Bit by a Bad Bug

On January 7, I was admitted to the JSS Hospital in Mysore. While celebrating New Years in Kochi I was bit by a bad bug and contracted Malaria as a result. While Kochi has historic and cultural charm, it also has a serious mosquito problem due to its open, dirty sewers and stagnant water. It wasn't until leaving Kochi, on the night train to Mangalore on January 3 that I began to feel weak and chilled, and brushed it off as just a flu or fatigue. Even though we traveled in an air-conditioned compartment, I experienced heavy sweating throughout the night. When we arrived in Mangalore the next morning, we still had a full day of travel to reach our destination of Belur. This involved rickshaw and two more buses. By the time we arrived the chills were getting worse and my head was feeling quite heavy.

This wasn't the first time I felt flu-like symptoms with achy joints, fever and chills during our journey, but to be sure, I went to a small medical clinic across the street from the hotel. The doctor there diagnosed me as with either the flu, conditions resulting in a change in climate, or the effects of drinking some bad water: he wasn't really sure. When I asked him about Malaria, he said that wasn't the case and prescribed antipyretic and antibiotics for the next two days. At the clinic, the cost of diagnosis was free, and most of the patients were poor villagers, who waited in long queues for their turn to see the doctor. While diagnosis is free, patients must pay a percentage of the prescription cost, as set by their medical benefit system. My prescriptions turned out to be 52 Rupees, about $1.20 in US dollars.

I was stuck in the hotel for obvious reasons, and wasn't able to fully explore the town of Belur. Finally, on January 6, my fever calmed down and I ventured out to visit Channekeshava Temple, well known for it's intricate and beautiful stone carvings. However, once the antipyretic wore off, the chills and fever returned stronger than before, and my body temperature shot up to 103 degrees. It was becoming more obvious everyday that this was not the flu or some other simple illness. The following morning, January 7th, Lyn hired a car and driver to take us to Mysore, the closest city from Belur with appropriate medical facilities. The chills were so bad during the four-hour drive that I asked the driver to stop just so I could stand in the hot sun to "warm up" for a few minutes.

Upon arriving in Mysore, we went straight to the Government Hospital Emergency Room and paid the 10 Rupees to register. As hard as it is to imagine an Emergency Room closing for lunch, this was the case, and no doctor was available during the 1PM to 2PM break. A young doctor advised us that if we wanted better care, we should try JSS Hospital. That's all we needed to make the move to another facility. Fortunately, JSS was not far away and our driver high-tailed it in that direction. Upon arrival, I was given a bed in the ER and the nurse immediately took my temperature, which registered 104 degrees, the highest yet. Because of the high fever, and perhaps because I was a foreigner, the doctors seemed concerned and went straight to work, asking questions about my health and immediately began an IV and gave me a shot to reduce the fever.

JSS Hospital is a medical collage, and therefore many on its staff are interns. I was passed around from intern to post-grad, and then to a senior professor who made the final decision to admit me to the hospital immediately. After a rather tedious admission process for a room in the private ward, the nurses took my blood to send to the lab. A short while later, the intense-looking post-grad came to collect me for a trip to a private lab in town, as the hospitals own testing facility would take another day for the results. After the 20-minute wait at the private lab, the results came back: I tested positive for Malaria. We drove back to the hospital and I began a "rapid treatment program" with IVs mixed with anti-Malarial medications that would last the next 5 days.

The professor surrounds himself with interns and doctors, each of whom is an expert in internal medicine, pharmacology, virus, epidemics and so on. They seemed to be brilliant and knowledgeable, exchanging information and ideas and coming to a collective decision on the treatment to be given, with the professor at the center of the team. The intense-looking post-grad said to us that he felt that Indian doctors were better trained than any doctor in the west because conditions in a developing nation present them with the full range of medical problems, the type that doctors in the west don't often see.

Nurses, on the other hand, are completely different story. They are friendly, kind and caring, but when it comes to executing doctors' orders, there seemed to be some confusion. They had trouble finding a vain in my arm for the IV, and to my irritation, I was stabbed several times before they got it right. We both found it best to double-check the medications and dosages to be sure they were correct.

The ward itself was small and not very clean, let alone fully sanitized. The bathroom was cleaned often but only with water, a dirty towel and a brush made from twigs. The ceiling of the bathroom dripped some unknown fluid that created stalactite, like you would see in some dark cave. Giant cockroaches ran free and mosquitoes entered through windows without screens. India is such a place where Malaria patients have to worry about mosquitoes inside a hospital where they are treated. The signs in the hallway read "Keep Quiet!" but it wasn't possible as other patients' moans and coughs, cries of newborn babies, and the voices of families gossiping in the hallway went on all day and night.

The hospital does not provide meals in its ward facilities. The only way to obtain food is to have someone bring meals in or venture out yourself to a nearby restaurant. Furthermore, patients or their family must run to the pharmacy at the doctors' request to purchase all medical supplies such as IVs, injection sets, and medications. I was fortunate to have Lyn with me in the ward throughout my illness to run for food or medications. I can't help but wonder how a single person would handle the logistics alone.

The fever started to go down immediately after I started the anti-Malaria drugs through the IVs. This treatment took three days to complete, with two more days of oral meds to complete the total elimination of the parasites from my bloodstream. The team of doctors headed by the professor visited me every morning, checked my body temperature, pulse and blood pressure, received reports from nurses and gave them further instructions. They conducted another blood test on the 5th day, which came back negative: the parasite was eradicated. Based on the result, I was discharged on the morning of January 12. Although I was impressed with the speedy and decisive handling by the professor and his students throughout my treatment, we were back to typical India when it came to the discharge process and all the associated paperwork, and waited over three hours before I could set a free foot out the door.

The diagnosis and treatment costs at JSS Hospital are considered low because it is a medical college, and as a result many of the patients come for poorer backgrounds. The private ward cost 250 Rupees a day with a 2,000 Rupees advance to be paid before admission. Having the money to pay for the advance is a decisive point for many of the patients wishing to stay in the private or semi-private room. Mysore has several other hospitals, which we heard offer a better overall environment, but which also come with a higher price, up to five times that of the medical collage hospital.

The total cost to treat my Malaria, including diagnosis, treatment, blood tests, medications, and the private ward, was less than 250 US dollars. JSS may not be the cleanest, or the most modern but the diagnosis and treatment given to me was on par with what I'd expect at home. The high cost of health care in America has become a huge social issue. High insurance costs, even higher costs for medical treatment have left many individuals without healthcare at all. While I've read that India also faces huge increases in medical care in the future, it's good to know that villagers, even in a small town like Belur, have access to some form of healthcare.

It is not a positive story to write about being hospitalized for Malaria in India. But looking back at the experience from a position of recovery, I gained insights into another aspect of Indian life, despite the unpleasant circumstances.