India is in the 77th day of the lockdown together with the economy slowly limping to normalcy. Concerns are now being raised on account of a rise in the number of coronavirus infected people country wide, which stands at a lot more than 2,65,000 with 7,466 deaths. Some are even accusing the governments of not listening to expert advice and allowing the resumption of economic activities without setting up a complete assessment. Questions may also be being raised regarding the rationality and efficacy of the choice to impose complete lockdown from 25 March, when India had reported only 500-odd coronavirus cases and opening the economy when the quantity of corona infected people started rising , the us government has made a decision to allow opening of the economy in all respects with fewer restrictions. Apparently the argument seems logical until we compare the Indian scenario as to what is going on in other major countries around the world.
The United States of America with a population of 33 crores has reported nearly 20 lakh coronavirus cases with 1.1 lakh deaths, Spain has 2.9 lakh cases and 27,000 deaths, the United Kingdom has reported 2.8 lakh cases and more than 40,000 deaths and Italy’s 6 crore population has had 2.3 lakh coronavirus infections with more than 33,000 deaths, as things stand now. Compare this with 2,66,598 cases reported in India, a country with a population in excess of 130 crore, and merely 7,466 deaths. Clearly India has been doing well in the combat the coronavirus. We will remember all the countries referred above are western world with many advanced health systems and in comparison to them our health and wellbeing delivery systems are not only poor but extremely inadequate. Despite this crucial shortcoming, if we were able to minimise the number of people who died due to the Sars-CoV-2 pathogen, we must give due credit to the governments for their efforts and our medical professionals who have so far succeeded in managing the pandemic with scarce resources.
However the pandemic has been doing well to set the spotlight on our overall health system – after a very long time. As the number of cases began to rise, shortages of all kinds of medical infrastructure became apparent. Makeshift hospitals must be put in place though most public hospitals are serving coronavirus patients. An acute shortage of doctors, nurses and other paramedics is also being felt throughout the country.
That India has been lacking doctors is widely acknowledged. India’s option of doctors per thousand population does come close to the World Health Organisation’s prescribed doctor-patient ratio of 1: 1000 once we include all the registered ayurvedic, homeopathic, allopathic and unani doctors. But the quantity of doctors who practise is quite a bit lower. Additionally it is far under many countries including Russia, the united states, and the European Union countries where the ratio is above 3 doctors per one thousand population. Unless we improve the ratio to the amount of better performing countries about the health front, poor people in India will continue to suffer.
The issue of shortage of doctors as well as other support staff continues to be able to linger over the past several decades because of short-sighted policies of your institutions for example Medical Council of India, which, in its new incarnation, is still pursuing the same sort of archaic policies. The result is that 532 medical colleges have 76,928 seats for the MBBS course. Only half these seats have been in state-run medical colleges. If India has to get the doctor-patient ratio of 1: one thousand, we need nearly 20 lakh more doctors with the year 2030.
India faced a similar shortage of engineers from the 1990s when there have been only 1,30,000 engineering seats on offer. However in 2000, the federal government dismantled the stranglehold of your engineering education regulatory body, AICTE, and reworked the regulatory framework that governed opening of engineering colleges. This contributed to an increase in the intake in engineering colleges by four times in just five-years.
Unfortunately, this type of reform is yet to happen in medical education. Shortages in medical seats still exist and students are, according to one estimate, collectively made to pay nearly 15,000 crores in capitation fee, as a result. Thousands of others line up to look for admission in countries including China, Australia, Russia and many others, paying vast amounts of money. We certainly have seen this annual loot of thousands of crores for too long and made our students and people suffer. Time has arrived we reform the medical education system, end the pervasive corruption over these regulatory institutions and make certain that we perform the expansion in a manner which we make the required quantity of doctors to take care of our population.