Monday, January 5, 2015

Health sector needs booster shot

Below is story I read in TOI, Mumbai edition on last friday. The story was written by Malathy Iyer a journalist who has covered Health related issues for a very long time. The story gives interesting insightes on how Swine Flu helped the rich and poor come together for treatments.

Swine flu has been the biggest leveler in recent times. Breach Candy resident Chetan Shah, for the first time in his 34 years, stepped into a public hospital in August. He wouldn’t have ventured inside Kasturba Hospital if he didn’t need to check his H1N1 status after traveling to the US. The novelty factor associated with swine flu brought slumwallahs together with the owners of swanky cars as they lined up outside testing centres. Suddenly, little-known civic hospitals—Mahatma Phule Hospital in Vikhroli or S K Patil Nursing Home in Malad—were known across the city as they became swine flu testing centres.

Maharashtra has had many positives on the health front in the past five years. From the management of avian flu to swine flu and bettering maternal/infant mortality rates to ensuring better vaccination coverage, the state’s efforts have been lauded. Public health expert Dr R Potdar said,“There is political will to spend on health. Every year, the government has been increasing expenditure on health.’’
At present, public health officials have been basking in praises heaped on them by the WHO for taking radical decisions like closing down schools for 10 days and disbursing Tamiflu on suspicion of H1N1. But is the public health machinery in tune with the health needs of the Great Indian Middle-Class? Not at all, admits a senior doctor in a public hospital. Over 70% of Indians go to the private sector instead of government facilities.
Shah confessed he wouldn’t want to be admitted to a public hospital. “The staff appear earnest and efficient, but the systemic apathy is there for all to see,’’ he said. The unclean beds are only part of the problem. There is the scare of bed bugs, and rats and strays. There is always a doctor on call, but s/he is too overworked. Not surpsrisingly then, relatives have taken the law into their ownhands. The government introduced a special legislation protecting doctors and medical infrastructure, but stray incidents still continue.
Medicines are in short supply and there is a long queue for a CT/MRI scan. Even in Mumbai’s premier teaching hospitals, such as KEM and JJ, the waiting list is too long for anyone’s comfort.
A former WHO official, Dr Chandra Gulati, said in Maharashtra, more than in other states, the difference between India and Bharat is stark. In the context of the swine fu epidemic, he said, “Do primary health centres have doctors for people to come in for a check-up? The state government promised to operate PHCs 24*7, but health activists say given the shoratage of doctors, many PHCs still operate only on alternate days.
Potdar said while many health programmes are running concurrently, there is no integration at the user level. The women and child welfare department’s struggle with malnutrion is far removed from the public health department’s efforts to improve infant mortality. “All health workers are bogged by the demands of the Pulse Polio programme,’’ he added.
Jan Swasthya Abhiyan (JSA), a network of health NGOs, has prepared a manifesto with demands ranging from healthcare for all to better women and child schemes. “The new government should enact a State Health Act so that every citizen has the right to comprehensive, quality healthcare at public expense in relevant health institutions,’’ said Dr Anant Phadke of JSA. He said the state government should ensure that charity-run hospitals reserve 20% of their beds for the needy. “The government should also plan and implement the National Urban Health Mission, which has provisions to cover the most vulnerable sections of the urban population on the streets, the homeless people, people living in temporary settlements and slums,” he added.


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