Buoyed by the success of their rustic web series Panchayat, the makers have recently released a series titled Gram Chikitsalay. It portrays a rural primary health centre (PHC) or Prathmik Chikitsalaya in complete disarray — devoid of staff, drugs, equipment, and plagued by neglect and corruption. Into this scene enters the protagonist — a fresh and ideal medical officer (rich boy with a dad-run nursing home) who works hard to deliver health care to people of that village, competing with a local, highly popular, but unqualified doctor. While his fight with the system makes little progress, he has a pyrrhic victory at the end of the first season when he diagnoses a psychiatric disorder in a patient and gets him treated through personal efforts.
I watched the whole series, though after the first episode, I knew where it was going and had lost interest. Did I take the portrayal of the poor health system personally? Was my dislike coloured by hurt rather than an objective assessment? Are such series “passe” or a “trope”?
Cinema has conventionally thrived on showing individual brilliance and has always undermined the system. Against this backdrop, this web series is not an exception but the rule. While there is no doubt that such stories have a place, the question is: Are these the only stories that need to be told? The reality is usually worse than what is shown on screen, but here we have a case where the reality may be probably better than what is depicted.
There has been an enormous change in the way our PHCs work in the last two decades. I am not discounting the fact that there could be some PHCs in India, possibly in a remote place, which may be in a state of disrepair.
The public perception of the government health system remains mostly negative. Some facilities are seen to be plagued by serious entry and navigational barriers like difficulty in getting appointments, long waiting times, and too quick a disposal by the doctor with poor follow-up systems. Other facilities are seen as poorly utilised, lacking medicines and supplies. In all cases, the system is seen as indifferent to patients’ sufferings.
This is not to say that such things have entirely disappeared, but it is also equally true that many facilities are no longer plagued by these problems and are doing an excellent job of delivering quality healthcare. There will always be some systemic issues that need to be addressed. This is true for any service industry. This is a work in progress. However, social responsibility demands that we do not paint a one-sided picture.
The perception of the police force in the United States has been shaped by their positive portrayal in multiple “cop” web series. They are seen as people who are not only fighting crimes and criminals, but also individual and politico-bureaucratic demons. The popularity of a gritty Kurt Wallander in a world dominated by the flamboyant Sherlock Holmes or Hercule Poirot proves that such characterisation works well.
There is a need to change this poor public perception, as it is built over decades of poor performance and anecdotal experiences. The primary responsibility of changing the perceptions of the public health system rests with the health departments. Many state governments have done a splendid job of strengthening their health system, and consequently, perceptions are changing, albeit slowly. It is not enough for the system to change; it should also be seen to have changed. The primary health care system in India has come a long way, but mainstream cinema is yet to include it in its stories.
Improved public perception will be a morale booster to the tireless health workers. It is an uphill battle; let us not make it worse by poor portrayals. I am certain that many medical officers and other allied healthcare staff at primary health centres are also fighting the system and their own personal battles to deliver better care. These can also be gripping stories.
Filmmakers must look for such stories and present them with finesse and nuance. Can the next season of Gram Chikitsalay take up this challenge and course correct?
The writer is a Professor, Community Medicine at the All-India Institute of Medical Sciences, New Delhi. Views are personal
