What ails our Temples of Health? Gorakhpur Medical College.

170822 Hospitals

The deaths of children on account of the Japanese Encephalitis Virus at the Gorakhpur Medical College is completely unacceptable and I share the anguish of every citizen of our country on these man made errors.

But as always happens, it is only a matter of time before our activist press members will find something new to cover, our politicians will get busy with new challenges and our doctors, who are responsible for these deaths every year will breathe a sigh of relief as the spotlight will shift from them.

Japanese Encephalitis is an infection of the brain caused by the mosquito borne Japanese encephalitis virus. This virus makes its annual appearance during the period July – September months in Gorakhpur district and neighbourhood areas. The fatalities in the last few years are as follows:

  1. 2012: 557
  2. 2013: 650.
  3. 2014: 525
  4. 2015: 491
  5. 2016: 641
  6. 2017: 100, so far

What is important for the authorities is to ensure that they must not allow the deaths of these children to become an annual affair that needs to be justified and shouted about for a short period of time because it gets attention and it gets media coverage, only to go back to status quo ante when the noise recedes. Proactive steps need to be taken from vaccination to cleanliness to substantial improvement of the facilities and infrastructure at these government owned medical institutions.

It is time for us to take stock of the state of our medical colleges not just in Gorakhpur or the state of Uttar Pradesh but in the entire country. Have we ever wondered why it is always the poor who suffer because they are the only people who have to seek medical help in government owned medical colleges, civil hospitals or primary health centres?

Has a journalist ever made a surprise visit to any of these hospitals and seen the pathetic state of the hospitals and even the Intensive Care units? They would be shocked to see that it is quite common to experience a big shortage of ICU beds and to see patients lying on the floor with their relatives holding up the drip connected to their bodies because there is no equipment even to hold the bottle of saline or the bag of blood.

In addition to the unsanitary conditions in our temples of health, it is quite common to see stray dogs, monkeys and rats everywhere in the hospital.

Have we looked at the pathetic state of waiting areas for patients in government owned medical colleges? In summer, patients sit in the intense heat with no provision of water. In monsoons, there is no covered area outside and in winter, they have to brave the bone chilling winter of North India. Patients come from villages spread hundreds of kilometers around the medical colleges and they have no idea how long they may have to wait to get an appointment. At the same time have we seen how easily it is for VIP’s to not only get immediate attention and the best medicines but also the best rooms while everyone else is struggling to find a place on the floor in the hospital to sit or to lie down?

Government doctors are happily operating their private practices from their homes and no one bothers to enforce the rule that government doctors are not permitted to have a private practice. In several states there is a new term called “propaganda medicine” that has evolved over a period of time. There are specialist doctors in several medical colleges who have now taken control of the entire value chain from prescription to purchase. These doctors write the prescription, manufacture the medicines that they prescribe in partnership with someone and they have even set up a chemist shop where these medicines are exclusively available.

Have we looked at the availability of medicines in Government hospitals, which under most state laws are supposed to be given free of charge to people in the economically weaker sections of society? These medicines are supplied to these medical college shops by the Government and are prescribed by the doctors. More often than not, these medicines are not available. It is the norm that when a poor patient takes the prescription to the shop, he is told that medicines are out of stock. In the same breath, the pharmacist at the store tells the patient that he should walk across the road and go to the private chemist on the other side of the road where all these medicines are easily available, albeit at a cost.

Where are the medicines that were procured by the Government and supplied to these medical colleges? Why are they not available in the hospital stores? Has anyone bothered to investigate this or is this news not “breaking” enough for people to sit up and take notice?

In order to prevent theft and re-sale of government procured medicines, a simple solution is available. All medicines procured by the government for distribution free of charge should be packaged not in a silver strip but in a black foil strip with the medicine name and ingredients printed clearly across the strip in red. The medicine strips should also clearly state that these medicines are distributed free of charge and if anyone is found to be selling these medicines severe and exemplary action will be taken. This is a very simple solution to solve the problem but may not be economically beneficial to the procurement officials.

The poor face challenges all the time. There are chemists who have shops outside medical colleges and they specialise in supply of medicines for illnesses where a patient is unlikely to recover such as cancer. These chemists sit with a lawyer who specialises in land title deeds and they take away the land of the poor people in exchange for medicines that the patient needs. Can there really be any other trade worse than this?

We need some serious introspection on the condition of all government owned health institutions in our country and the service they provide for the poor and the masses of our nation for whom they were really setup. Governments come and governments go. Some lip-sync their concerns and sympathy a little more than the others but most of them have done nothing after seven decades of our independence.

Only when we start going to the grass root of the problems will we be able to start fixing the institutions of health that serve the people.  Accountability has to be sought and discipline must be enforced. Otherwise every year there will be an outbreak of encephalitis and every year we will express our shock only to forget about the outbreak till the next epidemic strikes.

It is impossible to get anything done overnight but a beginning has to be made.


The author is the founder Chairman of Guardian Pharmacies and the author of 5 best-selling books, Reboot. Reinvent. Rewire: Managing Retirement in the 21st Century; The Corner Office; An Eye for an Eye; The Buck Stops Here – Learnings of a #Startup Entrepreneur and The Buck Stops Here – My Journey from a Manager to an Entrepreneur.

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