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New Modules To Heal
Why India’s abysmal doctor-population ratio requires innovative solutions
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On 29 December 2017, the National Medical Commission Bill 2017, was introduced in Parliament to replace the Medical Council of India (MCI), India’s current medical education regulator, with a new body. One of the aims of the Bill is to allow those practising homoeopathic and ayurvedic forms of medicine to be able to practice allopathy, upon clearing a bridge course. According to Clause 49 of the Bill, a joint sitting of the Central Council of Indian Medicine, the Central Council of Homoeopathy and the National Medical Commission will be held at least once a year in order “to enhance the interface between homoeopathy, Indian systems of medicine and modern systems of medicine”.
This move by the government has, naturally, ruffled many feathers. It even resulted in a nationwide strike by doctors. India with its 1.30 billion population has a healthcare system that is heavily stretched in terms of infrastructure and manpower. To bridge this chasm between demand and supply, there is clearly a need for out-of-the-box and innovative solutions.
Integrating the Western and traditional forms of medicine for India, especially rural India, is one such idea. In rural India and among the urban less-educated, the chemist dispenses medicines for various ailments. Ayurvedic doctors and homoeopaths, too, dispense allopathic medication for primary health issues. They even undertake minor surgeries. For people residing in rural India, for whom travelling to a big hospital in town is expensive and time-consuming, these ayurvedic doctors and homoeopaths who dispense allopathic drugs are the best solution.
India is not alone in proposing such grassroot-level health solutions for its population. China had pioneered village health workers trained in basic health as part of a coordinated system. These health providers came to be known as ‘barefoot doctors’, for they were usually secondary school passouts who were given training at a county or community hospital for periods ranging from six to 18 months. They worked as primary healthcare providers focussed on disease prevention, providing immunisations, delivering pregnant women and helping improve sanitation. Even the WHO endorsed this programme as a revolutionary breakthrough in international health ideology.
According to information provided to Parliament, as on 31 March 2017, there were a little over 10.22 lakh allopathic doctors in India and the nation’s doctor-population ratio is 0.62:1,000. This is far less than the WHO recommended 1:1,000 figure. India also has 7.37 lakh practitioners of alternative streams of medicine, such as Ayurveda, Siddha, Homoeopathy and Unani. Of these, ayurvedic doctors at 3.99 lakh, and homoeopathy practitioners at 2.8 lakh make up the lion’s share.
The government of India has tried to make rural service mandatory for medical students. But vested interests have always thwarted this effort, leaving those in rural and semi-urban areas without even sound primary healthcare facilities. Also, with the cost of medical education in India being very high, doctors find little financial benefit in practicing in rural or semi-urban areas. Under such a scenario, making available a bridge course for India’s ayurvedic doctors and homoeopaths who possess basic knowledge of physiology and medicine, to help them provide primary care in rural, semi-urban settings and remote areas, is surely among the best ways forward for now. Of course, care must be taken to set parameters on the types of diseases and drugs that these doctors are permitted to treat and prescribe.
The Bill was recently tabled in Rajya Sabha and then referred to the Standing Committee on Health. However, it should not turn out to be another Bill languishing in cold storage. For it will then be a great jolt to the reformations badly needed to be implemented to transform the ailing healthcare system of the country.
Disclaimer: The views expressed in the article above are those of the authors' and do not necessarily represent or reflect the views of this publishing house. Unless otherwise noted, the author is writing in his/her personal capacity. They are not intended and should not be thought to represent official ideas, attitudes, or policies of any agency or institution.