HOSPITAL IN INDIA

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Title
HOSPITAL IN INDIA
extracted text
FOCUS: HEALTH & MEDICAL CARE IN CHENNAI

A gateway to health
In terms of the availability of a large number of well-equipped hospitals, dedicated doctors and
treatment expertise of international standards, all at a relatively low cost, Chennai is the place to be
for dependable medical care.
ASHA KRISHNAKUMAR
'“T’HE Chennai Central railway sta1 tion’s passenger concourse has a
large back-lit display listing the city’s
m;tajor hospitals. This is no routine publie announcement but constitutes infor­
mation that is crucial to thousands of
ople who come to Chennai seeking
medical help. In fact, elsewhere in the
concourse functions a telemedicine faci­
lity, which also has ECG equipment to
provide emergency diagnosis in the case
of passengers with heart ailments.
With its numerous multi- and super­
speciality hospitals that provide diagnos­
tic, technical and treatment expertise of
international standards, Chennai is a virtual gateway to health. Patients come
from all over the world, in some cases
with medical conditions that are consid­
ered elsewhere to be too complicated for
treatment or too risky for surgery. Of
course, ffor the thousands of people who
come from outside the country the rela­
tively low cost is an added attraction.
Some nine lakh patients are admitted every year to the nearly 500 hospitals

■

k

*

’

*

and nursing homes in Chennai. More
than five lakh patients come from out­
side Tamil Nadu. The majority of the
patients from outside Tamil Nadu come
to the corporate and multi-speciality
hospitals such as Apollo, Malar and Devaki or to the multi-speciality trust hospitals such as Sri Ramachandra Medical
and
Research
Institute
College
(SRMCRI), Vijaya and Sundaram Med­
ical Foundation.
The other major centres are: Sankara
Nethralaya, the Agarwal Eye Hospital,
the Eye Research Foundation and the
Rajan Eye Care Hospital, the M.V. Hos­
pital for Diabetes and Diabetes Research
Centre and the M.V. Diabetes Speciality
Centre; the
' Cancer Institute; the
i Madras
\< i
ENT Research Foundation and the
KKR ENT Hospital and Research In­
stitute; the MIOT Hospitals and the
Bone and Joint Clinic; the Kanchi Kamakoti Childs Trust Hospital.... and
the Institute of Cardiovascular Diseases
(Madras Medical Mission), the Heart Insitute (at the Vijaya Health Centre) and
the Heart Foundation (at the Vijaya
Hospital).

&

MBS . •

The Madras Medical Mission, Chennai.
110

There are also several trust and char­
itable multi-speciality hospitals includ­
ing the Hindu Mission Hospital the
Public Health Centre, the E.V. Kalyani
Multispeciality Hospital and the Volun­
tary Health Services that cater to patients
of average means.
Among the oldest multi-speciality
hospitals set up by Christian mission­
aries in the country are Chennai’^ St.
Isabel’s Hospital and the CSI Rainy
Hospital which provide advanced r(reatment at a reasonable cost.
The hospitals that offer modern
techniques such as liposuction (to re­
move fat from certain parts of the body
using metal tubular instruments con­
nected to a suction machine), hair trans­
plantation
(using
the
follicular
micro-grafting technique), infertility
clinics and cosmetic surgery (to alter the
shape of facial parts such as the nose) are
Hande Hospital, Apollo, SRMCRI,
G.G. Hospital and the Madras Medical
Mission.
Offering a range of facilities, hospi­
tals in Chennai have done much pio­
neering work. They have to
- their credit several firsts in Asia,
i Among these are trans-myocar| dial revascularisation laser surgery (1994), magnetopexy (a
surgical procedure using mag­
nets to treat giant retinal de­
tachments: 1988) and the
Batista operation to improve
the performance of the ventricle
(of the heart) by reducing its
size on a two year old, the
youngest person in the world to
undergo this type of surgery.
Chennai has the only hospital in
Asia where giant aneurysms are
operated upon.
The city is justifiably proud
of several medical firsts. Among
them are the setting up of the
country’s first nuclear medical
oncology department (1956),
employing lymphangiography
in the diagnosis of lymphoid tu­
mours (1960); using mammogFRONTLINE, JUNE 6, 1003

FOCUS: HEALTH & MEDICAL CARE IN CHENNAI
the Institute of Mental Health, play a
crucial role, catering as they do to the
overwhelming majority of the poor.
Seeing an opportunity the private
sector stepped in, and thanks to the
abundant talent available, has reached
commanding heights today. Perhaps
aware of its own limitations and the heed
L
i
J
to attract more investments in the ipedical field, the State government offered
subsidies, soft loans, duty exemption and
so on to private investors. The require­
ment of governmental sanction or ap­
proval to start a hospital was
withdrawn. Thus private sector in­
vestment in the medical field,
which was marginal until the
mid-1970s, grew rapidly. Today
some 50 per cent of hospital beds
and 40 per cent of doctors ate in
the private sector in Chepnai,
compared to 21 per cent and 29
per cent respectively in Tamil Na­
du as a whole and 35 per cent and
30 per cent respectively in the
country. While most of the private
A LL this has happened in the
hospitals have their own investiga­
private sector, though the
tive facilities with the latest equip­
foundation for quality medical
ment and modern laboratories,
care in Chennai was laid over time
there
are also a number of exclu­
by government hospitals, of which
sive
laboratories,
blood banks and
there are 24 in the city, including
scanning centres that offer highmulti-speciality and super-special­
quality,
reliable
diagnostic
ity hospitals. Most of these now
facilities.
have state-of-the-art diagnostic
Besides hospitals and diagrnlOSand treatment facilities, but are
tic
facilities,
Chennai has a num­
short of funds to maintain them.
ber of non-profit, service-oriented
While the Union and State gov­
private facilities such as Sneha (a
ernments are responsible for pro­
suicide prevention centre), | the
viding universal access to health
T.T. Ranganathan Clinical 'Re­
are limited.
limited.
A kidney transplant procedure in progress at the
are, their resources are
search Foundation (working on
In a paper, “Healthcare Bud- Apollo Hospital, Chennai.
substance abuse rehabilitation),
gets in a Changing Political Econand
Banyan
(a home for mentally ill
omy” published in the Economic and in-patients are treated at Chennai’s Gov­
women)
to
offer
help to the depreissed
ernment
General
Hospital
eveiy
day,
but
Political Weekly, health researcher Ravi
and
the
mentally-ill;
Saraswati Kendra,
Duggal says that the government’s reve­ its staff strength is not adequate to cater
the
Kaleidoscope
Learning
Centre and
to
even
a
fourth
of
these
numbers.
This
nue expenditure on health in Tamil Na­
du declined from 7.7 per cent of the total leads to problems of corruption and ha­ the Madras Dyslexia Association to help
revenue expenditure in the mid-1980s to rassment. Although treatment is free for children with development and learning
5.7 per cent in the mid-1990s. Accord­ patients with a monthly income of less disabilities; the Spastics Society of Tamil
ing to the paper, the percentage of ex­ than Rs.500, poor patients going to gov­ Nadu and the Schizophrenia Research
penditure on medicare of the total health ernment hospitals complain of harass­ Foundation (to care for and treat people
expenditure came down from 41 to 36 in ment by sections of the staff at various with mental disability); CanStop ofSunstages, starting with the income level as­ daram Medical Foundation and Sanctu­
the same period.
According to another paper, “From sessment counters. Yet, with all the prob­ ary of the Cancer Institute (to provide
the government hospitals, emotional support and counsel cancer
Philanthropy to Human Right - A Per­ lems,
including
multi-speciality hospitals such patients) and YRGCare. There are a
spective for Activism in the Field of
Health Care,” presented by Dr. Amar as the General Hospital, the Kilpauk number of non-governmental organisa­
Jesani at a seminar organised by the Medical College Hospital and the Stan­ tions that offer treatment, care and sup­
Mumbai-based Indira Gandhi Institute ley Hospital and super-speciality hospi­ port to HIV/AIDS patients.
While all this was possible because
for Development Research, the govern­ tals such as the Kasturba Gandhi
hospitals
and diagnostic units could be
Hospital
for
Women
and
Children,
the
ment spent Rs.64 per head in 1991 (in­
cluding expenditure on water supply), Government Ophthalmic Hospital and set up with relative ease, the trend has a

raphy to diagnose occult breast tumours
(1965), using therapeutic endoscopy
(1975), introducing hyperbaric oxygen
therapy (1978), hyperthermia (1984),
and the use of intra-operative electron
therapy (1992) in the treatment of
cancer.
Chennai’s list of other firsts include
the country’s first cryo-surgery for the
eye (1966), successful kidney transplant
(1985), successful heart and heart lung
transplant (1995), successful lung trans­
plant; 1997), successful umbilical cord
blood transplant (which involves
the use of blood in the placental or
umbilical cord which contains the
life-saving progressive tissue need­
ed in bone marrow transplants
)97), steriotactic radio surgery
(a non-invasive technique to deliv­
er radiation doses accurately to the
affected part of the brain), and an
arterial switch operation on a 10hour-old infant.

112

while the people spent Rs.200-250 per
capita. The out-of-pocket expenditure
on medical care incurred by people today
is around Rs.450 per person a year, while
government spending has declined.
Government hospitals frequently
face a shortage of emergency drugs, IV
(intravenous) fluids and even needles
and cotton. Water supply is inadequate
and of poor quality.
There is a chronic shortage of med­
ical and non-medical staff. For instance,
more than 8,000 out-patients and 2,000

FRONTLINE, JUNE 6, 2003

FOCUS: HEALTH & MEDICAL CARE IN CHENNAI
healthcare increased. Hospitals, dis­
pensaries and primary health centres
were set up all over the State to meet
Indians were admitted as in-patients. the demand, particularly for the poor
ASHA KRISHNAKUMAR__
In 1889 it became a full-fledged civil- who could not afford to pay for diag­
intry
’
s
ian facility. Major reconstruction was nosis, care or treatment. But the base is
VyrHAT was perhaps the cou
W first hospital was set up over 300 undertaken in 1928. By the 1930s, it provided by the 300-year-old facility
years ago in Chennapatna, now Chen­ had come to be regarded as one of the now simply called the GH, which has
.i. It was Governor Edward Winter best hospitals in Asia. According to S. state-of-the-art facilities to treat and
nai.
care for a wide range of
who set up that hospital at Fort. St. Muthiah, historian of
diseases - from heart
the Madras Presidency,
The Madras
George, for the British residents.
and renal ailments to
By 1679, the services offered by the this reputation was in
Medical College
cancer to HIV infec­
two-bed hospital were so much in de- large measure due to
managed
to
tion. The country’s
the
setting
up
in
1835
mand that a two-storeyed building was
first bone bank is to be
retain its
built close to the original structure. In of the Madras Medical
set up at the GH soon.
1690, Governor Elihu Yale inaugu- School. Among the
reputation as a
According to 2002
rated a bigger hospital, built at a cost of teachers were doyens of
top-ranking
figures, the State has
2,500 pagodas (about Rs.65,000 in to­ medicine such as Dr.
326 hospitals, 208 dis­
institution,
day’s terms) on _James Street within the Rangachari, Dr. M.R.
pensaries, 208 primary
Guruswami (their stat­
Fort.
thanks mainly to health centres and
In 1761, a decision was apparently ues stand on the cam­
the excellent
1,410 health sub-cen­
taken to build a permanent hospital. pus of the Madras
tres, including 11 mo­
teachers it had.
But it was nearly a decade before action Medical College today)
bile medical units and
would be taken on this decision. On and Dr. Lakshmanasone
leprosy unit.
October 15, 1772, the hospital was in­ wami Mudaliar, who
There are 50,000 beds
medicine
augurated where the Government studied
General Hospital stands today. This abroad and returned to serve the coun­ available, some 11,000 of them in
structure grew into a sprawling com­ try. The institution was granted the sta­ Chennai. Of the nearly 10,000 govern­
plex with several buildings and depart­ tus of a medical college 15 years later, ment doctors in the State, nearly twoments added to it over time. Its main after which it grew from strength to fifths are in the city.
The growth of the Madras Presi­
block, which is now being pulled down strength under the guidance of some of
dency
after Independence and the fi­
to make way for two new blocks, dates the best minds in the field in the
nancial
crunch that followed the
country.
back to 1835.
As the population grew and with it reorganisation of States, affected all
However, the hospital became truly
CC
• •
hospital” only
in 1842,
when
the types of diseases, the demand for government hospitals, in particular the
a ’general
I
GH. The Madras Medical College
| managed to retain its reputation as a
| top-ranking institution,
thanks
r mainly to the excellent teachers it
& had, such as Dr. B. Ramamurthi and
wDr, Krishnamoorthi Srinivas (neu­
rology), Dr. T.J. Cherian (cardiol­
ogy) and Dr. K.V. Thiruvengadam
(general medicine).
Starved of adequate space and
faced with staff shortages and infras­
tructure constraints, the General
Hospital today is a pale shadow of
what it was in the inter-War years.
The main reason for this situation is
the falling allocation of funds. Hard­
ly 1.7 per cent of the State domestic
product goes to healthcare, much be­
low the World Health Organisationrecommended level of 6 per cent.
But despite its shortcomings, the
GH continues to serve lakhs of poor
patients - from all over and even out­
side the State, with rhe aid of modern
technology.
■
Outside the Government General Hospital, Chennai.

An early start

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114

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FRONTLINE, JUNE 6, 2003

A FLEET OF HEALTH CARE
PROVIDERS IN THE MAKING

<

DISEASES BETTER
PREVENTED THAN CURED

SRI ramachandra\
Medical College
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College of Pharmacy
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Allied Health Sciences
Clinical Psychology
Audiology & Speech Language Pathology
Human Genetics
Clinical Nutrition, Bio-Technology
Emergency & Trauma Care Tech.
Hospital & Health Systems
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MEDICAL COLLEGE AND RESEARCH INSTITUTE

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TEL : 2476 5629 FAX: 2476 7008
Website : www.srmc.edu

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A Harvard Medical International
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OUR EFFORTS TODAY FOR A BETTER TOMORROW
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FOCUS: HEAL TH AND MEDICAL CARE IN CHENNAI
flip side too. Tamil Nadu Governor P.
Ramamohan Rao, recently observed that
“medicine has become commercialised”.
Says Dr. C.V. Krishna Rao, a gastro­
enterologist: “All one needs to set up a
hospital is a couple of beds, nothing
more.” This, according to the Federation
of Consumer Organisations in Tamil
Nadu, has led to unethical practices and
of\quacks. Several nursing
a proliferation
1
homes do not even have sterile operation
theatres. Many do not have the facility to
match blood sources from blood banks.
There is, according to R. Desikan of the
Federation of Consumer Organisations a
need for the government to monitor
healthcare services closely.
Several private organisations
that
■ganisations that
provide high-quality services fault the
government for the poor infrastructure,
Says Dr. K.M. Cherian, Director, Madras Medical Mission: “With the money
1 spend just to get clean water to the
hospital at least five heart operations can
be performed free of cost every year.” Dr.
D. Rout, neurologist at the SRMCR1,
wants an efficient system to be put in
place to rush trauma patients to hospital,
Even if it does not become possible to
save a victim, this, according to Dr. R.
Ravichandran, Director, Madras Insti­
tute of Nephrology, Vijaya Hospital, can
save a number of lives indirectly by facil­
itating the harvesting of organs for
transplantation.
But where all the facilities are avail­
able, medical care becomes expensive
and beyond the reach of the poor and the
middle-class, except in cases where em.oyers meet medical expenses or there is
a medical insurance facility. But health
insurance comes at a price that is beyond
the reach of many people. According to
Desikan, it is important to cover the
medical expenses of the poor and the
needy under some scheme or the other.
Chennai has shown the way in this. The
Voluntary Health Services was started in
the 1970s to reach medical care to the
poor living in the peripheral areas of
Chennai by means of an insurance
scheme with affordable premia. This, ac­
cording to Desikan, has benefited thou­
sands of poor in and around Chennai
and is worth replicating.
Chennai’s healthcare facilities may
have some problems that are common to
any city in India, but undoubtedly these
are some of the best in Asia. Much of its
strength is derived from the vision, dedi­
cation, hard work and enterprise of a
large number of doctors. ■
116

Accent on preventive care
Diabetes, hypertension, heart ailments, renal disease... a growing
list of medical problems have their roots in the way people live
their lives. On what is on offer in Chennai to help cope with the
SltUOtlOH.

ASHA
KRISHNAKUMAR
----------------------------------- ------

'hat Boing TT

Tr I”'"3

become the diabetes capital or the world
'TT’ HE state of a person’s health is often by 2025. It has also declared the country to
JL direcdy related to that person’s life- be one with a fast-growing rate of heart
style.
disease. If in the 1950s 1 to 3 .per cent of the
_v— With
---- more and more tpeople
k aping
x
the \7estern
Western food culture, which involves population had hypertension, recent studstuffhigh
high in
in saturated
saturatedsalt,
salt,fat
fatand
andcalories
calories ies show that the figure has risen to 25-40
stuff
but low on fibre,
fibre, vitamins
vitamins and
and proteins,
proteins, per cent, particularly in the urban areas. It is
obesity is on the
the rise.
rise. This,
This, in
in turn,
turn, isis leadlead- the most serious risk factor behind cardio­
ing to a higher incidence of hypertension vascular diseases.
While in 1980 coronary artery bypass
and diabetes than before.
While a third of the population of In- grafting accounted for less than 10 per cent
dia is obese, over half the people suffer from of all cardiac surgical procedures in India,
of today the figure is over 60 per cent. Every
hypertension, often leading to ailments
j
the heart, the kidney and die eye. Diabetes year, some 25,000 coronary bypass surger­
and hypertension are the primary causes of iies
< and 12,000 percutaneous transluminal
kidney disease and blindness. The World coronary angioplasty procedures > are carried
In 1999-2000, valve replacements
Health Organisation (WHO) has predicted out. I"
were done in 6,607 cases
and surgical procedures to
correct congenital heart de­
fects were carried out in
6,750 cases. As many as
42,000 open heart surger­
ies were performed in

1999-2000.

The Dr. V. Seshiah Diabetic Care and Research Institute.

For all these ailments
Chennai offers some of the
best diagnostic treatment
facilities. Patients come
here even from Western
countries. It offers facilities
of international standards
at an affordable cost The
87-year-old
American,
Brennan Benard Emerson,
who was recendy operated
upon (to replace the mitral
valve with a bio-prosthetic
valve) at a city hospital,
says: “As against $40,000
in the U.S., the cost of sur­
gery, along with four
weeks’ stay in the hospital,
including medical expens­
es, was less than $8,000 in
Chennai.” Apart from
open heart surgery, angio­
plasty and valve replace­
ment procedures, hospitals
in Chennai perform atheFRONTLINE, JUNE 6, 2003

jKjM.V, HOSPITAL FOR DIABETES
DIABETES RESEARCH CENTRE
4

ROYAPURAM

►

Consultants:

Specialties:

Dr. A. Ramachandran, m.d„ Ph.D. frcr, d.sc.

• Diabetes Education

Dr. Vijay Viswanathan, m.d„ Ph.o.

• Diabetes Heart Care

Dr. M. Manoharan, m.d.,dd

• Diabetes Foot Care

Dr. Uma Mahesh, m.b.b.s., mdrc

• Diet Counselling

Dr. K.V.S. Mahesh, M.B.B.S., MDRC

• Diabetes wound care

Dr. Syed Abuthaahir, m.d

• Diabetes Eye Care

Dr. Ashok Krishnan, m.b.b.s., mdrc.

• Modern Lab Facilities
• Impotence Clinic
• Diabetes Dental Care

• Obesity Counselling
ISO 9001 : 2000
Founder : Prof. M. Viswanathan

WHO Collaborating Centre for Research, Education & Training in Diabetes
No.4, Main Road, Royapuram, Chennai - 600 013.
Phone : 25954913 - 15/ 2595 0711 / 2595 3342 / 2596 3746 / 2596 0518. Fax : 91 - 44 2595 4919
www.mvdiabetes.com,www.mvdiabeticfoot.com, www.whoccdindia.com
Email: appointments@mvdiabetes.com

/.>k

FOCUS: HEALTH & MEDICAL CARE IN CHENNAI
rectomy and coil embolisation to treat AV
malformation to interrupt anomalous vascular channels and collateral vessels in the
case of acquired and congenital heart dis­
eases. IBalloon valvuloplasty and angioplasty
procedures routinely
routinely done
done in
in cases
cases in
in-­
are procedures
' pulmo
' ­
volving rheumatic mitral stenosis,
>is, congenital
and degenerative
nary stenosis,
o
P.
O
aortic stenosis, peripheral pulmonary stenosis and coartation of the aorta.
Arterial switch operations, pulmonary
atresia and single stage correction of intracardiac anomalies along with repair of arch
obstructions, beating heart surgery, complex
multi-valvular surgery, repair of cardiac
aneurysms, redo surgeries and the Ross Pro­
cedure are all routinely performed here.
Certain hospitals specialise in non-invasive
diology.
Among the doyens of cardiology in the
country is Dr. TJ. Cherian, who now offers
consultations at Devaki Hospital. Among
the surgeons who specialise in the treatment
of cardio-thoracic diseases in Chennai are
Dr. K.M. Cherian at the Madras Medical
Mission, Dr. V.V. Bashi at the MIOT Hospitals, Dr. K.R. Balakrishnan at the Sri Ra\
machandra
Medical College and’ Researchh
Institute, Dr. Solomon Victor at the Heart
Institute in the Vijaya Health Centre com­
plex, Dr. M.R. Girinath at the Apollo Hos­
pitals and Dr. K.N. Reddy at the Heart

agement centres. The M.V. Hospital I for
Diabetes and Diabetes Research Centre
(MVHR), the M.V. Diabetes Speciality
Centre (MVSC) and the Dr. V. Seshiah
Institute are
Diabetic Care and Research Institutej
major
major facilities.
facilities. The
The MVHR
MVHR isis one
one of the
oldest
oldest such
such hospitals
hospitals in
in the
the country.
couni Staked
asaager
genei
in 1954 by Dr. M. Viswanathan as
eral
1
•
1
•
1
______ _________ 1____ ™
hospital, it became a specialised centre in
1972. Over one lakh diabetics have been
treated here. One of its features is th it it
^e
focusses5 on diagnosing early those foot, eye
and kidney diseases that are rooted in diabetes. It has a well-structured diabetes edu­
cation programme. It was the first in Asia to
start an exclusive department for the pri­
mary prevention of diabetes. After Dr. Vis­
wanathan’s passing in 1996, Dr. Vijay
Viswanathan and Dr. A. Ramachandrati are
disease
is on thelifestyle
rise, owing
of the Centre,
jAl MOTHER
mainly to the
changing
and the directors
Dr. V. Mohan,
who was initially widi
mainly to the changing lifestyle and
eating habits - diabetes. A diabetic is two to the MVHR, started the M.V. Diabetes Spefour times more prone to heart disease and ciality Centre in 1991. More than 4^,000
30 times more prone to kidney disease than patients from within and outside the counothers. Seventy per cent of diabetics suffer try are treated at the MVSC every year. The
hospital has a full-fledged eye unit to | treat
mild to severe nerve damage and vision impairment. According to the International < diabetic retinopathy, a heart clinic, a foot
Diabetes Federation, India has over 33 mil- unit and' an impotency clinic.
According to Dr. S. Balaji of Apollo
lion diabetics, the largest number for any
one country. The figure is expected to dou­ Hospitals and Dr. Madhuri S. Balaji df the
Dr. V. Seshiah Diabetes Care and Research
ble in the next 10 years.
Chennai has a number ofdiabetes man- Institute, the alarming rate of increase in the

Foundation at the Vijaya Hospital.
The Madras Medical Mission (MMM)
that set uprthe Institute of Cardio Vascular
Diseases in June 1987 and does over 2,000
diagnostic and 3,000 interventional procedures every year, performed the countiy s
first successfid heart transplant
in the private
*
sector in 1995. It was the first in Asia to do
/
t. i
1
•
•
TMR (transmyocardial revascularisation)
laser surgery, itit has performed over
over 200
200
laser
such procedures. MMM specialises in the
arterial switch operation; this procedure was
donei on a four-year-old, the youngest to
undergo
it in India.
1
The Vijaya Heart Foundation, that
charges nominally for surgery, is wellequipped and offers comprehensive rehabil­
itation and preventive cardiology services.

The Sri Ramachandra Medical College and Research Institute.
118

FRONTLINE, JUNE 6, 2003

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incidence of diabetes can be halted only by primary prevention
j methods; lifestyle changes will not prevent die disease, they will
only postpone its onset. Maternal hyperglycemia, they say, has a
I direct effect on the insulin secretion function in the foetus. Thus, it
I is important to control gestation diabetes (diabetes during preg­
nancy), die risk of which for Indian women is 11.3 times higher
| compared to women in the West. Thus, they conclude that taking
care of pregnant women with abnormal glucose tolerance is die
I only way to prevent India from becoming “the diabetes capital of
I the world”.
A serious fallout of diabetes is end stage renal disease (ESRD)
i or kidney failure. Every year, over a lakh of people in India are
diagnosed to have ESRD, necessitating a kidney transplant or
continual dialysis. With hardly 650 dialysis units - equipment that
performs the work of die kidney - in the country, ESRD patients
often turn to Chennai for kidney transplants. The city has a
thriving trade in kidneys. Of course the city has an excellent set of
doctors who specialise in die management of renal problems and
perform kidney transplants. The nephrologists in Chennai include
Dr. M.K. Mani (Apollo) Dr. Sunil Shroff (SRMCRI), Dr. Amalorpavanadian (Government General Hospital), Dr. R. Ravichandran (Vijaya Hospital), Dr. K.C. Reddy (Devaki Hospital) and
Dr. Georgi Abraham (SRMCRI).
But with hardly 2,500 kidney transplant procedures being
' performed each year, managing the condition of renal failure
patients, supporting them and ensuring preventive care, have be­
come important tasks. In Chennai, there are institutions such as
| the Mohan Foundation and the Tamil Nadu Kidney Research
l Foundation that work on this. The former has created a support
| group for patients, physicians and the public and promotes a
I multi-organ cadaver programme set up by Dr. Sunil Shrofr. The
latter foundation set up by Dr. Georgi Abraham, provides fiI nancial assistance to the poor for dialysis, transplants, investiga­
tions and life-supporting medicines. Dr. M.K. Mani focusses on
| preventive care. His group at Apollo has adopted the Chennai
suburb of Sunkuvarchadiiram, and has been screening the over
25,000 people there for diabetes and hypertension since 1996.
With both these diseases under control at Sunkuvarchathiram,
nobody has had a kidney problem there in the last seven years.
Such preventive measures, says Dr. Mani, is what India needs as it
cannot afford to provide dialysis or transplant facilities to all those
who will otherwise need them.
Diabetes affects the eyes also. Over 60 per cent of diabetics end
up with retinopathy and lose dieir sight.
Among the well known eye care centres are Sankara Nethralaya (under Dr. S.S. Badrinath, offers consultations and treatment
to over 1,000 patients a day; 30 per cent of them free of cost);
Agarwal’s Eye Clinic (headed by Dr. R.S. Agarwal, it has a vision
analyser for mentally challenged persons and for children who
cannot express themselves); Rajan’s Eye Clinic (under Dr. N.
Rajan, specialises in squint and glaucoma); and the Eye Research
Foundation in Vijaya Hospital (Dr. Babu Rajendran here pio­
neered the use of lasers to treat eye diseases).
Some of the modern procedures and facilities available at these
centres are sutureless cataract surgery, automatic visual field analys­
er, excimer and lasik laser, Hindus flourescein angiography, laser
photocoagulation, paediatric ophthalmology’ and eye bank.
While Chennai has excellent facilities and professionals to treat
diseases caused by lifestyle changes, the importance of preventive
healthcare cannot be over-stated. For this, there is a need to map
the population, conduct epidemiological studies and concentrate
on preventive measures. I
FRONTLINE, JUNS 6, 2003

<

FOCUS: HEALTH & MEDICAL CARE IN CHENNAI

Coping with a deadly duo
Chennai has systems in place to cope with the challenges posed by HIV-AIDS and cancer.
ASHA KRISHNAKUMAR
' | 1 HERE is life after cancer and HIV
1 infection. To give patients and
their families this hope is the mission of
many of Chennai’s doctors.
There was a time when cancer was
seen as a terminal disease. But thanks to
sustained research and development ef­
forts in pharmacology and diagnostics
r-"! interventional advances, most
is of cancer are curable now, espe­
cially if they are detected early. The
Cancer Institute in Chennai function­
ing under the guidance of Dr. V. Shanta, a pioneer in the treatment of cancer
in Asia, has achieved a 75 per cent cure
rate, including in the case of paediatric
leukaemia. Dr. Shanta in fact says that
there can be a hundred per cent cure if
the disease is detected and treated early.
However, there has been a signif­
icant increase in the incidence of the
disease: the numbers have doubled in
the past decade. In India, about 10 lakh
people develop cancer every year, half
of them because of tobacco use. Tobac­
co use leads to oral (mouth), pharyngal
(throat), laryngal (voice box), oesoph­
ageal (food passage) and lung cancers.

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It is estimated that just by curbing to­
bacco use the share of oral cancer in the
incidence of all of forms of cancers can
be reduced from 29 per cent to 4 per
cent.
The Cancer Institute, which caters
mainly to the weaker sections, has
state-of-the-art facilities. Apart from
radiation therapy, chemotherapy and
surgery, it offers facilities for intra-operational radiation and 3-D conformal
therapy. Multimodal therapy for the
sake of organ conservation, and optimi­
sation methods to salvage limbs, apart
from surgical programmes, including
of the brain, are the strengths of the
Institute. Its bone marrow and paedia­
tric oncology departments are among
the best in the country. The Hereditary
Clinic, a first in the country, studies the
genetics of the disease. Its tobacco ces­
sation clinic is one of its kind in India.
In 1969 it was along with the Cancer
Institute that the World Health Orga­
nisation set up the first international
Cancer Control Programme in the de­
veloping world.
At the Institute the emphasis is on
preventive oncology, which has two i
components - prevention and early de-

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The main new block of the Cancer Institute, Adyar.
FRONTLINE, JUNE 6, 2003

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* BHAGWAN ADINATH JAIN COMPLKl «

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tection. The Cancer Institute seeks to
be sensitive to the patient’s emotional
needs, for which it has a specialised
support group, named Sanctuary.
The Institute’s financial needs are
great. A novel fund-raising campaign,
“iruvadhu varai iruvadhu” (20 till 20) is
under way. The idea is to collect Rs.20
from each person who can afford the
sum to raise Rs.20 crores. Says Dr.
Shanta: “This is not just about collect­
ing money, but a way of creating aware­
ness and generating hope and positive
action among people about cancer.’
Besides the Cancer Institute, the
multi-speciality hospitals involved in
oncological diagnosis and treatment are
Apollo Speciality Hospital, Sri Ramachandra Medical College and Research
Institute and the Rai Memorial
Hospital.

HE scourge of HIV/AIDS has reJL placed cancer as the biggest med­
ical concern. The first case of HIV
(human immunodeficiency virus) in­
fection in the country was detected at
the Madras Medical College Hospital
by Dr. Suniti Solomon. Since then, this
Professor of Microbiology has been acz tively working on the
§ clinical aspects of the
| disease, including in the
3 areas of research, train­
ing and management.
In 1993, Dr. Suniti So­
lomon set up a charit­
able trust, YRGCgre.
Apart from creating
awareness about AIDS
(Acquired Immune De­
ficiency Syndrome) and
training AIDS preven­
tion educators, the cen­
tre provides medical
care to economically
disadvantaged HIV pa­
tients. It is one of the
few centres in the coun­
try that is equipped and
willing to admit readily
.
patients
who
are
HIV-positive.
The centre now
functions on the prem121

Il

FOCUS: HEALTH & MEDICAL CARE IN CHENNAI____________ 1
over 70 such NGOs in the
ises of Voluntary Health Servic­
State. Among the better-known
es, with a 16-bed in-patient
NGOs working in the field in
facility, and also has the coun­
Chennai are the South India
try’s first intensive-care unit for
AIDS Action Programme (start­
such patients, apart from cre­
ed in 1988), the Community
ating a consortium of consult­
Health
Education
Society
ants to treat HIV-infected
(1997)
and
the
Indian
Commu
­
persons.
nity Welfare Organisation
According to WHO esti­
(1994). The Government Hos­
mates, India has the largest
pital for Thoracic Medicine, lo­
number of HIV-infected per­
cated at Tambaram on the
sons for any country and over
outskirts of Chennai, handles
half of all HIV-positive persons
the largest number of HIV-pos­
in South-East Asia. Tamil Na­
itive in-patients in any one
du, with a third of the country’s
medical facility in Asia. Started
identified HIV-infected per­
some decades ago as a sanato­
sons, woke up to the problem
rium for tuberculosis patienrc
early and created the country’s
the hospital has become a s
first AIDS prevention agency,
tuary for the HIV-positive, par­
the Tamil Nadu State AIDS
AIDS patients under treatment at the Government Hospital ticularly those from the poorer
Control Society (TANSACS).
for Thoracic Medicine in Tambaram, Chennai.
sections. About 50 per cent of
Realising the role of the comits 1,000 in-patients are HIV-positive.
mu:nity in the task, district-level socie­ to reach the people.
Providing a link with life is what
TANSACS, along with the AIDS
ties were formed under the District
Collectors. The government also in­ Prevention and Control Programme Chennai’s well-equipped hospitals, doc­
volved in the task non-governmental or­ (APAC) which is housed at the Volun­ tors and other medical professionals and
ganisations - most of them trusts and tary Health Services and is funded by NGOs do for the lakhs of people who
charity organisations, realising that they USAID, the United States Agency for come to the city with hopes of a cure for
could constitute the most effective route International Development, finances their ills. M

Rajan Eye Care Hospital
Center for Total Eye Care
State of Art Laser Eye Center for

_ Cataract
. Glaucoma
_ Diabetic Retinopathy
. Refractive Errors (short &
long sight)

Achievements Till Date
. 40,000 lOLs implanted for Cataracts

_ 450 Corneal transplant surgeries

_ 500 free eye-screening camps
30,000 school children - screened
. 50,000 people provided free medicines
1,00,000 people provided free spectacles

Also at
BHARANI HOSPITAL
#22, Arcot Road, Saligramam, Chennai-93 Tel ; 24847825 / 24840488

Eye Emergency Services Round the Clock

Rajan Eye Care Hospital
No.5, VIDYODAYA EAST II STREET, T.NAGAR, CHENNAI - 600 01 7
PHONE: 28259635/ 1468, 28231838 Fax: 91-44 -2827 8768
e-mail: rajaneye@md2.vsnl.net.in website : www.rajaneye.com

Towards
122

Excellence

in

EyeCare
FRONTLINE, JUNE 6, 2003
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