When Dr Hema Saxena took four days’ leave for Diwali, it plunged the hospital where she works into chaos.
Dr Saxena is the sole anaesthetist at the Government Doon Medical College in Dehradun, Uttarakhand. In Dr Saxena’s absence, the hospital registered a backlog of more than a hundred surgeries. Patients were left waiting for days, for procedures ranging from neurosurgery to treatment for kidney disease.
Surgeries did not resume at the hospital until Dr Saxena’s return. This was despite hospital officials attempting to draft in anaesthetists from nearby health centres so that surgeries could be performed. Another anaesthetist was also recruited, hospital administrators have said.
The case spotlights one of the biggest issues facing India’s public health system: its shortage of doctors and healthcare staff, especially those in specialist positions. In the case of anaesthetists, India has just 16,500 – one for every 100,000 people.
Shortages befall a number of other disciplines across the country’s beleaguered public health system. For example, the country has just 4,000 cardiologists when it needs 88,000. This staggering shortfall occurs despite heart disease being the country’s biggest killer.
In community health centres, 81 percent of specialist positions are vacant. This includes an 84 percent shortage of surgeons; an 83.2 percent shortage of general physicians; and an 80.1 percent shortage of paediatricians.
While these numbers are shocking, they are not as shocking as the stories of the patients affected by these vacancies. One patient told of having to wait since October 21 for an anaesthetist so she could undergo surgery. Another told of her husband having to wait six days while suffering from kidney disease because no anaesthetist was available.
With India’s public health system in such dire straits, it is patients who are suffering. Where a hospital cannot provide, it is reflective of a broken system in urgent need of a fix. Yet staffing levels have plateaued in many health centres for years. Health authorities are simply failing to adequately respond to increased demand facilities are facing. Many state governments do not even spend the money allocated to them for healthcare spending.
This state of affairs is forcing many to turn to alternative methods to government hospitals, such as seeking expensive treatment in the private sector or consulting doctors via telemedicine. Some are even turning to quack doctors to plug the gaps in India’s health system.
The case of one absentee anaesthetist in Uttarakhand is not just one case at the pan-Indian level. It is emblematic of chronic and debilitating understaffing of public health facilities nationwide – and it is patients left out in the cold as a consequence.