Healthcare in India: myth busted

The other day i read that India is one of the top destinations for medical tourists.for those not in the loop this refers to foreigners mostly from developed countries like US, Russia, Germany, Singapore, Korea, etc who do not qualify for healthcare insurance in their home countries who come to India for cheap medical care so that they can get similar or better care for less than one tenth of the price in their home country.When i read this article i couldn't help but wonder whether we should really be gloating over treating foreigners for cheap while millions die in our country due to dire need for basic healthcare.We in India apparently follow a socialistic policy in healthcare. Is it really so?
I recently read an article by Dr. Devi Shetty,a famous cardiothoracic surgeon and leading philanthropist in the field of healthcare.He said only 8% of the people needing cardiac surgery actually get operated and in a country like India we have a huge backlog.In his own words this is ridiculous even for a developing country like India.He has bought down costs of heart surgery to less than Rs. 1lakh and he’s desperately trying to get it to less than Rs. 40k.He’s doing a commendable job and needs every bit of adulation and support he can get.But really where is the Government in all this? its conspicuous by its absence!
I work as a resident in the premier Govt. Eye Institute in West Bengal which incidentally is the top govt  eye inst in the whole of eastern India. we have top of the line instruments, microscopes, lasers, machines, diagnostic aids and first class infrastructure.we undertake all kinds of surgeries done in any of the top institutes of the country.This should in effect should help the masses.But unfortunately not everything is free.True cataract surgery covered by the national program for control of blindness in India is free but nothing much else is totally free of cost for the patient.the patient still has to buy consumables for surgery such as silicone oil or perfluro-gas(Retinal Detachment surgery),silicone prosthesis,sutures and many other consumables.A typical RD surgery costs the patient around Rs. 12,000 in our institute(only consumables).In other diseases for proper diagnosis CT scans,MRI,histopathology,expensive blood reports,immunohistochemistry,etc. needs to be done for which the patient has to shell out from his/her own pocket.All this and not to mention other daily expenditures in eye drops,costly antibiotics,pain killers and sometimes hospital fees.Drugs supplied by the govt. form a woefully short list or for the most part ineffective probably due to adulteration and poor quality control.So many expenditures in a Govt Hospital which is a premier institute at that in a supposedly socialised medical healthcare.This much expenditure to a man/woman who probably earns less than Rs. 100 a day.does it sound right? can our conscience make peace with this fact? if this is the state in a premier institute what is the state of peripheral hospitals.I’m not blaming the people who run our hospital for all this.they are doing a great job to the masses with the limited resources at their disposal.the costs that are being borne by the patients is due to the helplessness of these doctors and due to their endeavour to provide world class care to patients with limited expenditure to the society. In this scenario doctors are stressed to provide healthcare and the public blames them for any incident that happens. This is the reason why doctors in govt sectors are getting frustrated with the system. its not them but our healthcare policy that is to blame.It is flawed left right and centre!
I’m speaking in the midst of one hospital and i’m talking of ground realities in one govt hospital as i’m a part of one.But this is the story of nearly every govt hospital in India.it is just that the categories of expenditure changes.Our society will be judged by how we treat the weakest(read poorest) among us.And our country falls terribly short of an ideal.
As i have mentioned previously in my blogs,Indian govt. spends less than 1percent of our GDP on healthcare.Even countries like Bangladesh and Sri Lanka spend 16 and 32 pc respectively.UK spends 7pc and yet provides Universal free healthcare to every citizen and immigrant.In India 80pc of the health care burden is borne by the pvt. sector.We are quick to downgrade the insurance based healthcare of the USA but in India we neither have an Insurance based healthcare of USA nor a Socialised Healthcare like UK,France,Sweden,Denmark,etc. the common retort by the govt is India is a poor country and we do not collect sufficient taxes to sponsor universal healthcare in India.But this is a poor argument because though only 3 pc of the population pays income tax,we all pay tax in every other way.sales tax,wealth tax,property tax,road tax,service tax,luxury tax,custom tax,education cess,advertisement tax,service tax,value added tax,….phew just to name a few!!!! Only birth tax and death tax is left to be enforced.where does all this money go? We have a horrendous education system,pitiable healthcare and a treacherous bureaucracy and yet we have any non-descript politician worth his salt(not necessarily elected) being ridden across the country in a fleet of 10 cars or helicopters or jets! govt officials,bureaucrats and govt aides lead a life of extreme luxury.our politicians and bureaucrats must be among the richest politicians and bureaucrats in the world(and we are a poor country mind you!!!)No other country in the world has more black money in Swiss Banks than India.So who do you think owns all that money? the above people and also some huge businessmen. So do I still hear somebody call India a poor country. We now know who are the beneficiaries of these many taxes.
Solutions are quite often very simple but simple things aren’t done without a political will in this country.The masses don't demand healthcare because they have nothing to eat so why will anybody talk about health? Healthcare needs to be removed as a state subject and be transferred to being a union subject.Doctors and healthcare professionals need to be paid more as professionalism demands money.you can’t attract the best talent in any industry with pitiful pay packets.same should hold true for healthcare.Govt budgetary allocation to healthcare should increase to 5pc of GDP for a start and should eventually increase to at least 8pc.another 10pc to our education system because to sustain a healthcare this massive we need an educated population.All these budgetary allocation should come from defence cuts.We don't need bombs and missiles.we need medicines and medical care.there needs to be a stringent quality control body for healthcare delivery and of course for the quality of drugs and consumables being supplied.In effect we need a complete overhaul of our healthcare and education policy.Do these sound difficult. hell yes!!! because attitudes need to be changed,awareness needs to be increased and most of all corruption should be minimised.All this is easier said than done but it still is simple stuff no?
I sometimes feel really bad when patients suffer because they either can’t afford treatments or we are restrained from giving them the best treatment due to the many impediments i have mentioned above.There is a certain joy in treating patients and you need to have empathy to understand their varied problems.Its a hell of a tough job but there is nothing else in this world which gives the same high as that got by alleviating suffering of people.It is for this incredible satisfaction that most doctors work even in trying conditions,amongst apathetic govts.,and high personal sacrifices(both monetary and social).So if we doctors can treat our patients without worrying about whether the patient can afford the treatment we can at least bring back nobility to our profession.its not only the rich who deserve to get sick and be cured.even the poor have every right to lead a healthy life.So the next time you fall sick and get treated think about the millions who are not as lucky as you and be grateful for the same.Also try in your own way to do something about it.sometimes a simple thing such as a change in attitude will do.

17th April,2011                                  Raghuraj Hegde

The anatomy of hate and the geography of patriotism

The world cup is over and India have lifted the world cup in grand style after 28 long yrs.I am happy and proud as every other Indian ought to be.But I'm not going to talk about Saturday's game or the many  wonderful moments this world cup has given me.I’m going to talk about the impact sports has on people.

Sport is essential in life.It provides joy to so many people playing it and the so many more watching it.Some say sports does not affect the common man.I disagree.The same thing can be said about music,movies,dance,art,fashion,etc but we all know how important these are to our lives.So sport has its value and its high up there.I’ve been a true sports fan for so long.It started with cricket,moved to football,tennis and F1.I've enjoyed every bit of watching these sports and also the suffered the heartbreaks that comes with it.So i know first hand how sport fans think.Joy,grief,faith and un-reasonability all in equal measure

The days before the India-pakistan semi-final the tension was building intensely.There was so much hype surrounding the clash that most people just wanted that match to get over as soon as possible to spare them the anxiety.There was a lot of pak-bashing going on.I assume there equal India-bashing on the other side.Even I joined in all the excitement and maybe indulged in some myself.But then as the clash was nearing the things being said in public discussions and forums,over news channels,SMSes,newspapers,e-mail forwards and social networking sites got ugly and then it was plain indecent at times.there was so many hate filled messages and statements going around everywhere.Much more than before the Australia quarter-final clash or when India lost to South Africa.Some insecure fans threatening the Indian team against losing to Pakistan.Things being said about pakis mothers and sisters.It was somehow ok to the fans with India losing to Australia or South Africa but it was a strict no when it came to Pakistan.I asked myself at that point…why so?

True that since the partition there’s always been tension between our countries And Pakistan being a very poorly governed country this tension had just increased over the years.True our borders are being challenged everyday as i speak.They might be infringing on our internationally recognised land.Pakistan is also the safe haven to so many terrorists  who repeatedly attack India and also other countries. causing so many lives to be lost.We’ve had two wars with them and there so many wounds yet to heal.But my point is what has the Pakistan cricketers,cricket officials,common people of Pakistan have to do with what is essentially a political problem.More over what has sports got to do with it? Maybe the partition was not the best thing to happen to us but it happened more than 63yrs back and we cant with all our powers change that.What gives us the right to abuse anybody just on the basis of him belonging to a country we think we hate.Why do we forget that these are people who suffer the very same problems that we face or maybe at times even more than us.

Some months ago,Sania Mirza decided to tie the knot with Pakistani cricketer Shoaib Malik.There was a huge furore in the country which was reflected by “Breaking news” features everyday in the news channels.Sania Mirza could have got married to anybody in the world(or any foreigner for good effect) but the fact that she was marrying a Pakistani was not acceptable to our people.I found it bemusing at best.We Indians think just because Sania plays tennis for our country(and of course we are proud of her for that) we have a say in her personal life.Well that’s not my point here actually.my point here is her husband being a “Pakistani” was offensive to Indians.Again why so much hatred for individuals? The country was quick to react with threats to Sania’s life,controversy regarding some non valid earlier marriage of Shoaib and lastly the fatwas issued by the muslim community of India.Sania was labelled a traitor for marrying a Pakistani.I’m not in anyway suggesting the discord is just from our side.Shoaib Malik who was captain of the Pakistani team when India beat them to win the Inaugural T20 world cup in 2007,his first words at the presentation ceremony was ”I want to thank all the Muslims of the world who supported the Pakistani team”.He apparently forgot that the man of the match in the final was Irfan Pathan and the Indian team had two other Muslims, Zaheer and Yusuf.I guess a less educated Shoaib Malik did not have enough maturity to realize such a blaring fact and he uttered publicly what he thought his country believed.This in part reflects the queasy feeling that Muslims in our country get when such things occur.They are somehow anxious not to be be seen as supporting Pakistan in anyway lest they be seen as traitors.But really it can’t be the case.There are more Muslims in India than in Pakistan and also we have the second largest Muslim population in any single country behind Indonesia.So Muslims in India are as Indian as anyone else.Nobody has the right to question their allegiance to our secular country.This to India’s credit reflects our amazing culture of tolerance.I’m not an idealist.I too at some level share some of the prejudices against Pakistan hence I understand the hatred that seems to be all around us.But in my few years on this planet I have realized that so much hatred is bad and brings negative energy to our country.It stunts our progress.We invest 20-30pc of our budget on defence,weapons and to maintain a million strong army all for the fear of our neighbours, Pakistan.If we shared cordial relations with them we wouldn’t have to invest so much on the military.we could use that extra resources towards eradicating poverty by good education to our countrymen.Even Pakistan can stop investing in weapons and do good to their country.Its not enough to be anti-war its more important to be pro-peace.We need an atmosphere of peace to stop this kind of hate taking root in our hearts.We shouldn’t let these politicians sell us false stories to create hatred to help their own political agendas.Let us all live in peace.

India finally won the world cup after 28 yrs.It was an extremely emotional moment for me to witness India winning the world cup in my lifetime(i was not even born when they won in ‘83).The scenes around my house was overwhelming and the joy one witnessed in everybody’s faces was incredible.For one night the whole of India forgot all their problems,biases,prejudices and celebrated whole-heartedly.Those scenes will stay with me for the rest of my life and i shall always cherish it.It was truly a kodak moment in history for all Indians.It is also imperative that one highlights the unforgiving Indian fan in the midst of all these celebrating and euphoric days.We Indian cricket fans make gods out of cricketers when they win but our whole world comes down when India loses.These very cricketing heroes become India’s most hated people.They are publicly abused and vehemently castigated.I understand that Indians are emotional people and maybe we have some right to criticize the players but only up to a point.The rule of sport is that one team wins and another team loses.Either one individual wins or loses like we experience in our daily lives.So we should treat sport as part of our life and not our whole life’s endeavour so our reactions to wins and loses must be appropriate.

Its incredible that Indian cricket team has so much support across the country.Nothing seems to unite the country more than a cricket match win(or maybe in times of war).But our patriotism is restricted to these few moments.Our patriotism is not evoked when we vote for all the wrong men who after getting elected are involved in a number of scams eating up crores of the tax payer’s money in the bargain.It never pains us that not a single politician in India is convicted of corruption.Even very few bureaucrats are punished for corruption.Our patriotism is never evoked when we bribe the traffic policeman to let us go or buttering a government official’s hands to make our papers pass through the red tape.But our blood starts to boil when India loses a cricket match against Pakistan or when an Indian marries a Pakistani or some irresponsible Pakistani minister makes an inflammatory statement against India.In the true perspective of things don’t we think our reactions are unbalanced and mostly misplaced.I hope you see how blind this hate for Pakistan has made us.For all we know,for all the unbridled and unreasonable hatred we have for these unknown Pakistanis if you go to their homes they might turn out to be as hospitable and warm as we are to our guests.Think about it!

 

4th April,2011                               Raghuraj S. Hegde

The Year that went by….

Of course every new year’s eve presents a moment to reflect the life you are living and how you want to live it from there.This new year’s eve has been a different experience. Maybe it is because I've had an ordinary 2010. But of course I'm not here to bore you to death with the travails of my boring year gone by. One important lesson I've learnt is that a lot of us spend a lot of time complaining about everything which prevents us from enjoying what we are blessed with.I for one remember 2010 as the year i got pissed off with a lot of people.I got lost in an unending routine in work that i got fed up of the drab life i was living.I somehow let small situations,petty people and quirks of fate upset my incredible balance in life i had earlier enjoyed.2009 was the best year of my life largely because i concentrated on all the positive aspects of my life and all good things came to me.New friends,new life and whole new view to life.But 2010 was a total anti-thesis to 2009.Many misunderstandings,a few fights,uncomfortable realisations, changing equations with people and life’s not that hunky-dory anymore.Of course people would say the good comes with the bad and 2010 can’t be all that awful.It certainly wasn’t.it was just that i spent so much of my year getting pissed with things i couldn’t see all the good things that was happening to me throughout the year.Probably looking back after a few years i might have had one of my most productive years.But that's the way our priorities line up when we spend a lot of our time being angry. My point is if we dwell on negativity our life will be an unsatisfactory one.we need to remove all the unpleasant experiences from our lives and take only positive constructive lessons from it.So now i have to take the constructive lesson out of this experience too.Of course i hope 2011 will bring me better joy since i resolve to remedy this malady.The real compass of our lives is our own desires.They show us the direction our life should take.So you are happy only if you choose to be happy!!!

That apart,though 2010 has been a largely uneventful year for me.The earth hasn’t stopped revolving nor have people stopped living their life and rocking their worlds and ours.My foremost remembrance of 2010 is the year that Sachin Tendulkar,a man born to just play cricket resurrected himself to the top echelons of the game.Of course after 14,000+ runs and 17,000+ runs in test and ODI’s respectively he was already a legend before this year.But his double against SA in an ODI and his 50 centuries mark that he achieved stamped his class as the best batsman the game has even seen.And to top it all he had the best year of his professional career in 2010.i have always admired people like Sachin and Dravid the way they play the game for the love of it and nothing else in this world concerns them except their game.i guess that’s why I'm their fan rather than all the records they have broken.They are true gentlemen in every sense of the word.

India has reached the No. 1 in the test cricket rankings.I’m absolutely proud of that fact but something doesn’t seem right.I’m not saying they don’t deserve the ranking but to win the coming world cup with a bowling attack like the present one seems difficult for me.But i guess this is our best fast bowling attack that has ever been and Zaheer is the man to look out to.Hope the other fast bowlers and Bhajji give him enough support.Moreover I have incredible faith in the little man Tendulkar that he’ll give us the world cup before he retires.

Spain won its first world cup and anyone seeing them play had no doubt who would win.They looked the best team and played like one till the end barring the forgettable first game of the tournament.I was supporting Argentina too since my favourite player Messi was in in it but was disappointed to see him playing alone with 6 defenders attacking him and yet he managed to show his magic.He certainly deserved better teammates.Maradona erred terribly by not taking Riquelmé and Cambiasso.By 2014 i hope Messi will lead a much better team.

One of my favourite sports which i have never played but always watched with wonder…Tennis.People like Agassi,Ivanisevic,Pat Rafter and now Roger Federer have kept me amazed by this game.Of course Kournikova ,Sharpova ,Ivanovic and the likes have kept it interesting :-)…one of my biggest sporting heroes has been Roger Federer.I have always found inspiration in the grace of his game! he’s had an ordinary year in 2010 and he now seems a shadow of the greatness that enveloped him earlier.but he’s a man who could find sanity in the kind of incredible success he enjoyed.I never saw,heard or read about him misbehaving,showing his airs or any of the now common among sports celebs-sex scandals right through his career.Never before did success sit so well on a human being.It is for  this that i shall remain his greatest fan! But his game is immortal because even his shadow is reaching semi-finals and finals of every tournament he plays.That's testimony to his amazing game.And I’ve got this inner belief…kind of a hunch that he’s not done yet and he’ll come back to win more grand slams before saying goodbye!

Closer home our CWG games was saved from disgrace by some last minute adjustment for which we Indians are famed for.we actually pulled it off!!! And we also won more than a 100 medals.Kudos to all the athletes who made our country proud.They continued the good show in the Asian games(59 medals,14gold)) but of course they were paled in comparison to China(199 Gold) and Korea who dominated the field.A country of a billion people is sure to have better talent than that.Again I'm not belittling the efforts and achievements of our sporting heroes but the medal tally shows our country’s collective apathy towards sports.These sportsmen need better facilities,funds and sponsors to fuel our sporting growth.I hope that the CWG and Asian games foretell a better future for all budding sportspersons.

Politically,the central government run by the UPA which is lead by the Congress probably had their worst year in their history…scams after scams.tainted politician after tainted politician.They need to show something concrete to hold their own from here on in.The huge 20,000 crore CWG mess was messy enough and coming in its heels the 1.76lakh crore 2G spectrum sale scam resulting in the resigning of A Raja.Coalition politics,ulterior motives or vested interests? Can somebody please explain because sometime in the future if these people don't answer our questions we shall not vote for them.We may even vote for the saffron that we don't particularly like but we certainly don’t like liars and people who take our votes for granted.

These are the few highlights of the year gone by that i felt i had something to say.There may be many more important events that begs a lot of importance but i certainly have nothing substantial to contribute to it.So here i am again bringing my long story to an end!

 

3rd January,2010                                   Raghuraj S. Hegde