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Saturday, October 12, 2002

Recently a friend’s son was hit by a bout of fever. When my friend called me and explained the symptoms, I have immediately advised to start him on a course of anti malarial medicine and the kid recovered in no time. The whole episode costed my friend very little – no hospitalization, no trauma associated with long illness or anything of such sort.

But imagine your plight if you were unfortunate enough to be poor in this country. To start with your sickness/illness wouldn’t be diagnosed on time. In the meantime you and your family would suffer not only from the disease but also from lost productivity and income. Then you will find that the primary health center which was supposed to cater to you is either non-existent or non functional. Then you end up visiting a private practitioner, who is at best of dubious quality who will probably subject you to a battery of tests which will cost you a lot more than you can afford. And he will put you on antibiotics and several other unnecessary medications, but will never think of simple anti-malarials. No wonder the poorest 20 % of Indians have more than double the mortality rates, malnutrition, and fertility rates of the richest quintile! The private sector provides for 79 % of outpatient care for those below poverty line, much of which is of low quality and provided by untrained practitioners.

A recent world bank report on healthcare in India makes a startling disclosure that hospitalized Indians spent more than half (58 %) of their total annual expenditures on healthcare. More than 40 % of hospitalized people borrow money or sell assets to cover expenses. One conservative estimate finds that one quarter of hospitalized Indians fall below the poverty line because of hospital expenses!

As a country we have made significant progress in the past 50 years. Between 1950 and 200 our life expectancy at birth increased from 32 to 65 years and infant mortality decreased from 200 to 69 per 1000 births. But we have a long way to go. Our infant mortality rate is still one of the highest in the world and even neighboring Sri Lanka with 16 per 1000 is way ahead of us. A high proportion of the population continues to suffer and die from preventable diseases, pregnancy and child birth related complications and under nutrition. Communicable diseases and maternal and perinatal cases currently account for a large number of deaths in India . Only 40 % children get full immunization cover and nearly 500,000 children suffer from rheumatic fever, which starts as an innocent sore throat in children, and damages the heart.

Too many of our people are suffering from avoidable sickness, and untold millions are meeting untimely graves. In a modern society, this is simply unacceptable. Quality healthcare is the very essence of modern civilization. Posh homes and expensive cars do not indicate development. Healthy children and easy access to healthcare facilities for every citizen are the true indicators of robust development. Sickly domestic help, underweight babies and malnourished children do not make a happy society. And widespread preventable disease puts everyone, including the wealthy, at risk. We need to stand up for the rights of the poor for our own good.

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