Health Check: 'One powerful human story such as this is worth a dozen political platitudes'

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Indy Lifestyle Online

Once a year I escape the scandal-driven British press to breathe the headier air of a developing country's media. It is my attempt to cleanse my soul of the sin of trivia. So 10 days ago I found myself in the National Cancer Hospital, Colombo, with a bunch of Sri Lankan reporters, talking to Digna.

Digna's 10-year-old son, Kevin, has leukaemia and his mother has found him a precious bed in this, the only cancer hospital on the tropical island. The ward, with its low grey walls, is jammed with anxious mothers and children, some with grotesque tumours disfiguring their faces. Kevin has been here for three months occupying a corner of the scruffy paediatric ward just big enough to accommodate a cot for him and a moulded plastic chair for her.

On each side of Kevin's head, a zig zag plaster marks the spot where the radiotherapy is targeted. A shy lad, he swings his emaciated legs - the treatment has killed his appetite - over the side of the cot, beneath a small poster of Christ giving a blessing, which Digna has stuck to the wall.

We have come here in search of real patients with real experiences of the government health system, which is free but where there is much criticism of the offhand manner of doctors and nurses. My aim is to demonstrate to the local reporters on this British Council-sponsored course how one powerful human story is worth a dozen political platitudes.

So the reporters begin probing Digna. How does she feel about the treatment her son has received? Excellent, she says. But essential drugs are short, the equipment old and outdated and there are not enough staff, the reporters insist. The staff do a very good job, she retorts.

Well, the reporters persist, if there were one thing she could change what would it be? She pauses. Then, sheepishly, she indicates the small blue, straight-backed plastic chair beside her. For three months she has eaten, slept and lived on it. It would have been good, she says, if it had been a bit... softer.

You cannot talk to someone like Digna, and witness her serene composure in the midst of such hardship, without wondering about your own petty obsessions, and those that dominate lives in the West. Whatever happened to stoicism?

The strange thing about these courses, intended to give local reporters a new perspective, is how they change me. At home, the indignation that permeates much public debate about the state of the health service seems to me contrived and overdone. But in Colombo I found myself raging against the lack of accountability of politicians and officials and urging the reporters to shake them from their complacency.

There was something else I learnt, too, about private medicine. Sri Lanka has a national health service which provides free care to all. It is genuinely free - even for drugs (no NHS-style prescription charges). But there is also a thriving private sector and the newspapers are full of advertisements for private hospitals vying for patients by peddling details of their hi-tech scanners and new diagnostic tests.

There was a curious divergence of view about these services. Among those who could just about afford them, such as cab drivers, the private hospitals were regarded as far superior to the government hospitals. They were cleaner, more modern, less crowded and - most important - doctors and nurses treated the patients like people. In a government hospital you could have travelled 10 hours from the other side of the country to attend an appointment, people told me, and then get 30 seconds with the doctor during which he might not even look up from the prescription he was scribbling.

But middle class Sri Lankans, such as the reporters in my group, were more sceptical. They regarded the private hospitals as profit oriented and market-driven, who would never order one test where six would do, and who would hurt your pocket as soon as cure your disease.

I think that was why Digna, whose husband ran a photographic studio and was better off than most of the mothers around her, preferred to take her chance in the government cancer hospital. Rationing is the danger in a state-run service, but over-treatment is the danger of a private one.

On my last day I witnessed a different kind of excess. I had visited Jaffna, the battle-scarred city in the north with its depleted, but still functioning, 1,000-bed hospital and was waiting under a sheet of corrugated iron in the middle of a field for the plane back to Colombo, when a team of 11 Korean doctors and their helpers arrived.

They were members of a Korean version of Médecins sans Frontières and had spent three days giving patients at Jaffna hospital... acupuncture. I am sure that, like Digna, the patients dying of haemorrhagic dengue fever received their ministrations with perfect grace.

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