While watching the Jurassic Park in 1993, the message I left the theater with was that no matter how scientific we get about controlling nature, it will find a way. In the case of the movie, the dinosaurs found a way to reproduce and proliferate. We are no different.
When there are talks about the lack of doctors in the rural parts of the country, we are reminded about the skewed ratio of physicians and healthcare infrastructure in India. But people fall sick and doctor or no doctor, they need care. So no surprises that people are turning to Quacks or unqualified doctors in parts of rural India.
According to a WHO report and as reported by the Hindu, many of our citizens in parts of rural India are being looked after by people not qualified to do so. The problem is worse up north and slightly better in the south. But overall all the picture is grim.
The Hindu quotes that “Almost one-third (31 per cent) of those who claimed to be allopathic doctors in 2001 were educated only up to the secondary school level and 57 per cent did not have any medical qualification, a recent WHO report found, ringing the alarm bells on India’s healthcare workforce.”
Well I am not surprised. I started my career at a multi-specialty clinic and we had a compounder/ Assistant there who used to help out with cases. He would serve as a clinic administrative assistant. Lets call him X. So X would observe how the doctors at the clinic at Delhi, would give injections or put in sutures for example. After a while he started helping out and learning all the way. The one fine day he quit. He had some family issues in Bihar so he left. The last I heard was that he had set up his clinic at his village.
Also only 18 of the allopathic doctors in rural India are qualified and most of the medical staff are non-allopathic, Ayurvedic, Homeopathic and Unani. In addition to that there are dentists in the mix.
Interesting women health professions numbering only 38 % of the total were more qualified than the men. Allopathic doctors had around 70% qualified women as compared to only 38 % of men. Disparity among the states was massive. Kerala for example has 30 % of doctors in India and only 3 % of the population. The situation was worst in North-East and Central Indian states.
So what is the solution?
Well again we can’t produce doctors overnight and at the same time we cannot allow Quacks to continue practicing.
So these are some suggestions
- Work on developing a layer of health workers, qualified workers not doctors. Give them basic training in healthcare and focus on the key infectious diseases in their regions, let them be local people and let the diploma’s be recognized by MCI and be supervised by qualified Allopathic doctors
- Work on a Digital Health network. This way patients aided by a healthcare worker or a junior doctor, can confer with physicians in the cities. This way leveraging simple technologies like VOIP and SMS, patients can gain access to qualified physicians and not visit quacks
- Work on a preventive health strategy that reduces the need for patients to visit hospitals. Again leveraging simple systems like voice calls, sms and alerts, people can be trained to take care of their health
As always suggestions are welcome, I would love to hear your views on the same.