Funding . . . The Paradoxes in Indian Healthcare - Part 2

The other day during a meeting, someone commented on how easy and freely available is HIV testing in almost all government facilities compared to other investigations such as hemoglobin, urine albumin etc. Someone suggested that even there are places where HIV testing is available, but a sphygmomanometer to measure blood pressure is not available. 

I'm afraid that this situation is actually true. 

There is quite a lot of funding available for HIV. But, no money for Reproductive and Child Health Care. So, no sphygmomanometers or instruments to measure hemoglobin or urine albumin. Well, I would not need to do explanations on the importance of doing a hemoglobin for a pregnant lady as part of her antenatal care. Or a routine check up of blood pressure. 

I'm not touting for HIV testing to be stopped . . . it is a lifeline for babies who are born to mothers who could be diagnosed to be HIV positive. But, we need to rule out anemia for all our women who become pregnant . . . for anemia is supposed to be the commonest indirect cause of maternal mortality in the world. 

Talking about maternal mortality . . . it irritates me when the Polio Surveillance officer calls me every Monday to check out if there has been any case of Acute Flaccid Paralysis in the hospital over the week. I'm not irritated because I don't like this guy . . . he's in fact a good friend. I'm irritated because there are young mothers dying while giving birth. We fill up the Institutional Death Reviews and send them . . . On October 18th, it will be one year since we've started the reviews. Till today, I've not been called for any meeting related to any of the deaths. 

Leave alone maternal deaths, I've had men, women and children coming with symptoms suggestive of viral hemorrhagic disease most probably dengue . . . nobody turned up until someone accidently put it in the papers. Still the response has been quite muted. There were 3 proved cases of cholera in the hospital. I informed the authorities responsible. No response. 

It does not need any brains to explain that nobody is interested in maternal deaths, tuberculosis, malaria or cholera as there is hardly any money in it. There is money in HIV, Polio . . . even cancer. And now, Non-communicable diseases. Because that's what the West is quite concerned of. HIV, polio . . . because they are quite concerned that we will transmit the diseases to them. 

Non-communicable diseases - - - so that they can get back all the expenditure spent on research of drugs which have been proved to be either useless or has side-effects. Recently, I had a mail from one of my elderly friends (not a doctor) who told me how he was 'detoxified' from all the medicines he and his wife had been prescribed by his cardiologist et al in India, after he went to the US to be with his son. He was put on a regular regime of exercises and dieting. He is doing good with no problems . .. ... 

My previous post had been on the pharmaceutical industry. Even for the pharmaceutical industry, there is nothing much in store from maternal or child health and infectious diseases such as malaria or cholera. 

There is only one solution for this issue. Our friends in the Health Ministry needs to realise the pressing healthcare issues of the country and ensure that funds and personnel are available for research on those issues. We have enough research to show that the metabolic functioning varies in cultures and races. Following research, we need to have systems put in place such that the research can be converted into action. Only then, can the real needs of healthcare in India be addressed . . . 

Depending on funds from any organisation abroad would only ensure that public healthcare issues of those regions would only be addressed and we would remain with healthcare issues such as Maternal and Child Health, Tuberculosis, Malaria etc which we have been continuing to grapple with since ages. 

Coming to funding . . . there are more issues. Like the issue of adequate infrastructure not available for Primary Health Centres and other public healthcare institutions to start. And worse than that is the all out dependence on Private Medical Colleges to help us with staffing our Health Centres with doctors . . . Well, that is fodder for another post . . .

Burns Unit - NJH

We have been talking about a separate facility for the management of burns patients at NJH for quite a long time.

The initial process of deciding on the final details had been going on for the last one year. Sometime during last February, we had Dr Ron Hiles do a symbolic removal of a brick from a portion of the building which we plan to renovate as part of the burns unit.

There are 3 key people who have been very instrumental in pursuing the dream of a separate facility for burn patient management at NJH. Dr Colin Binks, who was the surgeon at NJH for quite a long time – almost 30 years, Dr Ron Hiles, consultant plastic surgeon from the UK who has been regularly visiting NJH since the last 25 years and Ms RuthAnn Fanstone, consultant at Interburns.

Later, I had the opportunity to be part of a Burns care workshop organized by Interburns in Srimongol, Sylhet, Bangladesh. It was a great time where I could grasp more concepts about the setting up of the burns unit at NJH.

RuthAnn was with us in September, where further discussions took place on the organization of the burns unit and we were well set to start the process of constructions.

The construction was kicked off with few of us starting off the digging for the foundation of the building sometime in early October.

Later, during the celebration of the Golden Jubilee, Dr Ron Hiles and Dr Santosh Mathew laid the foundation stone for the building in the presence of quite an august audience. Work has been progressing since then.

We have started the construction of the building in faith. The total budget for the building is about 32, 00,000. As of now we only have about 25% of the money. We depend on the Lord for the rest of the funds necessary to complete the construction. And we need to get it quite fast as delay in the completion would only raise the costs involved.

In addition, we also need a good committed and dedicated team to build around Dr Nandamani who leads the initiative. As the work among burns patients are on the increase, we also look at the possibility of having one more surgeon who would be able to shoulder the increasing number of general surgery patients.

Please keep us in prayers and do respond in whichever way possible.