Doctor, heal thyself

Ear To The Ground

Government plans mandatory one-year rural postings for doctors. This should, in fact, be the norm for all professionals who have the privilege of living in the country.

The medical fraternity is once again spitting fire. Reason: The government of India's plan to introduce compulsory one-year rural posting for them.

The doctors protesting in Chennai and New Delhi say they are being penalised for the government's failure to post doctors in rural primary health centres.

Albert Schweitzer, a German doctor who spent most of his life working in remote Africa, is long forgotten. It is also unlikely that the protesting doctors would have come across a copy of The Citadel, a novel by another doctor, AJ Cronin, whose life was spent practising among the mining communities and whose novel was the basis for the UK's National Health Service, whose jobs our pampered doctors covet so much.

The Centre's plan to introduce a legislation making rural postings compulsory for permanent registration with the Medical Council of India is being opposed especially in New Delhi and Tamil Nadu. The doctors feel their five-and-a-half-year MBBS course will be extended by another year if they have to serve in rural areas. But what would be the gains for the country if they saved an year by not working in rural areas?

Many countries have been setting up shops in India to get young boys and girls to study in their medical colleges. These include Russia, China, Kyrgyzstan and Uzbekistan. Maybe the students should grab these attractive offers and then take up jobs in the UK or wherever they are welcome. But those who study in India should have nothing against working for a year in villages.

In fact, the government should not target just doctors. It should ask teachers, in fact, people in all walks of life who have the privilege of living in this country, to do one year of compulsory service in rural areas.

It should be a mandatory "conscription,'' beginning with early exposure to the needs of the community in the school itself.

The doctors posted in rural areas whine, and rightly so, that they often work under threat to their lives. Besides, children of these doctors are denied access to good schools.

But the moment the flow of professionals towards the countryside begins, there will be a sea change. There would be more facilities with more demand and spending power.

According to a committee of the National Rural Health Mission, primary health centres face a 56 per cent shortage of surgeons and gynaecologists. This figure is 67 per cent for paediatricians.

Whether the doctors are moved by these statistics or not, they couch their angst in the garb of anger at the government's insufficient health spending.

The government of India spends merely 0.9 per cent of GDP on health. In fact, private investment in the sector is almost 80 per cent of the total. This is against the fact that the poor and the rural masses comprise over three-fourths of the country's population. The demand to increase the spending to at least 3 per cent of GDP has been a long-standing one. In fact, a glance at the latest Human Development Report of the United Nations is enough to show how India stands on a par with Bangladesh in health spending. Even Ethiopia and Uganda are better off.

But had Indian doctors been so concerned about the insufficient funds in the health sector rather than their urban comforts, they would have made increase in funding a condition for rural postings rather than make lack of funds an excuse for not spending a year in villages.