Dr. P K Sasidharan
Our health system is now designed to keep us sick
LET US BUILD A HEALTHIER INDIA
We need a better India, a healthier India having very low disease burden. Now the disease burden is so high that it is increasing disproportionately in comparison to population growth. There is at least a thirty-fold estimated increase in disease burden in the last six decades, but during this period the population has only doubled. One simple and direct reason for that is our primary health care has become inefficient, inappropriate and weaker in last six decades. When the disease burden was very low, we had only primary care doctors till 1970s, and slowly they have completely vanished over the last six decades.
Benefits of modern scientific medicine is not reaching the masses in India due to absence of properly trained and motivated primary care doctors. Because of that people in India do not have the kind of doctors to promote health and wellness, to promote public health and help them scientifically and be friends, philosophers and guides to nurture scientific attitudes in them. Our people now seek treatments for all their ailments directly from bigger hospitals and the superspecialists only even for their minor ailments. For guidance on family problems, they seek the help from astrologers and religious leaders.
When it comes to treatment of diseases now, either they go to traditional practitioners or go to organ centred care in super-specialty hospitals. Majority of people and even the doctors today do not know or believe in the power of science and public health. People and doctors now believe only in organ centred care and ultra-modern technology, or they believe in the traditional practices only. Medical students are wrongly guided to take up specialisation and super specialisation alone rather than attracting them to the most vital services in primary care. The disorganised and damaged health system that we have we do not allow them to be transformed into competent primary care doctors.
Our health policy makers are still in the dark about the most essential capacity building training needed after MBBS to make them competent and confident to take up the most challenging but satisfying job of primary health care. Properly trained family doctors would naturally become the champions and torch bearers of public health. Due to lack of scientific attitudes the people still believe in the powers of numerous gods and supernatural powers. There are political parties taking advantage of this situation dividing the people and ruling the people with this unscientific mindset.
India is not a poor country; it is very rich in natural resources and human resources. At the same time people with lack of vision boast of our advancements in medical field in India- because several Indian hospitals are ultramodern with the most modern equipment and technology and the doctors there are capable of providing world class treatments for any disease in these hospitals, provided they have money or they can get government funds for the huge expenses. But when diseases are multiplying how many patients can these hospitals treat and at what expense? How many patients can afford treatments form such hospitals? Is such hospital- centred treatment needed for all? What is the efficiency and cost effectiveness of these hospital-centred treatment scenario in India? Is it appropriate to use government funds to repay hospital expenses after increasing the disease burden by neglecting public health and primary health care?
Public health now is a neglected orphan in India. How long this trend go on? Our health system is now designed to keep the people sick and not healthy. It is time to wake up and realise that the diseases are multiplying disproportionate to the population growth only because public health and primary care are neglected orphans here. Even as we do not have good primary healthcare and proper primary education, we have ultramodern hospitals and ultramodern airports. We forget to provide safe drinking water through pipes, we do not have foolproof waste management, large numbers of people do not have shelter, sanitation and the sewerage facilities are in infancy and we do not have good primary education. We fail to fight the enemy within – lack of public health, lack of good primary health care, lack of good primary education and lack of scientific temperament are our real enemies within. Had we had invested money and reoriented our resources into public health, good primary health care and good primary education and if majority of our doctors were in primary care, the existing number of medical colleges and hospitals are more than enough for this sick society.
Is our Health System designed to keep us sick or Healthy?
