My Heartless India
By Poonam I Kaushish
“What’s the use of coming now? He is already dead. All are dead. The Administration is hopeless, useless,” angrily shouted an anguished parent. Sounds familiar, doesn’t it? Day after day, month by month anguished wails pierce India’s comatose dark skies. As our netagan continue to glibly take pot shots at each other, parrot trivia and get their knickers in knots. Standing testimony that the aam aadmi translates into a sterile statistic!
Certainly, the death of 107 children and counting at Rajasthan Kota’s JK Lon hospital is heart-wrenching. But it was a calamity waiting to happen. Shockingly, 70% of the radiant warmers are dysfunctional as are 320 of 533 equipments for want of maintenance. Topped by a 13.1 bed nurse ratio against the 4.1 standard and absence of oxygen pipeline in the Special Newborn Care Unit. More horrifying is the ensuing political slugfest between the BJP and Congress with the former demanding the resignation of Chief Minister Gehlot. The Congress rebuttal: BJP destroyed medical facilities from 2014-19, there is no negligence and the death toll in 2019 is the lowest in five years. Sic.
Importantly, given our leaders penchant for short-cuts and quick-fix solutions, what else can one expect, but this ghisa-pitta reaction? They are no wiser nor have learnt any lessons from the painful 2017 Gorakhpur Baba Raghav Das Medical College calamity where 300 infants died due to a shortage of oxygen supply and poor management.
Spotlighting once again our polity’s cavalier churlish attitude and approach to a tragedy. Shrugging it off as an issue which will die its natural death within days. Not for them the need to execute damage control measures, put health dispensers in a wringer and apply balm on heart- broken parents.
Who will bear responsibility? Be accountable? Does anyone really care? Alas, gone are the days when Shastri resigned in 1956 following a train accident. Today, we are captive of double standards and skullduggeries wherein demands for resignations are dismissed by netas as political redundancies.
Paradoxically, Kota underscores India’s appalling state of healthcare system which makes us particularly vulnerable to disease. How can we? India spends just 1.4% of GDP on healthcare which underscores why our healthcare needs have remained underserved specially for the poor leaving them at the mercy of private hospitals, who shun them.
Scandalously, not only Kota but nation-wide hospitals infrastructure continues to be in shambles as medical facilities are ill equipped to handle the number of patients. There are two-three patients on one ICU bed, lack of hygiene and creaking, leaking roofs. Rats nibbling on a new born’s ears and stray dogs moving about in gynecological wards no longer make news, as they are common occurrences in Government hospitals in urban and rural areas.
Worse, none is willing to learn the ABC of health and crisis management or finding lasting solutions. India has a shortage of an estimated 600,000 doctors and two million nurses, claims a study conducted by the Centre for Disease Dynamics, Economics & Policy. Only 58% of those who refer themselves as doctors in cities have a medical degree; in rural areas the proportion is just 19% and a third of ‘doctors’ have only secondary school education.
Further, there is only one allopathic doctor per 10,189 people, only one hospital bed per 2046 persons and one State-run hospital per 90,343 people and one million allopathic doctors for 1.3 billion people of which only 10% work in the public health sector. Three thousand children die of malnutrition every day, 14.9% of our population is undernourished and nearly one million die annually due to scarce healthcare facilities.
Coupled with medical apathy, severe resources crunch, medical staff, inadequate number of doctors functioning in unhygienic conditions, shortage of medical equipments with 70% machines out of order including oxygen resulting in infections are some of the reasons behind this shoddy state of affairs.
Alongside, primary healthcare is in a mess. There is only one primary healthcare centre with just one doctor for over 51,000 people. When he is away on call all is left to God. There is only 1.1 beds per 1,000 persons compared to the world average of 2.7. Besides, the doctor-patient ratio is less than the World Health Organisation prescribed limit of 1:1000. There is opaqueness in diagnosis, poor quality of services which ensures that people get treated below the WHO standards.
Moreover, a study done by the Global Antibiotic Resistance Partnership-India Working Group and the Centre for Disease Dynamics, Economics and Policy found the infections rate of Indian hospitals wards and intensive care units is five times more than in the rest of the world. Of which some diseases are not only difficult but also impossible to treat leading to death. Clearly, highlighting the real filth is more administrative and political.
Additionally, poor care leads to more deaths than insufficient access to healthcare — 16 lakh Indians died due to poor quality of care in 2016, nearly twice as many as due to non-utilisation of healthcare services (838,000 persons). Is providing care without ensuring the quality of health services effective? Some 24 lakh Indians die of treatable conditions every year, the worst situation among 136 nations according to a study in The Lancet.
Appallingly, 34 out of 1,000 children die in the mother’s womb, nine lakh children below 5 years before they can read the word hunger and 3,000 kids die of malnutrition every day while 19 crore people are compelled to sleep on empty stomachs.
According to a CAG report last year there was a 24 to 38% shortfall in the availability of medical personnel at primary health and community health centres in 28 States while in 24 there were reports of non-availability of essential drugs. More. Over 700 million rural folks have no access to specialist care as 80% of specialists live in urban areas.
Undeniably, with India’s healthcare in a state of ‘emergency’ the Government needing urgent ‘oxygen’, public and private service providers, medical professionals and patients collectively need to make constructive efforts to end the trust deficit. Our polity needs to have respect for human life and reshape the paradigm of healthcare to achieve the goal of Healthy India.
It needs to put in place efficient administrative and political machinery and provide hygienic sanitary conditions (only half of the country’s garbage is cleared). It is now imperative for India to rethink its strategies and approaches to safeguard public health infrastructure, constitute a public health policy, establish fresh priorities, improve service delivery in public hospitals with people at the centre of social development.
The Government can no longer bury its head in the sand. Ministerial conferences and directives from the Centre to States will not do. People are sick of hearing the same old refrain: “Don’t panic…The Government is doing everything that is necessary…things are improving”. Really, you could have fooled me!
Remember, all crises are surmountable. What is insurmountable is damned casualness. That is the tragedy of our nation. The time is for gone for the Government to play the pied piper with a ki pharak painda hai attitude. Will the future generation be weighed down by our moribund, casual and politicking leaders albatross round its neck who aver with a shocking casualness – “Let them bleed, its only life, stupid!” —- INFA