Meghalaya’s attempt to address shortfall of medical specialists needs to be appreciated

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Health care facilities in the state of Meghalaya have been one of the most expensive services where, according to various surveys, it costs about seventy-five percent of the total income of the individual. While the middle class and Below Poverty Line section of the society finds it impossible to avail specialized (not to talk about super-specialized) medical treatment, either due to high cost of investigation, medicine and worst of all non-availability of medical practitioners in the state, the affluent can easily seek treatment outside the state and abroad.

The advancement of science has actually increased the cost of health care for various tests, as investigation, hospitalization is yet another burden for the family members of the patient. This has compelled the rural folks to seek medical treatment from quacks or home remedies due to the absence of para-medical practitioners in the health centres.

As per the announcement made by Secretary of the Health Department, Pravin Bakshi, Meghalaya government has launched the Design and adoption of Alternate models for Responding to address the shortage of medical specialists in the state to fill the shortage of critical and specialist health work force. Under the programme, Large District Hospitals (LDHs) will be leveraged upon for specialist doctors training and this is in keeping with the National Health Policy 2017 and Ministry of Health and Family Welfare Steering Committee for advocating scaling-up of specialist training options like that of the College of Physicians and Surgeons (CPS) in district hospital.

Bakshi also informed that this is as per the ADARSH project, design and scale-up alternate models for responding to the critical shortage of medical specialists in the state to train doctors in the public sector, this CPS model is an alternative model that will be adopted in Meghalaya. PHFI/IIPH will work closely with the Government of India, State Governments, the CPS and other stakeholders to facilitate specialist doctors strengthening in the public sector.

Hopefully this will bridge the gap and ensure health care in the rural sectors in particular. Meghalaya for over a couple of decades has made few attempts to explore the possibilities, taking advantage of being known as the hub of various medicinal plants but had only banked on the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH), a part of the Ministry of Health and Family Welfare of the Government of India. The former President of India, late Dr A.P.J. Abdul Kalam, who understood the potential of the medicinal plants of Meghalaya, invited the practitioners of traditional medicine to plant saplings in the Mughal Garden of the Rahtrapati Bhavan. In Meghalaya, till date, only the individual or village base is preserving all the traditional plants; none of the government departments or organizations attempted to promote the medicinal plants.

The traditional practitioners here in the state, unaware of the Intellectual Property rights, fear their methods being duplicated. The findings and practices by the traditional practitioners have been kept close to their chest, not even letting the family members know of their findings, resulting in a loss of the invaluable knowledge after their demise.

In this backdrop, the central government is giving priority to tap this potential of the northeast as well as placing high priority on people’s health, which will be helpful in tapping the natural organic resources for the health benefit of the citizens.

It may be mentioned that health services in India are deteriorating lately, particularly the private hospitals. In the past it was mainly the infrastructural issues like the fire escape and smoke detectors or the parking spaces in the hospital. In 2017, the mismanagement came to the fore, starting from Gorakhpur hospital deaths allegedly due to Oxygen shortage in Uttar Pradesh, than the Max Hospital in Shalimar Bagh, Delhi, which had wrongly declared a newborn baby dead who was later found to be alive.

At the grassroots level, the health care is one of the most expensive services particularly for the middle class till Below Poverty Line sectors, while most of the Human Resources in the hospital services are untrained. Not only have they failed to perform, in most cases they are said to be rough and unprofessional.

In Meghalaya too, similar to the practice along with the rest of nation, has a three-tiered system of healthcare starting from the Health Sub-Centres (HSCs) located at the village level. The second tier consists of Public Healthcare Centres (PHCs) which serve as a referral units for HSCs. The third tier consists of Community Health Centres (CHCs) that have hospital facilities and serve as a referral unit for PHCs.

There is a claim that Yoga can solve the health issues in Meghalaya, while the lifestyle and food habits of the indigenous tribals are being blamed for the failure to popularize the practice.

While on paper, the health services and Yoga practices are shown as successful, at ground zero, most of the Health Centres do not have paramedical staff and some only function on weekly market days of the respective village. Most government doctors refuse to serve in rural areas in the absence of proper infrastructure, especially the emergency rooms and beds for the patients who require observation. In the case of government hospitals, medicine and lifesaving drugs are always in shortage of supply; hence health care is extremely expensive for the economically weaker section of the society.

More than popularization of Yoga, the Modi government should stick to the Swachh Bharat – Clean India campaign, which, if properly executed, can have a better impact on the overall health scenario. The ever growing population along with the poor civic sense of the society at large, poor practice of disposal of waste, non – maintenance of disposal bins across the city, just to name a few, besides the unhealthy practice of collection and disposal of waste by various agencies, lack of public toilets have adversely affected the society, hence constant cleaning drives are one of the solutions to keep our city clean.

Most important of all, the bonded doctors in the state should be called back and dutifully complete their services as per the bond, failing so, the state government should write to the Medical Council to cancel their licence, otherwise, such unethical medical practitioners will keep refusing to serve the state and the rural area in particular.