Extreme poverty leads to the death of nearly 50% of patients with severe head injury cases within six months of their discharge from the trauma centre at the All India Institute of Medical Sciences, an internal study has found.
Almost all of them slipped into a vegetative state after sustaining severe head or spine injury, and the families did not have enough means to meet their nutritional requirements and provide nursing care, underlining the importance of hospice facilities that are scarce in India.
The doctors at the centre followed up on 2,500 discharged patients from the neurosurgery department over a period of five years, starting 2008. Patients were observed for a maximum of one year before being declared vegetative.
“These people belonged to migrant families in the Capital and usually were the sole breadwinners who left their village in search of work. Their wives were unable to generate enough money to keep them alive, especially with three-four kids to take care of,” said Dr Deepak Agrawal, senior surgeon at the trauma centre.
The trauma centre – the only functional one in the Capital -- gets about 200 injury cases in a day, of which about 40% suffer head or spine injury. 10% of those need admission, which means the hospital requires 10-15 vacant beds daily.
In hospitals such as AIIMS, where shortage of beds is a daily problem, these patients with no chance of recovery– at least six at any given point – occupy beds for the want of any hospice facility.
Over 3,300 people die in road accidents everyday in India and nearly a third of them result in severe head injuries but hospice facilities are scarce, resulting in terminally-ill patients occupying care beds and denying them to some acutely-injured patients.
Due to lack of enough research, however, there is no consolidated data to gauge the enormity of the problem.
About 20% of those discharged from the AIIMS trauma centre are in a vegetative state, which means there is no responsiveness and awareness due to irreversible injury to the brain. All these people need is nursing care to avoid bed sores and chest infection.
These patients can’t eat regular meals; a mixture of a glass of milk, sugar, soybean powder and a little ghee or oil is what they require three times a day to survive.
As most of the people in a vegetative state come from a very poor financial background, the families are unable to bear the maintenance cost.
"We have seen many families get wiped out due to this problem. It’s high time the government takes note and focus on rehabilitation of such people or at least provide some financial assistance to their families,” Dr Agrawal added.