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The Bad Health
of our Hospitals
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On September 3, 2006, Puralia
Devi (name changed), a
resident of Narkatiaganj
village in Bihar, was in
advanced labor when her husband
Rambha brought her to the local
government hospital. Like most hospitals
of this area, this hospital was unhygienic
and was plagued by an utter lack of
modern medical facilities and medicines.
Two hours after being admitted, Puralia’s
condition started deteriorating.
The doctors and the nurses at the
hospital threw up their hands saying
that the case was too complicated for
them to handle. Puralia’s husband had
no choice, but to rush her to a private
hospital, where she gave birth to a
stillborn child. To meet the expenses at
the private hospital Rambha, who works
as a daily wage laborer, had to avail a
loan of rupees 7,000, which the family
now finds very difficult to pay back.
Janki Devi is a resident of an idyllic
village near Indore. She and her husband
work as farm laborers. Her troubles
began on a routine day when she was
working barefoot and a splinter of wood
pierced her left foot. She applied some
herbs to the wound, but by next day her
left foot was swollen and she found it
impossible to walk or even stand on her
feet. Her husband took her to the local
village hospital, but the staff there was
completely insensitive to her plight. They
made her wait for hours in the corridor.
When she got the chance to see the
doctor, he took a perfunctory look at
her wound and declared that the foot
had become poisoned and it had to be
surgically removed. As soon as Janki
heard this, she fled from the hospital
with her husband in tow. At home they
continued with the herb treatment and |
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| within a week her foot became normal,
allowing her to walk and work properly.
She shudders with horror, as she
reminisces her tryst with the doctor who
was planning to chop off her leg. |
| When Iqbali Singh’s elder brother fell
ill with a severe nerve ailment in a remote
village in the eastern state of Bihar,
he found that there were hardly any
hospitals in the state with the expertise
to even diagnose that ailment. He was
forced to bring his brother all the way
to New Delhi’s premier All India Institute
of Medical Sciences. For a poor man like
Iqbali traveling to Delhi was fraught with
many problems.
He had to give up his job as a security
guard in Bihar. The treatment at AIIMS
is free, but to pay for the tests, he was
forced to borrow 15,000 rupees at a
crippling interest of nearly 50 percent a
year. Now he and his brother are in a grip
of severe financial crisis, as they have no
time left to earn their livelihood. Their
days are mostly spent navigating the
long lines of patients at the overcrowded
AIIMS. |
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Puralia Devi, Janki Devi and Iqbali
Singh are just three names, out of millions
of economically weak Indians, who are
forced to struggle with India’s healthcare
system that remains overburdened in
cities and is virtually nonexistent in
villages.
The biggest problem plaguing India’s
healthcare sector is the misdistribution
of hospitals and doctors. While majority
of the population resides in villages, most
of the hospitals and doctors are based in
the cities. It is not just advanced care
that poses a problem. Even good basic
care is inaccessible to the vast majority
of people. Thousands of primary medical
centers exist in rural areas, but these
establishments are perpetually short of
personnel and medicines. Due to the lack
of proper facilities poor people are often
forced to depend on local quacks.
India’s healthcare statistics paint a
particularly dismal picture. According to
the National Family Health Survey, 46%
of all Indian children are malnourished.
The infant mortality rate, though
improving, is still high and much worse
than that in other developing countries.
This is complicated by the fact that less
than half of all Indian women receive
care after childbirth and only 40% give
birth in hospitals or medical centers. It
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is scandalous that in country that touts
itself as an emerging superpower, an
easily curable disease like childhood
diarrhea remains the major killer of
Indian children.
When it comes to transmittable
diseases like Hepatitis B and AIDS the
situation becomes murkier. According
to one survey done by IHR (India Health
Report) in year 2000 about 3.86 million
Indians were infected with the HIV virus.
But the actual number of HIV positive
might be much higher as many people
prefer not to visit the doctor. Due to
the stigma attached to the disease, they
prefer to die a slow and lingering death
in the secrecy of their homes. In any case, as vast majorities of the infected
people reside in villages and belong to
the low-income level backgrounds, it is
impossible for them to gain access to
advanced medical techniques, like the
anti-retroviral therapy that has been
found very effective in combating AIDS. |
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| In rural areas, healthcare is mostly
provided through government-operated
PHCs (Public Health Clinic), at village and
town levels. But like every government
department in India, these PHCs operate
in a very inefficient and callous manner.
These under-funded clinics are plagued
by non-availability of infrastructure,
including advanced medical equipment
and consumables. The poorly paid
doctors based at the rural PHCs don’t
think too highly of their job and they lack
the motivation to do their work well.
In absence of proper hygiene and
sanitation, the clinics turn into a breeding
ground for communicable diseases,
instead of being a
place of cure.
But it is also a
fact that many
rural folks do not
seek timely medical
help because of
their disbeliefs,
superstitions and
lack of health
education. The
result of the
complete failure
of the health
machinery in
the rural areas is
that the diseases
neither get diagnosed in the early
stages, nor are they treated. Only when
the disease reaches an advanced stage,
and the patients are completely unable
to bear the suffering caused by it, that
they travel to the urban areas in order
to seek treatment, increasing the load
on city hospitals. It is such a terrible
and unnecessary predicament, when
treatable diseases are made to linger till
they become serious complications. |
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For a country like India that still
faces healthcare crisis of unimaginable
proportionls, radical reforms need to be enacted in order to rejuvenate the
healthcare sector. While it might not
be feasible to turn healthcare into an
entirely private affair, a slow and steady
process towards privatization has to
be made. Even a whiff of privatization
has the potential to usher in a regime
of transparency and efficiency. The
hospitals and clinics will become more
accountable and the poor people won’t
have to run from pillar to post in order
to get treated. But private healthcare is
going to cost lots of money, which the
majority of the poor in the country will
not be able to afford.
To take care of that problem we can
have a system of health insurance, where
those who have the capacity to pay can
pay their premiums, while those who
are classified as poor, about 60 per cent
in India, will have their premiums paid
by the government. More importantly,
healthcare will have to be proclaimed
a fundamental right through an Act of
Parliament. For the above to become
a reality, people will have to rise and
organize a campaign to build consensus
on a right to health care.
Only when the majority of Indians are
given basic healthcare facilities, can we
call India a true superpower. |
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