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Why are we lagging behind…healthwise?

Oh, we can find excuses galore for ourselves! After all, don’t we have a mammoth population? And a thousand other related problems that prevent our government from providing us the kind of health services that a citizen of, say, the UK expects…

Sorry, not a valid excuse anymore. Because as per the WHO sources, a developing nation like Cuba or even China — which also has a huge population burden — appear to have done far better than us.

Judge for yourself. Again as per WHO figures, the life expectancy at birth in China is 70.3 per cent, as compared to 60 per cent in India. Also, while China bears only 18.1 per cent of the world’s burden of communicable diseases, India has a crippling load of 30.3 per cent!

So what did the Chinese do that we did not?

1. They stressed on training local people — Barefoot doctors — to take care of the primary health care centres.

2. They integrated traditional medicine practitioners with the mainstream system.

3. The Chinese vaccination drive for diphtheria, measles and polio reached 85 per cent of the population by 1990.

In 1959, Cuba had only 6000 doctors. Today it has one doctor for every 200 persons. It has an infant mortality rate of 7.9 and life expectancy rate of 76 years, which compare with the UK and the USA. The Cubans have adopted preventive medicine in a big way and this has given a boost to the immunisation programmes. They have eradicated cholera, polio and measles. The Cubans have integrated different branches of medicine — like herbal medicine and acupuncture therapy — into mainstream health system.

Way to go?
Lets take stock again. Currently, there are two types of health services operating in India — public and private. There is also a third category — practitioners of alternative medicines. Did you know that nearly 70 per cent of the Indian population use indigenous herbal medicines as a means of primary health?

68-1.jpg (23541 bytes) The Indian way…
The Indian Systems of Medicine (ISM) includes six systems: Ayurveda, siddha, unani, yoga, naturopathy and homeopathy. At present there are 3004 ISM hospitals, 23,028 dispensaries and as many as 611,431 registered practitioners in India. But little has been done to set up a framework, to standardise education or to promote research. ISM has huge potential and can solve a large part of our health care problems because they are effective, safe and inexpensive.

Now all these systems are working parallelly. They will probably be far more effective if they worked together. For instance, the cheaper ISM remedies can be promoted through the public health care units. After all, this strategy has worked wonders in Cuba.

But the key phrase is ‘community participation’ — that is — getting the people trained and involved, at least in primary healthcare. And this method is being used in some parts of our country already. Let me give you an example. Some years ago, a group of village women in Parinche Valley in Pune district were trained in human and veterinary health by an NGO. Today these resourceful tais run the public health centres in 13 gram panchayats in the valley. Successfully.

Should we build an army of such tais to take care of the poor—who cannot afford the services of the thousands of medical graduates who pass out of our medical colleges every year? Or is there some other way? What do you think?

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