The town of Sevagram in central India has long been known for three things: its heat, which is oppressive even by Indian standards; its snakes, which are abundant; and its ashram, a derelict and increasingly malarial retreat preserved as a tribute to Mohandas Gandhi, who lived here and was known for tenderly relocating the poisonous vipers that slithered into his shack.Read on. Wired 14.03: A Nation of Guinea Pigs
Despite this intemperate setting, Sevagram's hospital has a good reputation. Though the power fails often, forcing medics to use the backlit screens of their cell phones for illumination, the standard of care is higher than at many of the country's public hospitals, and the facilities are comparatively plush. At the nearby government medical center in Nagpur, for instance, patients sometimes have to sleep on mattresses on the floor.
Last year, Sevagram began garnering even more cachet. A German pharmaceutical company called Boehringer Ingelheim, whose latest stroke-prevention drug was making its way through the clinical pipeline, approved the town's hospital as a trial site - one of 28 in India recruiting stroke victims to round out the company's 18,500-person study.
The drug regimen, known as Aggrenox, was being tested for its ability to forestall a second stroke. S. P. Kalantri, the doctor tapped to lead the trial in Sevagram, quickly grasped the offer's appeal. Patients in Sevagram are poor enough that the benefits of taking part in the study would amount to a health care windfall; among other things, Boehringer Ingelheim guaranteed participants two physicals during each of the three years that the trial would run. For each person enrolled, moreover, the hospital would receive 30,000 rupees (about $665) - no small amount, given the puny budget of the center's stroke ward, a single room of eight pallet beds. Kalantri talked the matter over with the chair of the hospital's ethics committee, and the two concluded that the trial drug itself, with its possible side effects and limited efficacy, would provide little benefit to their patients. Then they went ahead and signed up.