By Ankur Sohanpal:
UP’s district hospital of Bulandshahr had a sweeper as an acting physician, suturing the wounds of patients. Somewhere else, another ‘unqualified’ hospital staff, a ward boy, was injecting a patient. These words should strike me as an outrageous monstrous impossibility, but they don’t. In this piece, I am going to try to provide a sane and obvious rationale as to why they don’t.
Just for the fun of it, I YouTube’d some of the ‘leading’ Hindi news channels’ take on this. They had seemed to outdo their regular measure of sensationalism on this one — they were practically OD’ing on it. While it does treat me to a good laugh, it does upset me too, when I think about the kind of influence these news channels have over our country’s people, who eat almost everything that is fed to them with a healthy dose of sensationalism. Why am I upset? Because now, lesser people than usual, in rural India would opt to go to hospitals and clinics than they currently do (their current number would depress you). They would rather sit out their discomforts at home, endangering themselves in the process. No one is going to take note of unified doctor-generated news posts, talking about how it is the most natural thing to have the so called unqualified medical staff helps with suturing, injecting, applying splints/POP casts. In the absence of doctors/doctor’s attention (due to other pressing cases), would it then be more natural to help a patient, or let her/him suffer in pain or in an extreme case, bleed to death?
According to one of the posts I read regarding this, India needs an entire army to medically serve its rural areas. No kidding — there is a shortage of 40-50 per cent of nursing staff in rural India. As a researcher on social enterprises, I can vouch for that. While most of the qualified doctors of our country migrate to developed countries after having had their tuition paid through our taxes, the lesser ones stay behind in the urban areas. No one wants to be posted to the rural areas, and consequently, mostly no one is. Even when they are, absenteeism is the rule of the book. Why, this is what the whole concept of telemedicine is based on — to get the bunch of qualified doctors, found only in urban or semi-urban hubs to give advice to the rural folk.
The government of India is well aware of this problem. There has been a parliamentary bill on creation of a bachelor course on Rural Health Care — clinical care providers with a shorter duration who will then effectively be alternatives to physicians, and mind you – the lack of physicians and nurses is, in fact the root of the problem.
Interestingly, the most informed report (based on a state-specific study) holds that live-training of the BRHC (Bachelor of Rural Health Care) graduates making them competent enough to cater to the health problems of rural India, which in mass are usually very basic. Then, is it not foolish to have the CMOs and their ‘unqualified’ but highly field-trained assistants transfer, and quit, respectively?
In the end, rationality dictates that to have a patient catered to by the unqualified, but highly efficient staff beats letting the patient’s condition exacerbate, or worse letting the patient die.