Medicines–Hurdle in Conducting Medical Camps in Rural Area of Bharat : National Medicos Organisation

Medicines–Hurdle in Conducting Medical Camps in Rural Area of Bharat- Now a days Medicines are the main hurdle / obstacle in conducting

“Medical Camps in Rural Areas of Bharat" as - 

1. Who will arrange / sponsor medicine, so if medicines are not arranged, there will be no medical camp even if all the interested doctors are willing to conduct or go to rural area every week ....but availability of medicines is the main hurdle for them.
2. If medicines are arranged any how then sometimes low cost medicines (open tablets) and quality may be compromised), which may harm the patients on long storage ( After expiry ).
3. Who will carry medicines to village (transportation of medicines), car, jeep or arrangement of vehicle if not arranged, no medical camp ? 
4. Whether all medicines are there or not, there is hidden fear in team that, if any important medicine is missing then what will happen in camp ? Concern of authorities & doctors .
5. Who will dispense the medicines, whether he will be dispensed as prescribed or not, errors in prescribing and dispensing may be unexperienced staff or in hurry.
6. After prescribing medicines, there will be NO TIME for patient education, which is most important part of any prescription.What is patient's attitude after prescription ? Patient will try to get rid of consulting chamber as he has ess time, moreover doctor also satisfied by giving medicines ( Gifting kidney failure, gastritis by pain killers) for joint pain.In fact doctors are sacrificing their patients kidneys, liver and stomach for simple protective symptom of pain.Moreover after first or second consultation patient self medicate himself by consuming pain killers and lend up in damaging his/ her kidney, liver, stomach and other vital organs ( Burden for Nation).
7. When medicines are available, 50 % patients will attend camp to take medicines to store at home ( esp. Syrups of vitamins , Iron and Cough ) and no. of patient attending medical camps will increase 400 - 500 patients in ___ hours ,
so all team has to work fast, NO PROPER HISTORY,NO PROPER DIAGNOSIS ,NO PATIENT EDUCATION, if doctor is in doubt about diagnosis, how he prescribe medicines ? So incorrect diagnosis lend up with wrong 
prescription resulting in Iatrogenic drug related disease, wastage of medicines, drug resistance, drug interactions in short “ Irrational Use of Medicines ”. 
8. All these things / experience happened to us all, many times but we are still doing the same thing (Just like eating junk food in party, hotel and marriages though we don’t like it) on and on, so think it over that when doctor visit village
without medicines ...what is villager’s reaction ??? They will not pay any attention to doctor and his team, so what to do ????
There is lot of POOJA / SEVA / WORK for the patients / people who attend "MEDICAL CAMP WITHOUT MEDICINES" which are as follows – 
Medical Camp Without Medicines – 
1. Our country is flooded with life style disease and in near future there will be epidemic of diabetes , hypertension, coronary artery disease , obesity , osteoporosis , depression , cancers etc all these can be prevented , by a responsible doctors of the Bharat and medicines are not required for this work , only the will/ desire of doctor with monitoring and awareness about the disease is required.
2. Measure blood pressure and motivate hypertensives to follow life styles modifications +Regular Medicines & BP check up record. If we detect any prehypertensive (Systolic between 121 - 140 and diastolic between 81 - 90 mm of Hg ) or new hypertensive and convince him / her that life style modification alone may retard or stop the progression of his raising blood pressure , then it will be of great help to him , his family and ultimately to the nation.
So during these camps (Without medicines) doctor should try to detect prehypertensives and educate them about disease, it's progression, possible complications and life style modification to prevent that disease or progression of disease or reverse the prehypertensive stage should be our goal / aim of MEDICAL CAMP WITHOUT MEDICINES.
3. Measure blood glucose of susceptible persons to diagnose diabetes mellitus and motivate them to do regular exercise ( swimming, walking, cycling etc ) and proper dietary advice.
4. Detect metabolic syndrome - According to guidelines from the National Heart, Lung, and Blood Institute (NHLBI) and the American Heart Association (AHA), metabolic syndrome is diagnosed when a patient has at least 3 of the following 5 conditions :-
1. Fasting glucose ≥100 mg/dL (or receiving drug therapy for hyperglycemia)
2. Blood pressure ≥130/85 mm Hg (or receiving drug therapy for hypertension)
3. Triglycerides ≥150 mg/dL (or receiving drug therapy for hypertriglyceridemia)
4. HDL-C <40 mg/dL in men or <50 mg/dL in women (or receiving drug therapy for reduced HDL-C)
5. Waist circumference ≥102 cm (40 in) in men or ≥ 88 cm (35 in) in women
If patient is in metabolic syndrome then there is 6–7% for all-cause mortality, 12–17% for cardiovascular disease, and 30–52% for diabetes. So in susceptible individuals and educate them to reverse the metabolic syndrome and progression of life style diseases like diabetes, hypertension , coronary artery diseases, obesity.
5. Educate people about scientific methods to quit tobacco and hazards of tobacco. Doctor should help them to quit tobacco and related products.(Carry photo albums, charts of Cancer Education).
If we are able to convince one tobacco chewer to quit tobaccoit will be of tremendous benefit in the nation building. Distribute Educational Pamphlets (Local language) about “Methods to quit tobacco” (One Side) and " Methods of quitting tobacco" (Other Side).
7. To educate and make people aware of benefits of cycling / exercise, like increase good cholesterol, increase bone calcium , prevent osteoporosis , prevent diabetes mellitus , relieves anxiety etc ).
Prepare at least one educational chart of "Benefits of Cycling or Exercise" in local language.
8. Educate people of village about of govt. health programmes like MAMTA CARD, health benefits for low income people (BPL CARD HOLDERS), school health programmes, National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases.
9. Educate about eye ,organ and blood donation. Educate people to donate blood esp. on their birthdays and tell them that 350 ml of their blood will save lives of four patients.
10. School health education.
Health education for schools - 
1. Hand Hygiene - Handwashing before meals 
2. Nail trimming every week ...
3. Teeth brushing after dinner ...
4. Study in 40 watt tube light ....
5. One glass milk and an egg daily ...
6. Motivate parents to leave tobacco / smoking / alcohol ...
7. Clean drinking water ...
8. Regular football ....
9. Pray before each meal ....
10. Visit to temple regularly ....
11. Avoid cell phones and internet connection in mobile phones....
12. Avoid to see dirty pictures ...
13. Avoid cricket TT / Kabbadi / Football ....
14. Do plantation and post plantation care ....
15. Importance for school prayer and pledge ....
16. Visit to nearby medical college and hospital if possible ..
17. Meeting of school childrens with pediatrician ..
18. Education about symptoms of common diseases typhoid , malaria , dengue, hypertension , diabetes, CAD , osteoporosis , diarrhoea, anemia, leukorrhoea, depression, stroke,...and how to prevent them ....
19. Importance of cycling, swimming and aerobics ...
20. Avoid to walk bare foot outside house
21. Avoid open field defecation
22. Help teachers in clean school ..clean village ..clean Bharat
23. Blink your eyes more and more during reading
24. If pain in eyes during reading ..consult opthalmologist ( Refractive error )
25. If tires early on mild exertion , consult physician ( Valvular heart diseases)
26. Take one fruit daily
27. Eat green leafy vegetables and pulses
28. Avoid uncooked meat , unboiled milk and raw edibles
29. Avoid swimming in dirty water collections...
30. Respect parents, elders, woman and teachers..
31. Weight and height regularly 
32. Separate latrine for boys and girls, soap should be available at wash basin with full supply of water for handwashing.
33. Blood test for Anemia for adolescent girls in schools.
34. Motivate parents to use Iodized salt. 
35. Use mosquito nets , repellants , to avoid bite
36. Pour sand and soil in small water collections in their villages to avoid breeding of mosquito
37. Empty small water collections , knowledge of dengue and malaria mosquito 
Suggestions expected .................................................. Bharat Mata Ki Jai...
Important to understand “Medical Camp Without Medicines” 
1. Doctor is more important than medicines and prove by your attitude, experience & knowledge. If patients have a respect for doctor he / she will definitely attend and listen you.
2. It is a challenge for a doctor to attend patients without medicines, doctors knowledge and experience will improve day by day to educate patients of hypertension, diabetes, joint pain, common cold, obesity , and other life style diseases. 
3. When medicines are not available, only interested people will attend the camp for health education and / or diagnosis of their ailment.
4. Due to shortage of money, medicines and infrastructure many of enthusiastic and patriotic doctors are restricting themselves to attend / visit villages. As they know that without medicines, their dignity and glamour of medical camp may be compromised.
5. Prescribe medicines in the camps after examining patients. When medicines are available in medical camps,most of the patients gives false history to store medicines. 
6. We experienced this in our clinics and hospitals that without follow up visits in most of the diseases treatment is incomplete. Moreover chances of misdiagnosis will increase when doctor - patient ratio is disturbed ( i.e. average 100 patients seen and treated by one doctor ) in one medical camp per day. Most of us are not super-specialists or post graduates, and we are treating the poorly educated patients in villages without proper diagnostic facilities. This is the 
So initially this concept of “ Medical Camp Without Medicines ” is less acceptable to some of our peers, but someone has to do work “ To Prevent And Detect The Disease esp, Hypertension and Metabolic Syndrome ”And “ Tobacco Deaddiction ”
“ Power is within you ; and you can do anything and everything in this world “
Dr. Narendrakumar P. Paliwal 
Joint Secretary ( West Zone ) National Medicos Organisation , 
Tutor and first year resident in Pharmacology,
Govt. Medical College,
Bhavnagar ( Gujarat ) , 364001
Mobile no- 09227500879 / 07777941110



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