When we got our independence, the first thing our planners did was to build heavy industries. The Health and education sections were sadly neglected. The result is, still we have poor HDI. The human capital was never developed.
As a practicing intern at AIIMS, the weak health system of India is starkly visible to me. Even for minor illness like PID (Pelvic Inflammatory disorder), patients come to AIIMS, Delhi, all the way from Bihar. Even after the Government has established Patna AIIMS, nothing has changed. The referral system is so bad that doctors from periphery refer people directly to AIIMS, Delhi, even when a patient can be managed at some lower level center. This burden AIIMS and hence people have to stand in line from morning 2 am to get a card made. Not only that, peripheral doctors treat patients wrongly, prescribe costliest medicine and get unnecessary investigations done.
Creation of new AIIMS has not solved any purpose, other than political mileage and a waste of resources. The new institutes are short of faculties, and even MBBS seats remain vacant each year. People prefer other medical colleges rather than local AIIMS.
It is no surprise that even Bangladesh has surged ahead of India in terms of health care indicators like Infant Mortality Rates. What India needs is general practitioners, but everyone wants to be super specialist and open a shop (no better than a shopkeeper). A recent study is Bihar revealed that there is a gross deficit in training of Doctors and health workers at a Primary Health Care level. No wonder millions of kids perish every year from easily preventable causes like diarrhea.
Surprisingly, AIIMS only recently started giving free medicines. Even now, many tests are not free. When a state like Rajasthan with scarce resources can provide its citizen free medicine and tests, why not AIIMS, the premier institute of the country?
The Primary health care is where we need to work hard. If we ensure that within half an hour, every child up to 5 years and every expecting lady reaches sub center, we can have far more productive workforce. Still, most of the deliveries are conducted at home with far reaching ill effects on both mother and infant. We need to get into action right now; it is shameful that 40% of our kids are stunted. With poor mental and physical capacity, how can they become a productive youth in the future?
One thing that needs to be abolished is private practice with a government job. When you are treating patients at home, naturally your commitment to patients in hospital is affected, besides teaching and research (hardly any research happens in the periphery). The doctors are hand in glove with lab centers and charge heavy commission.
Lastly, it is good to have bullet trains, but a rise in GDP spent on health will surely have a positive impact on growth by ensuring a productive workforce. India’s share of GDP on health is one of the lowest in the world. Though IMR is steadily falling, we are nowhere near achieving Millennium Development Goals. If Bangladesh can do it, so can we. Just political will and resolve is needed.
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