By Patricia Mukhim
“No amount of personal competency can compensate for personal insecurity.”
—Wayne Smith
The duty of the media is to highlight the ills and areas of malfunction in every public funded institution. Unless we do that we are failing in our duties because these institutions are created to serve the public good. When the North East Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS) started in Shillong there were high hopes that those from the region would not need to undertake rigorous trips to health care centres outside the region at great cost to the patients and their care givers.
Lest we forget, on January 22, 2000, the then Prime Minister, Mr Atal Behari Vajpayee declared NEIGRIHMS as an ‘Institute of National Importance’. The Institute was also declared as an “Institution of Excellence” by an Act of Parliament vide Gazette of India Notification dated 4th January 2007. This is the only Medical Institute that has been given such a status in the country.
NEIGRIHMS was conceived in 1987 and started with minimal services in 1998. The in-patient services started in 2001 with only 30 beds. Since then NEIGRIHMS has come a long way with 531 beds at present and an annual patient load of 2, 26,308 out-patients and 15,568 in-patients as of 2013-14. Currently the Institute conducts high end diagnostics and medi-care in interventional cardiology, open heart surgery, neurology, neurosurgery, CT- guided interventional Radiology video-endoscopic, laparoscopic facilities in general surgery, internal medicine, orthopedics, obstetrics & gynaecology, ophthalmology, critical care medicine, emergency medicine and resuscitation, urological surgery besides state-of-the-art medi-care in specialties like joint replacements, arthroscopy, GI endoscopy etc.
The present Director, Dr DM Thappa joined in April 2017. In November 2017, the NEIGRIHMS Faculty Association (NFA) held its general body meeting where 70 faculty members attended, making it more than two-thirds of the faculty strength. The meeting discussed the administrative vagaries where important orders which had far reaching effects on the careers of the faculty were taken without consulting them. The faculty said this style of functioning has demoralized them and hurt the work atmosphere and the output. Faculty complained about being denied study leave on flimsy pretext. The meeting demanded that a Faculty Development Cell be created to enable more transparent decision making processes.
After Dr Thappa joined the Institution the administration came up with a vacation schedule that left the Institute without doctors in critical departments because there was not enough faculty strength in many departments. This schedule would have been fine for an Institution with the full faculty strength; not NEIGRIHMs with its skeletal strength. Naturally, this badly affected patient care. But the major impact was felt by those needing surgery. The number of operating days was reduced to half and the list of patients needing surgery was very long due to the non-availability of Anesthesiologists. Even during the non-vacation period only two surgeries per day are conducted.
Most of the post graduate programmes have been de-recognised by the Medical Council of India (MCI). Instead of taking up this matter with the seriousness it deserves the faculty posts sanctioned by the Health Ministry were tampered with and faculty members were asked to sign on those tampered representations against their wishes. Those who protested were served with “memos” which has now become the norm in NEIGRIHMS. The major flaw pointed out by the MCI was that the Department of General Surgery and Anesthesia have not performed adequate number of operations. This could have been remedied by increasing the number of operating days which is a feasible option, considering that infrastructure is available and in place. Instead of that, the Director amalgamated the Super-specialty Surgical Branch with General Surgery without taking into consideration that this is a violation of MCI guidelines.
The NEIGRIHMS faculty is also aggrieved by the fact that the Assessment Promotion Scheme which is applied across all central government medical institutes has not been implemented in their Institute. This has affected the career graph of the existing faculty and their morale as well. Interestingly, since the Director joined in April 2017 up until November 2017, he has not called a single meeting to address their grievances or even to consider ways and means to improve the functioning of NEIGRIHMS so that it meets up with p8ublic expectations.
In June 2018, the NEIGRIHMS Faculty Association also wrote to Chief Minister, Conrad Sangma asking the state government to establish the State Medical Council as a regulatory body that can keep a check on the quality of medical practitioners. At present the graduates passing their MBBS from MEIGRIHMS have to register with Assam Medical Council. A state medical council further enables medical professionals to earn credit hours for workshops and conferences and continuing medical education (CME) seminars which are integral to the professional growth of the faculty.
What has triggered the present stand-off between the Institution and the NEIGRIHMS Resident Doctors Association (NRDA) is yet another arbitrary action of the Director. He asked Dr Tony Ete from the Department of Cardiology who had successfully completed his DM (Cardiology) and was to be appointed in the same Department where he has been working during his study period, to submit a character certificate, as a condition for his appointment in the Institute. The Dean of Studies NEIGRIHMS then gave a certificate that was adverse and would affect his career in the long run. The Director then used that same certificate to cancel the appointment of Dr Tony Ete. That this action of the Director is not only vindictive but a calculated move to punish someone for standing up to his coercive measures is a well established fact. As a result the NRDA had gone on strike on April 4.
Normally, the head of any institution should try and win the goodwill of his colleagues, including his juniors and peers. From observing the goings-on in NEIGRIHMS since April 2017, it appears that the Director has done everything possible to alienate the fraternity. The North East is a region with no caste system or the unhealthy culture of hegemony, unlike the rest of India and particularly in the medical profession. Here a team leader is just the first among equals. It is unfortunate that people with no understanding of the cultural nuances of this region are posted here to throw their weights around.
Every institution grows or withers away depending on the leadership at the helm. Someone has rightly stated that when it comes to what’s going on in the organization, leaders are either making it happen (good or bad), allowing it to happen (good or bad), or preventing it from happening (good or bad). Ultimately, the top leader is responsible, whether they accept responsibility or not. Psychologists have cautioned about insecure individuals heading major institutions because they are sure to bring down that institution to their level of insecurity.
High-impact, transformational leaders are what we need to build and sustain institutions. High-impact leaders take responsibility for everything that is happening in the institution but low-impact leaders avoid taking responsibility for readily pass the blame on to others. They create a tremendous amount of distrust throughout the organization as they try to maintain power and control.
The North East Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS) has been under assault since 2017, when the present director, DM Thappa, a Dermatologist from JIPMER, Pondicherry joined the Institute. NEIGRIHMS is both an academic and scientific institution providing space for educational research in the different fields of medicine. The stakeholders are the medical fraternity, teachers, students, administrative staff and the civil society around where the Institution is built. It would be wrong of any Director to think that the people of Meghalaya and of Shillong in particular do not have a say in the goings-on of NEIGRIHMS. Of course they do. But it also reflects badly on our civil society here and the ruling Government that they have allowed NEIGRIHMS to wither away.
Another very troubling aspect about NEIGRIHMS is that its Governing Council has not met a single time since it was constituted in 2014. On the website, amongst the names of nominated members (non-official) is that of late PA Sangma, who remains as a member. The other members are L Rynjah, IAS (Retd) based in New Delhi, Dr TM Mohapatra, Ex Director, Institute of Medical Sciences, BHU, Varanasi, Toki Blah, Retired IAS Shillong, Anil Pradhan, Retired IPS, Shillong, Wansuk Syiem, Rajya Sabha MP. That Mr PA Sangma’s name continues to appear means that no one really cares about this toothless Governing Council. And yet, the Governing Council is the governing body of NEIGRIHMS and should exercise general oversight over the institution. With such prominent non-official members on the Governing Council one wonders why they are all sitting back even while NEIGRIHMS is experiencing its worst ever assault.