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No Place to Go: Stories of Hope and Despair from India’s Ailing Health Sector Becoming a doctor is one of the most difficult tasks in contemporary times. Becoming a competent doctor is even more difficult. Becoming a competent doctor who is able to provide adequate service to the people despite the numerous structural constraints is simply asking too much from mere human beings. Yet a number of our doctors are able to do all three tasks quite well. Only a few of them are any more mercenary than say the neighbourhood greengrocer who under-weighs his goods, sprinkles water on a bag of peas so that their weight increases by 30 per cent and polishes his brinjals with waste machine oil so that they attract customers. Trashing the doctors and the hospitals they work in is an easy task. However, it takes far more effort to understand the structural problems troubling the health sector and sift through the competing and mutually disagreeing diagnoses of the ailments of the medical profession. Some of these diagnoses are particularly self-serving and dished out by their proponents to assist rather lowly avarice. It takes some maturity and wisdom to find one’s way through such ideas that cater to selfish interests with complete disregard to truth or the interests of others. Unfortunately, Subhadra Menon shows little of either in her book on the health sector in India. The best that can be said is that she is far too innocent to write a book on the health sector and its myriad achievements and failures. She gives the usual spiel of how doctors do not want to serve in rural areas without wondering why journalists, politicians, government officers et al do not want to do so either. She actually misses out the fact that most people in rural India would leave their sylvan surroundings for the grime of cities at the first opportunity. She lists some of the more important and popular diseases that stalk the people of India. Then she presents some of the efforts by health professionals and the government to control and combat the diseases. Yet Menon makes little effort to evaluate their contribution or the response of officialdom to such efforts. The absolute and complete cupidity shown by pharmaceutical companies on a regular basis does not even come for a passing comment. Menon feels quite satisfied with a general discussion about the need for a rational drug pricing policy. She, however, makes no effort to unpack the riddle of failure. Why does the government of India fail to come up with a list of essential drugs? Why does it fail to stop the sale of irrational combination of drugs? Is it that the government is merely foolish? Or is it that it is constrained by corrupt administrators who allow the pharmaceutical companies to get away, literally, with murder? Or is it that as yet, despite the efforts by various well-meaning civil society organisations, the population is still gullible enough to fall for irrational medical advice unquestioningly? Menon has nothing worthwhile to say on these matters. |
