Health agenda sick, no cure in sight

When Renuka Chaudhury became Union Minister of State for Health and family welfare, there was talk of a woman politician being given a soft’ (read inconsequential) ministry. So when a leader of the stature of Atal Bihari Vajpayee recently spoke of improving public health, it seemed a welcome change.

Unfortunately, current political concern for health amounts to mere lip service, and the real issues still remain unaddressed.

When quizzed about putting health on the political agenda, Lok Sabha candidates from Mumbaiagreed that it has never been given the importance it deserves. Some of them offered concrete examples like the ones quoted above indicating that things might change for the better.

“Though the per capita expenditure for health in Mumbai is a little more than the national average, (total state expenditure for health is 275 crores- 227.5 crores by the corporation and 50 crores by the state government) it has steadily declined in the last few years,” states Dr Santosh Karmarkar, paediatric surgeon at the Wadia Childrens’ hospital.

The central governmental expenditure is a mere 1.3 per cent of the Gross Domestic Product (per capita expenditure is a mere Rs 90) as against the WHO recommendation of five per cent of the GDP. The infant mortality rate of Mumbai is 48 per 1000.

Naik and Rawle speak of compulsory health check-ups for school children up to standard eight, supplementary food and knowledge of health problems. Promises apart, Naik dismisses malaria as a “natural fallout of monsoon in Mumbai whichwill continue to occur until the city is cleared of garbage”.

However, Dr Karmarkar points out that outbreaks of infectious diseases like dengue fever and the resurgence of malaria and tuberculosis are among the most serious health problems faced by Mumbai.

Plans for health care are sketchy and inappropriate, due to an obvious lack of knowledge on the subject. For instance, Rawle’s dreams of an AIDS hospital’ may not be appreciated by the HIV positive themselves, who have always attempted to integrate with the rest of the population. An AIDS hospital will only isolate them further.

Naik insists that Mumbai needs two medical colleges attached to the Bhagwati Hospital at Borivli and Rajawadi Hospital at Ghatkopar.

This, when statistics indicate that there is no shortage of doctors in India. A redistribution of doctors from urban to rural areas will solve the problem.

Sena candidate from Thane Prakash Paranjpe candidly admits that he does not know the exact number of municipal hospitals in hisconstituency. "We have no technical knowledge about medical care. But we would like to appoint teams of dedicated doctors and party workers. They will check that governmental facilities actually reach the common man."

Others like Sena candidate from North West Mumbai Madhukar Sarpotdar state that problems like siphoning of funds, red-tapism and corruption in public hospitals, are too minor to be handled by MPs. While Wamanrao Parab, RJD candidate from North East Mumbai, suggests that political parties appoint honorary doctors as observers to keep a check on these practices.

"Another reason for the lack of political patronage for health issues is the absence of lobbying on the part of medical associations and medical activists," says Dr Karmarkar. To show how powerful the medical profession can be, he cites the example of the British Medical Association (BMA): "Throughout the BMA’s history, its members have initiated public debates on matters of health policy, and it has been a major player in theconstruction of the National Health Service (NHS)."