PHA-Exchange> PHA 2 media coverage in an Indian Newspaper

[UNNIKRISHNAN P.V. (Dr)]

Deccan Herald, Bangalore, May 31, 2005 (Consumer Bytes page of Spectrum
supplement)
 
Death Stalks the poor in apathetic PHCs
 
Many PHCs that I have visited around the small towns and villabges,
never open, many don't have nurses or medicines, rues Sakuntala
Narasimhan
 
 

E
arlier this month, Delhi  saw an  outbreak of  meningitis that caused a
scare, with dozens of victims hospitalised. The electronic media quickly
latched on to the event as news, but once something else came up as
'newsworthy', the deplorable state of health and sanitation even in the
national  capital  quickly got shelved as an issue.In the next few
weeks, once the rains play havoc with low lying areas, and
gastroenteritis breaks out again (as it does year after year) it will
once again become 'news' (to be superceded as soon as more gory  or
graphic stories become available).
 
The basic neglect of health issues, which causes  such 'newsy' outbreaks
of illnesses, doesn't get tackled, and this leads to the loss of not
only lives but also thousands of hours of man hours of productivity for
the community and country. This is true in almost all developing
countries where  the trend is for resources to be apportioned for
'prestige' projects rather than for ensuring  the availability of  basic
medicine  for the citizenry.
 
Which is why six weeks from now, medical practitioners and activists
from around the world will be gathering in Ecuador in  south America for
the second global People's Health Assembly (PHA 2) to urge national
governments to prioritise health issues and prevent millions of
avoidable deaths that now take place annually, among children, men and
women. PHA 1 took place in Bangladesh in December 2000, with 1,453
participants from 92 countries.
 
Life spans have risen in almost all countries over the last fifty years,
but these statistics mask the fact that inequalities have been growing,
leaving the poor poorer and the rich richer. While sophisticated,
super-speciality hospitals come up in the   metropolitan areas,
thousands of slum dwellers living next to  these hospitals have no
access to even simple cures (or even to water and sanitation, for that
matter). Under the new economic policies of the last one decade,
government health services that used to be free are now  imposing 'user
fees' so the poor are actual;ly worse off. Medical emphasis is also
shifting towards  fancy  and expensive curative treatments rather than
simple, inexpensive preventive measures (ensuring clean, potable water
supply, sanitation, prevention of malnutrition, monitoring industrial
developments that increase pollution and cause ill health). 
 
The Voluntary Health Association of Karnataka recently brought to light
the case of a  woman who died  at a primary health centre in Sasalu
village near Doddballapur, because of medical negligence during an
abortion procedure.  The  teenaged daughter of a daily wage earner in
the Ambedkarnagar slum of Koramangala  in  Bangalore,  died  following
careless treatment at the local primary health centre, right in the
middle of the 'Electronics capital of India'. Many PHCs  that I have
visited around the small towns and villages, never open, many don't have
nurses or medicines, and there is a wide gap between the rhetoric of the
state government's boast about the number of PHCs set up on the one
hand, and the actual facilities available to the public, on the other.
 
Even among the well-off sections of the urban population, persistent
afflictions like asthma, allergies and water-borne  illnesses are on the
rise, and yet money spent on health services is far less than the
allocations for 'prestige projects' like flyovers and airports (which
benefit only the affluent) or for political rallies. It is clearly not a
question of lack of resources, but one of wrong priorities and a lack of
political will.
 
How many of us would choose  to go to a government clinic  or primary
health centre, if a private hospital were available as an alternative ?
Even the poor, who cannot afford  treatment at private hospitals, would
rather incur a debt  to pay for private medical care,  than opt for
treatment at a government clinic, because the latter is so woefully
unsatisfactory. 
 
The People's Health Movement seeks to bring  pressure on policy makers,
to treat healthcare - and preventive care in particular -- as a human
right (and  the pursuit of economic-political policies that cause ill
health as a violation of human rights). 'Health for All' was a slogan
that many governments around the world, including ours, adopted after
the Alma Ata declaration more than twenty five years ago, but precious
little has been done to translate that slogan into reality. Debilitating
illnesses like malaria, the WHO noted last month, have  now in fact
resurfaced widely, and health activists have pointed  out that if it is
a question of the relative importance of expanding exports or ensuring
basic health of the population, the answer is obvious. Manipulations by
transnational companies (especially pharmaceutical corporations) for
profit rather than the people's  good, is another cause for concern in
the context of public health.
 
Unless we as citizens demand better healthcare services as a right, this
state of affairs is not going to change. Why do we assume that
government health services cannot be improved, when other developing
countries  have shown that betterment is possible? Bolivia has fought
against privatisation of water, for instance. Brazil and El Salvador
have likewise notched up success stories in health. It is  strategies
like these that Indian participants at PHA 2 hope to bring back, for
possible replication on our country.
 
 
Pinch of salt -- Vat is that again?
 
Value Added Tax is  supposed to increase transparency, reduce corrupt
tax evasion, and even reduce prices for consumers. In reality - shops
continue to avoid giving a bill or worse, use VAT to round off prices to
higher amounts. Even the Janata Bazar (supposed to be for the common
man) sells an item marked Rs 13, for Rs 15, claiming VAT. Tax is only
12.5%, but the final price of Rs 14.60 is rounded off to 15.What was
that again, about consumers benefiting from VAT? 
 
Sakuntala Narasimhan
 
                       
 
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