Patricia Mukhim
There are several institutions created by governments from time to time and all paid for from the public exchequer. These institutions are erroneously perceived to “belong” to government and those working in such institutions believe they are accountable to politicians and bureaucrats running the day to day administration. This is a fallacious understanding of what a public institution is. Governments create institutions to enable the public to have better access to facilities. The reason why the North East Indira Gandhi Research Institute for Health and Medical Sciences (NEIGRIHMS), modeled along the lines of AIIMs, New Delhi was created was to enable better access to health facilities for the people of the region.
However, as the name implies, NEIGRIHMS is also a medical research institution. This means that apart from treating patients, specialist doctors also owe it to the public to share their considered views on health issues with the public through the media from time to time. But it is the experience of many that doctors and specialists working in these institutions almost believe they owe their loyalty to the Government and weigh their words so that they do not somehow get on the wrong side of their bosses. We don’t see much scholarly work or even articles for imparting better health education to the public, emanating from this Institute. True, the specialist doctors there take part in several seminars and flaunt those on their social media platforms but when it comes to sharing wisdom with the public in a language devoid of jargon and easily understood by the average reader we find that only a drought of ideas. It’s also true that doctors may be contributing to medical journals to build their career graphs but these are mostly read by other doctors. The common public hardly has access to these journals, especially as most of them are accessible only on payment.
The normal practice is for doctors to give a one-off write-up on a particular theme because there is a designated day for a particular disease. On other days it is as if the disease does not exist or take a rough turn. Recently Dr Amit Malviya gave a write-up “Non-Covid patients amidst the Corona pandemic.” (Oct 1, 2020). This article is quite an eye opener on how non-Covid patients suffer because every other ailment has been subsumed by Covid. While Covid infected patients receive attention, others are neglected. Dr Malviya suggested how the health system should respond better.
For most other practitioners though, NEIGRIHMS is like an impregnable fortress – an ivory tower of ideas where nothing gets out unless mandated by the Director of the Institute. In Institutions like AIIMS and NEIGRIHMS, the Director is only the first among equals. Other specialist doctors writing about a disease or an issue such as the pandemic should not necessarily have to get it vetted by him. After all, doctors serving in such public funded institutions owe their allegiance to the public – not to a director or the health bureaucracy. Alas! Most doctors in NEIGRIHMS go about their work only within the Institution attending to patients but don’t believe it is their duty to share nuggets of wisdom with the general public especially during this pandemic when both physical and mental health issues have come to the fore.
A good example of a doctor with a social responsibility is Dr Randeep Gulleria, Director, AIIMS. He comes on national television frequently and answers questions on different aspects of the pandemic; clears doubts of callers and generally reassures the public and calms their fears. He also informs about the latest developments on combating the virus and what challenges are being encountered in the battle against the pandemic. We don’t get this type of clear messaging; this reassurance from our doctors here. Sure we get daily briefs from the Director of Health Services or the Deputy CM, and we are not in any way undermining all that information. But what is wrong if other medical specialists that include pulmonologists, heart specialists, epidemiologists, psychiatrists (considering that the pandemic is taking a huge mental toll on people) and even neurologists (because the after effects of Covid19 are quite devastating), speak to the media? Those that have recovered from Covid report insomnia, loss of appetite, fatigue, headaches, muscle and joint pain etc. In Chennai, doctors who had recovered from COVID-19 to return to work complained of chronic fatigue myalgia (pain in a muscle or group of muscles) and feeling disoriented. Still others who have survived Covid say they are affected by post-traumatic stress syndrome, depression and anxiety.
In Meghalaya we have gone silent on the mental health impacts of Covid19. No one asks questions and none seek to answer them; not even the leading psychiatrists of the city here. Everyone seems to have gone into a shell as if mental health problems don’t exist. Either that or they are treating people who come to them but will not speak publicly about mental health problems caused by the pandemic. This is nothing short of an institutional failure towards the public.
October 10, being World Mental Health Day, we can expect an article or two from some psychiatrists/psychologists and that’s all there is to it. The well-heeled know where to get their treatment privately but what about those whose very existence hangs by a thread? Which is the institution they can access for mental health care and counseling? Many don’t even know how to get help and where to go for help. Mental health illness is still a taboo here and most people don’t yet understand that they need to seek help when depressed and not seek refuge in gadgets or drinks or drugs or in self harm.
If we are seeking transparency in the functioning of governments then we should put all public institutions through the same scrutiny. As media persons we get to hear of all kinds of experiences that Covid patients in our state are going through. Some are released from hospitals before being tested negative. When they go home and their symptoms return they are again asked to report to the hospital and make their own arrangements to come there. This has happened primarily because there are not enough beds now and the more serious patients have to be provided care while those who are thought to have recovered are sent home without a negative test and they wonder why. They are confused and distressed and this adds to their depressive state.
What governments and government-funded institutions need to take note of is that the media is doing a duty when it asks questions. We are asking questions on behalf of the public. That’s our primary duty. We don’t ask questions out of pique or personal curiousity and we don’t wish to embarrass anyone or needle anyone in particular so it’s ridiculous for people who are paid from public funds to imagine they don’t owe answers to the public. Of course we can do an RTI but not on every issues where an answer from those public authorities are enough to clear doubts. We are asking questions from public officials, including those heading public institutions because if we don’t do that we are not discharging our duties.
The duties of those in medical research institutions do not end only with research that fulfils the criteria of funding agencies. Every research must be in the larger public good hence it also involves public engagement. Any institution that becomes an ivory tower must be shaken from its isolation.