Healthcare in Odisha: Prospects and concerns

Over the years, quality health care has been perceived in many government institutions on par with good national institutions.
A Covid hospital in Odisha.(Photo | ENS)
A Covid hospital in Odisha.(Photo | ENS)

Prof Sidhartha Das

Health care and care for the sick is as old as human civilization. WHO brought the paradigm change in the concept by defining health as not mere absence of disease but all-round physical and mental wellbeing/fitness. This infused the change in strategy for health care.

The highly acclaimed Nobel Prize bestowed thesis on health and education by Prof. Dr. Amartya Sen added the icing on the cake. Investing in health care for a better tomorrow and positive growth of society enkindled the mind of policy makers and administrators. Governments realised that investment in health care can no longer be shelved.

We are still a developing nation, and the challenges are very many.

As a medical professional for more than four and half decades, medical educationist, researcher for nearly four decades and an organiser for health care development, I have experienced a sea of changes for the good over the past two and half decades. Health infrastructure at micro-levels has been fortified. Equipment procurement and maintenance has been addressed to a great extent so also supply of consumables through partly centralised and partly institution level management.

Shortcomings will always be there and attract criticism but what the system lacks is necessary promotion and placing the facts before society aptly. Any public/media allegation should not be construed as negative and government machinery need not take it defensively. It is only those who perform are visible and assessed. Attitude needs to be changed.

Growth in health sector

The state has faced many unprecedented health care challenges since 1998 where experience, appreciation and practical knowledge was limited but never failed to rise to the cause. To start with, the heat wave and unprecedented human tragedy of 1998, super-cyclone of 1999, natural disasters like floods and cyclones, massive road traffic disasters, liquor tragedies and gastroenteritis have been effectively managed.

The steady growth in the health care sector could handle them to a remarkable extent. Spontaneous action of medical professionals, paramedics, hospital administrations and government response are well appreciated by society with regard to management of Covid-19 pandemic. Creation of dedicated Covid hospitals with availability of high-end investigations like CT Scan with supply of expensive medications at State cost is worth commendation. Mobilising people and executing mass vaccination against Covid-19 stands proof to the available robust preventive health care facilities and commitment.
The Government's endeavour received global appreciation.

Health care for individuals has also seen remarkable development and enhancement. Availability of ICU, HDU and SNCU facilities at secondary and tertiary care institutions have grown leaps and bounds. State’s commitment to provide long-term care to chronic patients like haemodialysis is worth appreciation. Bone marrow transplant is another feather in the cap. Upgrading the only State run cancer institute to a post graduate teaching institution is a great milestone.

The concept of public-private partnership (PPP) with regards to establishment of high-end, expensive investigative facilities is a novel and beneficial concept. Patients as consumers get benefit, Government is relieved from huge investments and private investors make their bucks. This phenomenon has widespread visibility.

But the word of caution is that in tertiary medical teaching institutions, the door should be azar for academics and learning. The teaching department concerned and the trainees should have the desired liberty to use the systems for medical education. This will fortify health care and envisage advancements for the benefit of all. PPP should not be limited as a business concept, the MOU, thus, should be framed.

Boost to government facilities

Over the years, quality health care has been perceived in many government institutions on par with good national institutions. Yet it cannot be a generalisation. Many health care institutions require upliftment both in infrastructure and human resources. Human resource procurement and development should not be done in an ad-hoc/contractual mode. Systematic, long-term and visionary State policy has to be in place. This will not only enhance the confidence of the employees but ensure steady, effective and committed health care.

Vacillating rules and modus operandi are not conducive of positive growth in health care. Creation of new medical colleges is a welcome step but recruiting regular faculty seems to be a great challenge. The planning, approach and execution should be horizontal and not telescopic. While planning for construction of a medical college building, human resources required as per prevailing rules should also be addressed. Procedure for recruitment of faculty, paramedics and support staff has to be initiated through a regular process. In view of the gross disparity in supply and demand of human resources,
simpler and pragmatic recruitment rules need to be framed and archaic time-consuming methods be dismissed.

Excellent and extensively available health care does not only depend on doctors and nurses alone. A huge army of paramedics viz. ECG / EEG/ dialysis technicians, OT assistants, perfusionists to run ECMO/ bypass machines, ICU technicians etc. are required to be created.

State needs to envisage institutions for such training leading to diplomas in the subjects. Horizon is bright yet the traveller has to reach.

Prof Sidhartha Das is former, Dean and Principal, SCB Medical College & Hospital, Cuttack

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