The inadvertent case of Caustic Soda — I

TW : Medical terms and description

Being a part of the Healthcare industry, you often witness cases that throw curveballs at you since the entity of Medicine, as much as it is miraculous, is equally terrifying at times. Of the many cases that I have witnessed, one that I still cannot get rid of from my thoughts is of a man named Bharat, full of integrity, who did his work with all honesty and yet was met with an unfortunate event.

During the Junior year of my UG program, we were posted outside of the college premises for doing rounds at different hospitals. I was with my batch at a government hospital in the city. It was an optimally functional hospital with many mishaps taking place, nevertheless, the low medical costs and a few good doctors truly provided shelter to those who belonged to the underprivileged sectors. The hospital consisted of 5 departments that we had to attend for 15 days. On that particular day, I and a few other students were told to seek the surgery ward and prepare an assessment of the patients admitted there.

We quickly ran up to the 5th floor to choose the easiest case which would be finished early so we can have coffee later at the cafeteria. I reached there and saw several patients, and since it was mid-summer, there was a high influx of patients with heat stroke and dehydration. Amongst them, I saw a man trying to walk with all his weight on one functional leg while his mother was assisting him to move forward. I, without a thought, walked up to them, greeted them, and asked if it was okay for us to ask him a few questions regarding his stay at the hospital. Without a hint of hesitation, he agreed to let us assess him. In college you are more inclined to just not do anything, but, as a medical student, when you carry less exposure, patients like Bharat, who look at you with hope and eagerness to share their story, it reinforces your purpose beautifully.

Normally, while taking a medical assessment, the tasks are divided and so after doing that, we started asking the details and jot down notes. Bharat and his mother started to tell us about their financial situation and Bharat’s occupation as a manual laborer. He worked for a factory that involved him transferring goods onto a vehicle to send them to another location. One day he was transferring bags of Caustic Soda. While doing so and not knowing that there was a small cut on one of the bags, a little powdered soda fell onto his foot (dorsum). He simply dusted it off by shaking his foot and went back to what he was doing.

Days passed by and he started to feel a little burn in that region, however, he ignored it. And slowly the skin started to peel off which made him realize that he needs to do something about it, so he applied some local ointment suggested by the chemist. However, the ointment did not help, and he developed an infection. In the following few days, the skin was completely damaged and necrotized with the bones (metatarsals) being visible and the infection was still present. This led to a rather non-functional leg. There was a very clear risk of infection spreading upwards to the leg, so to avoid that and protect the healthy part of the leg, he had to get a foot amputation (Ankle disarticulation). Bharat told me how difficult it was for him to come to terms with this yet he knew it was necessary so he agreed. And now after the operation, he has been receiving training for walking with one-leg and soon would be fitted with a prosthetic.

He mentioned how it had affected his and his mother’s day-to-day life, minor and major changes which were difficult to cope up with, a financial crisis had come up and he talked about how helpless he felt. On the other hand, Bharat’s mother was a strong lady and had no doubt in her son’s determination. So we discussed all the protocols for training and tried to educate them as much and as simply as we could. We carried on with further assessment procedures and tried to help them understand the situation better.

After all the exchanges, I could see how strong both Bharat and his mother were, apart from a few tears while remembering the past, they were only smiling throughout the conversation and their eyes were filled with hope for a better tomorrow.

We left the area after taking a few more notes and discussed the case on our way out. Everyone mentioned that it was an unfortunate thing to happen to such a nice family. However, after hearing Bharat’s story, all I could think of was the only issue that led him to lose a part of his body, was that he wasn’t told what to do in such situations. He had no idea about the dangers of having skin contact with a chemical and not following a protocol to prevent injury. For a factory worker or laborer, the factory itself is responsible for their health and should teach the workers all the necessary precautions and what to do when such a situation takes place. According to the law stated under The Factories Act, 1948, the act has been promulgated primarily to provide safety measures and to promote the health and welfare of the workers employed in factories. What happened to Bharat is the result of an inadvertent scenario that occurred, with him having a price to pay that can’t be quantified with bills.

*The second part will talk about — Caustic soda/soda burns, what to do if that happens, Factory Worker health guidelines and the scenario in India.