Reflections on conducting medical camps in Nagaland

For Nagaland Post, Eastern Mirror, and Morung Express
NGOs including church bodies organize medical camps as a part of their humanitarian or mission work. Are such medical camps beneficial? Yes, of course. But I think the side-effects are also real. So, I want to draw attention to these untoward effects of such noble endeavors and suggest ways to minimize them.

First, Medical camps are one day affairs and have no sustainable impact on people’s health. They are, if I may be so unkind, a kind of ‘hit and run’ method of delivering health care. But many illnesses require time (and investigations) to come to a diagnosis, more time to assess the outcome of illnesses be it recovery or deterioration, and may require follow-up, revision of treatment, and so on. But medical camps compel a doctor to come to a diagnosis and give treatment on the spot. It is difficult to send away a patient in a medical camp without any medication. Therefore there is always the danger of wrong and unnecessary medication. Many people would turn up just to get free medicines; and faking of illnesses or narrating past illnesses as if they are present for getting medicines for future use happen quite often.

Secondly, Medical camps are costly and the adverse effects can be damaging in the long run. I sometimes wish that the money and medicines be instead donated to the existing rural health centers. All people do not suffer at a point in time, on the day when the camp is conducted. Therefore, if the resources can be donated to the health centers, that will help more people and over a period of time rather than those who are sick on the appointed day. If free medicine samples are used, chances of misuse are greater, especially antibiotics. Antibiotic samples hardly come as a full course, and if different brands are compiled to make a course, it is more confusing and patients are less likely to complete the full course. There is enough evidence that inappropriate use (not completing the course, saving some portions for future use, self medication and prescribing for family members, etc) and use of poor quality antibiotics (there are evidences to believe that some of the samples may be half chalk powder) are leading to drug resistance. Without the help of laboratory and other diagnostic facilities, doctors may resort to prescribe ‘blanket treatments’ by using broad spectrum antibiotics which can contribute to resistance. Resistance is a real and present danger. Antimicrobial Resistance simply means unresponsiveness to antimicrobial agents given in their standard doses.  It escalates the cost of health care, prolongs treatment and sickness, increases mortality and the burden on health system.

Thirdly, medical camps are concentrated on curative medical care when the emphasis should be on health promotion and prevention. Medical camps become a kind of an extended hospital OPD. A medical camp should instead be called a health camp or a health awareness camp with emphasis on health education, demonstration of first-aid and home based care methods, promotion of healthy lifestyle, etc. For instance, it is much cheaper, more effective and the impact much more lasting for diarrhea management if villagers can be taught how to prepare Oral Rehydration Salt at home with commonly available materials like salt, sugar and drinking water than to treat a few patients who come with complaints of diarrhea. And so are posters and handouts more effective than some do’s and don’ts muttered to patients in a typical heavily queued up medical camp. Free health check-ups can be put in place where people can be screened and only those with genuine illnesses be given treatment. Such a healthy mixture of promotion, prevention, and curative methods of health constitutes an ideal camp that any organization or the medical department can organize.