This post has been self-published on Youth Ki Awaaz by Jhilmil Breckenridge. Just like them, anyone can publish on Youth Ki Awaaz.

In The Story Of India’s Corrupt Healthcare System, The Doctor Is Not The Villain

More from Jhilmil Breckenridge

By Jhilmil Breckenridge:

Big Pharma rules everywhere.
We are all pawns in this nexus of money, kickbacks, referrals and sleaze. Healthcare? You’ve got to be kidding! In this scenario, is it even possible to be an ethical doctor, Dr Maharwar asks.

“The Ethical Doctor”, released recently by Harper Collins, asks tough questions, presents heart breaking case studies, offers options and alternatives and suggests reforms in the healthcare sector as a possible way forward. Written by Indian doctor, Dr Maharwar, who studied in India, used the low cost colleges to get certified in Chandigarh, and then proceeded to a better life in England, where he now works as Consultant General and Bariatric Surgeon with the NHS, this book is an attempt to give back a little to his homeland.

Dr Maharwar is clearly bothered enough to write a very clear and compelling read opening our eyes, as consumers, to the realities of hospitals, state medical boards, so-called professional alliances and boards, chemists, ultrasound clinics and pathological sample collecting centres, and of course, doctors. Those people in white coats who have all the authority, those people in white coats who demand our trust, those people in white coats who are supposed to care.

The reality is far from this.

And while you begin the book, with a deep hatred for these doctors, thinking they are the villains of the piece, as the book progresses, you begin to see their helplessness. A doctor who begins his profession, idealistic and well meaning, will soon succumb to the pressures of healthcare representatives, tie-ups for kickbacks with other clinics and healthcare providers, and will allow himself to be lured by luxurious conferences and more because he will soon realise, if he wants to make a living and provide for his family, he will have to join the system.

A system that is highly patriarchal, highly exploitative, where the only thing that matters is the ‘cha-ching’ sound that coins make, is beautifully portrayed in the cover image with a stethoscope hovering over a stack of coins.

And ethics? Well, those are shed as you step out of medical school and put up your name on a board announcing your practice.

The author rewrites news into compelling case studies which read like well written fiction. If only that were true. He writes about Samastipur in Bihar, where the sex ratio is an alarming 909, as compared to 940 per 1000 women which is India’s, far lower than most of the developed world. In 1992, Nobel Laureate Amartya Sen refers to this shortfall in the number of women as “missing women” in excess of 25 million. Surely this number should haunt generations of Indian doctors, or should we call them murderers, abetting murderers in the wombs of hapless women?

Dr Maharwar describes a uterus scandal at Samastipur through the story of Sunita, a poor woman eking out a meagre existence with her husband and three children on a tiny piece of land and a small 10 feet by 12 feet hut. Sunita goes to see Dr Goyal for heavy periods and abdominal pain, naively trusting that the tests and ultrasounds he would prescribe would actually help her. With absolute authority, Dr Goyal announces she has cancer of the womb and needs an operation that very day! Grateful Sunita goes under the knife in a few hours, after all, she has a government scheme smart card, and who would look after her three children if something were to happen to her?

Samastipur was just one of the districts where large payments were being made for this sort of operation called a hysterectomy, a total removal of the womb, to an ambitious health insurance scheme. Gullible women were conned into thinking they had cancer or some other life threatening illness and that they needed immediate surgery. Sadly, an insurance scheme that was meant to protect consumers became the very instrument of their exploitation.

The book continues to shine light on other scams: organ donation, surrogacy, guinea pigs for medical trials and more. As you read, you feel you are living in a sort of draconian, science fiction, alternative reality world, and anything could indeed happen.  The book is a roller coaster of facts, intelligently argued theories and the author’s views as he exposes one myth after another — cuts and commissions, completely unnecessary treatment and tests, Big Pharma and medical representatives, touts, professional bodies, private hospitals, the public sector and more.

In his author’s note as a preface, Dr Maharwar rues the fact that life deals us a set of cards, that we live in a society and systems that make the rules, and we have no option but to play. Of course, declining values and corruption is at the heart of most that he describes, but he suggests a time has come to take stock, introspect, evaluate and think of possible ways ahead. The last few chapters of the books do offer some reforms and an overhauling of the Medical Council of India and various other regulatory bodies. Dr Harsh Vardhan, Union Health Minister, in June 2014 said, “For a long time, the Medical Council of India has been a big source of corruption… instead of strengthening the components of medical eduction, it has weakened it.”

Although population is always quoted as the reason India’s systems, not just healthcare, are such a mess, this is far from true. Policy reform is needed everywhere and population is not the culprit. “The healthcare mess in India is a failure of policy,” says Dr Gita Sen of IIM Bangalore. From the role of the media, consumers, advocacy, patient complaint cells to many other small and big changes, Dr Maharwar offers several ways we can start. Let’s start anywhere, but yes, let’s start. It is time to start following the amended Hippocratic Oath, adopted by the 2nd General Assembly of the World Medical Association, Geneva, Switzerland: “I solemnly pledge to consecrate my life to the service of humanity. The health of my patient will be my first consideration.”

Let’s just start. Patients are losing their patience. And this is not a humane world for them.

Overall, the book is easy to read, well argued and is a must read for the layperson but it is not targeted at doctors or the medical fraternity.

You must be to comment.

More from Jhilmil Breckenridge

Similar Posts

By Nupur J

By Veronica Pallan

By Captain Black

Wondering what to write about?

Here are some topics to get you started

Share your details to download the report.

We promise not to spam or send irrelevant information.

Share your details to download the report.

We promise not to spam or send irrelevant information.

An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

Share your details to download the report.

We promise not to spam or send irrelevant information.

A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

Sign up for the Youth Ki Awaaz Prime Ministerial Brief below