Ailing medical services in India

This was the scene in an accident and emergency department in a tertiary hospital of New Delhi: the patient had sustained poly-trauma in a high-speed road traffic accident, but lay unattended, on the road, because the police had not arrived, and bystanders did not attempt to help the victim for fear of legal consequences. After the arrival of the police, the patient was transported to the hospital. However, without primary medical treatment and without knowledge of the status of his cervical spine, he was repeatedly pulled up and down by laymen. Ultimately he lay in the emergency department, waiting to get treatment. The long queue of waiting patients was being handled by three junior resident doctors and one intern. After some time, it was noticed that the patient was bleeding “somewhere below the waist”. That important finding was made not by a doctor; but by the sweeper cleaning the floor of the emergency ward. Thanks to the sweeper, the management of the patient finally began, after losing precious time.

I have been battling with my conscience for long and cannot justify the medical facilities that we offer to our fellow citizens in government hospitals. The hospital in which I work is a tertiary centre in the capital of India. It has a daily census of more than 1,000 patients. Obviously, with this high influx of patients and limited resources, the hospital cannot provide the facilities they do abroad. Still, everyone tries to contribute through his or her own piece of work. So, why aren’t we able to provide a minimum standard of care to patients?

Instead of focusing on providing better facilities to patients, our authorities are trying to make the hospitals “beautiful”. The hospital does not have even six functioning ventilators for six beds of the ICU, in a hospital of more than 1,000 beds; but there are granite tiles in the corridors. Costly shoe cover machines were installed at the doors of critical care units, and stopped functioning within two months. Couldn’t placing the slippers at the entry door have done just as well? Anyone can understand the hidden benefits behind these heavy purchases. To top it all, whenever the health minister visits the hospital, everything is in place, and things are made to seem orderly. A hospital does not become beautiful by these shams, but only by lowering the mortality and morbidity rates.

Similar examples can be seen in the wards, where most of the oxygen-dispensing ports mounted on the walls leak constantly when connected to the tubing for oxygen inhalation for the patient. The patients’ attendants are unaware that most of the oxygen from the ports is not going to the patient; they are satisfied with the mask over the face of their patient, so the nursing staff and doctors are also at peace. But the final results are tragic.

The hospital authorities cannot alone be blamed for the sickness of our health system. The defense budget of India is more than Rs 1 lakh crore for the year 2010-2011, while the health budget is merely Rs 23,000 crore. The government can spend at least half of the defense budget in the health sector, as more people are dying inside the country than on its borders.

It is easier to go along with a dirty system than try to change it. But we cannot shrug our shoulders and shirk our responsibilities. The system is made up of people like us. We must rise above thinking only of ourselves and move ahead with the motto of “country first”. And we have given this enough thought; we must stop our endless discussions and finger-pointing. It is time to act.