You would find a doctor sooner in the deprived, famished parts of Zambia, Cameroon and Democratic Republic of Congo than in eastern Maharashtra’s Gadchiroli. The district has 85 doctors for its 9.7 lakh people, or a doctor for 11,415 people. That’s roughly a physician attending to a super-packed Sunday mall, just that the next patient could be scores of kilometres away.
The ideal ratio, according to the World Health Organisation (WHO), should be one for 250 people. In rural areas, it is one in 450 people.
While even Mumbai, with one doctor for 656 people, does not meet the basic standard, recently released data from the Maharashtra Medical Council (MMC) on MBBS doctors registered in the state has revealed appalling doctor-patient ratio in the districts. Gondia’s ratio is one per 7,695 people, and Washim one for 6,376.
The cities Mumbai, Thane, Nagpur, Pune and Nashik have more doctors than all 28 districts put together. The cities taken together have 37,421 doctors, while the rest of the state has to make do with just 30,303.
There are 67,764 doctors registered under the MMC, confirmed registrar R.G. Janjal. Every doctor who wants to practice in the state has to register with the council. Some doctors who come from other states also practice here, mostly in cities, after registering with the respective state council or Medical Council of India.
“There must be about 7,000 more doctors from other states practicing here. That makes it 75,000,” said Prakash Doke, director general, health services, Maharashtra. “Earlier, we had estimated that there are at least one lakh doctors in the state, but the latest figures disprove that.”
He admitted that the doctor-to-patient ratio in the state, especially in the hinterland, was abysmal.
“Doctors refuse to work in these areas despite graduating from there.”
“To fill up the gap, we give them incentives like raising their pay scale to that of a civil surgeon instead of that of a medical officer. Still, they refuse to work in these areas, so we have started recruiting ayurvedic doctors instead,” said Doke.
He said dropouts from the public health system might be another reason for the poor ratio. “The attrition rate is high. Most doctors don’t work in villages for over a year. Besides going into private practice, many take up consultancy jobs or go abroad. It makes it very tough to operate under these conditions,” he said.
And since posts of doctors are vacant in rural hospitals and health centres, “one has to often travel several miles to find a doctor”, said Gopi Menon, state representative of the UNICEF.