Will public health system improve?

Women Security

By Dr. Oishee Mukherjee

Over the years non-violent forms of protest have become quite popular, not just in India but in many other countries. Moreover, if the protest is organised and led by women on an issue like rape and murder, it is bound to attract greater attention. This is exactly what has been happening in capital city of West Bengal, Kolkata after the gruesome rape and murder of a lady doctor within the premises of one of the city’s oldest and leading medical institutions.

Not only has the whole city and neighbouring areas joined the strike but the state and others as  a whole, specially hospitals in Mumbai, Delhi and Thiruvanthapuram etc. have come out in support.  Reports indicate that in England and New York there has been a strike called on August 17.

The call ‘Reclaim the Night’ on the eve of Independence Day elicited a response from lakhs of people who joined the protest march in the city and in most districts of the state. All doctors of the city, including myself and many other women and girls, converged at Jadavpur University and other places on the midnight of August 14 in solidarity with the murdered colleague doctor. According to a veteran political scientist, ‘the crowd could be compared with that of the Quit India movement and in recent decades such a huge congregation in the city and neighbouring areas has not been witnessed.’

It may be pertinent here to mention that such a call was given in England as part of the women liberation movement, which was inspired by marches  that had taken place throughout the 1970s in the US, when Susan Alexander Speeth was murdered while walking home from work in Philadelphia in 1975.

Thus, the question of the security of the female doctors in city hospitals comes up not just in Kolkata but in other places as well. As is well known, the healthcare system is such that forces people to come from neighbouring areas to get treatment in city hospitals, which are always overcrowded. And it’s the junior doctors who work relentlessly to address the problems of the patients. Unlike in many other countries, there are no working hours for junior doctors in this country.

There is no security at the gates of most hospitals, not to speak of Kolkata. The murder is not just a death but the result of many issues, the most important being under-funded healthcare, wanton corruption in admissions, theft of oxygen cylinders and other such things etc. This obviously has the concurrence of the head of the institution because such unethical activities are carried out by those in power and the revenue collected is shared at various levels. This also happens to be the case with the hospital (RG Kar Medical College & Hospital) where the incydent took place.

If this is the situation in city hospitals, one can easily imagine the conditions in sub-divisional and block hospitals and wellness centres. The people in authority, who mostly come from the rich or the middle income sections, are not bothered about such pathetic state of affairs in the whole system. It is because they get treated at sanitised, insulated private nursing homes and can afford the high costs. Even now the government wants such nursing homes to be opened in the semi-urban and rural areas so that a certain section can go there, even by selling their land and spending their life’s savings.

Why is there no regulation of how much these nursing homes can charge –whether it is for various diagnostic tests or bed charge or ICU chargé etc.? Why is not the government coming out with some form of regulation that reserves seats – say 20 per cent – for economically weaker sections and low income groups? On the other hand, the requirement of hospitals needs to be assessed, upgradation of at least two modern hospitals in each district, the posting of adequate number of doctors and specialists  so that overcrowding is checked and there is no migration to metros for good treatment.

The authoritarian nature of most governments, even state governments, has been found not just to curb resistance at any cost but to regulate the whole system as per their whims and fancies. Moreover, such governments are usually deeply entrenched in corruption and various forms of manipulation in recruitment in all sectors. The historic corruption of the state government in recruitment of teachers is a case in point and will stand out for years to come of the extent of corruption that can be resorted to. The same is the case with medical education and recruitment of doctors by the state government, where it is known that huge bribes have to be given for selection.

The question of providing affordable healthcare has remained a jargon but this is a crying need of the hour and is intrinsically linked to transforming conditions in public funded hospitals across the country. On the same day before independence, President Murmu in her message to the nation, stated that “social justice is a top priority for the Narendra Modi government”. If one looks at the state of affairs, specially the sufferings of the bottom segments of society, including the marginalised communities, can we say that the government is working towards social justice?

The other point made by President Murmu is about gender justice. One may mention here that women politicians and bureaucrats are few in number and their reservation in Parliament has not yet become a reality. Moreover, according to a report, though women outnumber men in medical college admissions presently, only 9 of the 46 professional medical associations in India have been led by women. In the largest association of doctors, Indian Medical Association, out of 92 individuals, who have served as presidents, only one was a woman. This study, published recently in ‘PLOS Global Public Health,’ stated that considering the predominant role of professional medical associations in shaping medical training and health policies in India and beyond, skewed gender representation was a major area of concern.

Thus, it remains to be seen how much can and will be done to ensure prompt justice, keeping in view that gender justice should be given top priority. Also steps need to be taken in the immediate future to stop the corruption racket which, in turn, will prohibit outsiders from entering hospitals and ensure safety, specially of the opposite sex. Not just the state government in Bengal but other states like U.P., Bihar will have to follow a procedure for which the Central government has to come forward. It is our expectation that female doctors would be able to work safely in hospitals at night and the public health system adequately enlarged to offer affordable health care to all citizens. — INFA