I am writing this post with much anger and frustration. Or should I say I do not see any solution for the below explained problem. I watched Al Jazeera’s news video on Indian Health System which reinforced my inference drawn from our past experience of rural health care.
All these days, we are experiencing and learning a lot on rural development initiatives in India. We are seeing new initiatives that are specifically designed to bridge the gap between the ‘Rural and Urban’. It can be an Internet connection or a detergent which is now easily made available across the villages of India. Many organizations (Public, Private and Not-for-Profit) are backing the progress with respect to the rural reach programs. In fact it is turning out to be a good profitable business to reach the 72% of the rural population mass with some value added. We are seeing enormous wealth being created. In short we are trying to make our beloved ‘Visionary’ of India Dr. A.P.J Abdul Kalam’s dream PURA (Providing Urban amenities in Rural Areas) a reality.
Interestingly, while the focus is more on rural areas, we are still encountering a major challenge with respect to Indian Health Care System. If you read the below statistics (from Al Jazeera news report) you will know the major challenge that we are encountering:
- India spends only 5% of its GDP on Medical Care.
- It is a very tiny amount when compared to the 15% in the United States.
- There is a shortage of 2.2 million hospital beds.
- 53% or 67 million children below 5 years lack access to even basic health care.
- 72% population live in Rural Areas and 80% doctors are in urban centres.
While the rural mass is being targeted by many global players and organizations to create wealth, where is the Indian Health Care system heading towards? Why is it that it is getting difficult to address the Rural Health issues? And where is the missing link?
It was a very disappointing experience, in spite of our sustained efforts in trying our best to collaborate with many of the doctors and hospitals, we were unsuccessful in convincing ‘One’ doctor who can give his/her service in the Primary Health Centre of Kandavara village in Chickballapur taluk. We met with quite a lot of doctors and physicians to discuss about the non-availability of doctor in the village and literally begged for their services. We went on to an extent where in we requested for ‘One-day-in-a-week’ or ‘Four-hours-per-week’ types of services. We failed in all our attempts. The reason for our failure was not because we had no money to buy doctors, but, doctors were not keen on being in a village or carryout their professional services in a village. All they wanted is to be in the city limits and make enough and more money. I feel sad when I think about the reasons we got to hear from them. We also tried our best to get medical students to do their internship in the PHC of Kandavara. They came, they saw, they left with literally no response from their end. We met with many of the medical associations, many young and senior doctors in Chickballapur, but we could not succeed and the reasons weren’t deviating from where it was. We also took the help of journalism students, who did a commendable job in making a documentary by interviewing the government officials. But nothing substantially worked with respect to appointing a doctor to the PHC. Eventually, PHC was demolished and fortunately a Nursing school is being constructed in its place. Hopefully it will also have a hospital or a clinic attached to it. We will believe it only when we see it.
On the other hand, we have seen a lot of doctors who are committed towards the rural health, like the team from VGKK (Vivekananda Girijana Kalyana Kendra) at B R Hills run by Dr. Sudarshan, Vaatsalya HealthCare run by Dr. Ashwin Naik and team. They are doing remarkably well in keeping their promises on to the needy. They are going out of their way towards the primary and secondary health. Dr. Prashanth, who works at VGKK, to me, is a great volunteer. He has dedicated his life to the mankind by providing his services in the remotest villages of India. All the above mentioned gentlemen have the highest qualifications in their field and they are not doing this just for money. They are trying to make a difference with their dedication, knowledge and commitment to the society. They are the real altruists! And I am very certain that there will be many more like them.
But not enough! Absolutely not!
Is making money holding all the doctors going into the rural areas? Or it is the lifestyle that they need cannot be seen in rural areas? Why is it that there are no doctors, including a lot who are from the same rural background, are backing out of giving their services to the needy?
As per our discussions with the DC and ZP of Chickballapur, they were ready to compensate the doctors well. In fact, surprising to know is that government is finding it very difficult to recruit doctors to the existing PHCs. They are now depending on the voluntary organizations to help them. There were a lot of programs and schemes designed for the betterment of the rural health care during the era of the Ex-Principal Secretary of Health, Madan Gopal. But what is the use if there are millions of people without access to even the basic health care. And this is the story with most of the states in India. In the news report, an example is quoted says ‘a place in Andhra Pradesh, there is only one hospital for 35000 people’. There are many places where in patients walk a dozen kilometers to reach hospitals.
While we are having the world’s best health care technologies in India, world’s famous doctors and highly talented in house human resources, we are not using our strengths to reflect on our own problems. I am not too sure as to how to make the doctors come out of their current mindset, but I only know that this challenge remains the same unless we find that missing link!
This is a never ending crisis!
Here is the link to Al Jazeera's news video.
Srik