Wealthy is healthy…the Indian Healthcare divide

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.