crosspathy.
Although it appears to be an avoidable decision, but still if required can be done by creating “doctors for area of need.
Following steps should be taken before implementation:
Main Aim; to create doctors for area of need. (AON doctor)
- To identify areas of need; most basic step is to identify the areas of need, where doctors are not available. Government should identify area of need and implement the scheme in selected areas, and with selected simple drugs. Such areas should be such that which do not have medical facilities or lack doctors. Areas which already have doctors will not accept the diluted or sub-optimal care, for example urban population.
- Limited seats-To identify the number required; let us say start with pilot project of selecting 500 to1000 such doctors. All the lakhs of alternate doctors can not be allowed to prescribe allopathic medicines. It will put the community at risk.
Each and every seat of AON and its doctor needs to be identified , earmarked and trained for the particular seat.
- To identify the skills required for the area; for example emergency, for paediatrics or obstretics and gynaecology, trauma.
- Willingness to work in area of need- to identify the doctors: have a written competition from all candidates who apply for bridge course. To identify doctors who have given willingness to work in these areas of need. People who perform well should be taken for bridge course only on limited seats. Bridge course should not free for all.
- To develop a structured bridge course, which should be around one year after comparing the course of MBBS and the course done by the candidate.
- Admission and exit in the bridge course should be through exam and limited seats.
- Bridge course and allopathic medicines should not be made free for all, that any body can dispense it. We can get benefit only if is specific to needs of people. If everyone is allowed to practice allopathy in all locality, it will be a global hazard besides our community .
- These trained doctors will have an undertaking to serve in area of need only. For a period at least 10 to 20 years.
- Number should be limited but training should be good.
- A special course needs to be designed separately for one year, so that people in area of need do not get substandard care
Without proper planning and implementation and identification of area of need, this bridge course will not benefit anyone, rather it can be disastrous.
Every medical case that goes to court involves lawyers and their expensive fees. Most of the time even though the doctors may be right, he has to defend himself with the help of lawyers. Law industry has been benefited enormously because of consumer protection act at the cost of doctors. Increasing mistrust and unhappiness in patient’s mind definitely does not help patients and doctors, but ends up benefiting law industry.
Strangely doctor’s fee are quite low but lawyers charges them astronomical amounts, which are beyond any logic.
In a country where people fight with their parents, brothers and sisters for money and property, it will be naive to think that idea of making money from doctor does not exist. With court compensations going into crores, doctors can sense many times that some patient relatives try to use the opportunity. They have nothing at stake so they try to make some noise on social media and harass the doctor in court or on social platforms. Even for patients, who had poor prognosis at the very onset of treatment, relatives can create problems, many times due to financial reasons. Doctors have no protection from these nuisance. All these factors further enhance insecurity in doctor’s mind.
It is because of career building of few professions, that medico-legal cases are being fueled. Medical errors and complications are integral part of the treatment . Even simplest of diseases carry some amount of risk. These will still remain, even if doctors are hanged to death. Natural complications, poor prognosis can be attributed to errors by clever lawyering and because of benefit derived by other professions.
Many careers are shining in name of preventable deaths and medical errors at the cost of medical profession. The managers, right activists, media and lawyers have made their career and wealth out of it. Ask any doctor really, are these issues really preventable beyond a point. The line separating errors or natural complications is really blurred and arbitrary. People who work in life and death situation know it well that even natural poor prognosis can be labelled and proved as error by retrospective analysis and wisdom of hindsight and more certainly with luxury of time at disposal for lawyers and courts.
It becomes a unbalanced match specially when the amount of money which was paid to doctor to save a life was peanuts as compared to now being paid to punish him.
Zero fee advertisements and fixed commission ads on television by lawyers in health systems in certain developed countries is an example of instigation against medical profession. They lure patients to file law suits and promise them hefty reimbursements. There is no dearth of such relatives, lawyers who are ready to try their luck, sometimes in vengeance and sometimes for lure of money received in compensations. This encouragement and instigation of lawsuit against doctors has become a major disadvantage for medical profession.
Sense of impending injustice is fueling among doctors, giving a feeling of sitting ducks for harassment.
Some one who is drowning, a small boat can save his life, till sea storm settles or the victim reaches a safe land. The boat will not settle the sea storm, but enough to save a person from catastrophe. In reality, ventilator is the invention, which should be worshiped. But contrarily, due to wrong projections and misguided perceptions, it has been hated despite saving lives.
Although doctors and ventilators are in a similar situation, projected in a wrong way, hated in spite of doing good work and saving lives. They are hated and despised, despite the only ones of help in life and death situations. Following are few myths and fact about ventilator.
- Myth : Once on ventilator, patients do not survive: common myth is that once the patient is placed on ventilator, he will not survive. Human body, when gets severely diseased or under stress, heart and lungs need to be supported for saving the life, till ailment So, when the battle for saving live is ongoing, almost all the patients will have to be placed on the ventilator. It is a last ditch attempt made to save the patient’s life. However when the patients do not survive people feel that it’s the ventilator which has caused death, rather than a rational thought about severe disease as a cause.
In reality, it is the severity of disease and possibility of death, when ventilator is required. It is necessary to support life.
- Myth : Ventilator is a modality for mere prolongation of life: every disease has a spectrum. Every disease can progress from a reversible to irreversible state. As an effort is ongoing while waiting to reverse the process, the patient will need ventilator to sustain life. Unless the disease reaches a stage of irreversibility, ventilator is indispensible for an absolute need to maintain life. Since in serious condition, it is an uncertain prognosis. In retrospect, combined with application of an average wisdom, the time of uncertainty and institution of ventilator can be interpreted as a mistake. As the whole exercise is labeled as futile and expensive by relatives. it’s a grey area and the negative thoughts are fuelled because of retrospective wisdom in hindsight. The real prognosis can not be predicted in real time.
In reality, Ventilator is a machine which just supports respiration and not responsible for heart beating. Therefore it buys time for healing and treatment of primary disease.
- Myth : Ventilator will cause death:
one can understand this simple logic on the basis that patients are placed on dialysis when kidneys fail. Patients are placed in cast when bones are fractured for a fixed predefined period of time. Similarly patient is placed on ventilator when lungs fail. Ventilator is used till the time lungs recover and become fully functional.
In reality; Risk is because of disease, which needs ventilator and not vice versa. Ventilator is a friendly machine which helps people who have failed lungs.
- Myth : Doctors and hospitals keep dead patients on ventilator for financial gains
Fact: placing patient on ventilator is a very critical decision, taken in best interest of patient to buy time, to so as to treat the disease. A patient needing on ventilator is actually so sick, that not instituting ventilator will risk the patient’s life. Knowing all these facts, doctors take a decision to keep the patients on ventilator.
As once the patient is on ventilator, it is a stress for the doctor to take the patient off the ventilator. As such ventilator is a SANCTUM SANCTORUM life saving machine, to be used only in life and death situations.
- Myth : Its miracle if the patient placed on ventilator survives.
Given the fact that placing the patient on ventilator on scientific facts. There are clear indications for putting the patient on ventilator. A much larger patients put on ventilator are actually saved and go home.
Fact: Everyday thousands of patients are placed on ventilator and sent home to lead a normal life: Any patient who is given general anesthesia is placed on ventilator in the operation theater and then taken off the ventilator at the end of the surgery. In these cases patients are placed on ventilator so as patient can be put to deep sleep (called anesthesia) during which surgery on desired part can be carried out. Soon after the surgery patient are taken off the ventilator and soon thereafter discharged for home after few days of healing.
- Myth :Doctors place patients on ventilator at their own will:
Fact: there are scientific parameters which decide when the patient should be placed on the ventilator and when the patient should be taken off the ventilator. So the decision to place the patient is scientific and based on objective parameters.
Contrary to this popular myth, it is a compulsion for the doctor to put patient on ventilator to prevent death in serious situations. Doctors are usually thinking several steps ahead of lay person about medical science.
- Myth :All patients placed on ventilator are unconscious:
Fact: this is not necessary. Usually patients are sedated for their comfort. they can be made to walk, write and even perform small tasks when on ventilator, depending upon their lung condition.
Patients are also put on ventilator in case of airway failure when unable to protect their airway for various reasons. Another reason why patients are placed on ventilator is inability of the patients to protect his or her airway. Conscious and alert patients can swallow normally formed mouth secretions. When patients consciousness level is dulled the ability of the patient to protect his airway is lost or compromised. This causes secretions from mouth to enter into the lungs trough the airway i.e. trachea causing infections in the lungs. The only way to prevent this and protect the patient’s lungs is to place a tube in his airway and then place them on the ventilator.
- Myth: Patients can be kept alive by placing on the ventilator:
General masses have a feeling that patient can be kept alive by keeping them on the ventilator. Even a dead person can be kept alive by placing on the ventilator, which is not true.
In reality: It is machine used only for breathing and not heart and brain.
- Myth : Ventilating the dead patients:
this is a common allegation on medical profession. This is no truth in this projected and perceived hearsay.
Facts: Assumptions are based on thoughts of lay persons. Patients on ventilator, may look like dead, because of the disease, sedation and paralyzed by drugs. But their heart and brain are working, so they can not be declared dead.
If there is some incident, it needs to be proved by medical personnel. In reality, it can be a very rare and remote exception. These untrue projection are creating lots of mistrust about life saving machine.
The problem is about correct projection and majority of people without knowledge of medical science do not even know the large number of lives been saved by the ventilators.
In nutshell: serious conditions and life threatening situations need higher technical interventions, to save a life. If correct projections are made, ventilators are life saving machines.
The research further establishes that this low lean mass has been a constant in South Asians for almost 11,000 years.
South Asians, even those who move to other countries, are at a higher risk of diabetes than people of most other ethnicity, and according to a study published last week in Nature Scientific Reports, the reason for this is their relatively low lean mass
The research further establishes that this low lean mass has been a constant in South Asians for almost 11,000 years.
Higher lean mass is associated with superior performance in some, but not all, sports.
Mesolithic hunter-gatherer ancestors of South Asians were much taller, but low lean mass has characterised South Asians for at least 11,000 years, putting them at higher risk of type-2 diabetes and other non-communicable diseases (NCDs) such as heart disease, according to the study which analysed 197 archaeological and recent South Asian adult skeletons.
Height decreased by 8.5cm in men and 7.7cm in women when South Asians transitioned from hunting and gathering to farming around 9,000 years ago, but their lean mass (organ and muscle mass) has remained unchanged over the past 11,000 years, the study said.
Since changes in lean mass are unlikely over the next four to five generations, making lifestyle interventions are crucial to containing NCDs, which account for 60% of all deaths in India.
The study suggests that while height is determined by nutritional factors, physique (bone breadth and lean mass) reflects ecological pressures. “The decrease in height probably took place very quickly (over hundreds of years rather than thousands). After the initial drop in height with the adoption of farming, it then continued to decrease very slowly between about 5,000 years ago and today,” lead author Dr Emma Pomeroy, lecturer in the Evolution of Health, Diet and Disease, Department of Archaeology, University of Cambridge, said in an email interview. “The ancient origins of low lean mass in South Asians would be most consistent with long-term adaptations to ecological pressures, rather than more recent dietary change or the impact of 19th-20th century famines exacerbated by British colonial policy,” said the study. Ecological pressures include adaptation to a predominantly hot, equatorial climate, which may have led to selection for lower body mass (which generates less heat and increases heat loss through a greater surface area to volume ratio) to reduce thermal load. “Low lean mass is present at birth in South Asian babies compared with European babies; even after South Asian families migrate to other parts of the world, such as the UK, after several generations in this new environment, their children still have low lean mass compared with children of European ancestry. This strongly suggests a major heritable component to South Asian low lean mass, but the contributions of genetic, epigenetic and environmental conditions are still unclear,” said Dr Pomeroy, referring to a study on type-2 diabetes in migrant South Asians published in The Lancet in 2015. People of South Asian ancestry are at a higher risk of diabetes even after risks like unhealthy diet, sedentary lifestyles and obesity are factored in. For example, South Asians in London have a two to three times greater type 2 diabetes compared with those of European ancestry, with onset typically five years earlier and at a lower body mass index (by 5 kg/m2). “The implications of the study are that low lean mass is a very ancient characteristic, so it is unlikely to change much in the coming generations. This means that other interventions, especially the promotion of healthy lifestyles, are particularly critical to manage the growing health and economic burden of chronic diseases,” said Dr Pomeroy.
Building muscle mass and high fitness levels have the potential for averting diabetes, and even heart disease.