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Security Shortcomings? Oversight on the recent suicide case at STNM

In the darkness before dawn, in the morning of August 3, at around 3:15 AM, a 60-year-old man from Tumin, who was admitted at STNM Sochagyang, Hospital, Gangtok, tried to end his own life and succumbed to the injuries he inflicted on himself at the operation theatre. Per sources, the man took his own life by stabbing himself on the neck and abdomen with a fruit knife that he somehow got his hands on.

As per reports from the Hospital sources, the man was undergoing treatment for Chronic Kidney Disease (CKD) and was in  haemodialysis (HD). He was reportedly admitted on June 27 at STNM. No reporters were allowed in to take any stock of the situation and the authorities had denied any official statements. However, police sources revealed that “on 03/08/2022 at around 0823 hrs, (police) received a call book intimation from a doctor (name withheld) STNM hospital, Gangtok mentioning that a patient named (name withheld), 60 yrs, s/o (name withheld), r/o Tumin who was admitted at the hospital had sustained self-inflicted stab injury over his neck and abdomen and thereafter the patient has expired in O.T on 03/08/2022 at around 0550 hrs.”

The report added, “Preliminary investigation revealed that the deceased was suffering from chronic kidney disease and admitted at STNM hospital since 27/06/2022 for dialysis. However, on the same day at around 0430 hrs, the deceased had stabbed himself over his neck and abdomen with a knife following which he succumbed to his injuries. The dead body of deceased was handed over to its legal guardian after conducting P.M at STNM hospital and other necessary legal action.”

Reporters from Sikkim Chronicle went to the hospital and contacted the authorities but the authorities denied any official statements on the matter, and the reporters were denied entry in the premises. There has been a public scrutiny about how the security of STNM has not been up to the mark and this unfortunate incident was due to the shabby state of security in the hospital.

Is security too casual at STNM?

Entering the premises of the main building at the hospital, there are generally always three guards deployed on the gates, two on the entry point and generally one guard at the exit point. Then there are guards that take rounds and guards who are deployed at the other buildings in the premises.

There’s a strict policy of no permission of sharp objects, lighters, cigarettes and any threat bearing objects into the hospital buildings. The security policies were revamped after the recent incident of a gruesome stabbing spree that a culprit went on inside the hospital premises costing the life of a great cardiologist from the state, Dr. Sanjay Upreti, who died trying to save the life of one of his colleagues, who was the actual target of the culprit.

The hospital authorities had revamped the security after the grievous incident, making it compulsory to have a visitors’ pass to attend to their patients, however, even after the revamping the security, criticism came saying that this was done a little too late, and that after 8:00 PM when security shifts change, there is a lacklustre way in the fortification of the premises by the security.

The question that goes begging is even after being revamped, how did security let the fruit knife get in without their knowledge and how is that not even after months of the previous stabbing incident, a revamp in the security, how there was a breach in the security in such close proximity to an incident that is still fresh in the hearts of the people who had been terrorised by it?

Another question that comes into mind is if CKD that the man faced, and was undergoing the treatment for, was the cause of such a big decision of the man to kill himself.

Cognitive Impairment (CI) s defined as “confusion or memory loss that is happening more often or is getting worse during the past 12 months.” Studies show that CI shows up in people with CKD and is also one of the reasons prevalent in the severity of depression in people undergoing dialysis.

Chronic Kidney Disease (CKD) refers to an irreversible deterioration in renal function. For operational purposes, CKD is defined as the presence, for at least three months, of evidence of kidney damage with an abnormal glomerular filtration rate (GFR) or, alternatively, by a 2 GFR below 60ml/min/1.73 m body surface area.

CKD a major epidemic of this century, has become a major public health problem both in terms of patient number and treatment cost, with most patients either referred to one of many renal replacement therapies such as haemodialysis, peritoneal dialysis and renal transplantation or death supervenes as a result of cardiovascular disease.

Speaking about Sikkim, there haven’t been many researches to provide concrete data but a study by PubMed Central (PMC), a free full-text archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health’s National Library of Medicine (NIH/NLM).

A study by Shijo John Joseph, Samrat Singh Bhandari, and Sanjiba Dutta, shows “Cognitive Impairment and its Correlates in Chronic Kidney Disease Patients Undergoing Haemodialysis”:

The study was approved by the Institutional Ethical Committee (IEC, 360/15–083) of SMIMS. A total of 50 patients who attended the dialysis units of SMIMS AND STNM hospitals and who were willing to participate in the study were included after a written consent was obtained from them. It was decided that all patients undergoing HD and meeting the inclusion criteria and providing informed consent during the one-year period would be taken up for this study.

Severity of Depression amongst CKD Patients Undergoing Hemodialysis, (NCBI/NLM/NIH)

In this study 50 patients suffering from CKD, undergoing HD from state of Sikkim were investigated. Minimum and maximum ages of the patients undergoing HD were 24 years and 70 years respectively with a mean of 50.32 years and SD of 12.4 years. Duration of dialysis for the patients had a mean of 18.8 months with SD of 15.11 months. The prevalence of depression in the patients was 42%.

The findings are shocking, as Sikkim has an already alarming rate of mental health diseases, and culturally the state is well known for an affiliation to alcohol, one of the biggest culprits behind CKD, the study shows that the correlation between the two, in people who suffer from CKD is ghastly. With the shocking facts stated in above, it is well in the territory of reason to state that many people have lost their life savings trying to battle renal diseases, and that it has lead people to take radical steps like taking their own lives.

It is hard to say if the 60-year-old man was battling depression or not, if it was inability of bearing the cost of his treatment, or if it was something else that lead to his suicide. Whatever the mental reason may be that lead to his radical decision and the grievous situation, the physical reason, the reason that shows up as the cause of death on the death certificate, was that he had stabbed himself with a fruit-knife which led to his death. A knife that was supposed to be seized at the door by the hospital security.

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