--- On Thu, 7/7/11, ss <[email protected]> wrote:
> From: ss <[email protected]>
> Subject: Re: [silk] Fwd: Srivatsa Krishna: Babu is not always a
> four-letter word
> To: [email protected]
> Date: Thursday, 7 July, 2011, 20:12
> 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
There's a book in here, Shiv.
