Did I teach him survival skills and healthcare priorities?

BMJ 1998; 317 doi: (Published 15 August 1998) Cite this as: BMJ 1998;317:461

An interesting encounter

  1. Krisantha Weerasuriya, professor of pharmacology
  1. Colombo, Sri Lanka

    There is a paraplegic—I wonder what the aetiology is—who, seated on the ground with his crutches next to him, asks for donations at the entrance to the supermarket. He is a pleasant man and always has a smile despite his disabilities. As a member of the middle class in an Asian society and a healthcare professional, I sympathise with his plight and realise that society must do more and that we should be part of the pressure group that tries to achieve this. But, caught up in a society that is privatising the basic services, we realise that we have to do enormous amounts in education and other things to see that our children get a decent start in life, and our priorities are elsewhere. My normal response is to give him some money or some food bought from the nearby shop.

    The other day when I passed him there was a new group—a mother and her children—on the other side of the entrance, who were also asking for donations. The children were thin and the hair slightly brown—was it early kwashiorkor or the dust in unwashed hair? I took a long hard look—especially at the children—and gave my token donation to the mother in the hope that it would be for nutrition for the children. He saw what happened but nevertheless gave his usual smile.

    The next day when I passed him his own two children were playing by his side and the little son was using one of the crutches as a toy. I gave him double what I normally give, and wished that my students would learn how to identify healthcare priorities as fast.