Don't have a heart attack...

...u00a0there are no ICU beds in Mumbai hospitals to accommodate you, say city docs. Malaria wave takes up most space, with shortage of medicines and patients developing complications

When 65-year-old Jaisingh Yadhav complained of acute breathlessness, owing to a heart ailment, he and his family had no inkling that they would have to shuttle for over three hours between their Versova residence, Bandra and back to Andheri.

Turns out that a majority of ICU beds in Mumbai are now occupied by malaria patients.

According to BMC figures,u00a0 over 6,300 malaria cases have been reported in the last nine months. This is an increase of nearly 47 per cent from 2,300 cases in the corresponding period last year, a trend attributed to the high humidity levels and soaring temperatures.

'We were helpless'
"My dad's condition was deteriorating in front of my eyes, but we were helpless. Luckily, the Holy Family hospital agreed to take the ECG and initiated the medical process to stabilise him. But when the question arose to keep him for the night in an ICU, we had to shift him to the Brahmakumari Hospital in Andheri," complains Yadhav's 18-year-old son, Nitin.u00a0

Yadhav's cardiologist Dr Robin Pinto categorically states that his patient's case was not an isolated one. Heart patients are routinely turned back by hospitals as their ICU units are filled with malaria patients.
"The monsoons in Mumbai may have been less than anticipated, but it has brought along much more than its fair share of malaria. With little or no space in ICUs, how will people with heart ailments get treated?" asks Dr Pinto.

Heart attack? Beware
Sharing his views, Dr Alan Soares, a physician attached to the Holy Family hospital in Bandra and Holy Spirit hospital in Marol, states that what was making matters worse was the fact that many malaria patients are also displaying symptoms of renal and chest complications.

"I now make it a point to book an ICU bed for my patients much in advance, as and when it is possible to schedule a surgery. But what if a patient has a sudden heart attack and needs to be admitted to an ICU urgently?" he asks.

'Blame high-end hospitals'
Cardiac surgeon Kaushal Pandey, who is attached to Hinduja, Lilavati and Wockhardt hospital, operates on almost 20 patients a week. He confirms that he was forced to postpone three to four operations in a week for the lack of ICU beds.

Dr Pandey puts the blame squarely on some high-end hospitals that deliberately turned back patients with malaria, as treating them was not a profit-making venture. This, he says, put extra pressure on lower-end hospitals and is now creating havoc.

"Many hospitals would rather have a patient in their ICU, who has a clear-cut operation like angioplasty or hip replacement. This has a high profit margin in minimum time. A malaria patient, if admitted, ends up occupying an ICU bed for days, but doesn't require any thing more that basic treatment. This is deemed as a low profit venture by such hospitals, which are run as pure business ventures," alleges Dr Pandey.

Dr Pandey adds that it is vital to have a humane approach to the anxieties of a heart patient and his family members, who can't be made to wait.

Less medicines, beds for malaria
Dr A V Hegde, of the internal medicine department in P D Hinduja hospital, says, "We are six doctors here admitting seven-eight malaria patients weekly. We have to turn away at least two because of the shortage of beds. In the OPD alone, we attend to two-three patients every day. Most patients display vivax strain that is less dangerous, but over the last two months, we have seen these patients displaying lung and kidney problems too."

Dr Vasant Shenoy, a senior physician from Santacruz, says that he was treating up to 50 cases of malaria on a daily basis.

What is making matters worse is the shortage of alpha-beta arteether, a high-end medicine for treating acute cases of malaria.

"I had to personally visit a wholesaler in South Mumbai to replenish my fast dwindling stock. Many malaria cases can be treated in the initial stages by this drug, which may avoid hospitalisation and clogging of beds in the ICU," says Dr Shenoy.

Have separate ICUs
Dr Hemant Thacker, consultant physician with Jaslok and Breach Candy hospital, says, "25 per cent of all malaria patients I have seen had to be hospitalised. Treatment is often incomplete or inadequate leading to resistance to medication and reoccurrence of the disease. Everyone from Malabar Hill to people living in the slums of Tardeo are affected. People suffering from other ailments are affected because the bed availability is on a first come, first serve basis and one can't turn away a patient without having them fully treated first."

Providing another solution to the problem, Dr Ashok Hatolkar, Medical Superintendent of Nanavati Hospital, states that other medical institutions should follow their suit by having separate dedicated departments and ICUs to deal with patients suffering from malaria and heart ailments. "Following this system, we have managed to keep a check on the problem," he states.

With inputs from Varun Singh and Alisha Coelho

No beds for you!
Most hospitals in the city do not have beds for the cardiac patients. Sunday MiD DAY called a few of them and this is what we were told by the doctors:
>>At Nair hospital, the doctor at the ICU told us that there were no beds available for any patient. "You better ask the doctor of the patient to talk to me. Right now, there is no bed available. If someone passes away or is discharged, the patient can be brought in."
>>At Bombay hospital, the scenario was a bit different. The doctor said, "The economy class ICU, where the patient has to pay Rs 1,500 per day is full, whereas the higher class ICU charging Rs 3,500 is available."
>>Dr Kishore Hargoli of the BMC said, "In the last six days, the number of samples examined is 10,293, out of which 737 patients have been tested positive for malaria. This year, the cases have gone up and the careless attitude of people not seeing a doctor for fever is one of the reasons why the numbers are rising."

The status
Bombay hospital: Beds available, but only in the costlier section
Nair Hospital: No beds available
Hinduja: No beds available
Bandra East Nursing home: No ICU
Parsi general hospital, Kemps Corner: Available
Lilavati: No beds available on Saturday, but available on Sunday.
Bhabha hospital: No beds available.
Breach candy: Beds available, but only if there is a dire emergency.

50
The average number of malaria cases hospitals are faced with everyday

737
Patients have tested positive for malaria in the last six days, says BMC