Between quacks and politicians

Even a hospital strike in Delhi — which, incidentally, is a national problem because much of the Capital’s patient traffic originates from outside the city — doesn’t get our politicians worked up, so how can we expect something like the Delhi Quackery Prohibition Bill to get them excited? But there’s a story in the fate of the Bill, a story with a lesson for all of us.

When Delhi’s Health Minister Harsh Vardhan tabled the Quackery Bill last year, everyone said it was a model for the restof the country to follow. Like Harsh Vardhan’s anti-smoking campaign that went up in smoke, but not before getting him a WHO medal, the Bill has been gathering dust for a year.

And now its future looks doomed, what with the Delhi BJP having more on its hands than it can handle, and an Assembly election round the corner. Not that any political leader is losing sleep over this, for the Quackery Bill won’t make any difference to anyone’s tally of votes. Nor for that matter would the state of the nation’s health. So quacks will continue to thrive till the next health minister wakes up one fine morning with a brainwave.

But why, you may wonder, must precious column inches be expended on quacks? Maybe this bit of information will jolt you out of your complacency. We all know that multi-drug resistant tuberculosis is a big health threat today, but do you know that quacks prescribing antibiotics indiscriminately have contributed as much to the problem as patients who don’t adhere to the prescribed course ofdrugs? And do you know that the increasing use of steroids, especially by compounders pretending to be qualified doctors, is making more and more Indians prone to infections, because steroids reduce the body’s natural defence systems? Who, then, are the quacks?

Whoever they are, they seem to wield considerable political clout to be able to block the passage of the Quackery Bill. And the law has allowed them to have their way, for it prescribes a mere Rs 250 fine for a heinous crime.

Imagine a quack could be making TB incurable for your domestic, and exposing you to its deadly bearhug, and get away with it simply by paying what he makes in a sitting. The law, though, is not as lenient in its definition of quacks. It says that anyone who is not registered with the Medical Council of India, or the Central Council of Indian Medicine, or even the Central Council of Homeopathy, cannot practice anywhere in India. A quack, in other words, is not just some witch doctor or a roadside vendor of aphrodisiacs — hecould be anyone who practises some form of medicine without a degree recognised by any of the three councils. But the law has been around for over 80 years — the Indian Medical Degrees Act came into effect in 1916 — yet why do quacks thrive at the expense of people bypassed by our perilously overstretched health-care delivery system?

It is because the political elite, the decision-makers and the opinion leaders have never been to a quack. They get their private rooms at the All India Institute of Medical Sciences (AIIMS) at a moment’s notice and they have the CGHS taking care of their medical bills, so why should they bother about people who promise magic remedies or, worse, administer intravenous glucose on the slightest pretext, even if the patient is dying.

Fortunately for the quacks, centuries of conditioning have made Indians blase about disease and death. They cash in on this defeatist world view, which is why even in Delhi the medical fraternity has identified over 20,000 quacks with thrivingpractices, mainly in what are known as jhuggi-jhompri clusters, where the majority lives. And Delhi is a city with a doctor-population ratio of 1:400, much higher than the WHO-recommended 1:1,000.

Delhi is also a fairly literate city, still we see eveningers carrying ads for tantric cures to epilepsy and cancer and worse, though the Drugs and Magic Remedies Act, 1954, prohibits advertisement of cures for 54 major diseases. It is a cognizable offence. Still, you’ll find sundry babas offering cures for afflictions ranging from premature ejaculation to Parkinson’s Disease.

Yet, the one good thing the Delhi Government could have gifted to the people, now that it has been officially declared to be five times more crime-prone than Bihar, is lying in cold storage. Not that a law will mean the instant eradication of a continuing crime, but at least it’ll be a big step forward. It’ll also be a model for the rest of the country, which it was meant to be. The Bill proposes to raise the Rs 250 fine to Rs10,000 and throws in a six-month prison term for good measure; it also makes the dirty business of doling out fake degrees punishable "with imprisonment which may extend to ten years, or with a fine which may extend to Rs 10 lakh, or with both."

The writing on the wall is there for everyone to see — you can’t mess with other people’s lives. But sadly, it’s only a noble statement of intention and like all such gestures, it may earn the minister another WHO medal, but achieve nothing beyond that. Your maid’s friendly-neighbourhood compounder, meanwhile, will continue making her, her family, her neighbours needlessly ill.