The Government and Us

                The public consultation on Healthcare in Urban Bangalore- Mar 09, 2012

Most of us have been accustomed to hear people speak of the government and its duties towards common man with such conviction and surety, that we’ve probably forgotten how we too have a role to play to make things work.

The event (Public Consultation on Healthcare in Bangalore) on Mar 09 was such a surprise as none of us really anticipated what we heard. The honesty to point a finger at itself, the openness to hear new ideas, and the fact that the BBMP called the public for such a discussion is truly praise worthy.

The event organized by the BBMP started with a presentation on the current status of healthcare in urban Bangalore. Around a 100 participants from the BBMP, Government, NGOs and others who were into healthcare were present. The BBMP Commissioner M.K. Shankar Linge Gowda & Mr. B.S. Ramaprasad, Commissioner of Health & Family Welfare were among those on the dais.

Introductory talk

The introductory talk straightaway dove into how despite several healthcare programs, healthcare institutions and charities, we still do not have a comprehensive plan covering the whole of Bangalore. For ex: Ward nos. 29, 38 and 27 are completely untouched by all healthcare programs. It was also said that there is an absolute lack of coordination within the various departments of the government. The purpose of this event was therefore to seek ideas and inputs on how the healthcare programs in urban Bangalore can be improved.

The introduction was followed by a very engaging talk by Mr. Shankar Linge Gowda. He spoke of Bangalore having 7000 General Physicians for its 8.5 million population, and yet so few in government service. He spoke of why it is important for every Specialist to sit in OPD to understand basic ailments, and how specialization in medicine is ending the important concept of a family physician. And, he openly welcomed NGOs to work with the government on solving healthcare issues.

Corruption!

Following this, other presentations were made which were startling in their revelation of cases of corruption seen in government hospitals where several services are supposed to be free of cost. Some points:
·         Normal deliveries are charged between Rs. 2000 – Rs. 3000 and Caesareans cost Rs. 5000
·         People are asked to pay Rs. 300 to see a female child and Rs. 500 to see a male child!
·         Pregnant women from economically challenged sections are at times not touched by the practising doctors because the doctor feels that the patient is unclean
·         There is no bread or milk available for in patients
·         Iron, Folic acid and Calcium tablets are often unavailable
·         There are either no doctors in the government hospitals or the ones who are present are insensitive to patients from slums
·         Many women do not get the available free schemes even if they are eligible. There is also no information available on the schemes.

(For whatever reason, it seemed to me that the government health services in Gulbarga were far better. This is something I’ve been told before as well – that urban government centres are much worse when compared to rural centres. )

Audience speaks

The session then opened up to the audience and 5-6 people came forward to share their experience and knowledge. The one that stayed in my mind was of a very energetic nurse named Shani who questioned why nurses are not given more roles or better payment in the government set-ups . She spoke of how nurses pretty much run PHCs in cases where there are no doctors available (I’ve seen this in Gulbarga) and can actually give doctors a run for their money if allowed in the system. She spoke of how nurses can fill in many of the gaps in delivering quality healthcare, but for some reason the government only seems to think about doctors, and nurses are almost completely excluded from their plans.

While some people kept blaming the government for the things they were not doing right and suggested new schemes and plans, Mrs. Swarupa (from Mahati Trust) spoke about how tightening the existing system might suffice rather than introducing new plans, much to the relief and applause from the government representatives .
Future of Healthcare

Some interesting aspects about the possibilities in the coming years about changes in healthcare:
·         Universal healthcare for all in India, regardless of income. This means, all of us can walk in to government hospitals and certain private hospitals for free basic healthcare
·         Should government regulate costs in private hospitals? This was being thought of so that the huge cost difference in government and private facilities are reduced, enabling common man to afford health facilities even in private hospitals
·         Introduce labs in more government centres (what costs Rs. 300 in a private lab will cost Rs. 30 in a government lab)

My take home

·         7000 General Physicians in Bangalore! Imagine if we reached out to even half of them to volunteer as part of DFS in Bangalore, we could happily cover all the 2000 odd schools, 325 notified slums, and still have room for more.
·         The government is looking for and willing to work with NGOs – an opportunity we should make the most of
·         One of the government representatives mentioned how they’ve tried just about everything to get doctors to work for them; they even approached 50 retired doctors, but only 12 had agreed to work for the government. This made me think that we must be doing something right to have 67 doctors and 31 hospitals volunteering with us!

To conclude

The government is another entity – trying, succeeding at times, failing at others. While we are quick to criticize all the wrongs that the government does, do we ever appreciate the good they do? And do we even attempt to join hands with them in the struggles and failures? After all, why should the government do so much for our families, while we do nothing much to even assist? Yes, we pay taxes, but money doesn't solve all issues. Citizen participation is very essential. 

I remember once when I was interacting with a group of children in a special home, they asked me “Akka, why have you chosen to do this work?” It is very tricky when you have to answer children; no amount of smart adult thinking can come to your rescue! So I thought of the first thing that comes to my mind when I see something that bothers me, and said to them “I do it because I feel it is my responsibility.”