Radha (name changed) is no more. Why did she die?

[Guest guest]

Dear all,

I want to share the grief of this lady's (who died in her mid

thirties,after around five years of ARV and HIV) family.

Radha (name changed) was brought to me way back in 2005 with Koch's,cd4 38 and

the internal medicine person having no hope of her survival.

She was admitted and her life's derailed train was brought back to rails-she

survived. Koch's treatment completed and ARV's were instituted at the start

only.

Few months after her survival, the money constraint started telling upon the

financial health of the family, not only that Amritsar also had the free ARV

roll out by then.

She ,therefore was referred to the the govt.ARTcentre.

Yesterday she was brought to me almost after four years in once again almost

dead state, which sent a shock wave down the spine of a physician like me who

has faith in ARV " s.

The reason was simple---her records told that although she was regular in her

hospital visits,tests and medicines, yet the persons

concerned failed to notice her going down by all ways (she was loosing

weight once again since last eight months or so, her last two cd4 counts were

showing a drastic downtrend.

These are done six months apart in govt run ARV centers,her Hb fell to as low as

5 gm%,she had reappearance of ? Koch).

My fear can go away if no more " Radha's die .

Why did she die?

The answer can be

1.The staff (specially MO) is incompetent and missed the failing regimens

2.The staff is over worked--I hear Amritsar center has same strength of staff

despite the work load being ten times or so

3.There are restrictions on the staff of to refer cases in time

4.There are restrictions on the staff to consult locally available expertise

5.The physician who refers the patient to these centers for the first time is

never kept in the loop.It is a practice of good centers to keep the referring

person informed about his/her patient.

There can be many more answers to be replied.

I have posted this condolence message so as to avoid any such mishaps in future.

Let's all specially those who matter do some post mortem studies and make things

more healthy.

let people not die despite regular treatments---do some introspection

Good luck NACO

Rakesh Bharti

e-mail: <rakesh.bharti1@...>