“Ache din aane waale hai”
Well,
that’s what I believe anyway. India used to be known as the ‘sone ki
chidiya’ – the Golden Bird, but that sadly is a thing of the past.
Corrupt officials, ineffective governance, ridiculous policies (both
foreign and national) and high level yes-men, have rendered this once
great nation, a laughing stock not only to the world, but also to its
very own residents. Having such a massive population, second only to
China, should have helped propel us forward, but it has been more of a
burden, dragging us behind. Restlessness and discontent was strife
against the current regime. A huge shake-up of the government, from top
to bottom, was massively required. And that is exactly what has
happened. A wave of change has swept over our country bringing with it
billions of hopes and expectations. And it is we, the youth, who stand
at the centre of this change.
Ten years from now, I see India as a
global superpower. I see us as a country at the pinnacle of
development, be it the economy, education, infrastructure or even the
health care sector. Yes, the health care sector! And this is where, as a
medical intern at Sion Hospital, I would like to give my not-so-expert
opinion.
According to me, the health care sector is one of the
most neglected fields in our country. And that, for a country with a
population exceeding a billion, is simply unacceptable. There is a lack
of availability of even the most basic of medical supplies, at the
primary health care level. For example, when I was doing my rural
rotation, the health centre I was posted at did not even have stock of
isosorbide dinitrate (simply called nitrate), a basic drug which is
critically important in the emergency management of myocardial
infarction, commonly known as a heart attack. Lack of such basic
supplies will hinder even the best doctor’s attempts at treating his
patients. The WHO guidelines dictate that there should be at least one
doctor for a population of 1,000 people. But the sad reality is that
this ratio currently stands at around 1:2,000 in our country. This
prevents people from availing even the most basic facilities, especially
at the primary level.
However, these problems are not just
limited to the rural level. They are also prevalent in the urban areas,
specifically the government-run hospitals. Most of these hospitals are
severely understaffed. Doctors are unable to give their complete
attention to every single patient, which results in them not getting the
appropriate medical treatment. Most of these hospitals are grossly
mismanaged, which results in the patient not getting timely, and in
certain cases, lifesaving medical care.
But it is not only the
patients who suffer. Doctors are in fact, the major victims of this poor
management of the health care sector. The ‘resident’ doctors, i.e., the
postgraduate student, are probably the ones who are the most affected.
These doctors are the ones who practically run the whole hospital. Along
with that, they have to battle a host of other problems such as
inhumane working hours (most of them don’t sleep more then 30-35 hours a
week), poor and unhygienic living conditions which predispose them to
various illnesses such as tuberculosis, abysmally low salaries, and
handling aggressive patients and their relatives, each of whom demand
the best treatment for themselves. Even after treating the patient to
the best of their abilities, there is always that nagging fear of
getting beaten up even if one miniscule thing goes wrong. In the private
set-up, although there are no problems of staffing or overcrowding as
such, it is the huge cost of treatment which acts as a deterrent, which
pushes people towards the public hospitals.
All these issues are
correctable, if the government shows the required desire, understanding
and dedication. The most obvious solution would be to increase the
number of doctors at all public hospitals. This increase should not only
be at the senior level, but should start from the grass roots, at the
undergraduate level. The number of seats at both UG (Undergraduate) and
PG (Postgraduate) level should be increased, which would results in an
increase in doctors at all levels. As of now, there are approximately
20,000 PG seats in government-run medical colleges throughout India.
This is totally inexcusable for a country with such a massive
population. Establishing new medical colleges and hospitals would go a
long way in providing better health services. It would reduce the
workload on already overburdened doctors. The aim of the government
should be to have at least a 100 new, tertiary hospitals in India in the
next 10 years. This would make a massive difference in ensuring quality
health care.The government must take steps to ensure better, sanitary
living conditions for resident doctors. Offering attractive
remunerations and financial packages would draw more doctors to take up
jobs at government hospitals. Another crucial decision should be to
increase the strength of the para-medical staff at all hospitals. These
include the nurses, ward boys, technicians etc. These people play a
critical role in the day to day efficient running of a hospital, without
whom, things would just come to a grinding halt. There should also be
an increased focus on infrastructure and basic facilities. For tertiary
health centres such as the big hospitals, providing them with the latest
technology, modern equipments and the best lab facilities, would go a
long way in enabling them to provide the best medical care that they
possibly can. For example, there are currently many hospital across
india which do not even have a CT scan! Primary health care as a whole
has been grossly neglected and steps must be taken to ensure that such
centers have access to basic, life-saving medications as well as simple
investigative equipment like x-ray machines. Our aim should not be to
provide medical care on par with the Western countries, but to provide
better care than them, simply because we have the resources to do so.
I
have a very limited knowledge of the budget and the constraints faced,
but I do know that expenses on health care were cut down by 10% for the
2014-15 budget. The most obvious solution would be increase the
allocation, and the subsequent expenditure, on health care. However, if
that is not possible, judicious and carefully planned use of the
resources should be made. There should be increased focus on certain
areas which require them the most, such as the primary health care
sector. Conducting increased number of health camps, with the assistance
of NGOs, would go a long way in tackling health problems in rural
areas. Special departments should be set up within the health ministry,
each given their exclusive objectives and asked specifically to focus on
them.
Ten years down the line, I would like to see every person, whether rich or poor, have the opportunity to access the best medical care and facilities. I would like to see India at the forefront of health care services. An India, where peo- ple from abroad come to access OUR health services, not the other way around. An India where our doctors get the respect and facilities they deserve, and are not vulnerable to the very diseases they are supposed to treat. An India where basic medicines are available throughout, such that not one single person should die from simple, preventable diseases like tuberculosis or malaria. All in all, I would like to see India achieve its tremendous potential, become the country that we know we can, and command awe and respect from the rest of the world. Bold claims maybe, but I firmly believe, with the current government in place, all of this is eminently achievable with the required will and hard work.
In the words of Martin Luther King Jr.,”I have a dream…”
