The doctor you know

Omair Ahmad | Updated on July 24, 2020

Close circuit: Private hospitals remain out of bounds for millions in a country like India, even as public hospitals inspire little confidence   -  THE HINDU/ SUDHAKARA JAIN

A contact here, a contact there — access to even basic healthcare depends on connections

Over the last couple of weeks I ended up making a few unexpected trips to the hospital. I was accompanying friends for tests and treatments, not related to the pandemic, thankfully. Visits to hospital are rarely a matter of joy. These days, with the fear of infection, they are even more troubling. In truth, though, my experiences were easy and trouble-free, unlike the horror stories I see of public hospitals on TV, my path was eased by access to money and private doctors.

I was also attending to my mother’s health issues. An endocrinologist arranged to consult her over a WhatsApp video call, an ophthalmologist shared advice over messages and prescribed medicine. This was comfort that I could afford for myself and my loved ones. Not all are as lucky.

My wife, who has been involved with some civil society organisations helping migrant labourers since the lockdown, brought home another story that centred about the access to medical attention. She came across an ailing senior citizen in one of the areas she visited for relief work. She then reached out to a general physician in our area for help. We both know the person well and trust her as a doctor. The woman generously agreed to treat the man pro bono, and my wife and I decided to buy the medicines prescribed.

The consultation, despite several issues with managing the call over a mobile phone, was successful, and the treatment brought immediate relief for the bedridden patient. Despite the success, the experience reduced my wife to helpless anger. It took very little on our part to solve the problem, merely making a call or two, but just the lack of connections at places that matter had deprived a man of the right to good health.

It brought home to us, in graphic detail, the yawning gap between the well-off and the not-so-well-offs. It is worth emphasising that the cost we incurred in the instance mentioned above was minimal. The doctor hadn’t charged anything. And it wasn’t the first time that a doctor we knew had agreed to forego consultation fees.

Much earlier, a woman who had cataract in both her eyes was unable to get an appointment with a doctor of her choice. She was willing to pay — money was not the problem; it was just that her family did not know how to navigate the system in public hospitals or private clinics. An ophthalmologist rose to the occasion. Not only did he treat her pro bono, but also gave her the same amount of time and attention as his wealthier clients. The operation was successful, but only in one eye; the delay had rendered the other eye inoperable. The family was happy to pay for the procedure (it was a hospital charge that the doctor was not in a position to waive) and the patient was happy to regain the ability to see after years of clouded vision.

In both these cases, the “successes” actually showcased how the poorly funded health infrastructure remains out of reach for much of our citizenry. India allocates less than 1 per cent of our budget to healthcare, which is amongst the lowest spendings in the world. It is no wonder that the poor, even the not-so-poor, fumble through the process of obtaining medical attention. The rapacious world of private hospitals, with a pricing system that is mostly opaque, is a terrain that people approach with caution.

For all the hospital visits I have made in the recent past, or even earlier, I have always gone by the advice of doctors in my family or friend circle. Such opportunities are, by nature, a product of accidents of birth or chance friendships.

I type these words sitting in Gorakhpur in eastern UP, my home town, infamous for countless encephalitis deaths over the years. Encephalitis is a symptom — a swelling in the brain — that is caused by a number of viral diseases such as herpes and measles. One reason behind the high number of deaths, though, is amply clear: The lack of decent hospitals and clinics in the region. The poor can either run extra miles for treatment or just sit at home and pray for recovery. The unfortunate event of a death becomes statistics for the government and data for a newspaper report. What remains undocumented is the indignity of not getting the chance to be cured; of not having that one important phone number to dial in a health crisis.

We may beat the pandemic that is Covid-19, but how will we change this?


Omair Ahmad is the South Asia Editor for The Third Pole, reporting on water issues in the Himalayas;

Twitter: @OmairTAhmad

Published on July 24, 2020

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