Building a fairer, healthier world ! World Health Day Reckoning : By Dr. Ashwani K. Malhotra
When I was a student in the 1970s in Dhanbad, the Government hospital OPDs were crowded by mostly the poor, malnourished and illiterate villagers from far flung villages and the wards were overflowing with patients, at time two patients to a bed. Many patients and their relatives would make the paths to the wards their temporary abode and sleep there till they got a bed in the ward. The burden of diseases was largely shared by the water, air and vector borne diseases such as diarrhoea, typhoid, jaundice, respiratory illnesses and malaria and it was not uncommon to see an epidemic now and then.
The commoner would often come fleeced by the village quack in an advanced state of illness in the absence of a well entrenched health system in the villages of Jharkhand. No wonder, then that the death rate was quite high in those days in infants and children and women in the maternal age group due to multiple pregnancies and their complications.
Later on, after graduation, as I joined the Punjab Civil Medical Services , I would come to see the same types of communicable diseases along with the non communicable ones, like high blood pressure and heart diseases, diabetes , HIV and cancer and many more, attributable to our changing lifestyle due to economic and social changes from rapid urbanization, migration to cities and a general improvement in the economic status of the people, though not to a great extent as we see today . What has not changed is the number of patients who on any working day, people from far flung areas throng the district hospitals and other Government Health Centres in the country for redress of their sickness.
The rich and the affluent, of course consulted the best of doctors in their private clinics and nursing homes and still do so. With the advent of the corporate hospitals, healthcare has become more within the reach of the large middle working class. Yet the majority of the poor people visit the public sector hospital, waiting for hours to consult the doctor or for a date for an operation !
Health is a fundamental right. Yet many in the country, especially in the states of Bihar, Jharkhand, U.P., Orissa and West Bengal are unable to exercise this right due to ignorance, poverty, illiteracy, superstitions, a thriving quackery and due to a inaccessibility from the nearest health facility.
Things, however are not all that bad. We have wonderful public health institutions like the AIIMS, PGI and the Government medical colleges and a wide network of CHCs, PHCs with ANMs and staff nurses posted in almost all the rural health centres. The ASHA workers, the anganwaaris, midday meal programme in schools and immunization at the village level have done wonders along with the improvement in sanitation and supply of potable drinking water to reduce the mortality rates in infants, children under five and pregnant women.
When Covid-19 struck last year we were found wanting in the health infrastructure to deal with the patients and deaths. However, a year later we are at par, if not better than the most advanced countries. And the public sector has done wonders to tackle this pandemic in terms of testing, treatment and vaccination! Covid-19 has highlighted the inequity in health in some people who not only have better health, but better access to health services than others. Elsewhere some people have better health due to a clean environment, better nutrition, housing, income, employment and better health services.
On 7th April 2021, World Health Day is celebrated throughout the World by the World Health Organization and many countries to build a fairer, healthier world in times when the Covid-19 pandemic has hit the people hard!
Dr Ashwani K. Malhotra MBBS, PGDMCH, PGDMLS, is a retired Senior Medical Officer,Punjab Government,and can be reached @M-9417188867 E-mail : email@example.com
Dr Ashwani K. Malhotra is an Alumnus Of SCD Govt. College, Ludhiana