Safar Banus death may be technically explained using concepts in Health

Economics, one of which is to layout particular details coinciding with the topics
under the framework for Health Economics. First in its structure are the influences
on health, upon which the determinants of health could be used as template.
Under this is the underlying socio-economic, demographic, and cultural factors
which indirectly affect health outomes and for which include Safar Banus age,
being 43 years old having to deliver her 10 th child and her heavy work in the field;
her husbands superstitious beliefs regarding the use of contraceptives, as well as
his belief on Allahs will and constant providing; the familys poor state of living
attributing to low income and resource from a lowly-paid job; the familys poor
educational backgorund, relying on superstitious beliefs and hearsay; the
transportation size and structure being inefficient and expensive; the social
structure involving village healers with unreliable expertise and medicine. Next are
the proximate factors which directly affect health outcomes, and which include the
health care service utilization of Safar Banu, not being able to have her prenatal
checkup; her occasional nutrient dietary intake being very low for eating very little;
and the injury that she had incurred during and after pregnancy, involving a great
deal of blood loss resulting to whole body swelling with profuse sweating but no
fever, and registering an extremely low pulse with difficulty in breathing.

The healthcare practice which contributed to Safar Banus death has certain
characteristics that can be related to the framework for health economics.
Underlying factors
-

No money, hospitals are very expensive

Gopal daktar: tradiitional healer is every bit as capable to tend us as those
doctors; charges less
Transportation not even covered by the hospital
Had to sell half a kani of land to get her to hospital
Thinking that safar had not bled enough to drain the polluted from from
womb and legs when safar had bled a great deal during and after the
delivery
Safar ate very little, worked very hard (always feeding husband and sons
first)
Husband not caring, went to the village healer instead
Fake healers village healer only caring about the money

Proximate:
-

Didnt go to prenatal checkup

Ate very little

Safar couldnt get up for 10 hours after the birth, whole body was swollen
and sweating profusely but with no fever (injury)
Unconscious on the 7th day
Pulse extremely low and had difficutly breathing

Story(that(inspired(Travelers(Aid(for(the(sick(project( It! was! the! plight! of! a!

young! child! who! moved! me! to! start! this! programme.! I! was! in! a! remote!
village!when!a!young!boy!of!two!(Nagaraju)!was!brought!to!me!by!his!mother.!
She!explained!that! the! boy! had! been! born! without! an! anus! and! that! her!
husband! and! his! sister! took! child! to! the! district!hospital!for!help,!but!that!
they!had!told!them!to!go!to!Hyderabad.!They!were!frightened! and!came!back!to!
the!village.!Then!they!decided!that!he!would!die!and!went!to!Hyderabad!very,!
very!reluctantly.
In!the!bus!terminal!they!met!a!kindly!person!who!told!them!
they!looked!worried!and!asked!if!he!
could!help.!He!said!he!knew!a!hospital!
where!the!doctor!just!loved!poor,!rural!people!and!that! he! would! charge! them!
only! a! little.! He! took! them! to! a! private! nursing! home! where! someone!
opened!the!anus!in!a!crude!manner.!(The!correct!treatment!is!to!leave!the!anus!
as!it!is!and!put!a! colostomy!or!tube!connecting!directly!to!the!gut.)!He!then!said!
that!the!hospital!needed!what!was!
the!equivalent!of!a!years!wages!from!the!
father.!He!returned!to!the!village!and!borrowed!money! from!everyone! and!even!
sold! his!little! plot! of!land! and! his! hut.!When! he! realized! that! he! could!
never!pay!off!the!debts,!he!never!returned!to!the!village.!When!I!saw!Nagaraju,!
now!aged!2!years,! his! anus!was! a!mass! of! scar! tissue! and! fecal!material!
was! coming! out! of! his! penis! and! he!was! nearly!dead.!I!took!the!boy!and!
went!back!to!Hyderabad!with!the!abandoned!mother!and!child.!A!
pediatric!
surgeon! had! to! operate! three! times! to! save! the! little! boys! life.! I! vowed!
to! start! our! programme!to!combat!the!touts!who!were!ruining!the!lives!of!
innocent!village!people.
Recently,!I!was!standing!outside!the!Mahbubnagar!
District!Hospital!when!I!saw!a!woman!run!
across!the!open!area!next!to!the!
hospital.!She!threw!herself!into!my!arms!and!said,!Remember!
me,!I!am!
Nagarajus!mother.!He!is!now!10!years!old.!What!more!inspiration!can!one!ask!
for?