The healthcare system has failed those who need institutional care. They deserve better.
In the twilight zone that institutionalised trauma victims inhabit, neither society nor the law holds any meaning. Both have shunned these unfortunate people as starkly brought out in an Hindustan Times report yesterday. The concept of life-long hospitalisation is still alien in India despite the growing number of people who need it. The most poignant is perhaps the case of those with mental health problems. Families are often unwilling to keep them at home or seek appropriate medical intervention. The state has little to offer by way of help given that India which has the highest number of mental health patients in the world has only 20,893 beds in the government sector and a mere 5,096 in the private sector for them. Both patients with mental problems and those who have suffered life-altering physical traumas simply do not have access to institutional facilities.
The government has not taken this issue seriously on the grounds that it is stretched even when it comes to providing basic healthcare facilities. In fact, the area of those with disabling traumas is opaque with few specialists in the field or facilities that can provide support and care to them. There are many patients who need care and not treatment after recovery. In the case of mentally challenged ones, families are often reluctant to take them back, unable to either bear the cost or the social stigma. The need for institutional care cannot be swept under the carpet any longer. With India’s growing number of patients, like those with Aids, who will suffer lifelong disabilities, the argument that this can wait until basic health care is provided is unacceptable. The few hospices there are in India are either run by NGOs who are cash-strapped or by the private sector and accessible only to those with the means. States like Kerala have home care attendants for the terminally disabled but they are again available only to those who can afford them. In the case of patients with special needs, untrained family members could do more harm than good.
The worrying aspect is that this issue is only raised when a report of the sort in HT is published.
The truth is that neither the government nor the private sector has any blueprint on how to handle this particular area of healthcare. It is a field in which the system will literally have to be built from scratch — from qualified personnel to the budget. But to ignore people who need institutional care as being an unnecessary add-on to an overburdened health system is to deny them their fundamental right to a life with dignity.