-Vidya Bhushan Rawat
Over one hundred children have died in Bihar due to Encephalitis or what they term locally as Chamaki Bukhar. The season is just beginning and you will hear stories from neighboring Uttar Pradesh where Poorvanchal region, dominated by Gorakhpur, will face it again unless a drastic change is done. Japanese encephalitis comes in the form of massive epidemic. While Bihar and Uttar Pradesh are known for horrible health services, India as a whole need to ponder over that without a solid health and education services India can not sustain its gain, Both the states along with other states like West Bengal, Rajasthan, Maharashtra, Madhya Pradesh, etc have a heavy rural population but the medical fraternity does not work in the villages. Over 75% of our rural population has about 32% Primary Health Centers or may be less than 20% of them have beds.
Rather than responding to this enormous rural crisis when the first aid too does not reach to the needy resulting in untimely deaths due to even very ordinary ailments, the government of India has cleverly provided a new ‘mantra’ imported from United States highly commercial health services where they are beyond the reach of the common people. This insurance culture may be good for the urban middle classes but can not replace the need for an accessible health services. The problem with the insurance culture is that your access is directly related to your premium and in the rural India if people have got health insurance, the private doctors use them heavily even for the ordinary services and if they suffer from bigger issues then it is beyond their reach.
I think the concept of Mohalla clinic in Delhi was a great revival of health services and Aam Admi Party need kudos for the same. State governments in India need to invest heavily in the health and education sector and make health an absolutely uncompromising issue. Every year, we see hundreds of children dying of various diseases and we have seen how in the medical college of Gorakhpur, the hospital did not have the oxygen cylinders and beds for the patients. Unfortunately, doctors as well as their associations have rarely spoken about this. Most of them dont even want to serve in rural areas and take it as punishment posts. After abusing all the subsidies for poor, the doctors who qualify from the subsidised medical colleges do not show any keenness to serve the poor. You cant imagine those who spend crores of rupees, paying, hefty donation fee in the private medical colleges, to serve the poor. Most of them would like to complete it at the earliest and get a visa to serve their colonial masters abroad.
Indian Medical Association has called for an all India strike against the ‘attack’ on doctors even when the doctors in West Bengal reached an amicable solution and called off their strike. We support the demands for the security of the doctors and the people have no right to physically assault the doctor. Even if they have complaints, it is time for IMA and medical fraternity to make their in house disciplinary mechanism stronger. There is another factor which is of serious nature. The sympathy of doctors with the dominant right wing is serious concern. Medical ethics calls for doctors to be above partisan nature and serve the patient irrespective of their caste, gender, and religion. Most of the time, IMA has behaved politically and is a group of people who are mostly against the politics and policies of social justice and inclusion. We have not forgotten when the doctors in All India institute of Medical ( Manuwadi) sciences ( AIIMS) in Delhi had launched a campaign against the government policy of reservation at the higher level initiated by late Arjun Singh, who was the HRD Minister in the first UPA. We saw worst form of casteist slogans by these doctors who started ‘Youth For ‘Equality’ campaign which actually was Youth for casteism and caste supremacy. Ofcourse, Delhi chief minister Arvind Kejriwal and many others of kinds have been in the forefront of supporting such initiatives though they might claim that it was just a thing which had happened and now Kejriwal support reservations for SC-ST-OBCs.
If IMA is an association which help the doctors and raise their issues then it must explain as why it failed to get Dr Kafil Khan, who was being penalised for serving the poor round the clock when children were dying because of the failure of the medical system. We have not heard a single statement even today from IMA regarding the continuous harassment of Dr Kafil Khan, by the Uttar Pradesh government even today.
Can IMA tell us what has it done with regards to discrimination faced by tribal doctor Payal Tadvi who was killed by the continuous harassment and indignation from the savarna doctors in Mumbai last month. A few days back, a talented Doctor in Chandigarh medical college too faced the caste based discrimination but IMA remain silent on the issue. In fact, it is mostly the organisation to protect the savarna interests of the doctors. It cant speak for a doctor who faced harassment because he was a Muslim or SC-ST-OBCs.
Before I conclude, I would share my own experience at a Medical college in Delhi. The incident is over six year old. One of my illustrious friend teaching in a prestigious medical college invited me to share my thoughts on Medical Ethics with his students. There was another person from abroad. I was asked to speak for 10 minutes. I had done an investigation into the case of deaths of several Safai Karmcharis in Delhi. I narrated what the family members of the deceased informed me that the doctors did not even touch the body of these people who were brought to RML. I also narrated a story from Uttar Pradesh where in a PHC in Balia, the sweepers would do the basic surgeries as doctors wont touch. Even in the medical colleges, most of the time, it is the sweeper who is asked to touch the dead bodies. I may be wrong that all doctors would not do but whereever these things happened or are happening, are wrong and must be condemned. I just said that a doctor has to rise above the caste, class, religion, nation, gender prejudices and unfortunately in India, they still suffer from them. Now, I also spoke about Praveen Togadia’s alleged statement long back, when he called medical fraternity to not to treat the Muslims. There are many who now calls that all those ‘anti nationals’ have no right to be treated. This is purely political rhetoric and doctors would do well to rise above them. Now, as soon as I said this, a senior stood up from his seat and came to the podium, snatched my mike and said that I would not be allowed to speak. He said, ‘ we are not here to listen to these rubbish. ‘pataa nahi kaha kaha se bulaa dete hai logo ko’. I said let me finish but he did not allow. Unfortunately, our organisers too could not do anything. I did not say anything but realise how deep rooted caste and religious prejudices have entered into the medical profession.
If we celebrate the medical profession as great achievement of modern science which saved people from life threatening diseases then can we say that our doctors and scientists are humanists and rationalists whose only interest is to serve humanity and propagate the idea of rationality. That caste system is an artificial creation by human being which goes against the spirit of people being born freely and equally in rights and privileges. That some people are better than others while many others are inferior is a concept of deep rooted prejudices which existed in our society and people need to be given special treatment to bring them to the level of others. That social justice is not a dirty word and merit not the monopoly of a few twice born communities would the true spirit of humanism and must be embraced by medical as well as science fraternity.
Yes, we do agree that no doctor should be humiliated or assaulted as many treatment succeed and many fails. If the efforts are made sincerely but if not then people have a right to lodge complain and accountability need to be fixed. Indian medical science suffer a crisis because of the hegemonic caste supremacists are converting it a tool to spread their hate propaganda. If the doctors or would be doctors fall in this trap then they will lose good will of the people as well as violating the medical ethics too which ask them to rise above narrow partisan interests of people’s identity and treat them equally.