ALIGARH // When Nasir Khan cried out at night from the searing pain of kidney stones, the entire slum could hear him.
A magic healer promised an inexpensive cure through chanting while pinching his side where the kidney stones were lodged, but it only made it worse. His condition became life-threatening, and doctors said he would need surgery for a fourth time.
The operation cost him - and his extended family - their home.
Without insurance and unable to get a loan, they sold the broken brick shack in the industrial north Indian city of Aligarh for 250,000 rupees (Dh20,500). It had been home to the Mr Khan, 35, his four brothers, three wives and 11 children.
"There is no choice. It is my life," Mr Khan said in gasps, writhing atop a crude wooden cot as his relatives hovered helplessly nearby. He screamed for his mother. He screamed for Allah. He screamed for anyone to deliver him from the pain.
His story is repeated so often across India it evokes little sympathy, yet it represents one of the biggest threats to India's battle to lift its poor up from squalor.
Each year, the cost of health care pushes 39 million people back into poverty, according to a study published in The Lancet medical journal. Patients shoulder up to 80 per cent of India's medical costs. Their share averages about 3,000 rupees (Dh246.4) annually per person - a crippling sum for the 800 million or so Indians living on less than US$2 (89 rupees) a day.
A diagnosis of asthma, a broken leg or a complicated childbirth can mean having to choose between medicine or food, spending on treatment or relying on prayer.
While India boasts an economic growth rate near 9 per cent, the wealth has done little to help millions burdened by poverty and disease. The poor, aside from struggling to afford care, also face extreme shortages of doctors and medicines.
The situation is particularly dire in rural areas, where more than 70 per cent of the country's 1.2 billion people live. Some desperate patients resort to seeing quacks. Others pay bribes. Many simply don't seek help until it is too late.
The World Bank and other experts have warned that failure to address the country's healthcare woes could take a toll on long-term growth.
Yet India's government spends comparatively little on health care: just 1.1 per cent of the country's GDP, a figure that has not changed much since 2006 when China was spending 1.9 per cent; Russia, 3.3 per cent and Brazil, 3.5 per cent, according to World Health Organisation figures.
Dr K Srinath Reddy, the president of the Public Health Foundation of India and a member of a government-commissioned committee recommending reforms, said: "The political will is simply not there yet. We have to help realign the country's priorities."
Statistics that might highlight areas of need are scarce, thanks to erratic case reporting, few autopsies and a tradition of quick cremation that destroys evidence of disease. WHO reports often leave India out for lack of data. A recent study in The Lancet suggests malaria deaths could be 10 times higher than estimated.
India, which says hospital costs impoverish a quarter of all patients, has vowed to raise spending on health to 3 per cent of GDP by 2015 and provide universal primary health care - but it is an unfulfilled promise that has been made before.
The Lancet, in a series on India in January, urged the government to double its pledge to 6 per cent by 2020 or jeopardise its ability to shake off poverty.
"What is the point of economic success if there is nothing in it for the population?" editor Richard Horton said.
Meanwhile, India boasts a thriving medical tourism industry with shiny private clinics luring tens of thousands of foreigners for everything from bargain tummy tucks to experimental stem-cell treatments in an industry estimated to be worth nearly 100 billion rupees. The pharmaceutical industry is making lifesaving drugs at cut-rate costs, private hospitals are pioneering advances in open-heart surgery and medical schools are churning out physicians eager to work in the West.
2011年6月8日星期三
Against doctor's orders
Justin Melton woke up urinating blood.
It was May 14, a Saturday. It was the second and final day of the 3A East Regional Track Meet. Melton was scheduled to compete in four different events. He won them all.
Tuesday is when the pain came. It was a sharp, stabbing pain that came out of his lower back and extended all across his midsection. It was the worst pain of his life for a kid whose suffered torn ligaments and broken bones on the football field.
Still in agony, Melton went to the emergency room on Wednesday morning.
After checking for a wide range of culprits like an appendicitis, the hospital took a CT scan and saw a kidney stone about the size of a pencil eraser. They gave him some pain pills to help while he was trying to pass it, but the pain made him so nauseous that he couldn’t keep them, or the food he was supposed to take them with, down. Doctors prescribed him a drug called Dilaudid to be given through IVs, which Melton said was several times stronger than morphine.
“I don’t know what happened, man,” Melton said. “Someone above was looking out for me because Thursday morning, I woke up and they were going to send me to Cheyenne for surgery to get the stone removed because it was blocking my urine from leaving my kidney and my kidney was swelling up.”
Before leaving to drive south on I-25 to Cheyenne, Melton called track coach Wes Gamble to let him know he wasn’t going to make it to the state meet in Casper. Gamble told Melton not to worry about it. His health comes first. On the side though, the two, along with the rest of the Bearcat squad, knew they couldn’t win a state championship without Melton.
“I hung up the phone with him and I could tell that he was about in tears, but I hung up the phone and sat there for a minute and beat the hell out of my bed in the hospital and got my knuckles all bloody,” Melton said. “I stood up, ripped the IVs out of my arm and said, ‘Mom, Dad, we are going to Casper.’”
Melton’s mom, Junan, took some convincing. She was concerned about him rupturing a kidney or worse during the state meet, where Melton was expected to compete in the long jump, 100-meter, 200-meter and 400-meter dashes over the next three days. His dad, Rusell, sided with his son. It was the last track meet of his high school career. If he could tolerate the pain, then go for it. Over the next 15 minutes, they talked mom into rolling the dice and drove west instead of south.
Junan texted Gamble’s wife right away, telling her to tell him not to scratch Melton from his races. If Gamble had already told the officials to replace Melton, there was no going back on it. She reached him as he was talking to the officials, but before he told them to scratch Melton.
“I’m just glad that didn’t happen. Someone was looking out for me,” Melton said.
The long jump was scheduled for 11 a.m. As Melton walked toward his teammates at Kelly Walsh High School, the wind was howling on the wrong side of freezing. Snow was falling. Melton’s face was almost as pale as the white flakes. His pupils were dilated. His head was loopy from all the painkillers still clinging to so many of his nerve endings.
“What are you doing here?” A stunned Gamble asked.
“I’m long jumping, coach,” Melton answered.
“Alright. We’ll see how you feel when you’re running down the runway,” Gamble said.
Running in the 200-meter dash prelims wasn’t very painful, but the sudden stopping and the hard landings of the long jump hurt. His swollen kidneys throbbed with each heavy step.
“You know what it’s like jumping up and down on a full stomach? Imagine that times 20,” Melton said.
After the long jump and 200-meter dash, Melton went to see a specialist in Casper. The doctor told him the intense pain on Tuesday and Wednesday was when the kidney stone was passing through three small passages in the ureter, which connects the kidneys to the bladder. He most likely got the kidney stone in the first place from being dehydrated. It has always been a bad habit. He never takes drinks with him on the bus, forgets to drink water during meets, and the team doesn’t stop for dinner on the way home.
“‘I’ll probably never get dehydrated again,” Melton said.
Friday, he felt a little better and by Saturday he was feeling great for the finals. He won three out of four events and broke his own 3A state record in the 100-meter dash by .02 seconds. Douglas took second overall at the state meet, losing to Lander by 11 points.
“This year, I was a lot more excited for the team score (than individual medals). Gamble and I had done some serious number crunching to see what the team scores might end up like, and we were right there. I think me not winning hurt us a little bit and the incidents in the 300-meter hurdles was just bad luck,” Melton said, referencing Ty Etchemendy being disqualified for knocking a hurdle into another lane and Michael Addleman false starting. “What can I say about Ty Etchemendy. That kid is a freak. I can’t wait to come back and watch him over the next couple years. What happened to him was just bad luck.”
The weekend brought around another argument between Justin and his mom. He had prepaid $1,400 to go to Puerto Vallarta with about two dozen fellow seniors and chaperones. However, he still hadn’t passed the kidney stone. After much begging, Junan once again let Justin chase a once-in-a-lifetime experience at the risk of his health.
“I kind of got away with murder there,” Melton said.
Junan packed his bags with enough medication that he may now be on the DEA’s radar for suspicion of drug trafficking, but she let him get in the car and head off to the Denver airport.
At 3 a.m. at DIA, Melton gritted his teeth through 20 seconds of searing pain, which suddenly subsided when the kidney stone finally passed through the last of his system. Behind it was more than a week’s worth of urine.
“It took forever. I think I took the world record. It took at least three minutes,” Melton recalled.
When he was finally done, Melton greeted his friends, celebrating like he just scored a touchdown in the state championship. He also called his mom and left a voicemail with the good news. Now he could enjoy his vacation and she didn’t have to worry . . . as much.
“It timed up just perfect. Like I said. Someone has been looking out for me for awhile now.”
It was May 14, a Saturday. It was the second and final day of the 3A East Regional Track Meet. Melton was scheduled to compete in four different events. He won them all.
Tuesday is when the pain came. It was a sharp, stabbing pain that came out of his lower back and extended all across his midsection. It was the worst pain of his life for a kid whose suffered torn ligaments and broken bones on the football field.
Still in agony, Melton went to the emergency room on Wednesday morning.
After checking for a wide range of culprits like an appendicitis, the hospital took a CT scan and saw a kidney stone about the size of a pencil eraser. They gave him some pain pills to help while he was trying to pass it, but the pain made him so nauseous that he couldn’t keep them, or the food he was supposed to take them with, down. Doctors prescribed him a drug called Dilaudid to be given through IVs, which Melton said was several times stronger than morphine.
“I don’t know what happened, man,” Melton said. “Someone above was looking out for me because Thursday morning, I woke up and they were going to send me to Cheyenne for surgery to get the stone removed because it was blocking my urine from leaving my kidney and my kidney was swelling up.”
Before leaving to drive south on I-25 to Cheyenne, Melton called track coach Wes Gamble to let him know he wasn’t going to make it to the state meet in Casper. Gamble told Melton not to worry about it. His health comes first. On the side though, the two, along with the rest of the Bearcat squad, knew they couldn’t win a state championship without Melton.
“I hung up the phone with him and I could tell that he was about in tears, but I hung up the phone and sat there for a minute and beat the hell out of my bed in the hospital and got my knuckles all bloody,” Melton said. “I stood up, ripped the IVs out of my arm and said, ‘Mom, Dad, we are going to Casper.’”
Melton’s mom, Junan, took some convincing. She was concerned about him rupturing a kidney or worse during the state meet, where Melton was expected to compete in the long jump, 100-meter, 200-meter and 400-meter dashes over the next three days. His dad, Rusell, sided with his son. It was the last track meet of his high school career. If he could tolerate the pain, then go for it. Over the next 15 minutes, they talked mom into rolling the dice and drove west instead of south.
Junan texted Gamble’s wife right away, telling her to tell him not to scratch Melton from his races. If Gamble had already told the officials to replace Melton, there was no going back on it. She reached him as he was talking to the officials, but before he told them to scratch Melton.
“I’m just glad that didn’t happen. Someone was looking out for me,” Melton said.
The long jump was scheduled for 11 a.m. As Melton walked toward his teammates at Kelly Walsh High School, the wind was howling on the wrong side of freezing. Snow was falling. Melton’s face was almost as pale as the white flakes. His pupils were dilated. His head was loopy from all the painkillers still clinging to so many of his nerve endings.
“What are you doing here?” A stunned Gamble asked.
“I’m long jumping, coach,” Melton answered.
“Alright. We’ll see how you feel when you’re running down the runway,” Gamble said.
Running in the 200-meter dash prelims wasn’t very painful, but the sudden stopping and the hard landings of the long jump hurt. His swollen kidneys throbbed with each heavy step.
“You know what it’s like jumping up and down on a full stomach? Imagine that times 20,” Melton said.
After the long jump and 200-meter dash, Melton went to see a specialist in Casper. The doctor told him the intense pain on Tuesday and Wednesday was when the kidney stone was passing through three small passages in the ureter, which connects the kidneys to the bladder. He most likely got the kidney stone in the first place from being dehydrated. It has always been a bad habit. He never takes drinks with him on the bus, forgets to drink water during meets, and the team doesn’t stop for dinner on the way home.
“‘I’ll probably never get dehydrated again,” Melton said.
Friday, he felt a little better and by Saturday he was feeling great for the finals. He won three out of four events and broke his own 3A state record in the 100-meter dash by .02 seconds. Douglas took second overall at the state meet, losing to Lander by 11 points.
“This year, I was a lot more excited for the team score (than individual medals). Gamble and I had done some serious number crunching to see what the team scores might end up like, and we were right there. I think me not winning hurt us a little bit and the incidents in the 300-meter hurdles was just bad luck,” Melton said, referencing Ty Etchemendy being disqualified for knocking a hurdle into another lane and Michael Addleman false starting. “What can I say about Ty Etchemendy. That kid is a freak. I can’t wait to come back and watch him over the next couple years. What happened to him was just bad luck.”
The weekend brought around another argument between Justin and his mom. He had prepaid $1,400 to go to Puerto Vallarta with about two dozen fellow seniors and chaperones. However, he still hadn’t passed the kidney stone. After much begging, Junan once again let Justin chase a once-in-a-lifetime experience at the risk of his health.
“I kind of got away with murder there,” Melton said.
Junan packed his bags with enough medication that he may now be on the DEA’s radar for suspicion of drug trafficking, but she let him get in the car and head off to the Denver airport.
At 3 a.m. at DIA, Melton gritted his teeth through 20 seconds of searing pain, which suddenly subsided when the kidney stone finally passed through the last of his system. Behind it was more than a week’s worth of urine.
“It took forever. I think I took the world record. It took at least three minutes,” Melton recalled.
When he was finally done, Melton greeted his friends, celebrating like he just scored a touchdown in the state championship. He also called his mom and left a voicemail with the good news. Now he could enjoy his vacation and she didn’t have to worry . . . as much.
“It timed up just perfect. Like I said. Someone has been looking out for me for awhile now.”
2011年6月6日星期一
NCCo Executive Paul Clark treated for painful kidney stone
New Castle County Executive Paul Clark was treated at Christiana Hospital today for a painful kidney stone.
Clark was beginning his remarks at a morning event in Newark when the pain hit, which Clark likened to “someone hitting you in the kidney with a baseball bat.”
Clark, 55, was treated at the hospital, where the kidney stone apparently passed, and drove himself home around 3:30 p.m.
The county executive was with Gov. Jack Markell and others at the Newark Municipal Building to celebrate the town getting a Great American Main Street Award. The national award was given for the success of the Downtown Newark Partnership, a public-private initiative that focuses on downtown improvement projects.
Clark had to cut his speech short. He tried to drive himself to the hospital, but the pain got so bad he had to pull over and call county paramedics for a ride.
He said he now understands why even women who have experienced childbirth have called passing a kidney stone one of the most painful things a person can experience.
“When I was a kid I had a broken arm reset without anesthesia,” Clark said. “That was nothing compared to this.”
Clark was beginning his remarks at a morning event in Newark when the pain hit, which Clark likened to “someone hitting you in the kidney with a baseball bat.”
Clark, 55, was treated at the hospital, where the kidney stone apparently passed, and drove himself home around 3:30 p.m.
The county executive was with Gov. Jack Markell and others at the Newark Municipal Building to celebrate the town getting a Great American Main Street Award. The national award was given for the success of the Downtown Newark Partnership, a public-private initiative that focuses on downtown improvement projects.
Clark had to cut his speech short. He tried to drive himself to the hospital, but the pain got so bad he had to pull over and call county paramedics for a ride.
He said he now understands why even women who have experienced childbirth have called passing a kidney stone one of the most painful things a person can experience.
“When I was a kid I had a broken arm reset without anesthesia,” Clark said. “That was nothing compared to this.”
Notes: Matt Harrison plans to start Tues
Despite still not passing a kidney stone, Rangers pitcher Matt Harrison said he's planning on starting Tuesday's game against the Tigers.
Harrison, 25, went to a Cleveland hospital on Friday night because of the pain and then stayed at the team hotel on Saturday. He was back at the ballpark on Sunday and threw a bullpen session.
“It was fine," Harrison said about the bullpen session. "I didn’t feel any pain throwing. I ran to see if it would hurt bouncing up and down and that was fine. I guess tomorrow I’ll just go out there and throw.”
Harrison said Monday that he experiences pain in the mornings when he wakes up and sometimes late at night, but doesn't believe it will impact his ability to pitch on Tuesday.
The Rangers, though, will have a backup plan. Dave Bush is slated to spot start (again) if he isn't needed in Monday's game.
Other notes:
* Josh Hamilton said he tried to back off a little bit in Tampa Bay to guard against injuries, but "felt off" and isn't worrying about it any more. He said he'll try to play as smart as he can but can't alter his game much. "I'm telling myself to just relax and play," Hamilton said.
He said he didn't fight manager Ron Washington when he told him he was getting a day off, saying he knows he needs the time and has to utilize it wisely.
"I need my rest and can take time to work on things, but also give my body a break," Hamilton said. "I feel good."
Hamilton noted that usually in rehab assignments he gets a chance to play the field for five innings, then six, seven, etc. This time, he was only the DH, so he didn't get that easing in period. That makes the off days important. And he added that despite hitting two homers in two days, he doesn't believe getting a day off will hurt his rhythm.
* Brandon Webb said he could throw a bullpen session Tuesday or Wednesday and then hopefully pitch in a game after that. His rehab was stalled last week with rotator cuff inflammation, but he says medication appears to be working and he feels better. But he's yet to throw hard since feeling the discomfort, so the club will see how he feels after his next session and decide the next step from there.
* Washington said his team will have to grind through a tough stretch of road games this month. They are only in Arlington for three days before heading back out for a 10-game, 11-day trip through Minnesota, New York and Atlanta. "How do you stay fresh in 101-degree heat out there?" Washington said. "That's what the schedule is and we have to keep getting after it."
* Washington said he put Craig Gentry in as a defensive replacement for Endy Chavez on Sunday in Cleveland because he feels like Gentry can run down balls in the gap better and he wanted to be sure anything hit deep could be snagged.
* Scott Feldman (right knee) is scheduled to throw a bullpen session today. He says he's curious to see how he feels following it.
Harrison, 25, went to a Cleveland hospital on Friday night because of the pain and then stayed at the team hotel on Saturday. He was back at the ballpark on Sunday and threw a bullpen session.
“It was fine," Harrison said about the bullpen session. "I didn’t feel any pain throwing. I ran to see if it would hurt bouncing up and down and that was fine. I guess tomorrow I’ll just go out there and throw.”
Harrison said Monday that he experiences pain in the mornings when he wakes up and sometimes late at night, but doesn't believe it will impact his ability to pitch on Tuesday.
The Rangers, though, will have a backup plan. Dave Bush is slated to spot start (again) if he isn't needed in Monday's game.
Other notes:
* Josh Hamilton said he tried to back off a little bit in Tampa Bay to guard against injuries, but "felt off" and isn't worrying about it any more. He said he'll try to play as smart as he can but can't alter his game much. "I'm telling myself to just relax and play," Hamilton said.
He said he didn't fight manager Ron Washington when he told him he was getting a day off, saying he knows he needs the time and has to utilize it wisely.
"I need my rest and can take time to work on things, but also give my body a break," Hamilton said. "I feel good."
Hamilton noted that usually in rehab assignments he gets a chance to play the field for five innings, then six, seven, etc. This time, he was only the DH, so he didn't get that easing in period. That makes the off days important. And he added that despite hitting two homers in two days, he doesn't believe getting a day off will hurt his rhythm.
* Brandon Webb said he could throw a bullpen session Tuesday or Wednesday and then hopefully pitch in a game after that. His rehab was stalled last week with rotator cuff inflammation, but he says medication appears to be working and he feels better. But he's yet to throw hard since feeling the discomfort, so the club will see how he feels after his next session and decide the next step from there.
* Washington said his team will have to grind through a tough stretch of road games this month. They are only in Arlington for three days before heading back out for a 10-game, 11-day trip through Minnesota, New York and Atlanta. "How do you stay fresh in 101-degree heat out there?" Washington said. "That's what the schedule is and we have to keep getting after it."
* Washington said he put Craig Gentry in as a defensive replacement for Endy Chavez on Sunday in Cleveland because he feels like Gentry can run down balls in the gap better and he wanted to be sure anything hit deep could be snagged.
* Scott Feldman (right knee) is scheduled to throw a bullpen session today. He says he's curious to see how he feels following it.
2011年6月1日星期三
Causes of Kidney Problems
Kidney is one of the important organs of our body, which works as a filter for flushing out waste products and various toxins from our body through urine. It is also responsible for regulating electrolyte levels from the body, which is very important for living a healthy life. Here are some of the causes of Kidney problems:
Improper Diet: Unhealthy diet is one of the most important causes of kidney issues, as food that is high in calcium may lead to kidney problems such as stone or other related issue. So, patient of kidney problems should avoid food, which is high in calcium.
Obstruction of the bladder: Problems in bladder can also cause backpressure to kidneys, as the urine float back into the kidneys. Therefore, the kidneys can be damaged due to the backpressure of urine. This condition can be serious, so immediate supervision of doctor is required.
Caffeine and Junk Food: Excess consumption of caffeine such as tea, coffie and junk food can also be responsible for kidney stones or other problems, as it disturbs our metabolism and digestive system.
Wrong Medications: Wrong medications and excess consumption of vitamins A and D are also related to the formation of calcium in the body.
The above-mentioned causes can help readers to get a better understanding about the disease, which can be used to take preventive measures to get rid of kidney issues. It is strongly recommended to consult your doctor before following any of the mentioned measures in the article.
Improper Diet: Unhealthy diet is one of the most important causes of kidney issues, as food that is high in calcium may lead to kidney problems such as stone or other related issue. So, patient of kidney problems should avoid food, which is high in calcium.
Obstruction of the bladder: Problems in bladder can also cause backpressure to kidneys, as the urine float back into the kidneys. Therefore, the kidneys can be damaged due to the backpressure of urine. This condition can be serious, so immediate supervision of doctor is required.
Caffeine and Junk Food: Excess consumption of caffeine such as tea, coffie and junk food can also be responsible for kidney stones or other problems, as it disturbs our metabolism and digestive system.
Wrong Medications: Wrong medications and excess consumption of vitamins A and D are also related to the formation of calcium in the body.
The above-mentioned causes can help readers to get a better understanding about the disease, which can be used to take preventive measures to get rid of kidney issues. It is strongly recommended to consult your doctor before following any of the mentioned measures in the article.
Delhi zoo water not fit for consumption
New Delhi: A year after nearly 20 blackbucks died in the Delhi zoo because of contaminated water, little has been done. A study by the central pollution control board reveals that the water in the zoo remains contaminated.
The report found high levels of dissolved solids - upto 16 times over the permissible limit of 500 milligrams per litre. This can lead to kidney stones and intestinal infections in mammals. High levels of Biological Oxygen demand were found upto 35 milligrams per litre way above the limit of 3 milligrams per litre, beyond which, fish don't survive. The total hardness of the water too was 5 to 8 times beyond the normal.
High levels of Total Dissolved Solids or the minute solid particles found in water ranged from 950 to 8000 mg/litre that is 2 to 16 times more than the permissible limit of 500 mg/L. This can lead to kidney stones and intestinal infections in mammals. High level of Biologial Oxygen Demand or the amount of oxygen required ranged from 19- 35 mg/L in the water bodies. The limit should be just 3mg/L.
The Environment Minister Jairam Ramesh who was at the zoo after the death of a giraffe last week, raised concern.
Jairam Ramesh said, "When I heard of the giraffe, first thing that came to my mind was that the water was contaminated."
Blocked drains at the zoo are also leading to the backflow of the sewage water which is further posing a threat to the health of the animals.
Wildlife activist Kartick said, "It's a city problem basically. MCD/PWD there are so many agencies - they control water supply going out of zoo and if that chanel is not cleared, Delhi zoo will not get its water out."
Zoo officials however maintain that safe drinking water is being supplied to the animals separately.
Water in the hippopotamus pond looks highly contaminated even through the naked eye. While various agencies are on a mission to de-silt the drains, the question is will this happen by the time monsoon arrives when there is always a risk of water logging and sewage contamination.
The report found high levels of dissolved solids - upto 16 times over the permissible limit of 500 milligrams per litre. This can lead to kidney stones and intestinal infections in mammals. High levels of Biological Oxygen demand were found upto 35 milligrams per litre way above the limit of 3 milligrams per litre, beyond which, fish don't survive. The total hardness of the water too was 5 to 8 times beyond the normal.
High levels of Total Dissolved Solids or the minute solid particles found in water ranged from 950 to 8000 mg/litre that is 2 to 16 times more than the permissible limit of 500 mg/L. This can lead to kidney stones and intestinal infections in mammals. High level of Biologial Oxygen Demand or the amount of oxygen required ranged from 19- 35 mg/L in the water bodies. The limit should be just 3mg/L.
The Environment Minister Jairam Ramesh who was at the zoo after the death of a giraffe last week, raised concern.
Jairam Ramesh said, "When I heard of the giraffe, first thing that came to my mind was that the water was contaminated."
Blocked drains at the zoo are also leading to the backflow of the sewage water which is further posing a threat to the health of the animals.
Wildlife activist Kartick said, "It's a city problem basically. MCD/PWD there are so many agencies - they control water supply going out of zoo and if that chanel is not cleared, Delhi zoo will not get its water out."
Zoo officials however maintain that safe drinking water is being supplied to the animals separately.
Water in the hippopotamus pond looks highly contaminated even through the naked eye. While various agencies are on a mission to de-silt the drains, the question is will this happen by the time monsoon arrives when there is always a risk of water logging and sewage contamination.
2011年5月29日星期日
After drug thefts from patients, hospitals are working to prevent such crimes, improve safety
Over six months last year, nearly 1,500 pills prescribed to 35 residents of a Sauk Rapids health care facility went missing under nurse Lora Asfeld's watch.
Asfeld later admitted to stealing the drugs, mostly painkillers. She was fired, reported to police and had her license suspended in February by the Minnesota Board of Nursing — one of 13 licensees to be disciplined over a roughly four-month period for stealing pain medication.
While drug thefts have long been an issue in hospitals and nursing homes, top health officials are taking new steps to address the problem. The Minnesota Hospital Association and state Health Department are organizing a coalition of hospitals and licensing boards to identify and close loopholes in drug-handling protocols that make it easier to steal.
"People are starting to realize that this is a serious and ongoing problem," said Keith Berge, who chairs Mayo Clinic's medication diversion prevention committee. "They're starting to recognize what they've been seeing. I think we've been seeing this all along and not recognizing it for what it is."
In perhaps the most dramatic recent case, a nurse anesthetist in Minneapolis was accused of taking most of the painkiller intended for a patient undergoing kidney stone surgery in November. A criminal complaint said the nurse told the patient to "man up" as he endured the worst pain.
Opioid pain relievers like fentanyl or oxycodone are the most commonly stolen prescription drugs, according to the Drug Enforcement Agency. Hospital workers have stolen them by replacing a patient's prescription with ibuprofen, siphoning medication from IV bags, taking leftovers meant for the trash, falsifying patient records and forging prescriptions.
Once someone is addicted to prescription drugs, they'll go to great lengths to get their fix, said Ron Buzzeo, who was deputy director of the DEA's Office of Diversion Control for more than two decades before retiring in 1990. He now consults for hospitals.
"People who are abusing drugs are extremely creative," Buzzeo said. "It's difficult to stay one step ahead of them."
There is no central tracking system for drug theft by medical personnel in Minnesota, and since facilities report incidents to a variety of entities, it's difficult to tell how often it happens. Many facilities don't report all drug thefts to the DEA, despite a federal law requiring that they do, said Jack Henderson, supervisor of the DEA's local diversion group.
Hospitals can be vulnerable if they don't have a thorough tracking system for their medications, ideally an electronic one. Since many drugs stolen are bound for the trash, hospitals should also have a disposal system that includes safeguards such as requiring half-empty bottles or syringes be returned to the pharmacy.
Tracking is generally done through software linked to password-protected medication cabinets called automated dispensing units. That lets facilities check for high-use patterns by a certain employee, or for more complaints of pain than usual from patients who should've received enough medication.
In the past decade, most hospitals in Minnesota have gotten automated dispensing machines. At Hennepin County Medical Center, they look like short, wide vending machines. When a nurse enters his or her password, a list of patients pops up, along with the medications for each. Once a medication is selected, a drawer pops open.
If a drug is packaged in a quantity larger than the patient's dose, the remainder must be thrown away. If it's a narcotic, many hospitals require nurses to have a co-worker verify they watched by typing their password into the machine.
After a 2008 incident in a Mayo hospital in Mankato in which a nurse replaced fentanyl with saline, Mayo Clinic in Rochester formed a committee to improve their protocols. All leftover medication from operating rooms is now collected in a locked drop box that's returned to the pharmacy, which randomly tests them to ensure they weren't diluted, Berge said. That method will soon include all high-use areas.
"This system is expensive, labor-intensive and somewhat cumbersome," Berge said, "but it's the only way you can close the loop on dealing with this problem.'"
In March, St. Cloud Hospital found itself dealing with a rash of unusual infections that it ultimately concluded were caused by a nurse using a syringe to steal painkiller from IV bags. The hospital has taken steps to make that harder, including placing tamper-resistant plastic caps over the ports where medication is added. Plastic bags are placed over the IV bags that can only be removed by perforating them.
High-tech systems such as dispensing machines are expensive. HCMC spent more than $2.5 million on its 80 machines. Smaller hospitals and nursing homes may rely on paper records to spot thefts.
Benedictine Health Systems, a long-term care provider with headquarters in Duluth and Cambridge, typically uses bound notebooks with numbered pages to document medication, and it'd be obvious if a page was missing, said Howard Juni, who provides medications to Benedictine facilities.
Some nursing homes use video cameras. That's how a Burnsville assisted living center caught a health care aide in 2009 stealing OxyContin from an 89-year-old resident and replacing it with ibuprofen. But Juni said placing video cameras in residents' rooms raises privacy issues and can be done only with permission and when there's reason to believe the employee is stealing.
Despite hospitals' best efforts, most experts say it's impossible to eliminate drug theft entirely.
"We could spend an infinite amount of money creating electric fences around these things, and we would still never completely stop the problem," Berge said.
Asfeld later admitted to stealing the drugs, mostly painkillers. She was fired, reported to police and had her license suspended in February by the Minnesota Board of Nursing — one of 13 licensees to be disciplined over a roughly four-month period for stealing pain medication.
While drug thefts have long been an issue in hospitals and nursing homes, top health officials are taking new steps to address the problem. The Minnesota Hospital Association and state Health Department are organizing a coalition of hospitals and licensing boards to identify and close loopholes in drug-handling protocols that make it easier to steal.
"People are starting to realize that this is a serious and ongoing problem," said Keith Berge, who chairs Mayo Clinic's medication diversion prevention committee. "They're starting to recognize what they've been seeing. I think we've been seeing this all along and not recognizing it for what it is."
In perhaps the most dramatic recent case, a nurse anesthetist in Minneapolis was accused of taking most of the painkiller intended for a patient undergoing kidney stone surgery in November. A criminal complaint said the nurse told the patient to "man up" as he endured the worst pain.
Opioid pain relievers like fentanyl or oxycodone are the most commonly stolen prescription drugs, according to the Drug Enforcement Agency. Hospital workers have stolen them by replacing a patient's prescription with ibuprofen, siphoning medication from IV bags, taking leftovers meant for the trash, falsifying patient records and forging prescriptions.
Once someone is addicted to prescription drugs, they'll go to great lengths to get their fix, said Ron Buzzeo, who was deputy director of the DEA's Office of Diversion Control for more than two decades before retiring in 1990. He now consults for hospitals.
"People who are abusing drugs are extremely creative," Buzzeo said. "It's difficult to stay one step ahead of them."
There is no central tracking system for drug theft by medical personnel in Minnesota, and since facilities report incidents to a variety of entities, it's difficult to tell how often it happens. Many facilities don't report all drug thefts to the DEA, despite a federal law requiring that they do, said Jack Henderson, supervisor of the DEA's local diversion group.
Hospitals can be vulnerable if they don't have a thorough tracking system for their medications, ideally an electronic one. Since many drugs stolen are bound for the trash, hospitals should also have a disposal system that includes safeguards such as requiring half-empty bottles or syringes be returned to the pharmacy.
Tracking is generally done through software linked to password-protected medication cabinets called automated dispensing units. That lets facilities check for high-use patterns by a certain employee, or for more complaints of pain than usual from patients who should've received enough medication.
In the past decade, most hospitals in Minnesota have gotten automated dispensing machines. At Hennepin County Medical Center, they look like short, wide vending machines. When a nurse enters his or her password, a list of patients pops up, along with the medications for each. Once a medication is selected, a drawer pops open.
If a drug is packaged in a quantity larger than the patient's dose, the remainder must be thrown away. If it's a narcotic, many hospitals require nurses to have a co-worker verify they watched by typing their password into the machine.
After a 2008 incident in a Mayo hospital in Mankato in which a nurse replaced fentanyl with saline, Mayo Clinic in Rochester formed a committee to improve their protocols. All leftover medication from operating rooms is now collected in a locked drop box that's returned to the pharmacy, which randomly tests them to ensure they weren't diluted, Berge said. That method will soon include all high-use areas.
"This system is expensive, labor-intensive and somewhat cumbersome," Berge said, "but it's the only way you can close the loop on dealing with this problem.'"
In March, St. Cloud Hospital found itself dealing with a rash of unusual infections that it ultimately concluded were caused by a nurse using a syringe to steal painkiller from IV bags. The hospital has taken steps to make that harder, including placing tamper-resistant plastic caps over the ports where medication is added. Plastic bags are placed over the IV bags that can only be removed by perforating them.
High-tech systems such as dispensing machines are expensive. HCMC spent more than $2.5 million on its 80 machines. Smaller hospitals and nursing homes may rely on paper records to spot thefts.
Benedictine Health Systems, a long-term care provider with headquarters in Duluth and Cambridge, typically uses bound notebooks with numbered pages to document medication, and it'd be obvious if a page was missing, said Howard Juni, who provides medications to Benedictine facilities.
Some nursing homes use video cameras. That's how a Burnsville assisted living center caught a health care aide in 2009 stealing OxyContin from an 89-year-old resident and replacing it with ibuprofen. But Juni said placing video cameras in residents' rooms raises privacy issues and can be done only with permission and when there's reason to believe the employee is stealing.
Despite hospitals' best efforts, most experts say it's impossible to eliminate drug theft entirely.
"We could spend an infinite amount of money creating electric fences around these things, and we would still never completely stop the problem," Berge said.
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