These are testing times as the coronavirus pandemic takes its toll. The recession has morbidly crippled the economy with a precipitous decline paralleling the Great Depression, as recognized by IMF. Healthcare institutions and services are over-strained, and medical professionals globally are overworked. Huge constraints are ailing the healthcare system of third-world countries. GDP has sharply plummeted, Indian healthcare is significantly affected, and a sense of exasperation and disbelief has gripped the people. Doctors, especially residents, are bridging the huge infrastructure gap in resource-poor countries. The general population is expected not to be condemning their comprehensive efforts out of vanity and misguided contemplation.
The ground reality of Indian healthcare…
The fractional GDP expended on Indian healthcare is abysmally lower than the world average of ~6%, as budget allocation since the independence hasn’t seen any major reforms, consequently raising the out-of-pocket expenditure of the general masses. Most of the population isn’t covered by any healthcare policy, and a big chunk (~7% population) is annually driven into poverty due to medical expenses. To our dismay, no comparison can be drawn with the healthcare of any developed nation due to a significant lack of financial resources and infrastructure.
The low healthcare costs adjusted against wages, innovations in healthcare, laws conferring redundancy on the monopoly of patented drugs, treatments, and pharmaceutical companies have tried to achieve the laudable feats of affordable healthcare in a country that perpetually struggled to have a categorically educated and conscientious political representation.
The structural pillar of Democracy is laid down on the foundation of people, by the people and for the people with no regard for a voice that is eccentrically loud or perhaps rational.
What if most of those laying the foundation are misguided by decades of ill practices, misbeliefs, and confabulations propagated by men with “controversial” knowledge gained after years of desolate rumination and rote learning practices with a loss of touch with the perceived reality?
Indian Healthcare, then loses its context with a defeated purpose if bulk of the population don’t believe in the system that exists in place to meet the social needs.
No mechanisms to gauge the quality of Healthcare
To add to the vexing situation, there is a large wage gap between the resident doctors working across the country, and the duty hours are preposterous with no standardization or capping. There is a need for a native Libby Zion law, to limit the resident working hours. Such incidents, unlike developed countries, are under-reported.
In addition, there are no mandatory requirements for reporting adverse outcomes and no objective mechanisms in place to gauge the quality of Indian healthcare since that is not a prime concern for a country still fighting a battle for universal health coverage, poverty, and embroiled in petty religious conflicts.
The healthcare knowledge in India is thought to be internalized and omnipresent, passed down through generations and by common public opinions, with everyone possessing it, but no one is ready to be held accountable for the grave consequences that can arise out of practicing the ‘traditional’ knowledge.
Moreover, the virtual absence of culpability of attacks on doctors treating a patient who is either dead on arrival or would be imminently so in a matter of minutes adds to the grim situation.
The hypocrisy
Doctors have been equated to Gods since the time when magic was considered sorcery/witchcraft due to a limited understanding of the human body and its capabilities. Society has since progressed and learned significantly more due to easily and widely available scientific knowledge, and doctors are now contentiously held accountable for every comprehensible error. This seems rational, but has also stemmed a sense of disbelief in the widely practiced “modern medicine”.
Out of desperate attempts to find alternate solutions to this ‘seemingly’ failing system, especially so for chronic and incurable disease conditions, we have leaped towards anecdotal remedies with non-standardized compositions and lacking proof of large-scale evidence.
When asked the pertinent questions of – “What, How, and Why,” yogis, sadhus, babas, and sometimes the practitioners of traditional systems of medicine fail to reciprocate with sound scientific arguments.
Since ancient Indian history is so gloriously magnificent and riveting, the consensus is to look for answers in the distant past while incessantly disregarding the voice of reason and rationality and refuting science. This country is where ancient wisdom and practices are conferred upon much more value than a well-researched published article on the same subject.
Hidden rage & disbelief are engrained in Indian people availing of Healthcare
A thick veil of anger and skepticism against healthcare has embodied the masses, and doctors become easy scapegoats. The lesser/uneducated have little/no knowledge of the disease conditions and prognoses. They idolize the doctors until witnessing an ‘expected’ death of a dear one, which is a breaking point for them.
The intellectuals and privileged think there is a large conspiracy and hospitals are a scam run by healthcare workers to make money off the people. They don’t have high regard for doctors and usually intimidate them, not with injunctions or litigation but by death threats.
Both groups fail to realize a mere 1% GDP spending by the country on healthcare, which is dismally low to buy enough ventilators, extraordinary life-saving measures, or provide decent healthcare facilities at par with the developed nations. This illiteracy and unfounded allegations add to the confusion, distrust, and weakens the doctor-patient relationship.
Unless steps can be taken to increase the budget allocated for healthcare, the system can only be expected to keep afloat so far, regardless of the optimistically enthusiastic attempts at increasing the number of trained doctors to hike the doctor-patient ratio.
