 "Can community clinics boost health care?")
It is 2 in the afternoon. The sun is beating down harsh. But inside the neat prefabricated structure, which is Delhi's first 'mohalla clinic', or community clinic, the air is cool. The air-conditioned room where the doctor attends to his patients, a majority of whom come from the Peeragarhi Relief Camp where the clinic is located, is a far cry from the dreary government health care centres one is so used to seeing.
This mohalla clinic in Peeragarhi in West Delhi, an initiative of the Aam Aadmi Party government, is a pilot project that kicked off in July 2015. The government has set a target of a thousand such community clinics by the end of the year.
Getting to the relief camp takes some effort. Located close to Punjabi Bagh and Paschim Vihar, two reasonably well-to-do neighbourhoods, and with a Delhi Metro line running close to it, it can be approached only after a 10-minute walk through decrepit surroundings. Outside of the relief camp, not many shopkeepers or even rickshaw-pullers appeared to be aware of its existence.
But as you reach, the contrast is staggering. The area is a little more than a slum. The sanitised clinic stands out of its rundown surroundings.
There is a neat row of chairs for patients to wait their turn. Inside, it is a two-room arrangement. The first room, reasonably spacious, has an attendant who mans the medicine counter. This room also houses the laboratory facilities to conduct tests like blood count, kidney function, liver function, urine routine, microscopy and lipid profile. Among the machines is a glucometer to check blood sugar levels.
The second room, which is air-conditioned, is where the doctor sits. Pankaj Kumar, the resident doctor at the Peeragarhi mohalla clinic, moved here from the dispensary in Khyala, a village in West Delhi.
Comparing the facilities at the dispensaries and the mohalla clinic, he says that while the treatment and medicines are free at both facilities, the clinic has an edge because it has a well-equipped laboratory which is a big advantage for the patients. They would otherwise come to the dispensaries for consultation and then run around for the tests.
The clinic appears to be functioning smoothly and the doctor seems to have the time to patiently listen to people and attend to their problems.
Unlike dispensaries, which function for six hours either in the morning or in the evening, the clinic is open from 7 am to 7 pm, six days a week. It remains closed on Sundays and on public holidays.
The Peeragarhi mohalla clinic was built at a cost of Rs 15 lakh. Setting up a dispensary, on the other hand, costs close to Rs 5 crore.
The government dispensary in the south Delhi neighbourhood of Saket is much more spacious in comparison to the Peeragarhi mohalla clinic. It has 12 rooms, including a pharmacy, medicine store, homeopathic unit, injection and immunisation room and a store room.
The Delhi government, which is pushing the idea of community clinics, says that dispensaries take up too much space and are a waste of money. The mohalla clinics, their argument is, are better equipped and offer services almost at people's doorstep. Besides, patients do not have to suffer long queues while awaiting their turn. At the dispensary, some patients complained about the waiting time. "Sometimes I have to wait for over an hour for my turn," says a patient.
The residents at the Peeragarhi relief camp are happy with their community clinic. "There used to be a dispensary here about 15 years ago, but it got damaged," recalls Shalu, a resident of the relief camp who uses only her first name. "We were forced to travel quite a distance for treatment. The process would take a very long time," she adds. A lot of people in the area, she says, cannot afford private treatment. "For them, this mohalla clinic is a god-send."
Rajesh Kumar, another resident of the locality, says they get whatever medicines they need for free from the clinic. "The mohalla clinic really helped when my mother was seriously ill. It has made a massive impact to this area in a short span of time, so much so that now people from outside have also started coming here."
Most residents of Peeragarhi are daily-wagers. In the past, a visit to the dispensary would mean losing half the day's wages, a luxury they could not afford. Now, with the consultation, medicines, lab tests and test reports being conducted and available under one roof, they say their worries are reduced.
Mohalla clinics have the potential of becoming a game changer for health care in India. Kumar, the doctor at the Peeragarhi clinic, says, "This centre has made it possible for the poorest of the poor to get access to the kind of treatment they would not have been able to get at government dispensaries." The level of cleanliness and the fact that these clinics are less crowded as compared to dispensaries leave the patients feeling better, he adds.
So far the pilot project appears to be a success. In its first month, the clinic attracted 3,316 patients and the number peaked to 5,186 in September last year. On an average, around 4,000 patients visit the clinic in a month.
Arunoday Prakash, the media advisor to the Delhi government, is upbeat about the progress community clinics have made. But the question is: will the government succeed in achieving its target of setting up 1,000 such clinics by the end of the year? Prakash is confident it will happen. He says a hundred such clinics are already in place.
Prakash looks at this project as one which could change the woeful primary health care system of the country. "These mohalla clinics will be an example for other state governments to emulate," he says.
While the primary motive for setting up these community clinics is to address the health concerns of the lowest income bracket of society, Prakash insists that with the high standards of quality that have already been set, people from higher income brackets will also not shy away from availing of these facilities.
Public health care, especially for the poor, has always been a massive challenge. In light of this, the concept of the mohalla clinic can make a significant difference. If the Delhi government delivers on its promises, and ambitions, then we could well be looking at a game changer.
