My new project in the new job has given me a lot of insight in to the nuts and bolts of carrying out community work and the politics behind it.... I have started to work on a primary health model with community partnership and ownership where we try to bring down the disease load through early detection and referral... the model also looks at integrating other care providers to ensure comprehensive care to the community...
we first went to the community and we started off with a Participatory Rural Appraisal (PRA) exercise where we map the basic data on demographics and health. it is also a method of bringing the community together and getting them to start on the projcet for full community ownership....
though i had read in theory that we should include the excluded community like women, scheduled caste and other marginalised section in the exercise, but practically i saw that this is somehow difficult coz there are dominant forces in the community which tries to take a from seat in all the exercise... then it takes a very honest and genuine effort for the practitioner to actually rope in this people in the exercise... i ca not say how much of it we achieved but we ensured their representation somehow in the exercise....
we are lucky to have a village where the youth are organised in to a youth club and very enthusiastic to carry out the project...
despite my feeling that that the volunteer to carry out the project would be prferebly women, most of the people who have volunteered are men and young men at that....
though we had a good meeting with the district medical officer we did not see much enthusiasm from the Private practitioners...
these private practitioners are mostly government doctors who practice in the evening analmost to the mid of day in their hospital and if there is any time left they go to the govt. hospital for official duty...
everybody wonders: when India has so much medical resources (and of excellent quality at that) then why do we as a nation trail so much behind in terms of health...
the answer lies in the resources themselves and how they are allocated...
medical profession has cease to be the noble life saving profession it used to be and has become a money spinning factory... the nexus and mafia involving the doctors, pharmaceuticals and bureaucrat along with a lack of political willingness is what is killing the state of healthcare in India...
Govt. to be populistic doles out goodies like health insurance for all and other services... but does it ever monitor how these schemes are actually faring.... millions of rupees is spent in paying premium for the poor without knowing whether the beneficiaries have the i.d card or not. ..nobody ever tries to find out where this patient lands up in the name of free health insurance... coz of non payment to hospitals by the insurers, good hospitals are turning out the patients to smaller doubtful setups ... are we in our effort to become populist making the healthcare more complex and dagerous...
nobody knows and nobody cares.... everybody is busy defending his/her model... in the mean while the poor does the best it can : it avails healthcare from quacks and unqualified people thereby endangering their lives....
This can be summed up in an interaction which i had with one local politician whom we met to get some grants for the project... he said clearly 'do nt do it in the village (belonging to other political affiliation) chosen by you but do it in my village and i will ensure all cooperation'...
dats d way we are heading today....
may we have better senses and minmise our rhetoric, our intellectual discursions... its high time we turned our attention to the real man on the street and understand what damage such steps from our end has done to them...
Let better sense prevail!
we first went to the community and we started off with a Participatory Rural Appraisal (PRA) exercise where we map the basic data on demographics and health. it is also a method of bringing the community together and getting them to start on the projcet for full community ownership....
though i had read in theory that we should include the excluded community like women, scheduled caste and other marginalised section in the exercise, but practically i saw that this is somehow difficult coz there are dominant forces in the community which tries to take a from seat in all the exercise... then it takes a very honest and genuine effort for the practitioner to actually rope in this people in the exercise... i ca not say how much of it we achieved but we ensured their representation somehow in the exercise....
we are lucky to have a village where the youth are organised in to a youth club and very enthusiastic to carry out the project...
despite my feeling that that the volunteer to carry out the project would be prferebly women, most of the people who have volunteered are men and young men at that....
though we had a good meeting with the district medical officer we did not see much enthusiasm from the Private practitioners...
these private practitioners are mostly government doctors who practice in the evening analmost to the mid of day in their hospital and if there is any time left they go to the govt. hospital for official duty...
everybody wonders: when India has so much medical resources (and of excellent quality at that) then why do we as a nation trail so much behind in terms of health...
the answer lies in the resources themselves and how they are allocated...
medical profession has cease to be the noble life saving profession it used to be and has become a money spinning factory... the nexus and mafia involving the doctors, pharmaceuticals and bureaucrat along with a lack of political willingness is what is killing the state of healthcare in India...
Govt. to be populistic doles out goodies like health insurance for all and other services... but does it ever monitor how these schemes are actually faring.... millions of rupees is spent in paying premium for the poor without knowing whether the beneficiaries have the i.d card or not. ..nobody ever tries to find out where this patient lands up in the name of free health insurance... coz of non payment to hospitals by the insurers, good hospitals are turning out the patients to smaller doubtful setups ... are we in our effort to become populist making the healthcare more complex and dagerous...
nobody knows and nobody cares.... everybody is busy defending his/her model... in the mean while the poor does the best it can : it avails healthcare from quacks and unqualified people thereby endangering their lives....
This can be summed up in an interaction which i had with one local politician whom we met to get some grants for the project... he said clearly 'do nt do it in the village (belonging to other political affiliation) chosen by you but do it in my village and i will ensure all cooperation'...
dats d way we are heading today....
may we have better senses and minmise our rhetoric, our intellectual discursions... its high time we turned our attention to the real man on the street and understand what damage such steps from our end has done to them...
Let better sense prevail!
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