'These things take time' is the routine answer from officialdom when asked why things are not improving in India's public healthcare system. But for the chronically ill patients who have been forced to live in a urinal on the premises of India's premier referral hospital, the All India Institute of Medical Sciences (AIIMS), time is running out. In a shocking story, this paper has chronicled the appalling manner in which people from distant places, many with heart ailments and cancers, have no place to go while awaiting treatment other than the pavement and in some cases, as documented, a urinal. If this does not shake up a moribund health ministry, nothing will. That these unfortunate people had to travel all the way to AIIMS for treatment is in itself a scandal. Clearly, it is because the specialised care they need is not remotely close at hand in other states.
With a patient to bed ratio of 1:65 and a doctor to patient ratio of 1:1,300, AIIMS is already stretched to breaking point. It is no secret that India today has a dual burden of disease with not just a deadly cocktail of communicable ailments but also lifestyle ones like diabetes and cardiovascular diseases. Seventy per cent of cancers are detected in advanced stages. These cannot be treated at local facilities, they require specialised care. But as the plight of those at AIIMS shows, the malaise at the bottom of the pyramid which is public health centres equally affects the top-end. The same crippling infrastructural deficiencies have created a situation where getting the appropriate treatment is never guaranteed. The ministry of health and state health departments as always assure us that initiatives are underway. If so, we would like to hear more about them.
One ambitious plan has been to decongest AIIMS and move non-critical care to another facility. But that is a drop in the ocean given the millions who need the kind of care that facilities like AIIMS can provide. For years, the health ministry, run by one inept minister after another, has been proposing to set up AIIMS-like centres in other metros and towns across the country. This would mean that patients could access them far more easily and would not have to come all the way to the capital for affordable, quality care. Even if by some miracle such facilities sprang up overnight with adequate infrastructure, the next problem would be that of personnel. There are massive lacunae in the field of nursing and ancillary health staff, all vital for critical care. But, we presume, plugging that will 'take time'. If the government moves to provide safe, clean shelter for these patients living out their days in a urinal, it would send out a small, but right signal.