The Hindu : `Beautiful hospitals, inconsistent care'

Online edition of India's National Newspaper
Sunday, Mar 28, 2004

Tamil Nadu

Tamil Nadu

`Beautiful hospitals, inconsistent care'

By Ramya Kannan

CHENNAI, MARCH 27. Health care professionals in the country should aim at making health care affordable to the poor, said Randas Batista, Brazilian surgeon credited with the invention of the Batista Procedure in remodelling the heart.

"The rich can go to doctors and take medicines. But what about the poor? This worries me a lot, since I also work in a poor environment. I have to focus on inexpensive procedures and economising costs," Dr. Batista said. "A number of doctors call me and say, `We have a patient for you. But, we're sorry, he is poor.' Why should they be sorry? It is my task to take care of patients, never mind their social class."

It is in pursuit of this agenda that he has set up a heart foundation in Brazil to provide quality care to the poor. It will raise funds to "give the poor the same quality of medicine as the rich. In my foundation, you cannot say who is rich and who is poor. That is the kind of work that is rewarding to me."

Talking about the Batista Procedure, which involves excising a portion of the diseased ventricle when it has become dilated and thereby reducing the size of the heart, the inventor said it was relevant in a country such as Brazil, where quality health care was neither consistent nor affordable, while the incidence of heart disease was rising.

" Here, I see the same as what I see at home. You have beautiful hospitals, but inconsistent care," he said. "In Europe and the United States, quality is pretty much the same. That, however, does not happen here or in my country. There is disparity in medical practice from hospital to hospital."

Dr. Batista held that if the surgeon was experienced and had a good hospital environment, the results would be as good as in the West. He himself has performed 1000 Batista procedures, 800 of them in Brazil. While the Cleveland Clinic Foundation in Ohio, U.S., adopted the procedure, Western science has been rather sceptical of its utility and success.

However, the way its inventor looked at it, the Batista procedure provided hope and life when there was little left. "What is success? Mortality? I prefer to look at survival. If anyone, statistically supposed to be dead in six months, goes on to live for four years, that is success." He claimed that in his hands, the chances of someone leaving hospital after surgery were 80-85 per cent. Of those who went home, 60-65 per cent lived for a year. About 55 per cent would be alive for five-10 years.

"But it is not so much that. It is the quality of life they have after the procedure. The patient's relatives say to me, `Those were the best days of his life.' We do not realise what it is to wake up two or three times at night, gasping for breath, looking for a ventilator. After surgery they have a normal life," Dr. Batista explained.

Though admitting that his job was to repair problems, which were not prevented, he believed that preventive medicine was more important. Lifestyle modifications could prevent people from being wheeled into surgery.

In India, as in Brazil, there were not enough cardiologists to take care of the needs of the population.

"Ideally, we need more doctors, but we need to go a long way, before we can take care of all our patients."

Therefore, prevention was the best way out and education had an important role to play. "The more they know, the more it is likely that people will take care of themselves."

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