Jolene Prins

Finding the “care” in “healthcare”

16th November 2023

My 18-year-old daughter and I had to temporarily interrupt our trip through India because my little girl was feeling increasingly lousy: nausea, frequent vomiting and increased sensitivity to noise and light.

Her complaints are the aftermath of a fall she took three years ago during her Kung-Fu training in which she fell on her head, resulting in a concussion and displaced ribs. During our trip, her complaints came back so bad that we had to consult a local doctor.

India is not exactly the number-one country when it comes to healthcare. According to the Indian Times, the gap in demand and supply and chronic shortages are some of the concerns that need urgent attention*. And since mostly all processes here are agonisingly slow and inefficient, I was all the more surprised to find that I could make an appointment with a neurologist at Fortis Hospital in Vasant Kunj with just a few clicks on my mobile, skipping the appointment with a general practitioner that normally precedes seeing a specialist.

Sometimes, although initial arrangements might happen quickly, the real challenge of navigating the Indian healthcare system begins once you enter Fortis and descend to the basement where the consulting rooms are located. The place feels as crowded as the streets of Delhi, teeming with heavy traffic of patients, whole families and staff.

Ensuring your place in the consulting room

In the waiting-space, between all the consulting rooms where you patiently wait your turn, you have one job: to keep others from jumping the queue and taking your turn. While in the Netherlands, I might pass this time reading a magazine or scrolling on my phone, here, there are no magazines, and even if there were, it is too noisy, crowded and chaotic to read anything at all. And being distracted by your phone leaves you vulnerable to losing your place in line. I immediately understood why some people waited directly in front of the doctor’s door; while this initially comes across as being “pushy”, it’s just simply “ensuring your place”. Sometimes, there are entire families ensuring their place, clustered at the same door.

For my daughter — who went to the toilet on the verge of vomiting but came out even paler, her nausea worsened by the stench and filth in the bathroom — this kind of commotion was too much, and my motherly instincts kicked in. I just want to take my daughter, push past everyone, skip all the normal steps and get her into an MRI so I could get to answers faster.

And yet, Fortis is considered a quality hospital for people with money. Access to proper care — or any kind of care at all, for that matter — is very different for people living outside the city. For example, I heard a story about a the wife of a driver from Himachal Pradesh who had an accident: she was riding in the open doorway of an overcrowded bus and literally flew out of the bus as it took a very sharp curve at high speed, hitting her head on a rock. She fractured her skull and was carried by fellow passengers into the car of a passerby who noticed that urgent help was needed. In these areas, you need helpful people like that because either there aren’t any ambulances available or the many curves and potholes of the mountain roads make the wait for transport too long in an emergency. Not to mention the high costs.

As long as you have money, you stand a chance.

Delhi is many times better than rural areas in this respect. Even though you have to be familiar with the system to be helped, as long as you have money, you stand a chance. Fortis is a middle-class hospital, but in my opinion the rooms are a bit shabby, old-fashioned and even a bit dilapidated. I’m not sure I want to know what a hospital looks like where the poor have to go.

Despite its appearance, the smelly, unhygienic washroom and busy crowd, the neurologist took time to listen to my daughters story, to understand her condition and then to discuss options. Given how busy things were before we entered the consulting room, I was surprised at the serene and peaceful sensation this neurologist gave us. We got so much more time and attention than I initially expected.

Without a doubt, given the pain my daughter had in her neck, she referred us to the MRI department, and just 30 minutes later, my daughter was in the tube. Although medical discussions are slightly beyond the reach of our current knowledge of Hindi, we were treated with care and patience I have never experienced.

In the Netherlands, it takes at least two weeks to make an appointment with a private physician or general practitioner, then another three weeks to get the MRI done — if one gets a referral at all, which we didn’t there — and then another two to four weeks to get the results, which requires a new appointment with the private physician. Here, we literally entered the hospital at 10.30 in the morning and left at one in the afternoon with the report of the MRI scan under our arm to meet a chiropractor who was already at our doorstep to give her daily therapy at home. Although India is known for processes being difficult, and everything always takes a lot time, in this case, the Netherlands could learn from this speed and ease of care at home.

New perspective for Dutch healthcare

To me, it became clear that in India, the difference between healthcare options in the village and the city and what is available to the rich and poor, respectively, is mind-blowingly huge. Only money gets you somewhere, and not everyone in this country has access to that resource.

It has given us a different perspective on how privileged we are in the Netherlands, where we — rich and poor alike — can access a basic level of healthcare that is, by all measures, not too bad (though considerably slower than our experience at Fortis). While driving home, we realised this lack of a basic option for all leaves the poor in India at a tremendous disadvantage. It made me also realise how fortunate we are to have access to care in India as well. For us, the hospital visit was a good experience, which is not so for those less lucky and privileged.

About the author
Jolene has always had a strong connection to writing. While her professional work includes content for annual reports, websites, internal magazines, and company films, it’s the more personal, reflective writing that resonates most with her. She writes about what she observes, questions, and learns in everyday life. As Managing Director of a leadership communication agency THEY, Jolene divides her time between the Netherlands and India. Living and working in Delhi gives her the rare opportunity to experience local life up close—an experience that continues to shape both her perspective and her writing. Her blog offers reflections born from cultural friction as well as connection. She doesn’t write to explain, but to explore—and often gives voice to things others may have felt but not yet found the words for.

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