Service with a heart in remote centres

It was 9.30 pm on a weekday in the temple town of Sringeri in Chikmagaluru district of Karnataka. At the local Janaushadhi kendra (government-run pharmacy), the owner, Prashanth, had taken the ECG (electrocardiography) of a local resident, transmitted it to a WhatsApp group of cardiologists and received their opinion.

Based on their medical advice, the resident was referred to a tertiary healthcare centre in the district to treat his arrhythmia. The entire sequence of steps worked seamlessly, thanks to the Cardiology At Doorstep (CAD) Foundation run by the Mangaluru-based interventional cardiologist Padmanabha Kamath.

In fact, Kamath has taken this informal arrangement to 14 Janaushadhi kendras in the region, equipping them with ECG machines to detect heart problems. And the voluntary initiative illustrates a model the Government could consider — of giving Janaushadhi kendras an expanded role beyond their primary task of selling low-cost medicines.

By placing ECG machines at these healthcare facilities in remote semi-urban and rural areas of Karnataka, the CAD Foundation has helped detect more than 300 heart attack cases in the last two years, says Kamath.

It all began in 2018 when Kamath decided to set up and operate an ECG network through primary health centres (PHC) and small clinics in remote rural and semi-urban areas, connecting them through CAD WhatsApp groups.

This helped people in remote areas get a free ECG done during non-working hours also, besides getting a cardiologist’s opinion and advice. “This was beyond our imagination earlier, but now we have been able to do it,” he says.

In fact, the advantage of extending the ECG service through Janaushadhi kendras was felt during the pandemic-induced lockdown when clinics in urban centres too remained shut.

At these 14 kendras offering CAD-supported ECG service, most of them in remote towns, the pharmacists are trained to handle the ECGs. While there isn’t a formal alliance with the Government, Kamath says the BPPI (Bureau of Pharma Public Sector Undertakings of India, which implements the Janaushadhi scheme) had appreciated CAD’s initiative in a written communication on similar support through PHCs and small clinics.

The CAD support group for the Janaushadhi kendras is called ‘Kayakalpa’ and Kamath hopes to notch it up one level by adding services such as blood pressure and blood sugar checks. This will benefit many people in areas where such facilities are rare, he says.

Yatish Baikampady, member of the Karnataka State Management Committee of the Indian Red Cross Society, describes the initiative as an excellent way of reaching out to people and suggests that the Government adapt it for the rest of the country. Even the highly successful Pulse Polio programme was started by a non-governmental organisation, he points out.

Requesting the Government to replicate this model across the country, especially in rural and semi-urban centres, Isaac Vas, President of Kanara Chamber of Commerce and Industry, said these areas lack facilities to detect heart ailments.

Asked about the number of ECGs done in these kendras, Kamath says the CAD group gets 70-80 readings from them in a month. “It is not the number that is important here. It is the concept that matters,” he says, adding that many lives can be saved with timely intervention.

Bundling more health services into the Janaushadhi kendras will not just take healthcare closer to the people, but also popularise these centres, a health expert adds. In the twelfth year since the centres were launched in November 2008, it remains to be seen if the Government will explore such a redefined prescription for them.