June 3: It's an emergency. Four-year-old Raju from a nearby slum is hit by a vehicle. His mother rushes him to the KEM hospital. A critical head injury, say the doctors. A Computer Tomography (CT) scan is a must. That's when the mother's anguish shoots up and the doctors too appear worried. Nothing can be done for the scanner is not functioning.It's 15 days now into its second major `breakdown' this year. It had happened two months ago when for a whole month the Rs 2.2-crore machine was out of order. The first time, in February, it was the X-ray tube that needed to be replaced; this time it's the motor which rotates the main gantry. The part costs about Rs 8 lakh and has to be imported. This is where the trouble lies, say doctors.It's a bureaucratic marathon. First a quotation is sought, then approval from the municipal accounts department, the deputy municipal commissioner and the civic standing committee before the part is shipped and cleared by the customs. ``Most times it takes around a year to place an order due to the red tape,'' say doctors.``We have to switch the machine off between scans to let it cool down,'' says a doctor in the radiology unit. ``It's the only way we can keep it working partly.'' There too the machine is waiting for the X-ray tube. The hospital's order for the first tube has just been passed, eight months after it was placed and, meanwhile, the second tube has broken down.The scanners in all three hospitals were imported from Germany in 1993. Their parts are available from Siemens and, to cut time, the hospitals get the company's Indian arm to speed up deliveries. The BMC owes Siemens Rs 25 lakh for previous orders and with the tube to be obtained for the KEM, the dues will mount to about Rs 33 lakh.Ravi Ramakant, head of the KEM's radiology department, points out, ``The delay is eminently avoidable. Why doesn't the BMC empower hospital deans to buy spares?'' Better still, it would make a lot more economic sense if spare tubes are kept in stock as all three hospitals have the same machines.An X-ray tube costs between Rs 14 lakh and Rs 18 lakh and needs to be replaced periodically.At the KEM, it's to be changed every four months while at the others it's after every six months. ``Replacing a part has nothing to do with mishandling of the equipment,'' clarifies Ramakant.Suleman Merchant, head of the radiology department at the Sion hospital, also feels that the procedure for orders should be more streamlined. A proposal for regular acquiring of spare tubes put forward a year ago was passed last week, he reveals. Meanwhile, due to the bureaucratic delays, families are put through immense distress and suffering. At the KEM, where on an average 45 patients are scanned daily, five are usually hyper-critical and 10 quite critical. ``The first four hours are most crucial, as in Raju's case. Beyond that a severe head injury could cause irreversible damage,'' says Ramakant.In desperation, people have no option but to pay three times more for CT scans at private hospitals. If they are lucky, these clinics agree to charge them the same fees as in municipal hospitals.
