India’s health services in ICU

Vidya Bhushan Rawat is a well-known social worker. The long strike of doctors in West Bengal came and the strike caused the patients problems. Vidya Bhushan raises many serious questions while analyzing the doctors’ strike. Do the doctors remain facade in state politics?

Over one
hundred children have died in Bihar due to Encephalitis or what
they term locally as Chamaki Bukhar. The season is just beginning
and you will hear stories from neighboring Uttar Pradesh where Poorvanchal
region, dominated by Gorakhpur, will face it again unless a drastic change is
done. Japanese encephalitis comes in the form of massive
epidemic.

While Bihar
and Uttar Pradesh are known for horrible health services, India as a whole need
to ponder over that without a solid health and education services India cannot
sustain its gain, Both the states along with other states like West Bengal,
Rajasthan, Maharashtra, Madhya Pradesh, etc. have a heavy rural population but the
medical fraternity does not work in the villages. Over 75% of our rural population has about 32% Primary Health Centers or may be less than 20% of them have beds.

Rather than
responding to this enormous rural crisis when the first aid too does not reach
to the needy resulting in untimely deaths due to even very ordinary ailments,
the government of India has cleverly provided a new ‘mantra’ imported from
United States highly commercial health services where they are beyond the reach
of the common people.

This
insurance culture may be good for the urban middle classes but cannot replace
the need for an accessible health service. The problem with the insurance
culture is that your access is directly related to your premium and in the
rural India if people have got health insurance, the private doctors use them
heavily even for the ordinary services and if they suffer from bigger issues
then it is beyond their reach.

I think the
concept of Mohalla clinic in Delhi was a great revival of health
services and Aam Aadmi Party need kudos for the same. State governments in
India need to invest heavily in the health and education sector and make health
an absolutely uncompromising issue.

Every year,
we see hundreds of children dying of various diseases and we have seen how in
the medical college of Gorakhpur, the hospital did not have the oxygen
cylinders and beds for the patients. Unfortunately, doctors as well as their
associations have rarely spoken about this. Most of them don’t even want to
serve in rural areas and take it as punishment posts. After abusing all the
subsidies for poor, the doctors who qualify from the subsidized medical
colleges do not show any keenness to serve the poor.

You can’t
imagine those who spend crores of rupees, paying, hefty donation fee in the
private medical colleges, to serve the poor. Most of them would like to
complete it at the earliest and get a visa to serve their colonial masters
abroad.

Indian
Medical Association
has called for an all India strike against the ‘attack’ on doctors
even when the doctors in West Bengal reached an amicable solution and
called off their strike.

We support
the demands for the security of the doctors and the people have no right to
physically assault the doctor. Even if they have complaints, it is time for IMA
and medical fraternity to make their in-house disciplinary mechanism stronger.

There is
another factor which is of serious nature.

The sympathy
of doctors with the dominant right wing is serious concern. Medical ethics
calls for doctors to be above partisan nature and serve the patient
irrespective of their caste, gender, and religion. Most of the time, IMA has
behaved politically and is a group of people who are mostly against the
politics and policies of social justice and inclusion.

We have not forgotten
when the doctors in All India institute of Medical (Manu wadi) sciences (AIIMS)
in Delhi had launched a campaign against the government policy of reservation
at the higher level initiated by late Arjun Singh, who was the HRD Minister in
the first UPA.

We saw worst
form of casteist slogans by these doctors who started ‘Youth For ‘Equality’
campaign which actually was Youth for casteism and caste supremacy.

Of course,
Delhi chief minister Arvind Kejriwal and many others of kinds have been in the
forefront of supporting such initiatives though they might claim that it was
just a thing which had happened and now Kejriwal support reservations for
SC-ST-OBCs.

If IMA is an
association which help the doctors and raise their issues then it must explain
as why it failed to get Dr Kafil Khan, who was being penalised for serving the
poor round the clock when children were dying because of the failure of the
medical system. We have not heard a single statement even today from IMA
regarding the continuous harassment of Dr Kafil Khan, by the Uttar Pradesh
government even today.

Can IMA tell
us what has it done with regards to discrimination faced by tribal doctor Payal
Tadvi who was killed by the continuous harassment and indignation from the
savarna doctors in Mumbai last month.

A few days
back, a talented Doctor in Chandigarh medical college too faced the caste-based
discrimination but IMA remain silent on the issue.

In fact, it
is mostly the organisation to protect the savarna interests of the doctors. It can’t
speak for a doctor who faced harassment because he was a Muslim or SC-ST-OBCs.

Before I
conclude, I would share my own experience at a Medical college in Delhi. The
incident is over six-year-old. One of my illustrious friend teaching in a
prestigious medical college invited me to share my thoughts on Medical Ethics
with his students. There was another person from abroad. I was asked to speak
for 10 minutes. I had done an investigation
into the case of deaths of several Safai Karmcharis in Delhi.

I narrated
what the family members of the deceased informed me that the doctors did not even
touch the body of these people who were brought to RML. I also narrated a story
from Uttar Pradesh where in a PHC in Balia, the sweepers would do the basic
surgeries as doctors won’t touch. Even in the medical colleges, most of the
time, it is the sweeper who is asked to touch the dead bodies.

I may be
wrong that all doctors would not do but where ever these things happened or are
happening, are wrong and must be condemned. I just said that a doctor has to
rise above the caste, class, religion, nation, gender prejudices and
unfortunately in India, they still suffer from them.

Now, I also
spoke about Praveen Togadia’s alleged statement long back, when he called
medical fraternity to not to treat the Muslims. There are many who now calls
that all those ‘anti nationals’ have no right to be treated. This is purely
political rhetoric and doctors would do well to rise above them.

Now, as soon
as I said this, a senior stood up from his seat and came to the podium,
snatched my mike and said that I would not be allowed to speak. He said, ‘we
are not here to listen to these rubbishes.’ pataa nahi kaha kaha se bulaa dete
hai logo ko’.

I said let
me finish but he did not allow. Unfortunately, our organisers too could not do
anything. I did not say anything but realise how deep-rooted caste and
religious prejudices have entered into the medical profession.

If we
celebrate the medical profession as great achievement of modern science which
saved people from life threatening diseases then can we say that our doctors
and scientists are humanists and rationalists whose only interest is to serve
humanity and propagate the idea of rationality.

That caste
system is an artificial creation by human being which goes against the spirit
of people being born freely and equally in rights and privileges. That some
people are better than others while many others are inferior is a concept of deep-rooted
prejudices which existed in our society and people need to be given special
treatment to bring them to the level of others. That social justice is not a
dirty word and merit not the monopoly of a few twice born communities would the
true spirit of humanism and must be embraced by medical as well as science
fraternity.

Yes, we do
agree that no doctor should be humiliated or assaulted as many treatments
succeed and many fails. If the efforts are made sincerely but if not, then
people have a right to lodge complain and accountability need to be fixed.

Indian
medical science suffers a crisis because of the hegemonic caste supremacists
are converting it a tool to spread their hate propaganda.

If the doctors or would be doctors fall in this trap then they will lose good will of the people as well as violating the medical ethics too which ask them to rise above narrow partisan interests of people’s identity and treat them equally.

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