Deaths in the Nanded district hospital a few weeks ago shocked the nation. Even by our blasé attitude towards death, 31 deaths in 48 hours and – according to reports – another 108 in the subsequent eight days, in one relatively small hospital, was alarming. It is disputable whether this was due to indifferent healthcare, inadequate staff, shortage of medicines, or some other reason.
In the absence of more sensational stories, this one got extensive coverage on TV channels, including field reports. To some, the footage may not have been surprising, but many were shocked at the dirt and squalor within the hospital, with even pigs comfortably coexisting with humans in the washing and cleaning area. So much for the emphasis on cleanliness and the Swachh Bharat campaign. Healthy visitors are in danger of ending up as patients! No wonder that Indian hospitals are regarded as hot spots for hospital-acquired infections.
Of course, there are clean and well-sanitised hospitals but, in the overall picture, they are exceptions. Most of these are inevitably expensive private hospitals in urban areas, catering to a limited clientele. Yet, they prove that it is entirely possible to have well-run, clean, and safe hospitals that provide high-quality healthcare.
Nanded, sadly, was not an isolated exception. Every now and then one reads of more such tragedies, even though not all are reported by media. The standard pattern is set: initial denials, reluctant acknowledgement after exposes, strong statements, finger-pointing and buck-passing, an enquiry committee, and promises to take action. There is little recognition of the fact that while incidents are specific, much of the problem is systemic. Poor management, inadequate staff, low motivation, and apathy are the bane of most such facilities, especially public or government ones. Amplifying these problems is the reality that health is rarely a priority for local bodies and states. Further, low budgetary allocations, combined with archaic procedures, results in shortages of medicines, healthcare staff, and maintenance funds.
The crux is inadequate funds and not enough thrust from top leadership. Where these exist, even to a degree (Kerala, Tamil Nadu, or Delhi, for instance), the situation is far better. While political leaders surmise that the electorate (a distinct categorisation, different from citizens) votes on the basis of other factors – community, caste, religion, etc. – there is enough evidence of this not being strictly true. For example, in Delhi, AAP has come to power and (overwhelmingly) won elections based on promising and providing basic needs – what I have dubbed as the SHE formula: safety and sanitation (including water); health; education and electricity. It also represents a gender emphasis.
Funds are always scarce, but our governments seem to find enough for “show” projects of little practical value. Examples are monuments and statues: not as artistic marks of remembrance or respect, but as competitive show pieces. Probably, they feel they are competing in the Olympics: faster, higher, stronger. Every statue has to be the tallest, biggest, in mid-water/sea, or most expensive. Amidst this, if there is no money to set up hospitals, hire staff, or buy medicines, any resulting deaths are unfortunate collateral damage.
If parties and governments decide that showpieces are a higher priority than saving lives, and that massive statues are more important than hospitals, citizens may well feel otherwise. And political leaders will do well to remember that citizens become electors every five years.
*The author loves to think in tongue-in-cheek ways, with no maliciousness or offence intended. At other times, he is a public policy analyst and author. His latest book is Decisive Decade: India 2030 Gazelle or Hippo (Rupa, 2021).