I could not miss writing post on this day even with self-inflicted busi-ness. Blog Action Day has a good cause (never mind if you think it is community building promotion gimmick). I was reminded about it gently way beforehand. I care, and I had written a blog action day poslast year as well.
This year the subject is poverty. Google helpfully offered me keywords: Poverty in India and Poverty in Africa.
Well, poverty is not confined to only India and Africa. There are poor people in US and there are poor people who work hard to make both ends meet in Europe. Though you may argue that living standards of poor in America are better than those in India. Yes, in India and Africa, it has been so worse that parents have been forced to sell their own kids. Farmers, in so-called agriculture-based country like India, routinely commit suicide. Thousands die in a day. Routinely.
Kevin Carter's Award Pulitzer Award Winning Image on Poverty
I am no economist, I will not dwell into why poverty happens. But I can firmly say, in India, its population that takes toll. There is crunch of basic resources like food, water, space that is compounded by mismanagement and corruption in the government.
Out of all the things, why I choose this aspect of population impacting poverty? It is based on my recent experience of two visits to government hospitals in Delhi. I went there because I required a medical fitness certificate and it was mandatory to get it from a government hospital.
I first visited Bhimrao Ambedkar hospital where after 3 hours of wait I got to see the doctor who had been overstaying her shift by one hour. She must have attended to over 200 patients in those three hours. You can imagine how much time each patient would have got. As I was entering the room, she anxiously asked the peon, who replied with grimace that about 60 more were waiting. There was still a long queue outside.
I hate to tell you there were several squabbles over queue as well. Nevertheless, I entered the room and found the doctor brusquely interrogating a patient. Compassion that is part of doctor’s healing touch was absent, there was no courtesey either. Patients too meekly accepted this. They were scared of being shooed away by the doctor without medicines or diagnosis. They would have accepted more rudeness from doctor, if need be. When I spoke to the doctor, she was perfectly civil but I could not forget that harsh, bursqe tone she has used earlier on the other patient. I did not get the fitness certificate as doctor said she was not authorised (!!). (And this was a doctor at government hospital) I went to AIIMS next week.
At AIIMS again, everywhere there were battered, bruised and visibly sick people. People were lying on every available space in the corridor. They were writhing in pain, those accompanying them were aggressively queuing up for doctors. Queues extended outside one whole room. It was not even 9 in the morning yet.
When my turn came to wait in doctor’s cabin, I again had a chance to see the doctor treating his previous patient. This patient was a lady accompanied by her husband. She could barely sit on patient’s stool. Her eyes were already dripping. Doctor clearly stated that she needed to be admitted in the hospital but there was no bed available. People have been waiting here for months for a bed. By ‘here’, we mean AIIMS: India’s premier medical institute. Doctor asked the husband of the patient where he came from. He replied, Rewari. A place that is supposedly 400kms away from Delhi. Doctor asked them to go back there, saying he had referred to a Rewari’s government hospital. Go back! In that condition! Chances are Rewari’s hospital was already helpless and that’s why they came here. I watched wordlessly, feeling as if my heart was turning into stone.
A brief chat with doctor told me it was a regular thing: seriously sick patients were returned back to their far-off cities/villages with first-aid. There is no space, he said, there are patients worse off. Worse than what I just saw. Not surprising that, just 2 weeks back, AIIMS was slapped a fine of 2 lakhs by State Consumer Commission for forcing a heart patient to seek treatment elsewhere due to on-availability of beds.
Who do you blame for non-availability of quality health services? The bursque doctors who regularly stretch their shifts, yet can not provide the required medication/attention or the patients who are poor and sick enough to die with it. I don’t know who to blame and how to help. You decide and tell me.
Related Posts:
My Last Year’s Blog Action Day Post
Global Issues, Causes of Poverty
An Heartening Front Page on Poverty
Wanting a Meal
Visceral Observations 
*thumbs up* good post on poverty. i participated in blog action day too, though i admit i’m quite ignorant about poverty.
Hi
Thanks for your post. You might like some of the free courses that concentrate on poverty, health and population. I give links to some of these at: http://www.open.ac.uk/blogs/openair/?p=334
Laura
The statistics on health care in our country are truly alarming. Every year 20 MILLION people fall into poverty over medical expenses.
I’ve written a post about how so many of the life saving interventions needed are low cost but still not available to most Indians.
http://blog.giveindia.org/2008/05/6-doctors-for-every-10000-indians.html
The picture is really disturbing..What we have in our nation is not lack of resources,but mismanagement ,not using the pool of using in effeicent and effective manner..Tons of rice and wheat grains and sugar are rotting inside FCI godowns..Tons of crops and vegetables get spoilt and are thrown away,simply bcoz they are not carried off to the and user,as when required..
Its not that we don’t know about it..Its that we are not bothered to act and make the change.Only when our own meal is delayed or when we don;t have sugar to add to tea,we’ll understand the basics of supply chain management..People like us are not much affected as we are in the higher end and somehow we can manage it all..But its not the same to the majority..
We have enough doctors and nurses passing out from our colleges..But we are not ready to pay them properly..Obviously they’ll take a visa and go to London and Ireland..There is no use of then sobing and shouting at them for being unpatriotic..In today’s world,to almost all of us,money matters..So,i don’t find fault with them..
It is not that we don’t have money tp pay them,but we don’t want to..We have MP’s and President having triple salary hikes ,but we hadrly see such efforts intented to right people..So all we can do is just make these topics “Lack of Suppple chain management in India”,”Brain Drain” etc etc etc as group discussion topics..Nothing more,nothing less..
There is nothing much we can do about population..People very well now about this,yet they choose to produce as many kids as possible..If government tries to regulate it in some way,we’ll have hell lot of religious people jumping upon them ..So forget about controlling poulation and let us concentrate on dispersing the resources effectively..I read somewhere that ‘overpopulation’ is just a hype,and that problems comes out merely due to improper use of resources..Will link it if I find it..
Sorry i took up lot of comment space..The picutre made me upset..and hence the long rant..Always remember that the same may happen to you or me or our kid tomorrow..I hope i made some sense somewhere along the rant..Good day to all..
Its the population which is taking a toll and on top of that we have a “chalta hai” attitude towards everything in life. If India needs to develop, we have to control the population somehow.
I came to know yesterday evening only. Too late to write a post.
I agree with Amit. Population is the biggest problem of India. Check out this post.
http://nomadsjournal.wordpress.com/2008/07/03/sad-state-of-health-affairs/
The frustration and roughness in many doctors’ treatment of patients is understandable.
In India, I believe, we have ample resources for the existing population. Like you had mentioned, our country is in this state only because of the mismanagement and corruption in the government.
Last Saturday, when I went for my eye checkup at Dr. Agarwal Eye Hospital, me along with a couple of others seated at the recption were referred as ‘Customers’ by an admin woman. Hospitals are slowly stopping the usage of the word ‘Patients’. Treatment charges in hospitals are alarming. One of my relative was diagnosed with a curable kind of cancer and for the treatment(Apollo Hospitals), they had to pay a sum of 23 lakhs. I posed a question to my friend as to what do people who fall under the low income group in such a situation. He promptly replied,” They die!”. Shocking but I think he is right !
@ Poonam:
You ask a very tough question.
My sister-in-law, who did her medicine at Lady Harding and could have worked in any job minting $$$ anywhere, chooses to work in an ESI Hospital where most of her patients are poor. She tells me that nearly 80% of her time, she sees patients who are ill because of poor hygiene and illiteracy. e.g. they bring a child with diarrhoea in, whose stomach is bulging but he is dehydrated; they say: doc saab, iss ke pet mein paani bhar gaya hai is liye isse paani nahin de rahe hain. How do you contend with this sort of stuff? Well, she says that she spends nearly 3/4 of her time giving people basic hygiene and prevention advice. I imagine she has wonderful bed side manner, because when we are out and about, and see her patients, they come and talk to her with great respect.
In a tropical country, like India, hygiene and contagion-containment are serious issues. It does not help that our towns and villages are poorly planned, and something as basic as drinking water can not be relied upon. On the other hand, there are chronic diseases, some genetically determined but others could benefit from lifestyle changes. Addictions are also common.
All these require different kinds of solutions but above all, they all need a decent standard of living with potable water and clean surroundings. Only then can we discuss chronic illnesses and mental health issues.
In my view, education of women, and health education in particular, would make a lot of difference. But then what do I know, eh?
Health and illness are two sides of the same coin.
I just came across this interesting site via techcrunch known as http://kiva.org/
@sulz: I commented on your post. You are lucky not to know aout poverty.
@Laura: Thanks for the links! I will check them out.
@Nimmy: I ahve already written to you about the picture. You can click the image to learn more.
Yes about million doctors migrate, I read somewhere. We are short of 6 million doctors. Everyone in India, including army professionals, think that they ar not paid well. Doctor to patient ratio is 1: 2000 in India compared to 1:200 in west.
Certainly mismanagement and cheating are main problems. I have no problem with you taking up the sapce. Imagine if a mere picture disturned you so much, reality must disturb bigtime.
@ Poonam:
Doctor to patient ratios are not that great in the West either. In the UK, there is 1 GP for 600 patients. In some remote areas, there might be 1 GP to over 3000 patients.
Cuba has an enviable 1:175 of GP to patient ratio. But they give housing and other benefits to their doctors.
For an Indian doctor to work in the NHS in the UK is a steep, uphill climb, worse, if he/ she is a surgeon etc. The money is very bad at the start and the life is very unstable as they have to move wherever they get training contracts. Only the very tenacious and very competent survive. Many go back to India. The US is even tougher.
It is doubtful if these doctors would do much for public health if they stayed in India. They would likely be in private practice and not in government hospitals. In that rarefied atmosphere of loaded patients, I doubt many miss these doctors who leave. Cynical as it sounds, consider its closeness to bitter truths on the ground in India.
@Amit: Yes, chat hai attitude hurts. 😦 As Nimmy says, unless its matter of my food, I wouldn’t pay heed to it.
@Reema: I read Nomad’s post. Distressing npiece of news!
@Vimal: Yes, we are customers to them. Its business. I hate how they issue legal threats like we don’t opertae unless you pay!
@Shefaly: I like it when you come back to say more. 🙂
I wish we had more doctors like your sister-in-law. 🙂 I wish there were more community awareness programs. Personally I know many going on in the city, but its just not enough. YOu are right, we need to handle base issues including diarrhoea rather than aiming for bigger/killer illnesses.
It is alarming to know doctor: patient ratio is detoriating in london too. Cuba! Benefits of being small country. Why less doctors in London? Is it because it is too demanding or too difficult to be certified/trained?
@Anshul: It is an interesting site. Thanks for sharing! I searched for Indian nedy people yet could not find, I guess I ahve to look for more pages. I found Pakistani’s though. Maybe I can put here someone I know who needs help.
@ Poonam:
I return to see what you said 😉
My sister-in-law lives in Delhi. So it isn’t that the story is from some small idyllic small town of India 🙂 Several women in my family and my adopted families are doctors and all have made the same sort of principled choices.
Cuba’s isolation has done them wonders in some ways. They have one of the most vibrant biotechnology industries and the world’s best medical care system.
In the UK, there are systemic reasons for this chaos. At the beginning-of-pipe too few students are choosing science; in the middle-of-pipe, medicine studies are not just long but also very costly and we do not have enough public funds so doctors graduate with huge debts and understandably want to make different choices. Our GPs do get paid well but all sorts of other regulations related to work and workplace mean that surgery hours are restricted. NHS is run in trusts and they vary hugely in performance. This can be a PhD thesis on its own, without even mentioning the politics of healthcare provision in the UK… 🙂
I do not mean to imply we need to focus on diarrhoea rather than bigger diseases. But if people can understand how to prevent the preventable problems and manage the smaller problems themselves, it could save clogging of GPs’ practices and GPs can get on with dealing with more serious patients who need referrals to specialists much faster. However in the light of my observations about Indians’ love for self-medication, these measures are tricky too.
I have been active on Kiva for some time.
Rang De (www.rangde.com) is a similar initiative in India. I urge everyone to go and check it out.
@Vaibhav, I think you are talking of RangDe.org and not dot com. 🙂
That’s right Anshul. I meant rande.org.
@Vaibhav , I think you are talking of RangDe.org and not Rande.org 😀
really sad photo.
Kevin Carter committed suicide after taking that photograph.
@Shefaly: Every bit in the country counts. 🙂
@Vaibhav, Anshul: I registered at RangDe.org 2 days back. Yet email notifications has not arrived in my mailbox. ITs not in psma and I registered twice with same results. 😦
@BXylene, Chirag: Yes, photographer Kevin Carter committed suicide as this picture haunted him for long. He hadn’t done anything for the child in the picture as tehy ahd been asked to keep away dur to infection threat. Click on the picture in the blog to know the story of Kevin Carter in details.
It’s quite depressing to see the present state of affairs. While there is little that can be done to change the situation in a jiffy, we – as educated people – can surely try to make a difference. Being compassionate with the underprivileged is perhaps the bare minimum we can do.
http://renjithmn.wordpress.com/2008/10/25/global-economic-downturn-and-indian-reality
@Lalit: YEs, change first has to start at individual level. BUt it must extend to communities and nations for it to succeed.
@Renjith: No notes? How is the link related? I will check it out, I guesss, to find out.
Lovely examinations. A surprising spot with such regular delights. I will certainly organize my exceptional trip to this place.thanks for the sharing your best points of view. all are so much charming…
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