Monday, 4 February 2013

Bharat 2020 - Doctors and Healthcare


Many visionaries and politicians have promised about India becoming a developed nation by the year 2020, and just like any other election promise it will be a dream for many Indians who believed. The definition of being a developed nation varies from person to person and there is no universal understanding as to what it means. In a dynamic world, the already developed nations are progressing and the developing nations have to move faster to come closer the levels of developed nations. If a nation can protect its citizens from external and internal artificial disturbances and during/after natural calamities it can be called a developed nation. The disturbances can be financial, food, employment, security lapses, health etc which are required for the peaceful existence of the citizens of a community.By this definition there is no one nation that can be called developed, but the achievement levels are different and thus a scale be obtained.

A healthy society and a young society can be a very productive society. India today with majority of its population in the age 18-40 form a huge work force. This work force has been one of the reasons for the development of the southern part of the nation, together with the better penetration of the education services. The shift is now in the northern part of the country where the education is getting spread at a rapid force, and more number of young people are getting qualified for skilled jobs, still the scale of transformaton and those who have missed this wave are found as migrant labour. There are some pockets where the educaton has not spread and the development benefits have not benefited, but still on the whole, the progress of the southern portion is better and the northern part is taking its lead in this decade.

If he country is proud of its young citizens, then it is also a cause of concern for the people who plan the nation's course. This large number of young citizens will become unproductive in a very quick time and the productivity will be down drastically. Also the population rate of growth has slowed down for the first time since the independence of even before. This growth may bring happy smiles on a few faces who plan urban development, but on the larger scale this is big issue due to loss of people available at hand for productive work. Also with average life expectancy increasing, the population growth rate decreasing, young population can give a death knell to the growth story. Many nations are facing this dilemma of how to solve this issue and there is no clear cut answer, but only time can tell its long term effects.

With aging population and the fast paced life, will bring many lifestyle diseases like diabetes, depression, hyper tension, etc. The less amount of physical activity in the work makes the body lose its strength, the bones and muscles weaker. Also the food habits of the people have changed drastically from good home cooked food to the junk food with high energy contents. India is considered to be the diabetes capital of the world and the scenario is only going to be get worse. The spread of the importance of physical activity is seen in many places where large number of people are beginning to take long walks in parks, early in the morning, evenings, the increasing number of gyms, etc. The physical activity of the people in walking is reduced also for the reason for not availability of proper footpaths which are en-roached by a number of entities like vendors, vehicle parking, beggars, improper foot paths or their absence.

In many western developed nations, the importance of cycling as a non polluting mode of transportation for short distance is being recommended with separate tracks for cyclists. Also the footpaths are made walkable for people of all kinds right from old people, people with disabilities, women carring their children. This can boost the  people to walk. Alto the government should construct large number of maintained parks where can people can walk without the fear of getting attacked, or robbed right from the early from early mornings to late in the evenings. Apart from making more and more people to come to the parks and spend time, it can work as a pseudo social gathering which is being missed with closed door houses. Other public facilities like gyms, swimming pools should be started where necessary with charges for maintenance. If the facilities are provided and properly maintained, in the medium term the facility will be fully used by the public, because it is their money that is spend. 

Life style diseases apart, one menace that has been eradicated is the polio. With the aid of foreign funding and a intense campaign the disease has been sort of packed off from this country with no cases reported. with the mission achieved and the India no longer a economically weak nation, the funding has stopped. The onus is on the government to make sure that the 2drops are continued to be given for every child born. The other diseases that are not contagious but indirectly promoted by the government is the addiction of the people to tobacco and alcohol. On onside it is the government of the past with short-term gains in focus promoted the business and  now realizing the long term harmful effects it is promoting organization which are trying to ban these. The corporations that run the tobacco and alcohol business are the ones that control the ministers who sit the assemblies and parliament. Now young people at the age 12start to smoke and at 15start to consume alcohol. The consumption is the choice of the person, but in the end the rich can afford to get the treatments who do the ad campaign, while the problem of the poor is to be taken up by the government. Thus the taxes are used on the poor and rich cry about the welfare schemes of the government. Thus a complete abolition of these products is required for a healthy society not at the top but the lower rungs of the society, with strict cotnrol on the availability of narcotic substances.

The diseases arising from food and water are more in the rural areas then in the urban ares. But the diseases spread very fast in populations of high density like the cities, and in slums. the diseases arising from water are mainly due to the contamination of the natural resources with sewage, industrial waste discharge, gargage dumping in the rivers, open defecation etc all contribute to the problem. Apart from this in some places the amount of cholorine added in the water is beyond any standards for human consumption. The piping system of drinking water has to be improved. 

The drainage systems are the biggest breeding grounds of mosquitoes, rats, worms which all help in speading diesases from simple to fever to malaria. The TB is another big problem and which long term treatments and even with medicine available at very low cost or free, people tend to stop the tablets only for the disease to become more drug resistant and even longterm treatment requirements. The patients loss of faith in the doctors is another big problem in the medial system is one side of the coin and the patients demanding certain treatments, procedures with knowledge from hearsay is another facet of the problem.

The healthcare system in cities, industrial areas operated by private entities, and which have become more business oriented than service oriented. The doctors with business targets are forced to prescribe more medicines, higher number of tests. People started to believe an injection and a few hours rests should cure every disease and this is my experience in TN expecially among the workers of factory who cannot afford to loose a day of work due to illness. A doctor who could cure the disease mostly fever in the shortest time is considered the best. Thus the doctors are forced to use higher dosages, and with time the dosage increases. It is well within the public domain how the medical reps lure the doctors to prescribe more number of medicines. The allopathic medicine has become the norm, while the homeopathy and aurvedic medicine are fining less relevance in the fast paced world.

Another new revolution in the medical world, is the annual maintenance checks of the body, just like we do to our machines. The usefulness of this system is not known, but people are thronging the hospitals because some diseases are diagnosed, while many others are taking pill which may not be necessary. To help the people achieve this the fear instilling insurance people have taken the task of increasing revenue. At the top, all  these companies are joined by financial, if one survives others suvive too. The insurance people have instilled so much fear in that everyone wants a health insurance and the policy is blatantly misused. This misuse is clear by the very fact, hospitals bill heavily by conducting many tests for those who have insurance and lesser tests for those who donot. 

When life saving profession has become more business oriented, with financial targets and rewards put to the life savers, the ordinary citizen is left to the diseases to die. The SC has done a great service to its citizens by allowing generic drug manufacturers to produce and sell many drugs which otherwise would have cost very much. But the SC can do only certain things, but the government has to take control over this illegal business like service sector to improve the performance. Though the salaries of the government doctors are good, the greed has overtaken and thus we can super-duper specialty hospitals springing in every city. To build a strong and healthy nation called Bharat 2020, the citizens should be healthy. Many improvements have to be brought by the government and the time is still ripe to implement many of them, and bifurcate the service and business targets to the doctors, and again make this profession more noble.

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