Sunday 2 June 2013

DAKTAWR LEH DAMLO INLAICHINNA


                         

 Thingtlang khaw pakhata daktawr awm chu lungphu chawlin a thi thut mai a, khaw mipuite chuan an ui em em mai a. Awmni khamin a khaw mipuite chuan an sun hial a. Hei pawh hi la duhtawk mai lovin state pum hriat atan chanchinbu lianah te hial an uizia thu an chhuah a nih chu! He thil hi Assam state-a Nalbari khawbul lawk area pakhata thil thleng a ni. He thil hian a entir chian em em mai chu- he daktawr leh mipuite inkarah inpawhna leh thawh hona tha tak a awm tih hi.

            Hmanlai Hippocrates, Sushruta leh Charaka te hunlai atang tawhin medical profession hi hna zahawma ngaih a lo ni daih tawh mai a. Damlote chuan daktawr te hi Pathian dawttu ang hialin an lo ngai thin a ni. Hmanlai daktawr thiam Charaka chuan, “ Daktawr chu mi huaisen, mahni inringtawk, dawhthei leh khawngaihna ngah mi a ni tur a ni a. Nu leh pa, unaute ang hialin damlote chungah a khawsa thin tur a ni,” a lo ti hial a. Kum 2500 liam tawhah khan Pluto chuan, “ Daktawr leh damlo ten inpawh leh tlangnel taka damlohna chunga harsatna an sawi dun hian damlo chuan damdawi tha ber a ei mek ang a ni,” tiin a lo ziak a. Sir William Osler of Oxford pawhin, “ Eng dinhmunah pawh nise, damlo beiseina neih chhun chu lak bo sak tur a ni lo,” a lo ti ve bawk.

             Tun dinhmun han thlir hian a lungawithlak  ta tlat lo mai. Eng nge a chhan ni le? Medical Science hian nasa taka hma a sawn zel avangin hmanrua tha leh changtlung tak tak a lo piang chhuak zel a. In enkawlna senso pawh a hautak sawt hle. MRI machine pakhat ringawt pawh hi vaibelchhe tel chin a awm loh chuan hospital changkang tak pawh a din theih loh tluk a ni ta. Hengte a nih tak avang hian medical profesion zahawm tak hi hlawk duhna rilru hian a chang chuan medical services hi sumdawnna hlawk tak chi khat ve maia ngaihte pawh a awl thin hle mai.

             Tunlai chhanah awareness te a that tawh bakah, lehkhathiamte an lo tam tak zel avangin medical services chungchangah mipuite pawh kan thikthu a chhe hmain, kan dikna chanvo humhalh duhna rilru kan lo pu ve ta fur bawk a. PJ Hinduja Hospital, Mumbai a daktawr, Dr.S. Iyer pawhin,  Tunah chuan damlote pawh mi vengva tak tak, lehkhathiam leh chinchang hre tak tak te an lo ni tawh a, daktawr te pawh fimkhur lehzual a tulin, inpekna tak tak a tul zual ta a ni e,”  a ti hial bawk a.  Pune-a daktawr, Dr.Sanjay Gupta pawhin, “ A chang chuan daktawr te ngei pawh damlote hnena thupha chawi hun a lo awm ta zauh zauh mai,”  a ti. Hospital-a hmanrua changkang hmanga enkawl an nih loh avangin damlo thenkhat chu an lungawi lova, chutiang bawkin enkawlna senso a hautak ang hu-a a result a that leh si lohvin an lungawi lo fo bawk. Daktawr leh damlo inlaichinna chungchangah hian tunhma atangin dan a lo awm daih tawh a. Entirna: Tort’s law, Helsinki Code (1964) revised in 1975, Medical ethics of Medical Council of India( 1970) etc. Daktawr- Damlo inlaichinna chungchang hi chik zawka zirchiang tur chuan point 4 ah a then theih a, chungte chu:

1)Paternalistic
2)Mutuality
3)Consumerist
4)Default

Tunhma a an lo inlaichinna chu Paternalistic type hi a ni a. Pa berin a fate thununa an chunga thuneihna a lekkawh ang hian damlote chuan zawhna nei lem lovin daktawr thurawn chu a kip a kawiin a zawm tawp mai a ni;daktawr chu hre ber tura ngaih a nih avangin. A chhânna awm chhun chu ‘Aw’ leh ‘Aih’ a ni tawp mai. Ama taksa mah nise damlo chuan a taksa enkawl danah chuan thu tlemte bak sawi theih a nei lova. Daktawr kutah a tlu lut tawp mai a ni. Hemi anih avang hian daktawr mawhphurhna pawh a sang bik hle a ni. Hun a rawn kal leh deuh a, mutuality inlaichinna a rawn piang a. Hetah hi chuan a natna hmuhchhuahah leh a enkawl dan turah daktawr leh damlote chuan sawi hona hun an hmang tlang thin a, thutlukna siamtu an nih tlan ang bawkin mawhphurhna kengtu an ni ve ve bawk.

            Consumerist inlaichinna a rawn piang ve leh a. Hetah hi chuan paternalistic letling chiahin, damlo chuan thutlukna a siam thung a. Entirnan:-Daktawrin tul lutuka a hriat loh pawhin damlovin  a duh tlat chuan zai pawh tih theih a ni thin. Daktawr chu damlo thupek nghakin a awm a ni deuh ber mai. Default ve thungah hi chuan daktawr chuan damlo chu a natna enkawl dan turah thutlukna siam turin zalenna zau tak a pe a. Mahse damlo chuan thutlukna a siam theih mai loh avangin tha a tih ang bera thutawp siam turin daktawr chu zalenna a hlan let ve thung a. Daktawr chuan thutlukna khirh tak chu a lo siam ta thin a ni.

              Daktawr leh damlo  inlaichinna kawngah hian daktawr te chauh hian mawh an phur em le? Teuh lo mai. An pahnihin tih tur hrang v eve an nei zawk a ni. Tunlai Science-a hmasawnna nasat ang zelin mipuite beiseina pawh a sang ve zel a. Amaherawhchu, thil pakhat kan hriatreng tur chu - Medical Science hi Biological Science a ni a, tawp chin a nei ve tih hi.  Daktawr ten nasa takin thawk mahse, natna zawng zawng hi tihdam a ni vek kherlo tih hi. A chhan chu,natna leh thihna hi hringnunah hian a beh tel tlat vang a ni.  ‘ Sawm thah niah pawh vawikhat lungngaih chu a awm châwk,’ tih ang deuh khan. Kan natna an tihdam theih loh avanga daktawr chunga thinur hi kan tih loh tawp tur a ni. Natna zawng zawng hi tidam vek thei nise chu daktawr nupui sûn leh daktawr thi an awm hauh lovang le. Daktawr leh damlote hi then hran theih loh an ni a. Pawisa tlâng leh lamin tlâng lehlam a nei zel ang hi a ni.  Inlaichinna tha tak nei tur chuan communication leh counselling te hi a pawimawh hle ang.

       General Medical Council ( GMC) of UK chuan daktawrte zawm tur guideline a siam a, chungte chu:

* I damlo enkawl chu i ngai pawimawh hmasa ber tur a ni.
* Damlote rin ngam turin i khawsain, i rintlak bawk tur a ni.
* Damlote leh vantlang hriselna i chawikangin, an tan i rilru i hmang reng tur a ni.
* I profession hi i practice hnem tur a ni.
* I thiamnate utawk tûr vawn mai lovin, i hmang tangkaiin, i zir thar zel tur a ni.( up to date).
* Damlo i enkawl chhung chuan i rilru zawng zawngin i thawkin, i duty hun chhung chu i hmang full ngei tur a ni.
* I damlote thatna tur anih dawn phawt chuan nang aia thiam zawk an awm a nih chuan râwn hreh suh ang che.
* I damlote chu duat takin enkawl la, an dikna leh chanva te i zah sak bawk tur a ni.
* Tawngkam mawi leh hawihhawm takin damlote chu i enkawl thin tur a ni.
* Damlovin thup duh a neih phawt chuan i zawt chuak kher tur a ni lo.
* I damlo enkawl nen chuan in thawk dun tur a ni.
* I damlo  thusawi chu uluk taka ngaithlain, an zawhna neihte tha takin i chhang thin tur a ni.
* Damloin hriat duh a neih chuan an hriatthiam theih dan turin i sawifiah sak tur a ni.
* Damlo thutlukna siam chu i zahsak tur a ni.

DAKTAWRTE  TIH NGEI TUR
* I qualification/training/experience/designation te prescription paper-ah ziah lan ngei tur a ni. Qualification han tih hian Indian Medical Degree Act-in a pawm theih degree/ diploma te a ni.
* Damloin a natna lai a sawi chu ngaithla ngawt lovin,i kut ngeiin I khawih tur a ni. Stethoscope i hmang ngei tur a ni.
* Uluk takin ngaithla la, chik takin en vel la, fing takin zawhna zawt ang che.
* Damdawi hming chiang takin ziak lang thin ang che. A eidan dose leh ei dan tur leh hunbi te i hre dik ngei tur a ni. I ziak lang bawk tur a ni a. Lamtawi pawh i duh chuan i hmang thei ang.
* Dan kalh zawngin medical Science hi i practice tur a ni lo.
* I documents neih reng reng uluk takin i vawng tur a ni.

DAKTAWRTE  TIH  LOH  TURTE

* Nang leh i damlo enkawl inkarah sakhuana, hnam, thlah, party, politics, social status i ngai pawimawh tur a ni lo.
* Damlovin a natna a sawi chu i awih nghal mai tur a ni lova. Nangmah ngeiin check velin, a  natna awmdan atangin a natna dik tak hmuh chhuah i tum tur a ni.
* Engkim hre vekah i inngai tur a ni lo.
* I qualification/theihnain a tlin bak chu i khawih tur a ni lo.
* Zanah nurse duty-in an rawn koh che chuan i kal ngei tur a ni. I dam a nih chuan chhuanlam i siam tur a ni lo.
* Laboratory Test tih laiin i hamhaihin i chi-ai tur a ni lo.
* Uchuak taka mahni infak ( advertise) leh inzawrh i ti tur a ni lo.
* Drugs  emaw zu ngawlvei i ni tur a ni lo.
* Medical science-a thiamna neive lote i hnathawhna hmuna hruaiin i tih tir ve chhin tur a ni lo.
* Mahni hlawkna tur umin damdawi siamtu company leh zuartute nen inlaichinna tenawm tak i nei tur a ni lo.
* Damlo emaw, a chhungte nen emawa mipat hmeichhiatna tenawm tak hman hi dânin a phal loh mai bakah i hna atanga paih theih ini tih i hre tur a ni.
* Mahni dinhmun remchanga hmanga I thawhpuite chunga mawi lo taka chet hi dân phal loh thil a ni.

DAMLOTE TIH VE TUR
* A hmasa berin daktawr leh damdawi in pan tur dik leh tha a thlang fel phawt tur a ni. Chumi hnuah chuan a chungah rinna a nghat ngam bawk tur a ni.
* Natna leh a kaihhnawih hrang hrang leh family background te felfai taka daktawr hrilh vek tur.
* Operation/procedure a hlauhawm dan a hrethiam ve tur a ni.
* Mi thusawi lêngvak mai mai, miten damdawi tha em ema an sawite pawh daktawr rintlak tak sawi a nih loh chuan rin nghal mai zel loh tur.
* Medical Science thiamna nei lote thuziak leh chhuahte rin nghal bur loh tur.
* Daktawr damdawi chawhte hriatchian loh neih chuan chiang taka zawh leh mai thin tur a ni. Inthlahrunna chi a ni lo.
* Harsatna nasa zawk leh thihna hial a lo thlen pawhin daktawrte mawhpuh ngei ngei kher loh tur a ni.
* Daktawr te thatchhiat vang a nih leh nih loh hriatchian tum vat zawk tur. Daktawrte inthlahdah  vanga harsatna lo thleng a nih chuan  Court-ah a khin  theih tih hriat tur a ni.

MEDICAL  NEGLIGENCE

Assamese nu pakhat chu a mît paihsak ( Cholecystectomy) a ni a. A zaitu daktawr chuan a zaina lamah bile duct chu a chemte hriam tak mai chuan chhetein a tai thler palh a. He hliam hi a rei hnu chuan  khir ( gangrene) rawn insiamin, chu chuan Thin atanga mît tui ( Bile) rawn luang chu lo dang buaiin natna hrang hrang- Thau lam ei theih lohna te, mitliam ( Jaundice) hialte a lo neih phah ta a. A hnu kum 5-ah chuan he nu hian a inentirna lamah daktawr fel tak puihna zarah a lo hre chhuak ta a. Kum 5 lai liam tawh mahse, Court-ah thubuai thehlut leh hnuhnawhin Court chuan  Medical Evidence fel tak a hmuh hnu chuan a zaitu daktawr chu he nu enkawlna tur senso zawng zawng tum sak turin thutlukna a siam ta hial a ni.

             Medical profession hian mawhphurhna sang tak a keng tel a; chuvang chuan tupawh he line-a kal te chuan Dân-in an laka a beisei ( Duties) hi an hriain an zawm ngei tur a ni. India ram bikah chuan daktawr te khawsak phunga Indian Medical Council  a lungawi loh chuan warning notice pein,  Daktawr te nihna  hlih sak leh medical practice phal tawh loh thlengin action a la theiin a la thin bawk.

DUTIES OF MEDICAL PRACTITIONER:-

1)Duty to exercise a reasonable degree of skill and knowledge.
   Daktawr chuan a thiamna phu tawk ang zelin damlo a enkawl tur a ni. A thlawna a enkawl pawhin a                       inthlahdah phah chuang tur a ni lova. A thiamna chu tupawhin ang khat vekin an chhawr thei tur a ni. A theih tawka thain a thawk tur a ni.

2) Duties with regard to attendance and examination.
   Daktawrin enkawl a lo tiam tawh chuan a tul chhung chu a damlo chu a enkawl tur a ni. A      laklawhah a chawlhsan mai tur a ni lo. Damlovin a enkawlna dawn tul tawh lova a hriat chuan a chawlhsan chauh ang. Amaherawhchu hengte hi a thleng anih chuan a chawlhsan thei bawk-
 a)Daktawr chu a damlohvin.
b)Damlo chu tider mai a lo nihin.
c)A damdawi chawh aia midang chawh damlo chuan a ei duh zawk tlatin.
d)A thurawnte damlo chuan a zawm duh tlat lohvin.
e)A remtihna tel lova damlo chuan daktawr dang enkawlna a dawnin.
Daktawr chuan a damloh avanga enkawl zawm thei dawna a inhriat loh chuan daktawr dang, rintlak leh thiam tak a damlo tan chuan a zawn sak tur a ni.

3)Duty to furnish proper and suitable medicines.
    Daktawr  chuan damdawi tha tak a neih nghal chuan damlo chu a kawhhmuh nghal mai tur a ni a. A nei lo a nih pawhin, felfai takin prescription a siam sak tur a ni. 

4)Duty to give instructions.
    Daktawr chuan damlo emaw, a awmpuitute hnenah ei tur tha leh a damdawi chawh te eidan tur dik leh fel tak a kawhhmuh thin tur a ni.  Side effect awmthei zawng zawng te hrilhlawkin, chumi a lo thleng a nih pawha rang taka daktawr pan vat tura hrilh hriat tur a ni.

5) Duty to third parties.
    Damlo chuan inkaichhawn awlsam ( infectious diseases) a nei a nih chuan daktawr chuan damlo chhungte, hnathawhpui te adt. Hnenah fimkhur a tul thu a hrilh hre ngei tur a ni.

6) Duty towards children and adults incapable of taking care of themselves.
    Naupang leh puitling, mahni inbuaipui thei lo te enkawl lai hian fimkhur hle tur a ni. Naupangte enkawl laia tuilum ip hman theihnghilh palh hian chhiatna nasa zawk, kâng hial a thlen thei a ni.

7) Duty to inform patients of risks.
    Inenkawlnaah emaw,operation-ah emaw a chhe ber thleng thei te chu damlovin hriat a duh chuan daktawr chuan thu dik tak chiang takin a hrilh  thin tur a ni.

8) Duty with regard to poisons.
    Tûr reng reng hi fimkhur taka khawih tur a ni a. Bur-ah dah that a, fel taka chhinchhiah a, naupang khawih phak loha dah hran thin tur a ni. Tûr ei palh chungchangah daktawr chuan rang takin enkawlna a pe nghal tur a ni.

9) Duty to notify certain diseases.
    Daktawr-te hi public health authorities-te hnenah hri hlauhawm lêng te, nau piang thar leh thihna te a ranglama report pe lut tura beisei an ni.

10) Duties with regards to Operations.
    a)Damlo remtihna a la hmasa tur a ni a, zai a tul dan leh a nasat dan tur a hrilhfiah tur a ni.
    b)A fimkhur hle tur a ni a, damlo zai tur dik tak, taksa dinglam nge veilam,adt.a hrefiah hmasa tur a ni.
    c)Daktawr chuan zai tura damlo remtihna a hmuh hnuah midang kutah a hlanchhawng mai tur a ni lo.
   d)Tunlai thiamna mil zelin a inzir thar tur a ni.
   e)Hmanraw thianghlim ( sterilised instrument) a hmang ngei tur a ni.
   f)Taksa chhungah hmanrua a theihnghilh thiang lo.
  g)Zai zawh hnuah duhtawk mai lovin, a enkawl zui zel dan tur a kawhhmuh tur a ni.

11) Duties under Geneva Conventions.
      Mihring tawh phawt chu, ramdang mi emaw, hmelma sipai emaw, prisoner of war emaw pawh ni sela, enlawlna mamawh tawh phawt chu thliar hranna awm lovin a enkawl tur a ni.

12) Duty in connection with X-Ray examination.  
   A theih chhung chu accident naa hliamte chu ( chhete tak tak a nih loh chuan) X-Ray hmanga enfiah vek tur a ni. A dik lo a X-Ray thlalak hrilhfiah leh enkawlna pek hi medical negligence a ngaih a ni.

PROFESSIONAL  SECRECY:-
   Damlo thuruk zawng zawng  chu a remtihna lo chuan daktawr chuan midang hnenah a sawi chhuak thiang lo ( Damlo chu rilru lama buai a nih loh chuan). Damlo remtihna lo chuan daktawr chuan damlo chhungte hnenah pawh a natna chungchanga zawhna an neihte chu a chhang mai tur a ni lo.  A enkawlna senso tumtu pawh nimah sela, nupa karah pawh ni rawh se, damlo ramtihna lak hmasak phawt a ngai. Pasalin a nupui a nih vang maiin a nupui natna chungchanga thuruk awm te a nupui remtihna lo chuan daktawr a zawtin a nei thiang lo a ni.  Dân hmaah chuan thiam loh chang a ni ngei ang. Chutiang bawkin damlo thuruk chu a pu ( employer) chuan tihluihna hmanga a hriat ngawtna dan a awm lo, damlo phalna la hmasa lo chuan.

    A chunga point tlemte atang khian daktawr te mawhphurhna sanzia kan hre awm e. Tunah chuan an dikna chanvo lo sawi ve thung ila:- 

DAKTAWR TE DIKNA CHANVO:-
1) Damlo pakhat aia tam an awm chuan damlo enkawl turah duh a thlang thei.
2) Medical profession hi eizawnna atan a hmang thiang.
3) Damdawi an hmang/zuar thiang.
4) Damdawi hlauhawm (poisonous drigs) pawh an kawl thiangin, a tul chuan damlo te an chawh thei.
5) An hmingah an title, degree,adt. An da thei.
6) Anmahni râwn man  an bithliah thiang.
7) Public leh local hospital khawi hmunah pawh rawih theih an ni.
8) Medical certificate an siam thei.
9) An duh chuan Court-a thuhretu ( Juror) anga ruatna/kohna an hnar thei.

       Tunah chuan mipui/damlo chanvo ve thung-

DAMLOTE DIKNA CHANVO:-

1) A duh ber daktawr a panin a rawn thiang.
2) Health care facilities hmuh theih zawng zawng te , emergency service te a dawng thei vek.
3) Inthliarhranna awm lova, duat tak leh hmangaih, uluk leh fimkhur taka enkawl hi a chanvo a ni.
4) Thu zêp duh a neih phawt chuandawktawrin a zawtin, a puandarh sak thiang lo.
5) A natna chungchang leh thil dangte a ruka vawn sak tlat hi a dikna chanvo a ni.
6) A natna diagnosis, investigation leh treatment zawng zawng hriat vek a duh chuan a zawt theiin, a zawhna tha tak leh dik taka chhanna pek hi a dikna chanvo a ni.
7) Nitina a hmasawn chhoh dante hi a hriat duh chuan a hre ve thiang a ni.
8) Daktawrin ti tura a tih thenkhat hi a hnial ve thiang.
9) A natna leh enkawlna dan record sak leh a hriat duh hrilh hi a chanvo a ni.
10) Enkawl chhunzawm a duh tlat chuan hnial sak tur a ni lova, a dikna chanvo a ni.
11) A nuam thei ang bera enkawlna pek hi a dikna chanvo a ni.
12) A complain theiin a sawisel thiang bawk.
13) Enkawl khawloh a nih chuan( medical negligence) zângnadawmna a dawng ngei tur a ni.

             Awle, a chunga point hrang hrang tarlan te khi a then a zar chauh a ni tih hria ila. Daktawr leh damlo inlaichinnaah hian point tam tak tarlan tur leh dânin a sawi tam tak a awm a. Daktawr leh damlote hian tihtur kan nei ve ve a. Daktawr tan enkawl tlem lutuk emaw, nasat lutuk a awm thei a. Chutiang bawkin damlo te tan thuawihna tur kawmg a awm ve bawk a ni. Daktawr leh Damlote hi tangruala  inzahtawn tur kan lo ni e.


Ziaktu: Joel Lâiremsanga,
Final Year MBBS.
Gauhati Medical College & Hospital; Guwahati.  
Date: 9th July, 2011 (Saturday, 2:00 pm)

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