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Quality Healthcare in Andhra Pradesh

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Patients in the waiting area of the outpatient neurology department of the Sri Venkateswara Institute of Medical Sciences. Image by Priya Ramchandra. India, 2015.

Sitting in the outpatient department’s neurology unit of Sri Venkateswara Institute of Medical Sciences (SVIMS) in Tirupati, Andhra Pradesh, a young physician examines patients of all ages. He explains that patients diagnosed with epilepsy, an illness for which SVIMS has been running medical camps for the last several years, are eligible to receive anti-seizure medications for up to a year after their diagnosis. They can also continue to obtain medication at health camps.

Extensive support for patients on behalf of SVIMS, a semi-autonomous institution managed by the state government of Andhra Pradesh and the trust that handles funds for the Venkateswara Temple (one of the busiest in the world), is remarkable considering recent political shifts. According to The Hindu Business Line, the 2014 split in Andhra Pradesh and the formation of the new Telengana state have left Andhra Pradesh to assume much of Telengana’s old costs and transition to a new state capital. While unprecedented changes have occurred in Andhra Pradesh, the high quality care and charitable outreach of SVIMS continue to be impactful.

SVIMS is led by a governing council established by the state government; the director of the institution is appointed by the chief minister of Andhra Pradesh. Dr. K.V Koti Reddy, a resident medical officer of SVIMS, offers his perspective on the government’s involvement at SVIMS in between dozens of calls and signing discharge paperwork.

“Projects like Aarogyasri, Pranadana—basically, most of the policy decisions regarding the hospital are taken by the director, unlike the state government which has strict rules,” says Reddy. “Big decisions like finances and appointments are overseen by the governing council.” The state government’s executive body and finance committee strictly regulate all spending allocations, especially for charitable programs like the Pranadana Scheme, which helps impoverished patients pay for complex medical care.

The recent Telengana split, if it's had any effect, has possibly expanded the SVIMS patient population. Hyderabad, now the capital of Telengana (and of Andhra for the next nine years only) is a large healthcare resources hub and home to many government and private hospitals, including the historic Osmania General Hospital and a branch of the private powerhouse Apollo Hospital. Because of access constraints, patients that may have once traveled to Telengana to receive medical care could flock to SVIMS. As Reddy puts it, “Now, there is a tendency to restrict to Andhra.”

In addition to taking care of its own patients, it’s not uncommon for SVIMS to receive large amounts of referrals from elsewhere, especially for complicated diagnoses and procedures.

“Our OPD [outpatient department] is more or less crowded,” Reddy explains. “In corporate hospitals, they may see 10-15 patients in 6 hours. We only have the morning to see 1,200 or 1,300 patients...but we still try to do the maximum with our time. The population needs are really high.”

But SVIMS does more to address patient needs than provide efficient physicians. Dr. Buma Vengamma, former director and vice chancellor at SVIMS, discussed her efforts to keep patients comfortable during their stay.

“We not only address physical needs, but also spiritual needs,” she explains. Originally the head of the neurology department at SVIMS, Dr. Vengamma was responsible for instituting changes at SVIMS that accommodated cultural and religious preferences, including the development of a nutritionally-complete liquid diet made of lentils and grains native to the Andhra region, as well as a devotional music and group hymnal session at the hospital.

One of the recipients of quality care at SVIMS is Veramma, a 36-year old housewife from Andhra Pradesh. Normally, when members of Veramma’s village get sick, they travel to a primary health center (PHC) about 30 minutes away.

However, when her husband fell severely ill with Gulliain-barre syndorme, an autoimmune disease which impairs muscles and can be fatal without proper treatment, the PHC was no longer an option. Veramma took a jeep from her village to a hospital in Kurnool, costing her nearly 10,000 Rs. (approximately $153) in the process.

“The Kurnool hospital told her that her husband cannot be treated for his condition,” says a translating physician. However, Veramma was informed that SVIMS could provide her husband with the care he needed and receive coverage from the Pranadana Scheme.

After arriving at SVIMS, Veramma’s husband immediately began treatment for his illness in the respiratory intensive care unit (RICU) and was well on his way to recovery. Happy with the treatment and standards at SVIMS, Veramma has already told her brothers, her husband’s family, and other extended relatives about the Pranadana Scheme.

“Pranadana covered the cost of everything. She didn’t have to pay a penny,” the physician elaborated. In a state where each penny matters, SVIMS continues to provide excellent care for all.