By Aristotle Lyngdoh
“In a developing country such as ours where the concentration of population and lifestyle of the public in general is highly vulnerable to contagious diseases, we cannot rule out the need to promote advanced public health mechanisms.”
‘Health is wealth’ is a phrase that is not strange to any person in any society. What is technically confusing is how to practically assimilate the living lifestyle for good health. For instance, if a person is sick and indisposed, the entire scope of acquiring good education is meaningless unless one first takes care of the health condition.
Individual health is good for an individual but that should also translate into the healthiness of the community or society. Thus, here lies the importance of medical science which helps to differentiate between micro and macro health and how to accord equal priority to both. Covid-19 has taught us many lessons and we have seen the kind of mentality and behaviour in the community when it comes to the pandemic and the contagion therein. Lest we forget, during the peak of the pandemic, the most estranged sections in the society that people were reluctant to come in contact with were medical professionals and front-line health workers. It is a sorry state of affairs that should not have happened but it is also a fact that medical science cannot address this problem. Therefore, there should be a third party that can bring convergence between individual health and community health and the acceptance thereof. I sincerely hope that more and more students would choose Public Health as a career because our state needs such professionals to address the complicated health issues especially in rural areas and among the lowest stratum of the society who are victim of all kinds of ailments and cannot afford the sophisticated treatment.
In a developing country such as ours where the concentration of population and lifestyle of the public in general is highly vulnerable to contagious diseases, we cannot rule out the need to promote advanced public health mechanisms. To achieve that, thorough knowledge through research and analysis should be carried out to understand the lifestyles and behaviour of common people in the region or locality. In my opinion a Public Health Policy should have been the core agenda of the Government and Public Health Institutions should have been established long time back. But to the dismay of the public at large, such a premier institution set up in collaboration with the Government, namely the Indian Institute for Public Health (IIPH) Shillong for the benefit of the state and the society is being impeded and why it is so or is it because of the conflict of interest and egotism. Finally who suffers if not the future generation whose aspirations to have a role in the development of the society is being shattered.
If we look at history we read of how the founders of medical science who were merely traditional physicians struggled immensely on how to treat infections that affected people and society. Their trial and error methods perhaps have given birth to the growth of medical science. Sometimes I wonder who were the faculty of the first medical graduates and what qualifications did they possess? Anyway, we are thankful and indebted to them for the growth that has taken placed till date. The growth of medical sciences from a voluntary health service in the 18th century to a commercially organized institution of the later centuries is phenomenal. So much so that today only excellent students and toppers of various entrance tests can get admission into such medical institutes besides spending huge amount of money. But how pathetic we are to have easily forgotten our recent past and history. Considering the fact that here in our own state what happened 30 or 40 years ago or even before, were there any such restrictions and high cut-off percentages to obtain a medical or engineering seat through government quota? None and thank God for that! Because if such restrictions were in place in those days, I am sure that most of the professionals from the fraternity would not be in their jobs and perhaps there will be a huge shortage of medical practitioners today.
Even in the case of nursing which is a highly demanding profession today the required qualification today is Class 12th passed or graduate level. Whereas, in those days it was only a training course provided by the premier Welsh Mission Hospital or the Robert’s Hospital Jaiaw with minimum qualification of 10th standard for trainees both from rural and urban areas. The goal in those days was driven by the mission to cater to public health in general and to assist medical practitioners whose mission was to heal patients at any cost.
As per the World Health Organisation (WHO) estimation, there is a requirement of health workforce in the ratio 5.9 skilled health professionals per 1000 population for Ending Preventable Maternal Deaths initiative, thus reducing global maternal deaths by 50 percent per lakh live births by 2035 (sources WHO 2016). Taking into consideration the above requirement of health professionals here in the state of Meghalaya with a population of 3.28 million as per 2021 statistics available from aadhar UIDAI, the number of health professionals would roughly be around 3 to 4 lakhs. The question is, from where can we bridge this huge gap unless more and more students venture into medical studies and allied courses.
We should be grateful to then State Government for bringing institutes like IIPH Shillong to the State where the long cherished hopes of a medical college is still a distant dream. But on the contrary, that young Institute too seems to have encountered the tip of an iceberg instead of garnering support and encouragement from every quarters of the society. The kind of humiliation and degradation perpetrated on the IIPH students and faculty should not have happened. Or has there been any administrative failure from the part of the present Government to handle such conflicts. Or should we say a ‘conflict of interest?’
Our memories are not yet blurred that there are a handful of medical professionals in the State who also became successful politicians and we know who they are. How could they achieve such support and trust if not because of their generous and friendly behaviour during their period of service and their interaction with the patients. But such familiarity and decency are absent today. Oh what a situation we are in! I think it’s high time that people at large should learn how to prevent and treat their own petty ailments as many citizens do in developed countries rather than depending on chemical laden allopathic medicines that will ultimately entail government expenditure amounting to crores of rupees in purchasing those drugs from the market. Of course, that reality is still a far away dream in a third world country like ours.
The mission of the central government to bring health services to the doorstep of the family will not materialise if there is a huge shortage of health workers and professionals which includes all category of health workers and social workers but more particularly public health workers.