We are an aspiring superpower that has the most vibrant democracy
in the world, an independent judiciary and a billion people. Some of our achievements
in the fields of information technology and space research have given us the
much needed belief that our nation has come of age to compete with the mighty industrialized
nations. Yet the access to quality healthcare to all irrespective of class
divide has still remained a challenge even in the seventh decade of our
independence. Our mass vaccination program has become phenomenal success with
the near elimination of Polio from India and we are on the way to become most successful
nation in terms of implementation of mass vaccination programs.
All these are matters of pride for any Indian. But the
question remains if we have made basic health care accessible to the poorest of
the poor…The answer from the point of view of a health department official
would be a yes…as he will give you the number of hospitals opened in last five
years under various schemes of government and the proposed hospitals to be
opened. The real problem lies not in the number of public health centers available
but the quality of service available at such centers. The rich and poor divide
is evident as the marginalized sections of society that depend on public health
centers are lacking the required infrastructure, human resource and more
importantly availability of quality drugs and at times the stock of emergency
medicines. They have acquired such a cult status that when I had been to the
taluk public health center of my locality for the sake of getting a medical
certificate I came across some healthy people getting admitted. The reason
being they wanted to file a police complaint against their rivals who belonged
to a political party for allegedly beating up these men. The police file a
first information report (FIR) in such cases only when someone gets admitted to
a Government Hospital. While the sick among the poor get admitted to these
hospitals, no one from a little privileged background would ever come to this
place unless they have a reason.
Consider these two scenarios...
A pregnant woman who is due to deliver today gets admitted
early in the morning in a brightly lit labour room with enough nurses and on
duty doctors who are round the clock supervising her as she takes rest in a
perfectly cushioned bed waiting for her turn for a normal delivery and the
doctors are monitoring her continuously to know if she is comfortable and if
not do they need to prepare for a cesarean as the case may be…All this while
the pregnant woman does not need to bother and
her attendants need to give only the consent and the rest is taken care
of by experts.
Second scenario is almost similar until the woman gets
admitted…changes being a dimly lit room with noise heard from outside. A couple
of nurses attending all the patients and one specialist along with two juniors
taking care of entire ward…and when they are inside the emergency the pregnant
woman holding on to a rough bed clutching her hands to cold metal bar of the
cot she is laying on with pressure increasing every moment ..At the same time
patient attendant helplessly moving from one pharmacy to another in search of emergency
drugs prescribed by the Doctor. As the hospital is short of medicines and
whatever available has to be kept in safe in order to meet the demands of
poorest of the poor.
The first scenario is that of a private super specialty hospital
and the second from a public health center. The differences do not end here. Instead
they begin here...the place where doctors and the patients do not have access
to emergency drugs, hot water round the clock and noise free surroundings coupled with worn out or obsolete furniture and
at times leaking
buildings.
I learnt of these things from a Doctor who has served in
government hospitals as a student in formative years and now as part of specialization
serves in one of the top hospitals in the country. The above mentioned doctor (name
withheld for confidentiality) is deeply traumatized and at times is guilty of
not having been able to do much for the poorest of the poor, as she tells me
rather sarcastically that health is indeed wealth…and wealthy are indeed
healthy in our society…a poor woman might deliver but with high chance of
maternal mortality…she doesn’t seem to
have a solution other than urging me to write this blog and I too don’t see a change happening anytime soon in our ‘health divide’..
We are fortunate if we have enough money to treat our
diseases and get healed from physiological
pain but that young mother from the street shall take a rebirth before giving
birth if she is lucky…and that young man
who got hit by carelessly driven car in the middle of the night by a drunken star shall
die anonymously in a government hospital
while the star would be treated for his small bruises resulting from
stunt sequences in a movie by a team of specialists in a reputed hospital……man…money
buys health...and I am in deep denial of
this reality as I am too patriotic to accept the fault in my system.
