Saturday, February 27, 2021

Health care system

Nagaland is far behind in almost every field especially in medical sector. Sure the government is trying its level best to overcome it at all possible levels; policies are being framed and funds are being allotted for upgradation of medical sector but corruption is a big hurdle for any positive change at the ground level. Whatever budget is being allotted is channelized through various departments and allegedly at almost every level a part of it is retained as a share. Reportedly what reaches at the ground level is just around half of the allocated budget. Policies are framed but not implemented. Let us start from dispensaries, sub centers and primary health centers. The services these places are supposed to render to our rural population are not being rendered, reason being that the staff strength at these places is not as per the provisions laid down, plus the basic facilities like lab investigations are not available in most of the places. Crores were spent for establishing these centers but one can just take it as a mockery on part of the authorities. Most of our dispensaries and sub centers are manned by a nursing orderly. We know that one of the basic facilities, arranged by the states all over the world for the citizens, is healthcare. It is no privilege, it is a fundamental right. The understanding of healthcare as a basic right of the citizens puts all the states under a popular pressure that the facilities should be available to all without any discrimination. But what about the people living in remote areas of the state that remain cut off for months together by landslides or other weather vagaries? They are literally left to fend for themselves. Not to speak of routine ailments, they are at the mercy of God even in medical emergencies. Those living in towns might wonder if there are any areas that are thrown into practical isolation during monsoon (as happens every year) in this age of modern technology. The fact of the matter is that there are people who live in such areas that remain cut off for months together, and no one is there to take care of them. In this age and time we still have villages that are not connected to the district headquarters through a dependable road. This is particularly so in the Eastern part of our state. Imagine if these people face any medical emergency what could they do. Our state is by and large an agricultural state and most of our population lives in rural areas. So besides improving on our hospitals in urban areas we have to focus how we can cater our rural population to our best. There is no doubt that our hospitals dispensaries and PHCs lack properly trained staff and at the same time is understaffed. The first step we need to do is to have in house training system. That can easily be done by introducing ‘continuing medical education programme’, where you learn from each other. Sure this system is being practiced at medical college level but this needs strictly to be implemented at all the levels down to the dispensaries. There should be accountability, feedback, record keeping and proper referral system at all the levels. Proper posting of doctors is a must so that the talent and expertise of our young doctors is properly utilized. We need a great dedicated and well trained nursing force and technologists for the labs, X-rays, ophthalmology and other allied fields. We need to remember modern technology is spreading fast and we always need well trained people to work on the modern gadgets. It will be disastrous to equip our hospitals with modern gadgets unless we have properly trained people to keep the system in order. Till then we will have to bank upon clinical assessments based on a thorough skill of history taking and clinical examination of our patients and where we don’t reach a diagnosis we should not hesitate to refer the patient to a proper place. We need to remember we cannot compare our health care system with the advanced states where they have unlimited resources besides years of experience to run the system. Health care system is an ongoing process of improvement all over the world and we should be no exception to that.