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This is an archive article published on October 19, 2000

Nobody talks about rickshawallahs’ knees

It is not in ``national interest'' to discuss the mess up in a few big hospitals where their ``good docs, bad docs'' mistreat their ``pats...

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It is not in “national interest” to discuss the mess up in a few big hospitals where their “good docs, bad docs” mistreat their “pats” (read patients), who happen to be good “polts” (read politicians), bad “polts”. This I say after reading your nicely written piece `Good docs, bad docs’ (October 7), in which you correctly pointed that politicians are generous about spending taxpayers’ money by getting themselves treated abroad just to satisfy their egos. Moreover, they know in their heart of hearts that the existing health system in the country has been destroyed by no one else but themselves. It is for this reason that they have no confidence in the system and prefer to patronise their own doctors and hospitals. These very rulers spend, as you stated, 5.2 per cent of India’s GDP every year on health as compared to Bangladesh’s 4.9 per cent. Yet the country ranks only 112th on the international health chart, a good 24 points below Bangladesh.

The pain and agony suffered by Kumaramangalam, followed by his death, as well as news of leaders like V.P. Singh, A.B. Vajpayee and Yashwant Sinha shunning the services of AIIMS and Apollo does not put me off these institutions. What does scare me, however, is the state of our PHCs (public health centres) where millions of my compatriots are forced to go for healthcare.

When Vajpayee develops a knee problem, reams and reams are written about it (Gupta’s own article is a case in point). But no one talks about those rickshawallahs in our small towns who have injured their knees and ankles badly thanks to their labour. The talk of the town should really be about providing them with first-rate treatment and not the Vajpayees, Sinhas and Singhs!

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All those who inhabit the margins of society make up the major share of patients completely dependent on these moribund PHCs. Many hospitals that are run under the public healthcare policy of bankrupt state governments are in a shambles. The compounders and untrained nurses of these hospitals play `doctor-doctor’. They may accidentally save some lives but, more often than not, they fail in delivering even the most basic care.

Sometimes, in the really remote areas, PHCs exist only on paper. To add to the agony of the common person, even at the district level these PHCs have no facilities to admit and attend to patients who are in urgent need of treatment. In these small villages, even today, pregnant women have to travel some 50- to 100-odd kilometres to find a hospital where she can give birth. Sometimes the babies are born on the way and survive only if luck is on their side. A heart patient in our villages and small towns are offered no roads to travel on and reach the nearest hospital, leave alone an ICU. So by the time their relatives transport them into the hands of a competent doctors, they may well be dead.

It would, therefore, be no exaggeration to say that a great majority of our population is at the mercy of village quacks, even as our politicians shun the AIIMS and Apollo Hospitals of the country. I would request the Vajpayees, Sinhas, Raos and Singhs to correct the biases in our public healthcare system and the ills of the AIIMS and Apollo Hospitals will automatically get corrected.

Just as Kumaramangalam’s death seems to have scared our politicians (some of whom have even flown abroad for treatment), let us hope that the suffering and deaths suffered by millions of poor people in our country because of their lack of access to good medical care, will at long last attract the attention of our policy makers. If the country can take some quick and concrete steps to ensure that its prime minister is given world-class treatment in one of Mumbai’s best-known hospitals, surely something can be done to ensure that ordinary people get their due in terms of healthcare?

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Will it not then be, Mr Gupta, in “national interest” for you to write some well-researched articles about the failed public healthcare system in the country and goad the authorities to do something about it?

The writer lives in Hathband village, Raipur district, Madhya Pradesh

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