Fix bias that victimises poor in medical crises
A recent tragedy in Tumakuru, Karnataka, highlighted the pathetic state of healthcare in our rural ramparts. A pregnant woman, Kasturi, was turned away by government hospital authorities for failing to furnish her Aadhaar or Thayi card— the latter is part of a scheme for poor pregnant women. Kasturi went into labour that night, and she and her newborn twins died of complications, alone and untended. The inhumanity of the hospital authorities is chilling. A card, or the lack of it, cannot dictate who can access healthcare, especially in an emergency.
While the government has suspended the doctor and three nurses of Tumakuru District Hospital, the situation calls for tougher action. Health Minister K Sudhakar has promised to bring in a new law to fix accountability and punish doctors and staff of government hospitals. The gynaecologist has written to the Karnataka Government Medical Officers’ Association, claiming that she was in the operation theatre and that Kasturi had declined admission.
An ongoing inquiry will, no doubt, establish the facts of the case, but the bigger concern is that a poor woman’s life holds little or no value in overcrowded government hospitals. The reasons for the pathetic healthcare conditions in rural areas are many lack of medical infrastructure, equipment, doctors, nursing staff and availability of medicine. The national doctor-patient ratio is reported to be 1:1445, far below the 1:1000 ratio prescribed by the World Health Organisation. No doubt, it is worse in villages. The government claims the ratio is 1:834, which appears to be a manipulation of Ayush practitioners. Government investment in the health sector leaves much to be desired, and it is left to private hospital chains and insurance companies to run it like a profitable business.
Doctors cannot be faulted for avoiding low-paying rural services, which can also be demoralising. After spending crores of rupees on medical seats and fees, it is natural that they opt for jobs in private hospitals to recoup their expenditure and repay loans. It has become a vicious circle, and the primary fault lies in our education system, where medical seats are sold at a premium. Increasing the number of undergraduate and postgraduate seats in medical colleges and making education affordable will make medicine the noble profession it is meant to be and encourage doctors to work in remote areas. Until then, many more Kasturis will be denied basic healthcare.