Hope that all is well with you, Lakshmi, Parvati and Aai Baba.
I have got a job with a very nice family in Mumbai. Their daughter is older than me and is studying Political Science in college. She did not have to drop out in the 8th like I did because there are many toilets in her school and also she can go safely on public transport. We have electricity and running water here for 24 hours.
We have many long chats in the evening after she gets back from college (all alone even after dark, imagine that!).You will not believe how many new things I have learnt in the last three months. She has also agreed to help me learn how to use a laptop computer!
She says Gandhi-ji believed that India lives in her villages. She thinks that if he were here today, as with many other things he believed in- such as truth and non- violence, he may have to re- think this too.
According to her, urbanization is the reality, not just for India, but for the entire planet. It is estimated that by 2050 close to 70% of the world’s population will be living in cities.
She says that we claim to be an agricultural country where the country depends on the farmer for food but the farmer cannot depend on the government for water!
As you know so well, in our villages there continue to be huge and often violent clashes between castes and genders, along with insecurity over regular income, lack of sanitation, electricity and other basic infrastructure.
Didi’s fiance is studying to be a doctor. Isn’t that wonderful? I wish some doctors like him were available when our Tai died in childbirth and Ganya from the farm died after his wound got infected and the local nurses also would not touch him because of our caste.
Adarsh Dada says that there is a huge gap in rural healthcare needs caused more by poor infrastructure and lack of accountability issues than just a lack of doctors and nurses. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014652/
He says that to assume that throwing more doctors at it is the solution is as absurd as trying to throw gold coins at a starving child.
He asks why aren’t IIT and IIM graduates also sent to the villages? The government subsidizes so many streams of education. Why don’t we have a rural bond for lawyers? Architects? Journalists? FTII graduates? Surely our rural population can benefit from all their inputs also.
If the government calculates the cost per head of medical training to include the running of the public hospitals then it’s kind of like including the cost of running India when you train an IAS officer. Or the cost of defending the country when you train an armed forces officer.
If you can afford to spend upto 1 crore or beyond then sure, become a doctor through a private medical college, bond free and then go abroad for your PG.
But if you cannot afford that and want/ need to get admission on merit, prepare to pay for expensive prep classes, give up your entire life for upwards of 2 years and then see what fate has in store for you.
Despite all this, there are still students from poor families entering medical colleges. He said there were some from our Kokan villages also! But many of them have to earn money by doing milk runs and newspaper rounds to be able to buy food in the canteen. Dada’s mother’s friends raised funds to set up a corpus so that they can help these students.
Basically this is like the jhuming we do in our farms, where you burn it all down so you can create a new crop. Remember how Baba talks of the time we had to incinerate all our hens 15 years ago due to the Ranikhet virus scare? And then people stopped buying ‘gavthi’ chicken and only the big companies selling packed meat from fridges stayed in the market.
Adarsh Dada says that this new scheme to force medical students to go villages is going to result in even less students opting for medicine in public colleges. It is a road to privatization, so brazen and yet so twisted, that eventually not just healthcare education but healthcare itself could become privatized and no one left accountable for it to the people any more.
We saw a really scary movie last week called Summer 2007, starring Gul Panag. It’s about five medical students who visit a village in Maharashtra and witness the misfortune of villagers. I think our Minister for Medical Education should also watch it!
Didi’s mother also saw the movie with us and said that says that when she did her rural internship, the doctor who was supposed to supervise them performed all surgeries— including caesareans and post mortems, since he was the only doctor around. One day a body was brought in by the cops. They said he was found dead behind a bush. She asked the Doctor what he died of. He gave her a strange look and said, “Whatever the cops said he died of. If I write something different then tomorrow you will find my body behind the bush.”
She said that after that chilling episode, she simply could not wait to leave the village and get back to urban safety!
Even now, women doctors and women health workers have no assured safety in the villages when they have to make house visits at odd hours in emergencies with no vehicles, no public transport, no street lights, no electricity. Why would anyone choose that life? http://ijme.in/wp-content/uploads/2017/02/20170221-the-safety-of-women.pdf
As a surprise to no one, when doctors are asked to settle in villages they also want the same things that anyone else wants—safety, sanitation, schools, social life and successful career. What of these can the government ensure??
On top of all that Didi says that the government reduces healthcare budget to almost less than 1 % of the GDP. Imagine, Mohan, if we had 100 Rs to spend at home and I give you only 1 Re for managing the entire month’s medical costs?
It is so absurd that I started laughing when she explained it!
I was remembering when we had to sell 2 guntha of our land to pay for medical care after you had broken your leg because our bullock Dhavalya ran into you. I cannot imagine why the government would keep such a ridiculously small budget for a country of 1.2 billion people! https://thewire.in/80401/increased-healthcare-spending-key-to-economic-growth-in-india/
Meanwhile it seems that India’s medical tourism is projected to grow to $7–8 billion in the next few years!
Didi’s mother says that the key to ensuring good healthcare in villages and even well managed villages is that every MP and MLA goes to his or her own constituency for healthcare.
No dashing off to AIIMS in Delhi or Beth Israel in America and certainly no using private care anywhere.
Every time the politicians say:
“India lives in the villages! Send doctors there to improve healthcare!”
Adarsh Dada wants to reply:
“India lives in the villages! Let all MPs and MLAs seek complete healthcare only in their own village!”
Looking forward to seeing all of you when I come down for Lakshmi’s wedding.