Sunday, August 13, 2017

From Tanjore to Gorakhpur: Government Hospitals are Pathetic

Moving beyond the politics of the moment in the murders (I refuse to call it tragedy) in Gorakhpur of 60 children the bottom line is Public Healthcare is in a pathetic state all over India, without exception. This primarily affects the poor. 
Dravidian party clowns are running around on Facebook claiming all sorts of statistics on TN's healthcare compared to other state. Yes TN fare better but if the benchmark is UP and Bihar the bar is very low indeed.  
Here's a news item in The HIndu about Government Children's Hospital in Chennai (http://www.thehindu.com/todays-paper/tp-national/tp-tamilnadu/childrens-hospital-flooded-with-patients/article12559570.ece). WHAT THE DAMN F*** is THIS? See the picture. Is this a children's ward in a hospital or a photo of a badly run Dharmasala? Go away clowns, hide your heads in shame and may we never hear from you again.


Government Children's Hospital Chennai (Image from The Hindu)

These are just some news clippings found after 2 minute search in Google.
Both my brother and I were born in a government hospital and my dad worked as an ENT surgeon in a Government hospital for 20 years. The lack of oxygen is a perennial problem in government hospitals. My father literally saved my life as an infant when he recognized that the oxygen supply had stopped from the common feeder and ran and dragged an oxygen supplier and put it on my face. Other children in the ward were not lucky. Once we procured oxygen from a private hospital and supplied it to an uncle admitted in Tanjore Medical College Hospital. That was in the mid-eighties.
My father used to swear by the facilities in a Medical College Hospital compared to the poorly run mom-and-pop shops that were the nursing homes that dotted the town. He used to say that unlike those 'polyclinics' in the government hospitals there were qualified doctors round the clock.
But even in those days Tanjore's Rajah Mirasdar Government Hospital was a bloody cess pool. I've been there in the eighties and I remember struggling not to vomit. The maternity wards were pathetic. In places the maternity wards would even lack privacy screens. Stop lecturing how great Government hospitals. If they were not called hospitals we could file human rights violations against those hospitals. Doctors suffer too. No proper restrooms, no proper sleeping quarters for duty doctors, pathetic instruments, badly maintained machinery. Oh the litany is endless.
The Karunanidhi scheme of medical insurance was daylight robbery and an outright scam that only contributed to inflating the costs and robbing much needed hundreds of crores from being invested in government hospitals.
The commercialization of medical education in Tamil Nadu and neighboring Southern states of Karnataka and Andhra is a healthcare crisis of mega proportions.
Tamil Nadu has 25 government run medical colleges of which many were created by just government fiat and lack proper facilities to be either called a college or a hospital. Tamil Nadu also has 24 private medical colleges where wallets determine whether someone can become a doctor. In private medical colleges seats are sold as 'package deals' that include a PG degree. Does that mean MBBS degree is already in the bag? These colleges lack proper faculty. (http://timesofindia.indiatimes.com/city/chennai/tamil-nadu-adds-1000-mbbs-seats-in-six-years/articleshow/58877893.cms)
Then there's the case of paucity of doctors, especially in specialties. The Endocrine society of India records 600 members. 600 Endocrinologists in a population of 1 billion (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263175/).
After my father's death, due to prostate cancer, I did some research on cancer care in India. India has only 1500 oncologists. ONLY 1500. Cancer care, from diagnosis to treatment, is mostly done by doctors who are not oncologists. The only popular cancer care center for the poor in Tamil Nadu is Adyar Cancer Institute. Cancer management in most Indian hospitals, private and government run, is pathetic. It is almost aboriginal compared to US. Make no mistake, every equipment and drug available in US is available in India. The problem is pathetic lack of qualified oncologists.
When my father was diagnosed with prostate cancer in 2002 he went to Apollo hospitals Chennai for radiation therapy. Apollo, at that time, had linear accelerator which provided precision treatment unlike the Cobalt treatment available in Tanjore government hospital. The latter would have created many side effects and destroyed much more of healthy tissues.
During another healthcare crises in 2013 we took my father to Apollo Chennai for a gastro-enterology surgery. We had to pay Rs 50,000 to get admitted. Thankfully money is not a problem for us. I saw a sea of humanity in Apollo hospitals. The place literally thronged with thousands. Most were just middle-class. In a city that had many government hospitals I wondered why this clamor for such an expensive private hospital that literally bankrupts many. Literally unless one is abjectly dirt poor none goes to government hospital and even they yearningly look at other options. The hospitals are pathetically run. From lack of proper facilities to more important lack of qualified doctors in specialities the government hospitals are an affront to the idea of public healthcare. No wonder the only thing that Karunanidhi and Jayalalitha agreed on was that Apollo Hospitals was their choice of place to get treated not the government hospitals in Chennai.
In what country would a dilettante film star become a health minister in the Union Cabinet? Only in India could a clown like Shatrughan Sinha become a health minister. But then only in India could a school dropout like Smriti Irani become an education minister. Anbumani Ramadoss, a doctor, on the other hand, was more interested in looting JIPMER and humiliating the dean of AIIMS than in providing healthcare to the impoverished millions. Dr. Harsh Vardhan, the current incumbent, is a fount of wisdom who suggested that sex education should be banned.
India does not 'invent' drugs but mostly plagiarizes them. The merits and demerits of that is a separate issue but it is a crucial issue that India faces with the WTO (World Trade Organization). India's drug policy is covered by the ministry of chemicals and fertilizers. For such an important ministry India nominated an illiterate thug like M.K. Azhagiri.
A Reuters article highlights the pathetic state of healthcare in India. India has "9 hospital beds and 6.5 physicians per 10,000 people according to World Health Organization. By comparison China has 42 beds and 14.2 doctors, while Britain has 33 beds and 27.4 physicians for every 10,000 people". The article notes in a one line paragraph, starkly, "those who can afford it tend to choose private health care" The article also highlighted the sever drug shortage in government hospitals. (http://in.reuters.com/article/india-free-drugs-chennai-public-health-idINDEE86M00I20120723). Another article also draws attention to an alarming drug shortage in Tamil Nadu (http://timesofindia.indiatimes.com/india/Tamil-Nadu-among-states-likely-to-face-drug-shortage-as-retailers-look-for-more-profits/articleshow/22172124.cms).
In 2015 my dad's prostate cancer had metastasized all over his bones and an expensive medicine was prescribed to manage the growth. It cost Rs 80,000 per month. Again, we could meet it. I had dashed down to Tanjore to be with my father and on my way back to Chennai I saw a group of construction workers working in the hot sun in drab clothes. My first thought was "what have governments done for these people? Their children depend on government school which are mostly cow sheds and they depend on government hospitals which are also cowsheds".
Access to quality education and healthcare is largely beyond the reach of the hundreds of millions of poor in India. The Gorakhpur murders are a sad reminder of that.












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