The Union Government launched with great fanfare the National Rural Health Mission [NRHM] in April 2005 as if to atone for the sins of the Congress Government which ruled India since independence continuously for over forty years. Prime Minister Dr. Manmohan Singh said, "We have grievously erred in the design of many of our health programmes. We have created a delivery model that fragments resources and dissipates energies. Most importantly we have paid inadequate attention to the public health issues and the possibilities of social and preventive medicine."
As if to make up for these lapses on the part of the Congress Government in the past, this NRHM was launched. But what is the progress made between April 2005 and May 2008 in fulfilling the objectives of the NRHM? The truth is that in our country there is absolutely no rural health care. All that we find today in rural areas, with teeming millions steeped in poverty, is the grand - mother’s medicine and what the quacks offer as medicine. Of course, ancient Indian medicine, Ayurveda, is also hugely practised in all the rural areas in the absence of Allopathic medical care with modern, qualified doctors. In fact, as in China during Mao's time, in India too, during the period when Raj Narain was the Health Minister during Janata Government at the Centre, the idea of barefoot doctors to serve the rural India was initiated. But it died at birth for obvious reasons. In a liberal democracy like ours, I think, it is impossible to implement such path - breaking ideas; no matter it was the only way to help the rural India.
It is indeed sad that the public share of health care spending in India today is just 17 per cent when compared to China’s 40 per cent. What do our Rulers and Medical experts say about poor spending on health care? Silence. Silence, figuratively speaking, of the grave. Just imagine the Congress party which is presently heading the UPA coalition Government, says this public health spending, which stands at 1 % of India’s GDP will be increased to 3 % by 2010. What does this suggest? It simply suggests India is not serious about the public health, especially rural public health.
There is a school of thought, which says in the present context of globalisation and economic liberalisation, India’s woes about rural health care can be handled through private sector. But, this is nothing short of wishful thinking for the reason no private sector medical facility will think of treating diarrhoea, improving nutrition, immunizing babies for various contagious diseases like tuberculosis, measles, malaria and most importantly polio etc. Reason: There is not much money in them. Therefore, in this country rural or urban health care to the poor is impossible without a very strong public sector. According to a public health expert quoted in Time magazine, when we spend billions of rupees acquiring new weapons for the defence of our country, it is not wise to shortchange a system like NRHM that will save lives." Well, it is truly said that you cannot be an economic superpower if you are too sick to work. Dr. A. P. J. Abdul Kalam, our former President, who predicted that India would be a super power by 2020, may have to further push the year by another few decades to realise his dream.
Yes, there is incredible economic growth in India; but with some perversion. The high-end health services no doubt are there to cater to the challenges of rich - world health diseases such as obesity, diabetes, heart attacks etc. No doubt the rich get the world-class health care from India’s world - class doctors; but the vast majority of poor Indians are deprived of the services of these skilled doctors. Naturally poor Indians due to diseases not only die while still young but also after prolonged agony. No wonder India remains a Sick Man of Asia. Looking at those emaciated, melancholy faces and figures of our own people standing in line to cast their valuable vote during the just concluded election, my heart sank. They were all looking sick and diseased on TV channels.
There is a flip side to this situation. That is, lack of infrastructure. We are not talking about fancy hospitals or latest medical equipment. We are talking about basic facilities such as clean drinking water, functioning sewage system with toilets, electricity, roads etc. that will definitely protect the rural mass from many of the common diseases and thus reduce pressure on rural health service. The World Health Organisation has estimated that more than nine lakh Indians die every year, not from drinking spurious alcohol like it happened just a couple of days back in Bangalore, but by drinking bad water and breathing bad air.
Do you know that immunization rates in India are significantly lower than in Bangladesh, China and Indonesia? Dr. Manmohan Singh, though not a medical doctor, may wake up to these realities and ensure that the Rural Health Care makes economic sense at the end of the day because, as mentioned earlier, you cannot, after all, be an economic super power if you are too sick to work. No wonder India is one of the unhealthiest places on earth.
India’s dreams of greatness will come to naught if immediate steps are not taken to improve the health concerns of all our people, both urban and rural, rich and poor. Even, otherwise, to ignore medical care, it is a national shame. Because you cannot be happy in a country, even if you are healthy and secured, while your neighbour is sick and unsecured.
In Karnataka we have seen Rural Health Centers which are just an apology? Poorly maintained with a small building where sometimes the ward boys and nurses double themselves for the doctor. If India wants to be a super power, as predicted by Dr. A. P. J. Abdul Kalam, then we must bring about the needed CHANGE. India, get well soon.
