India has the largest number of medical colleges in the world and has the best doctors as well, who are exported to many countries. But the tragedy lies in the fact that the people of our own country are sick and have a crumbling healthcare system. The public health spending has remained between 1.2% (2008-09) to 1.6% (2019-20) of GDP, in spite of being one of the world’s fastest-growing economies in the world’s second-most populous country.
The sub-centers and primary health care centers in the rural areas are mostly non-functioning with either lack of infrastructure or lack of medical resources. The remote rural areas not only have access to nearby functioning sub-centers nor proper transportation facilities to travel swiftly to farther distances. Super-specialty hospitals like AIIMS, which is an 1800 bedded hospital treating half a million people at subsidized rates, are already overburdened with the increasing population who are sick. Thus, the services are not provided timely, people wait outside for hours, days, or weeks to finally get an appointment, but it doesn’t end there. There are recommended tests and then again there are dates of checkup which take up to months. The documentary shows such an example where a person finally after a lot of struggle and wait gets the date of his surgery which is after a wait of around two years. He says that he has given up all hope, and leaves his fate of life or death to God. The private hospitals on the other hand are majorly aiming at profit-making and mostly looting the already ill patients. Recommending all sorts of expensive tests, wrong surgeries, and everything possible to completely loot the patient who belongs to an elite background, even making their health more deteriorated.
No doubt private hospitals have better facilities with modern technologies, but it comes with a price. All of these are not accessible to the underprivileged sects. The documentary says that there are at least 500 crores hospitals that have received public subsidies in around 10,000 crores rupees and have forgotten their ethical responsibilities of treating all patients equally, and the Government is always there to turn a blind eye.
Gross medical negligence was the reason for the deaths of many children in Gorakhpur at the Baba Raghav Das Memorial Medical College & Hospital. The blame for why there was inadequacy in oxygen supply because of insufficient funds, was just passed on from one authority to another, including the Chief Minister of Uttar Pradesh.
Encephalitis has been an endemic disease in the area and children have been dying. After 2010 mass vaccination the cases had started declining, but again it started rising again, which could have been controlled or eradicated.
Uttar Pradesh is the most populous state of India has all the problems that any populated place would have which are insufficient facilities, no proper water, hygiene, and sanitation practices, not even the basic health facilities. The BRD hospital treats people not only from Gorakhpur but also from Nepal and the eastern districts of Bihar. So, the entire burden comes on to this one hospital of all these populations.
The National Rural Health Mission had allocated around Rs 27,000 crores, also other health schemes like the Pradhan Mantri Swasthya Suraksha Yojana, which had a higher allocation of around Rs 6,000 crores (27% increase in funds from the previous year), focusing on correcting regional imbalances in the availability of affordable tertiary healthcare services. These are just a few instances to name and the question remains – where do the funds allocated goes if still there are existing non-functioning SCs, PHCs, or district hospitals? or why do areas like Gorakhpur depend only on one BRD hospital and also takes the responsibility of other neighboring states or districts? These are serious questions that need to be addressed and the documentaries are an eye-opener to the facts that, in spite of having so many policies, funds allocated, medical education, the poor are still deprived of adequate health facilities. Proper monitoring and evaluation of the health programs are required and remote rural areas should be given importance by the health schemes.
Centre of Social Medicine and Community Health,
Jawaharlal Nehru University.