Thiruvananthapuram: It's no exaggeration to say some women laugh their way to the labour room at the Government Taluk Hopital in Punalur, thanks to the mix of laughing gas (nitrous oxide) and oxygen administered to them during labour to help them with normal birthing instead of Cesarean. This has been an exceptional achievement by the multi-specialty taluk hospital, perhaps the only one in the Government sector. The number of Caesarean deliveries has come down to 10 percent. The painless normal delivery scheme, clocking an average 100 deliveries a month, also has the facility for birth companionship programme, allowing the husband or an immediate relative, in the labour room.
"This trend is catching up. Already we had 10 birth companionships this month", says Dr R Shahirsha, the superintendent, who has steered the destiny of the Government hospital past seven years. This March, orthopaedic surgeon Anu George and team at the hospital performed the first elbow replacement surgery in the history of taluk and district hospitals in the state, giving a new life to Jayakumari, 39, who had lost the flexibility of her elbow. The surgery would have cost Rs 4-5 lakh in private hospitals whereas it cost less than Rs one lakh in Punalur.
Dr Shahirsha's success depends on a core team, and he tackles issues one by one. When he took over, the revenue from the gate pass, comfort station and registration fee was a pittance owing to pilferage. He introduced electronic ticketing machines. The income shot up, but not to the level he estimated. He found the machines were tampered with. Contract staff were helped by bus conductors to maniupulate the machines and fudge the accounts. He intervened and in no time the monthly revenue touched Rs 25 lakh monthly. He is a great motivator, which is why philanthropists chip in whenever there is a paucity of Government funding. The hospital also makes good money from over 80,000 tests it conducts every month at rates one-fourth of a private laboratory. The 250-bed hospital is on expansion mode.
The Government has allotted Rs 60 crore and promised more. Finance Minister Thomas Isaac has been one of the votaries of the Punalur experiment, having visited the hospital to learn from Dr Shahirsha so that the model can be replicated. "The model may not be easy to replicate because the success depends on the initiative, commitment, innovative skills and professionalism of the hospital boss", says neurosurgeon P Balagopal, the superintendent at Cochin Cancer Centre, who had seen it all from close quarters.
Dr Shahirsha and wife, Dr Sindi, who was also a staffer at the taluk hospital, have had their quota of troubles too. Private hospital honchos got him transferred out and brought up negligence charges against Dr Sindi. But the groundswell of support for the inter-faith doctor couple has been such that the Government came to their help. Perhaps a key to the hospital's s early success has been Dr Shahisha's long exposure to the Government primary care sector and the tribal population, for whom the private sector has been inaccessible. "I was determined to address the needs of the poor tribal people and give them the best because if a Government doctor fails, the Government fails", said Dr Shahirsha.
