Rural healthcare: 3 percent of doctors, 70 percent of the population

Rural populations are estimated to make up 70 percent of the total population in India. Despite this only three percent of doctors operate out of rural locations. This creates the foundations of a highly unequal healthcare system in which those in rural areas often fall through the gaps in terms of access. Many in India are unable to access healthcare facilities as a result.

Many reports have hit the media that even when community health centres (CHCs) have been established, with the intention of providing free check ups and often free treatment for those in the poorest of rural communities, the care is sub-par.

An alarming example of this occurring was recently covered in by The Wire India. The article discusses the situation of Vandana, a farmer’s wife from Nabipur village in the district of Barabanki, Uttar Pradesh. She had complained of vaginal pain for some time, which eventually lead her to seek an appointment at a CHC.

During the appointment Vandana and her family were told surgery was necessary, and there would be an upfront cost. This took the family by surprise, as treatments at the CHC were meant to be free. Insistent on the cost of Rs 4000, the family offered up what they could at the time, half the price of the surgery, around Rs 2000.

According to Rajkumar, Vandana’s father in law, the doctors were visibly annoyed by the underpayment. The resulting surgery was a botched job says Rajkumar “When they operated on her, they were totally careless. They cut through her flesh and did a shoddy job of stitching her up”. Vandana was left with worse pain than before, and had stitches that had come loose, causing her to bleed profusely. To make matters worse, when the family requested a night’s stay in the hospital, they were told to leave immediately.

This is not an isolated case. Further injuries and even deaths due to medical negligence are commonplace throughout rural India. Budgets are stretched, leading to underfunded, understaffed, and under-equipped hospitals that are often unable to deal with the host of diseases that are common in rural areas. Incentives are needed to draw doctors to the poorer rural areas claims President Pranab Mukherjee, or else doctors will remain in the higher profit rural environments.

Some see opportunity in these pitfalls that are faced by the rural communities. Mobile and internet based medical startups are seeing a rise, and may provide the backbone for rural healthcare in the absence of adequate facilities until proper facilities are in place. For example internet based medical consultations can compensate for the lack of a doctor in the area.

Companies such as World Health Partnerships (Mr. Gopi Gopalakrishnan, President of the company, has provided an interview for Health Issues India previously) are training and providing medical practitioners with equipment to allow for healthcare coverage in rural areas. Limitations for this are obvious though, while a doctor may advise about a condition online, without proper facilities any required treatment must be found elsewhere.

Addressing the situation would require a drastic rehaul of current funding commitments, with an enlarged budget for rural areas. This is not a simple task, nor one that can be completed in any small amount of time. A more achievable and short term goal, such as that suggested by President Pranab Mukherjee may go a long way to solving some rural issues, directly addressing the staff shortages.