On Wednesday 06 Jul 2011 6:38:39 pm Badri Natarajan wrote: > As for medical facilities in India I am reminded of a chapter in one of > Atul Gawande's books where he talks about spending a couple months in some > rural hospital in Maharashtra, straight from his teaching hospital in > Boston. He was looking forward to teaching the locals a thing or two but > he was humbled to find that although he was much better than them in his > narrow surgery specialty, they were far better at handling a very wide > range of surgery and improvising with very limited resources.. >
This of course is well known to Indian doctors. But Indian doctors do not became doctors suitable for India by training in India. They do that by working long enough in India. When I finished my first two medical degrees (like Deepa's two brothers in law - from the same medical school that I attended) I was "America ready" - or at least "UK ready". I was not India ready. I am not at all surprised that Deepa's brothers in law went out and stayed out. Indian medical education is creating doctors for the English speaking elite, whose preferences are being copeid by the noveau riche business communities. People who are unwell are best catered to in a tiered system where everyone is first seen by a general practitioner or some type of "health assistant". If a person requires a higher level of care - he needs to be referred to a specialist of some sort. I am not sure if babus are responsible for the ignorance in India. They could be. India picks up the concept of "doctor patient ratio" from some foreign publication. Then the powers that be divide the population figure by the figure of number of doctors and they say "Eureka! We don't have enough doctors. We must make more!" Then a rich man asks for permission to build a medical college. He is asked for a hefty bribe which he pays. He then gets the land and sinks money into the college. Everyone is paid along the way - even the medical council representatives who need to give the necessary permissions. The students' parents foot the bill and since doctors are such a "respected community" people are willing to pay humongous amounts for medical seats - money that an Indian doctor will never earn in his lifetime. The resulting doctor is "foreign ready". the only place he can fit into in India is a glossy airconditioned "corporate hospital" where three days in hospital for the normal process of childbirth will cost 2 lakhs. This doctor - who is capable of implanting Rs 50,000 knees and Rs 80.000 stents is hardly going to be diagnosing and treating diarrheas in the village where he is really needed. Since the elite run the government, they build the medical colleges and their own kith and kin study or work in thiose medical colleges and corporate hospitals - no one gives a flying fuk for the real medical needs of Indians. Every now and agin some buffoon politician says "Doctors will serve 2 years in rural areas after their MBBS" That is the most laughable bullshit being foisted on Indians. You train a guy to do high tech medicine and ask him to treat people in a primary health center where te budget is Rs 50 per patient per year (or some such silly figure) it's not going to happen. No doctor can change the system. Doctors, polticians, babus and the wealthy are all deeply intertwined in a system that takes statistics and knowledge from the west and copy pastes it into India. Like the idiotic bathroom towel racks sold in India with rails and hooks to hang shampoo and soap bottles of a type (with hooks) that are unavailable in India. Or the other idiotic foreign import of keeping your shitting place and bathing place in the same room. shiv
