Boy Soldier

 

We ran for hours, deeper into the forest. The path had ended, but we kept running until the sky swallowed the sun and gave birth to the moon...

This must be one of the most harrowing real-life stories I have read so far.

It is about a twelve-year-old boy who loves reggae music, dancing, and hanging out with his friends. All of a sudden his world is turned up side down by an armed gang that attacks his village. The villagers scatter and run for their lives, leaving the boy gets separated from his family. While trying to escape a civil war, he ends up getting forced into becoming a combatant himself - part of a gang of teenage boys wielding machetes and AK-47s, marauding villages, killing innocent people as a form of revenge, or simply for fun - the oppressed becoming oppressors themselves.

I stood holding my gun and felt special because I was part of something that took me seriously and  I was not running from anyone, anymore...We were simply told to follow the path until we received instructions on what to do next. We walked for long hours and stopped only to eat sardines and corned beef with fari, sniff cocaine, brown-brown, and take some white pills...

A few years later, while this war of attrition is still dragging on, a UNICEF vehicles roll into their camp. The younger boys are taken away to a rehab centre where most of the children are just not able to adjust to a life without drugs and guns. Most of them revert back to fighting, but one, somehow escapes because of one dedicated, thoughtful nurse. This is is the story of that one boy - Ishmael.

"None of these things are your fault", she would always say sternly at the end of every conversation. Even though I had heard that phrase from every staff member - and frankly I had always hated it - I began that day to believe it...

Ishmael Beah's memoir, "A Long Way Gone", is centred around Siera Leone of the 1990s. A country with a population of just over 8 million, and an area that covers double the size of Kerala. Here the mistrust between various tribes and political factions boils over into a full blown civil war. 

Mourning the dead wasn't part of the business of killing and trying to stay alive...Little did I know that surviving the war that I was in, or any other kind of war, was not a matter of feeling trained or brave...

This is the story of just one among the 300,000 children across 20 countries who end up as soldiers on the frontlines of war. According to the UN, up to 40 percent of these are girls. Come to think of it,  perhaps it is a miracle that even a few of them manage to get back their childhoods, and return some semblance of a normal life.

This book is a small but vital window opening into a world we do not know much about. A place where brutality is on a loop, and where peace is an aberration, an abnormal state of affairs. 

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REFERENCES & LINKS

* UNICEF - Children recruited by armed forces or armed groups - https://www.unicef.org/protection/children-recruited-by-armed-forces

* Sierra Leone on the CIA World Factbook - https://www.cia.gov/the-world-factbook/static/b0a107fb587d45dbfc17e74a6dd39c4f/SL-summary.pdf

* HRW - Child Soldiers -  https://www.hrw.org/topic/childrens-rights/child-soldiers

* UN -  https://www.un.org/youthenvoy/2015/02/4-10-child-soldiers-girls/

* https://en.wikipedia.org/wiki/Sierra_Leone

Mucous Cyst Rx

"Its just a local trauma..."
"No, its a bacterial wart! be careful, it infectious...certainly needs a surgery and biopsy..."
"Oh, just a simple mucous cyst!"

Two months, four doctors and three hospitals and many thousand rupees later, we have gained a few insights into the way in which our medical system works. It give you a glimpse of how private medical care is designed to make a mountain out of a molehill, to scare and fleece the gullible.

Two months ago, our son Aki got a cut on his upper lip which, instead of healing, developed into an eruption. Flesh etruded out of the cut which bled profusely from time to time. One day it would seem to be healing with a black scab but return to a a fleshy, bleeding nodule the very next. About 10 days after it showed no signs of healing, we took him to a doctor at the nearby Jaypee Hosptital. The pediatrician said it was just a "local trauma" and prescribed a  an anti-inflamatory syrup.

Aki found the syrup tasty but it nothing to reduce the eruption, or the bleeding. So off we went for a second opinion, to pediatrician at Patparganj, one strongly recommended by doctor-friends. The clinic was crowded and, from the number of vaccine adverts on the walls, quite popular with pharma companies as well. The doctor here came through a fair, honest, consciencious physician. "This looks like a wart", he said, "It needs to be surgically excised...it is just an Out Patient (OP) procedure in any government hospital, but given the crowds, you won't be seen unless you know somebody personally. If you go to any private hosptial, make sure you get the estimates clearly, in writing, before you get the child admitted". He also graciously returned - to our amazement - his consultancy fees (INR500) because, in his words, "I only advised you to go elsewhere." 

Next stop, Max Hospital. Here we got to meet our first pediatric surgeon. One look at Aki's lip, and he declared that it was "mucous cyst". Pulling our a couple of blank sheets, he explained in detail how it developed. "Sometimes, the process of healing ends up blocking the flow of mucus cells...and instead of keeping the lip surface moist, they end up discharging mucus under the skin. This develops into a cyst which ruptures and bleeds easily." Surgery, apparently, was the only way to get the cyst removed.

How much would surgery cost? Well, the answer depends on whether or not you have a mediclaim insurance cover. If you do, then it would cost about INR 25,000 if you got it done at Max Hospital. The cost of booking an operation theatre, anaesthesia specialists and a days' stay at the hospital, we were told, made a relatively simple procedure expensive. 

Would this be defenitely covered under mediclaim? Guys at the billing office were not so sure. "Lets see", they said, "We will submit all the papers and then know in a couple of days". Not quite reassuring.

So now we went for fourth opinion with a surgeon at Kailash Hospital, Noida. The diagnosis at Max was reconfirmed. This certainly was a mucus cyst that needed to be 'surgically excised, or cauterized'. The cost was a couple of thousands less but, given the crowds at this hospital, nobody wanted to an operation date, or the insurance coverage.

Back at Jaypee Hospital, the feedback from the billing office was the same. The procedure would cost not less than INR 25,000, which included no less than INR 8000 for 'micellaneous consumables'! The cost of the biopsy, of course, would be extra.

Since none of the pediatric surgeons said that it was emergency procedure, we thought about it for a couple of days, checked with other hospital, and settled for a surgery at Felix Hospital. This was the only place were we met a pediatric surgeon who inspired confidence in us with his surgery-as-last-resort approach. This was the also only hospital that had an OT readily available, did not insist on conning insurance companies and came up with surgery cost estimates at INR 5500. The only down side at this hospital was that they charged thrice the amount for consultancy fees for pediatric surgeons, compared to far more reputed hospitals. 

Anyway, sometimes when all is not so well also ends well. A supposedly common medical condition was misdiagnosed, received inflated cost estimates for the surgery, and was finally sorted out for one-fifth the estimates. One thing is clear, the nexus between private private, medical insurance companies, and TPAs is designed to fleece patients - especially those who may not have the luxury of time to seek a fair deal.

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Postscript:
After the final follow-up visit, our doctor requested that we evaluate him online. I received three sites on WhatsApp -- Practo, Lybrate and JustDial. This is an interesting new trend - doctors want to create a reputation that is independent of the hospitals in which they serve. I am not sure if this is good for the patients because we now have one more broker in between, and the additional costs are built into the doctor's fees :(

* Practo: Verifies feedback with an OTP sent to mobile number, collects proof of visit (bill/prescription), and creates a login for you, on the sly. 
* Lybrate: Does not have a clear section for doctor feedback. Verified using OTP. No need to login.
* JustDial: Badly designed site. The doctor's review page forces you to post your comments on FaceBook and Twitter (default option). Crazy.

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LINKS:

- Oral mucocele - https://en.wikipedia.org/wiki/Oral_mucocele