The Hindu Business Line : Rural India needs large dose of health-care

Even as medical facilities in India are going hi-tech and its professionals global, Rural India seems to be languishing. There is a continuing flight of doctors and paramedical staff from the country, seeking greener pastures abroad.

With the income levels in the metros and towns soaring in the last decade, the demand for superior medical facilities has made health industry a lucrative business.

Doctors and medical professionals are now being increasingly attracted to these pockets of affluence. The advent of telemedicine and health tourism is reinforcing this trend of increasing returns for the health industry.

There is a great difference between medical facilities available in Western countries and that in India. But there is a common thread — Indian medical professionals.

In several developed countries, Indians constitute a substantial percentage of medical professionals. Reports are that close to 38 per cent of practising doctors and dentists in the US are of Indian origin.

The sheer profusion of qualified Indian doctors in the UK has sparked apprehensions among British medical professionals. A growing number of Indian nurses, pharmacists and other paramedical staff are going abroad every year.

Health tourism

Indian hospitals and medical facilities are also breaking new ground. National and international boundaries have disappeared with the advent of hi-tech equipment and advanced medical care. Patients from some of the most developed countries are seeking India's medical facilities, among the best and most competitively priced.

The huge cost advantage that medical treatment in India vis-a-vis the US and Europe has even spawned a new industry — health tourism. Heart patients from the US and the UK now travel to India and undergo a surgery for the equivalent of $6,000 against $30,000 in their home country.

Indian pharmaceutical companies have begun to assume a global role, acquiring companies overseas to expand coverage and market, even as pharma multinationals are scouting for fresh acquisitions to expand their production facilities in India. Technology has opened new opportunities. Telemedicine has helped bridge the technology divide, enabling real-time consultancy across vast distances.

Surely India is emerging a major player in the international health industry, but ironically all this is confined to the urban areas.

Unhealthy statistics

Health statistics are not at all healthy for Rural India. Figures from Rural Health Statistics reveal some startling trends. Sub-Centres, Primary Health Centres and Community Health Centres — the bedrock of rural health delivery — have grown in absolute numbers since Independence: From 725 in 1951 to 57,353 in 1981 to 1,68,986 in 2004. They remain the backbone of rural health-care in the absence of private sector presence.

No doubt, tremendous progress has been made. For instance, in 1951, there was one medical facility for a population of 4,98,000. By 1981, there was one for every 11,914 people. And, by 2001, one centre covered 6,087 citizens. But considering the limited facilities available in a sub-centre, quality health-care remains a mirage for much of Rural India. Compare this with the hospital (both public and private) beds available in the urban areas. There was one bed for every 3,081 of the population in 1951.

This improved to one bed for every 1,199 people by 1981 and for 1,124 persons by 2004. At current morbidity levels in the country, one bed for slightly over one thousand population is no mean achievement.

Growth in number of doctors

There has been good growth in the number of doctors in the country as well. Statistics from the Medical Council of India reveal that from one doctor for 5,842 people in 1951, the number improved to one doctor for 2,543 people by 1981 and to 1,645 persons in 2004. But this would also be urban centric.

The statistics for nursing personnel is equally encouraging. From one nursing personnel for 3,081 people in 1951, the number improved to one nurse for 1,199 people in 1981 and for 1,230 persons in 2004. It may not be the business of the government to be in business. But it definitely has to be in the business of healthcare, education, sanitation, water supply, etc.

With growing affluence, an increasing section of the urban population is beginning to take care of its own medical needs. A good reason and chance for the Government to hold the hand of Rural India.

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