The health of a nation depends on the health of its citizens. But, unfortunately, India is probably the only socialist country in the world that has failed to run a credible public health system which provides accessible, affordable, accountable, effective and reliable healthcare for its people. A report released by the National Council for Applied Economic Research says that about a quarter of Indians who get hospitalised every year slip below the poverty line thanks to medical expenses for which they are not insured. Considering that nearly 70 per cent Indian families depend on a single member’s income, it’s understandable why falling ill means entering into an unending debt trap. Such setbacks, in fact, lead to several other collateral and long-term damages for the family. The 2007-08 Economic Survey admits that India’s position on health parameters “compared even to some of its neighbours continues to be unsatisfactory”. India compares poorly not only with China and Sri Lanka, but also Bangladesh and Nepal with respect to some indicators.
This appalling state of affairs is not confined to rural areas alone. Things are not much better in the heart of the capital as shown by a recent report, the first in a series on government hospitals carried in this paper. The hospital under scrutiny — Guru Tegh Bahadur — lacks adequate number of doctors and paramedics, medicines as basic as painkillers and medical equipment like gloves and surgical caps. For doctors, this is also a kind of a punishment posting because of lax security and the absence of even a basic facility like a waiting room. In a scenario like this, expecting professionals to perform is like asking a soldier to fight without weapons. If this is the case in a hospital in the privileged Capital of India, one can well imagine the situation in public health centres in rural areas. The Minister of Health and Family Welfare, Dr A. Ramadoss, has often talked about making it mandatory for fresh medical graduates to serve in the rural areas. But even this plan will not improve the situation if the bare essentials are not made available. At present, the Economic Survey says, there is a shortage of 19,269 sub-centres, 4,337 Primary Health Centres and 3,206 Community Health Centres in the country. The National Rural Health Mission has probably improved the statistics but on the ground level the gap between demand and supply continues to be yawning.
India has a young population. But we will only be able to reap the benefits of this ‘demographic dividend’ by ensuring proper healthcare and education. The substandard delivery of public health has encouraged the development of an exploitative private enterprise in healthcare and often, in rural areas, is run by people who pose as medical professionals. There is no way for the patients to find out whether the person is qualified as a doctor or not. Only by increasing the outlay for health, community involvement and strict monitoring can India revitalise its tottering health infrastructure. Nobel laureate Amartya Sen has often talked of “fuller recognition” of health as a human right. Clearly, this is just what the doctor ordered.