August 12, 2009



The impending pandemic of swine flu has once again brought to the fore the hapless condition of Indian healthcare, the under preparedness of the government as well as the indifference with which the babudom tends to treat such incidents that generally plague the common man to a large extent. Incidentally, just as the news of swine flu is spreading panic like wildfire, these days there are also reports of thousands being affected by cerebral malaria in Bihar. Yet, that doesn’t make prime news; and won’t make much news even if the casualties there were to happen in multiples of those dying due to swine flu. And the reason? Well, deaths due to malaria and such diseases like dengue, Japanese encephalitis or say diarrhoea have a correlation with the socioeconomic conditions of the people affected by them. Thus, in the protocol driven corridors of babudom, the chances of these diseases creating any significant impact is slim. And so, they don’t make much of news.

But swine flu is different. It’s contagious and spreads fast and has nothing to do with the socioeconomic hierarchy. Anyone could get affected by swine flu even in the cleanest of environments. Chances are high that the impact would be more in public places like shopping malls, airports or hotels. Interestingly, unlike other diseases that have the possibility of becoming a pandemic, swine flu is spreading from cities to the other parts of India and not the other way round. So, the chances of anyone getting affected irrespective of class and creed, is much more. In spite of all the semblance of alacrity being shown by the government, what is visible all across is how the public healthcare system is woefully inadequate to take care of India’s burgeoning population. If the population, on one hand, is a reason for the inability of the handful of public hospitals in taking care of all cases, inefficiency and lack of proper management are also equally responsible for the same. Thus, the government has been forced to rope in private hospitals for checking the spread of swine flu. And surely this has happened for good.

The matter of fact is that whether it is swine flu which attacks irrespective of socio-economic background or the likes of malaria, dengue and encephalitis, it is imperative for the government to accept that private initiatives will have to be given its due importance and without that, India’s healthcare system would not improve. The reason for the same is simple. It has been observed that in most of the sectors wherever India has excelled, those have been private initiatives that have really played a critical role in bringing a paradigm shift in that sector. Whether in the telecom industry or in the aviation, insurance, consumer durables or pharmaceuticals industry, private players have played a critical role in bringing back resurgence. I wonder how many of the critical drugs that we generally use are from Indian government-owned pharma companies. If intense competition in telecom, insurance and consumer durables has been successful in bringing down the prices and in making products affordable for the poor, then one wonders why the same cannot be applied in the case of healthcare too. In this respect, what is important to note is that the upper middle class and the rich have stopped going to government hospitals a long time back, thanks to pathetic treatment, indifference and lack of basic hygiene. It is only the poor or the lower middle class who visit the government hospitals; but even then, it has been seen that given the huge number of patients involved, hospitals either find it difficult to treat each case or find it more convenient to simply brush their hands off . The nightmare happens especially in the case of surgery related issues in government hospitals, where most of the accessory expenditures are borne by the patient’s family; or the waiting time to get a date for a critical surgery is so long that they are forced to get the operations done in private hospitals.

It is for this reason that private participation is imperative in a big way in health care. And it is not that we do not have examples within the nation. The pioneering initiatives by renowned cardiac surgeon Dr. Devi Shetty with respect to affordable healthcare in Karnataka have been extremely successful and have shown that it is possible to have health insurance for something as low as Rs 5 – much like the chhota recharge concept in telecom. Just as the microfinance concept of Md. Younus has been revolutionizing rural business where conventional banking has relatively failed, the concept of micro health insurance has a similar ability to fuel a major change in the way healthcare is taken care of in India (This becomes all the more important, especially because of the fact that India’s standing is a dismal 128 in the Human development Index, a poor reflection of the state of things in rural India). No doubt, such innovations would originate only from entrepreneurs and not from government hospitals. Nevertheless, these need to be nurtured. Unfortunately, here too everything comes to a knot as it seems that not only is there a considerable lot of resistance by the bureaucracy but there is also a tendency to not let the leash or control of things go out of hand.

In the given environment, it is not just swine flu that needs to be arrested, but even the flu that ails the entire health infrastructure, i.e. the political mindset, needs to be corrected simultaneously.



Jon said...

I was surprised to read in today’s newspaper that 500+ people die daily due to fever related diseases. But swine flu gets the number 1 position in the newspaper while no other diseases, which are even more deadly, are mentioned. The main allegation that is taking shape now is some foreign pharmaceutical company which manufactures anti-swine flu vaccine deliberately started a secret campaign to create panic and there by pressurize government to buy their vaccines.

Regarding private participation in health care sector we need to be careful because we are giving direct access to human life. A profit motivated private healthcare institutions will ultimately try to compensate the reduction in income if they are forced to reduce the sale price due to competition. They may turn to illegal means too. I believe nonprofit private institutions has to be encouraged in health care sector.

Siddharth said...

I am a regular follower of your blogs and articles.The one thing that really strikes me and that has been a common denomination in all your ideas is that you are actually very critical of the Government.Your thoughts are so much laced with so much pessimism that one wonders that are you really "passionate about India".If you really are so much disgruntled with the present governance then why are you playing the role of just a loquacious spectator ??? Go on..dive into the dirty ditch of politics and set things right because commenting on various issues can be done by any humble commoner like me.I too can comment on India's failing Healthcare System.India requires a person like Nandan Nilekani.Its time that you turn your thoughts into action.Isnt it ????

Swine Flu Britain said...

1000 suffer side effects to swine flu anti-viral drugs

Hobo ........ ........ ........ said...

Prayers !!!

Preeti said...

Aishwarya Rai down with flu-like symptoms (read more)

ajay said...

The present crisis of Swine Flu has brought forth a few truths:-

1. That In spite of being independent for last 62 years, we are quite lacking in Health Care set up. Today when money is not a problem, the govt hospitals are still grossly inadequate. Shame on our present and past governments and the people who eulogise them.

2. That the private is as corrupt (if not more) as the government. In the government still there is some level of accountability, but the private sector is interested only in makin a quick buck. See the blackmarketing of the masks. It was definitely not the government servants who were indulging in the same.

3. Some of the big private players in the health care sector were found reluctant to assist the society in combating the Swine Flu problem. They were either incapable or were scared for loss of profit due to patients of other ailments turning away from them.

4. If there has been some success in dealing with the problem, it has been due to the untiring efforts of middle and low level government functionaries and doctor working in the government hospitals.

Ajay Kumar

shagun said...

Sadly. Unlike the swine flu, this flu cannot be contained!

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