Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Filter by Categories
Acknowledgements
Authors’ reply
Book Review
Book Reviews
Classics In Indian Medicine
Clinical Case Report
Clinical Case Reports
Clinical Research Methods
Clinico-pathological Conference
Clinicopathological Conference
Conferences
Correspondence
Corrigendum
Editorial
Eminent Indians in Medicine
Errata
Erratum
Everyday Practice
Film Review
History of Medicine
HOW TO DO IT
Images In Medicine
Indian Medical Institutions
Letter from Bristol
Letter from Chennai
Letter From Ganiyari
Letter from Glasgow
Letter from London
Letter from Mangalore
Letter From Mumbai
Letter From Nepal
Masala
Medical Education
Medical Ethics
Medicine and Society
News From Here And There
Notice of Retraction
Notices
Obituaries
Obituary
Original Article
Original Articles
Review Article
Selected Summaries
Selected Summary
Short Report
Short Reports
Speaking for Myself
Speaking for Ourselve
Speaking for Ourselves
Students@nmji
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Filter by Categories
Acknowledgements
Authors’ reply
Book Review
Book Reviews
Classics In Indian Medicine
Clinical Case Report
Clinical Case Reports
Clinical Research Methods
Clinico-pathological Conference
Clinicopathological Conference
Conferences
Correspondence
Corrigendum
Editorial
Eminent Indians in Medicine
Errata
Erratum
Everyday Practice
Film Review
History of Medicine
HOW TO DO IT
Images In Medicine
Indian Medical Institutions
Letter from Bristol
Letter from Chennai
Letter From Ganiyari
Letter from Glasgow
Letter from London
Letter from Mangalore
Letter From Mumbai
Letter From Nepal
Masala
Medical Education
Medical Ethics
Medicine and Society
News From Here And There
Notice of Retraction
Notices
Obituaries
Obituary
Original Article
Original Articles
Review Article
Selected Summaries
Selected Summary
Short Report
Short Reports
Speaking for Myself
Speaking for Ourselve
Speaking for Ourselves
Students@nmji
View/Download PDF

Translate this page into:

Letter from Chennai
36 (
4
); 271-272
doi:
10.25259/NMJI_715_2023

Letter from Chennai

Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

[To cite: Mani MK. Letter from Chennai. Natl Med J India 2023;36: 271–2. DOI: 10.25259/NMJI_715_2023]

SNAKE

My driver walked into the house one morning and announced that there was a snake in the garage. With the amount of construction going on in Chennai, I did not think it possible that snakes could survive in the city. I am aware that during a recent election in a neighbouring state politicians of competing parties referred to each other as snakes, but I am referring here to the reptilian variety. However, I have a small compound around my house, and this harbours some rats and bandicoots, so perhaps that was enough attraction for the few remaining snakes in the city.

There was a time when I could identify around a dozen species of snakes, specimens of which were in glass cases in the pathology museum of the Madras Medical College, but that was long ago. Today, I recognize three categories: cobras, banded kraits and others. We are advised that we should leave the non- venomous varieties alone and take steps to remove the venomous ones. My problem was that the ‘others’ in my knowledge of snakes included some that were venomous, and therefore I needed to seek more expert advice. I am aware that the Chennai Snake Park would send an expert to remove the snake on request, and turned to Google to find the telephone number. I was struck by an entry: ‘Snake catchers near me’ and thought it better to call a snake expert from my neighbourhood rather than one from the Snake Park, which is quite a distance from my house. There were many telephone numbers listed and I sat down, iPad in one hand and mobile in the other, and set out to call one, and then went down the whole list. The responses varied: ‘This number does not exist’, ‘The subscriber is out of range or the telephone is switched off’, ‘The subscriber is speaking to someone else; please try later’. Another reason to try later was ‘The called party is not answering’. One gentleman told me he was busy at the moment but would come to my place in the afternoon.

Running down the list, I came to the ‘Forest Range Office. Government office, open 24 hours’. The telephone number was provided, I called, and was answered promptly. The gentleman asked for my address, and said an expert would be with me shortly, and indeed the expert turned up within 15 minutes. He wore thick jeans, sports shoes, a shirt and a backpack. The snake was probably drowsy after a full meal, and was still in the corner of the garage where it had first been sighted. Our hero removed his backpack, calmly walked up to the snake and stamped on it just behind the head (does a snake have a neck?), fixing it firmly in place. It promptly woke up and coiled itself round his leg, but the neck was held under the shoe. The snake catcher unwound its body from his leg, held the tail in one hand and grabbed the neck in the other. He needed someone to help him by opening the backpack, thrust the snake into it and swiftly removed his hand and zipped up the opening. Since most of the zips on my luggage tend to stick and have to be manoeuvred carefully to close, I presume he had some lubricant on the zip to close it swiftly and smoothly. He identified the snake as a komberimookkan (Common Bronzeback Tree Snake), a non- venomous snake, which lives on small animals, particularly garden lizards. Why this particular specimen left its natural habitat (I have many trees around my house, with many lizards) and travelled to the garage, I do not know. Perhaps it just wanted a change of scene or of diet or both.

Many of us, and I must confess I am among that number, have a feeling that if it is a government institution it will not work. We tend to go to the private sector if the service is available. I am chastened. Here is one service where the private sector did not work, and the government service was prompt and efficient.

This was supposed to be a free service, and I should perhaps have thanked him and sent him off. I was so impressed with his efficiency that I gave him ₹500, a sum that one of the private snake catchers had quoted on the internet as his charge per snake. He disappointed me by demanding that I pay him ₹1000, reminding me of his promptness. I gave him the amount, but it set me wondering. Whose is the greater fault? His, for demanding payment for doing his duty, for which he was paid by the government, or mine by tempting him in the first place by offering him money?

HALF MEASURES

The Health Department has put out some figures regarding the progress of the Makkalai Thedi Maruttuvam (Medicine-seeking People) scheme. The Director of Public Health has associated himself with the figures quoted, so I believe the information, cited in The Hindu of 14 June 2023, is authentic. The door-to- door screening programme, concerned with many diseases but primarily with diabetes and hypertension, has so far covered 1 00 51 661 (just over 1 crore) persons once, and 30 47 186 persons for a second visit since its inauguration in August 2021, approximately two years ago. The figures seem huge, but we should remember that the population of Tamil Nadu is around 8 39 30 000 (8.39 crore). In other words, in two years just one in eight persons has been screened once. Someone who is free from diabetes or hypertension today could well develop either disease tomorrow, so it is important to do the screening every year. Only 3 million have had the second screening. We have no data on how effective the control of diabetes and hypertension has been.

I will not bore you again with details of the protocol established by the Kidney Help Trust, but you could look it up if you are interested.1 I believe that this screening should be split into small batches of the population, and it would be best to include this in the responsibilities of the primary health centre (PHC). It might include the addition of four workers to the staff of each PHC. We do not need trained doctors, nurses or technicians, but people who are able to ask a few questions, record the answers, check the blood pressure and do a strip test on the urine. A doctor may be posted to cover four or five PHCs, if it is felt that the load would be too much for the regular PHC doctor, though I feel the PHC is supposed to cover the public health side of the population too. It is important that checking, provision of medicines and monitoring control of diabetes and hypertension should be done on a domiciliary basis. An ounce of prevention is worth a pound of cure, and cure is anyway not possible once major complications develop.

MAN’S BEST FRIEND REVISITED

I wrote in a previous letter about the dangers to the community created by stray dogs on our streets. There were reports in the newspapers of their attacking cyclists and motorcyclists, people walking on the streets and even killing a child. However, there was immediately an outcry from dog lovers that we should nurture the dogs. They should be caught, sterilized and returned to the streets. Those who suffered from the tyranny of street dogs were cowed into silence.

In the years since then, the corporation has periodically caught dogs, sterilized them and let them loose on the roads again. The authorities say they have no money to increase the numbers treated in this way, and it is clearly ineffective. There are more and more of these stray dogs and they continue to attack pedestrians, riders of two-wheelers, and especially children. The public are murmuring again. The Kannur panchayat (in Kerala) took the matter to the Supreme Court (as reported by The Hindu on 13 July 2023) and entered a plea that it be permitted to euthanize dogs that were deemed a threat to humans. Animal rights activists said people should not be allowed to brand dogs as rabid or dangerous. Lawyers for the panchayat pointed out that an 11-year-old boy was mauled to death by stray dogs. They also presented data that 5794 attacks on humans by stray dogs were reported in 2019, 3951 in 2020, 7927 in 2021, 11 776 in 2022, and 6276 in the first 6 months of 2023, in Kannur alone. The Kerala State Commission for the Protection of Child Rights also had an advocate appear in the case, pointing out that children were often the victims.

I love dogs as house pets. I had dogs throughout my student life, and suffered mental agony whenever one of them died. However, dogs that are a menace to human life cannot be permitted to remain. Let those who object to their culling adopt all the stray dogs from the streets, keep them in their homes, love and nurture them, and ensure that they do not ever return to the streets and menace their fellow citizens. If they cannot do that, they should not permit them to run wild and endanger human beings. Sterilizing dogs and letting them loose on the streets can never be the solution. Clearly, the authorities do not have the funds to sterilize every stray dog, and catching a few and sterilizing them will not make any significant difference. Dogs are fertile, every litter will add half a dozen more pups to grow on the streets, and the menace will only grow. I hope the Supreme Court will realize that culling all stray dogs is the only solution.

References

  1. . Letter from Chennai. Natl Med J India. 2010;23:109-10.
    [Google Scholar]
Show Sections