From Tanjore to Gorakhpur: Government Hospitals are Pathetic

Moving beyond the politics of the moment in the murders (I refuse to call it tragedy) in Gorakhpur of 60 children the bottom line is Public Healthcare is in a pathetic state all over India, without exception. This primarily affects the poor. 
Dravidian party clowns are running around on Facebook claiming all sorts of statistics on TN's healthcare compared to other state. Yes TN fare better but if the benchmark is UP and Bihar the bar is very low indeed.  
Here's a news item in The HIndu about Government Children's Hospital in Chennai (http://www.thehindu.com/todays-paper/tp-national/tp-tamilnadu/childrens-hospital-flooded-with-patients/article12559570.ece). WHAT THE DAMN F*** is THIS? See the picture. Is this a children's ward in a hospital or a photo of a badly run Dharmasala? Go away clowns, hide your heads in shame and may we never hear from you again.

Government Children's Hospital Chennai (Image from The Hindu)

Dengue is becoming an epidemic in TN http://www.newindianexpress.com/states/tamil-nadu/2017/jul/30/two-children-die-of-dengue-in-coimbatore-toll-in-district-rises-to-12-in-two-months-1635847.html.

In Dharmapuri 5 infants died in 12 hours in a neonatal ward (http://timesofindia.indiatimes.com/city/chennai/5-infants-die-in-12-hours-at-Tamil-Nadu-hospital/articleshow/45163406.cms) .

These are just some news clippings found after 2 minute search in Google.

Both my brother and I were born in a government hospital and my dad worked as an ENT surgeon in a Government hospital for 20 years. The lack of oxygen is a perennial problem in government hospitals. My father literally saved my life as an infant when he recognized that the oxygen supply had stopped from the common feeder and ran and dragged an oxygen supplier and put it on my face. Other children in the ward were not lucky. Once we procured oxygen from a private hospital and supplied it to an uncle admitted in Tanjore Medical College Hospital. That was in the mid-eighties.

My father used to swear by the facilities in a Medical College Hospital compared to the poorly run mom-and-pop shops that were the nursing homes that dotted the town. He used to say that unlike those 'polyclinics' in the government hospitals there were qualified doctors round the clock.

But even in those days Tanjore's Rajah Mirasdar Government Hospital was a bloody cess pool. I've been there in the eighties and I remember struggling not to vomit. The maternity wards were pathetic. In places the maternity wards would even lack privacy screens. Stop lecturing how great Government hospitals. If they were not called hospitals we could file human rights violations against those hospitals. Doctors suffer too. No proper restrooms, no proper sleeping quarters for duty doctors, pathetic instruments, badly maintained machinery. Oh the litany is endless.

The Karunanidhi scheme of medical insurance was daylight robbery and an outright scam that only contributed to inflating the costs and robbing much needed hundreds of crores from being invested in government hospitals.

The commercialization of medical education in Tamil Nadu and neighboring Southern states of Karnataka and Andhra is a healthcare crisis of mega proportions.

Tamil Nadu has 25 government run medical colleges of which many were created by just government fiat and lack proper facilities to be either called a college or a hospital. Tamil Nadu also has 24 private medical colleges where wallets determine whether someone can become a doctor. In private medical colleges seats are sold as 'package deals' that include a PG degree. Does that mean MBBS degree is already in the bag? These colleges lack proper faculty. (http://timesofindia.indiatimes.com/city/chennai/tamil-nadu-adds-1000-mbbs-seats-in-six-years/articleshow/58877893.cms)

Then there's the case of paucity of doctors, especially in specialties. The Endocrine society of India records 600 members. 600 Endocrinologists in a population of 1 billion (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263175/).

After my father's death, due to prostate cancer, I did some research on cancer care in India. India has only 1500 oncologists. ONLY 1500. Cancer care, from diagnosis to treatment, is mostly done by doctors who are not oncologists. The only popular cancer care center for the poor in Tamil Nadu is Adyar Cancer Institute. Cancer management in most Indian hospitals, private and government run, is pathetic. It is almost aboriginal compared to US. Make no mistake, every equipment and drug available in US is available in India. The problem is pathetic lack of qualified oncologists.

When my father was diagnosed with prostate cancer in 2002 he went to Apollo hospitals Chennai for radiation therapy. Apollo, at that time, had linear accelerator which provided precision treatment unlike the Cobalt treatment available in Tanjore government hospital. The latter would have created many side effects and destroyed much more of healthy tissues.

During another healthcare crises in 2013 we took my father to Apollo Chennai for a gastro-enterology surgery. We had to pay Rs 50,000 to get admitted. Thankfully money is not a problem for us. I saw a sea of humanity in Apollo hospitals. The place literally thronged with thousands. Most were just middle-class. In a city that had many government hospitals I wondered why this clamor for such an expensive private hospital that literally bankrupts many. Literally unless one is abjectly dirt poor none goes to government hospital and even they yearningly look at other options. The hospitals are pathetically run. From lack of proper facilities to more important lack of qualified doctors in specialities the government hospitals are an affront to the idea of public healthcare. No wonder the only thing that Karunanidhi and Jayalalitha agreed on was that Apollo Hospitals was their choice of place to get treated not the government hospitals in Chennai.

In what country would a dilettante film star become a health minister in the Union Cabinet? Only in India could a clown like Shatrughan Sinha become a health minister. But then only in India could a school dropout like Smriti Irani become an education minister. Anbumani Ramadoss, a doctor, on the other hand, was more interested in looting JIPMER and humiliating the dean of AIIMS than in providing healthcare to the impoverished millions. Dr. Harsh Vardhan, the current incumbent, is a fount of wisdom who suggested that sex education should be banned.

India does not 'invent' drugs but mostly plagiarizes them. The merits and demerits of that is a separate issue but it is a crucial issue that India faces with the WTO (World Trade Organization). India's drug policy is covered by the ministry of chemicals and fertilizers. For such an important ministry India nominated an illiterate thug like M.K. Azhagiri.

A Reuters article highlights the pathetic state of healthcare in India. India has "9 hospital beds and 6.5 physicians per 10,000 people according to World Health Organization. By comparison China has 42 beds and 14.2 doctors, while Britain has 33 beds and 27.4 physicians for every 10,000 people". The article notes in a one line paragraph, starkly, "those who can afford it tend to choose private health care" The article also highlighted the sever drug shortage in government hospitals. (http://in.reuters.com/article/india-free-drugs-chennai-public-health-idINDEE86M00I20120723). Another article also draws attention to an alarming drug shortage in Tamil Nadu (http://timesofindia.indiatimes.com/india/Tamil-Nadu-among-states-likely-to-face-drug-shortage-as-retailers-look-for-more-profits/articleshow/22172124.cms).

In 2015 my dad's prostate cancer had metastasized all over his bones and an expensive medicine was prescribed to manage the growth. It cost Rs 80,000 per month. Again, we could meet it. I had dashed down to Tanjore to be with my father and on my way back to Chennai I saw a group of construction workers working in the hot sun in drab clothes. My first thought was "what have governments done for these people? Their children depend on government school which are mostly cow sheds and they depend on government hospitals which are also cowsheds".

Access to quality education and healthcare is largely beyond the reach of the hundreds of millions of poor in India. The Gorakhpur murders are a sad reminder of that.

LBJ's epochal moment and Obama's lowpoint

Seeing her supposed coronation vanish into thin air courtesy a freshman Senator with more supposedly silver tongue, Hillary railed "you campaign in poetry but you govern in prose". She then cited LBJ's achievement of enacting the Civil Rights bill in '64 and voting rights bill in'65. LBJ succeeded the uber-charismatic JFK under a very tragic circumstance. The country was a sheer cauldron of seething emotions tearing at the seams. A peaceful march was torn asunder by police dogs and water cannon as a nation watched in horror on live national TV. A president was killed. The country which won two world wars was being challenged by bicycle-riders in a hitherto unknown patch of land. LBJ was very unlike JFK, no charisma, avuncular looks, no soaring oratory, no Pulitzer prize. What did LBJ bring to the table other than the fact that he could deliver the 'south' in the election? [Many think Bush V Gore was a nail biter, check out JFK V Nixon and the allegations of rigging that swirl even today].

LBJ, as his biographer Robert Caro brings out in 3 volumes, brought to the table invaluable expertise in negotiating with the Congress. One volume of Caro's biography is aptly titled "Master of the Senate". The long years of forging relationships in the US Senate helped LBJ hone his negotiating skills. Harvard Business Review (HBR) once interviewed Caro to glean management techniques of LBJ that could be applied to corporate world.

The shock and trauma of Kennedy's death, the crescendo of Civil Rights movement both did provide an invaluable impetus in shepherding the landmark Civil Rights bills. However one should appreciate how an almost entirely White congress voted to overcome one of humanity's worst prejudices, that too ingrained over centuries of bias. Signing the bill LBJ is supposed to have said "we have signed away the south for a generation". That signing marked the end of democratic party's hold on southern states. LBJ was a democrat, he moved a bill that virtually killed his and his party chances in the South for generations to come.

When Hillary cited the above the Kennedy clan was peeved. They excoriated her for not mentioning JFK, whose brother RFK had MLK Jr taped by the FBI. Carrying their petulance forward they endorsed Obama in a much publicised event. For her share Maria Shriver Kennedy came straight from her 'daughters horse riding class' to ask the common Californian to vote for 'change' and for 'Barack Obama'. Hillary trounced Obama in the MA and CA primaries.

When Obama got elected duly, his enablers in the press (masquerading as journalists) predicted a new era of bipartisanship unlike the days of Bill Clinton and George Bush. Obama had ripped apart Hillary and Bill (by then they were pejoratively called 'Billary') as having failed to deliver health care reform because of their secretive ways and of course their having 'created' enemies. Bill Clinton retorted "yes we made enemies because we fought the fights that had to be fought like health care, Children's health insurance, FMLA etc". A populace swooning under Utopian ideas floated as virtues bought into Obama and he sailed into the presidency.

Obama came into office with unprecedented love and admiration. Clinton came into office despite 'bimbo eruptions', Bush came into office under a cloud, to put it mildly. Obama came into office riding on the cusp of history, a 'dream' come true, America's moment of redemption, America's repent for its original sin. His approval rating was in the stratosphere.

Then came reality. Unlike Bill Clinton in 92, all Presidential candidates in 2008 campaigned on the promise of reforming health care, cut health care costs, provide insurance for all etc. In 2008 America pleaded for health care to be tackled unlike in 1992. This was his moment to lose. Obama looks all ready to lose this. His legion of internet worshippers are nowhere to be seen. Opinionators predicted Obama redefining the Presidency with his netroots, they thought his legion would be his army of volunteers compelling every congressman to oblige the President for his bills. All of this came crashing down. The biggest let down was seeing the supposedly eloquent candidate hold prime time news conferences on health care only to confuse the viewer further.

All those who shrieked that Hillary will bring back old style politics, too many recriminations, too much politicking are now aghast at seeing Obama being hijacked by his own party. The man who was, conveniently, everything to everybody on the stump, now has his reckoning. He cannot satisfy the fiscal conservative because the reforms he supports are wrecking US deficit (projected at 9 trillion dollars), his liberal supporters are livid at the compromises made.

What is worse, for a candidate whose organizational skills, fund raising abilities, on-message discipline, ad-war abilities, none of that was in display as the health care debate unravelled. Scaremongers had a field day with rumors of 'death panels', 'rationed care' etc. The vaunted Obama operation team just watched. My guess is they were simply shocked that the sheen came off of "the One". I suspect that the shock of seeing their idol questioned put them in a comatose state.

Obama's approval rating continues to plummet and is now on par with G.W.Bush at this point in Bush's presidency. What a fall my countrymen.

If only we had had an LBJ...oops Hillary.