I was taking a long break for nearly ten days from writing a blog. I think it was not because I had become procrastinator but because I didn't know what to write about- Sri Lanakan elections, Padma Awards, Ruchika's case etc..etc. But suddenly the announcement came from Union health minister Sri Gulam Nabi Asad that the govt has a proposal to introduce a new course named as Bachelor of Rural Medicine & Surgery shortly which is a 3 1/2 years duration that will teach basic medical and surgical procedures suitable to villages. I found potent blog material in this announcement that it will kindle a lot of criticism among the doctors community and general public. These so called Doctors?! can't treat the patients in the towns and cities. Those will be treated by the regular ones with a proper 5 1/2 years training.
The pitfalls in this system are:-
1.As doctors we are aware that even that stipulated 5 1/2 years is not enough to sail the sea of medicine. How could one with a 3 1/2 years will master the basics and so called rural clinical knowledge and be ready to face the patients?
2.When the Union health minister had told this policy decision didn't he realise that the people in villages also belong to Homosapiens and not a different species?
3.If he considers them as fellow humans is it not inhumane to subject them for treatment by half baked doctors? National Human Rights Commission(NHRC) had strongly stressed this point recently.
4.Shall we consider that it is failure of our medical system that it can't persuade fully qualified doctors to work in rural areas?
5.On the contrary shall we consider that it is failure of fully qualified doctors to accept the decision made by Ex union health minister Dr.Anbumani to make rural service compulsory to newly recruited doctors? That Union govt has denied chances for those with 5 1/2 years degree to work and earn in the rural areas.
6.What are higher studies options of these rural doctors? Is it possible to switch to Urban?! medicine in the future?
7. The Union Health Minister had boasted that the system of rural doctors is a great success in the states of Jarkhand, Uttranchal. He had forgotten one thing that there are no doctors at all in those states which are newly created recently. Hence it was a run away it in those states. India is a diverse nation with each state posing different problems that same result cannot be expected in all states.
8. Also already in most of the rural areas in South India especially in Tamilnadu doctors are doing great service to the people. I don't know how many of you know that there is an "Association Of Rural Surgeons of India" for years together in our country which itself shows that there are like minded doctors who are dedicating their life to people in villages.
9. Again there are lot of doctors who had enrolled their names in Executive and Professional Employment Exchange and waiting for the governments call. They can very well be called for posts in rural areas. This point was endorsed by Director of Public Health of Tamilnadu in a weekly. He had also said that the system of rural doctors is not suitable for Tamilnadu.
10.A great joke is that the rural doctors will treat common ailments and refer the complicated ones to cities. That is what happening now at PHCs. PHC has to give primary health care and health education and do a timely referral if the case warrants. No doctor can treat decompensated liver failure at a PHC.
Of reading the above story one can judge that creating rural doctors will create confusion in our society.We don't know whether people will know the qualification of the doctor treating them. Where will I go? My own doctor or the one at town?, will be his question.It will create confusion among the rural doctors. Who am I? A doctor? A nurse?, will be his question.It will create confusion among the government. How much we have to pay?, will be its question. How long will it go we don't know.
We hope that before implementing this system govt will analyse the pros and cons and act judiciously. As for as I am concerned there are lot of cons than pros. What is your view?
The pitfalls in this system are:-
1.As doctors we are aware that even that stipulated 5 1/2 years is not enough to sail the sea of medicine. How could one with a 3 1/2 years will master the basics and so called rural clinical knowledge and be ready to face the patients?
2.When the Union health minister had told this policy decision didn't he realise that the people in villages also belong to Homosapiens and not a different species?
3.If he considers them as fellow humans is it not inhumane to subject them for treatment by half baked doctors? National Human Rights Commission(NHRC) had strongly stressed this point recently.
4.Shall we consider that it is failure of our medical system that it can't persuade fully qualified doctors to work in rural areas?
5.On the contrary shall we consider that it is failure of fully qualified doctors to accept the decision made by Ex union health minister Dr.Anbumani to make rural service compulsory to newly recruited doctors? That Union govt has denied chances for those with 5 1/2 years degree to work and earn in the rural areas.
6.What are higher studies options of these rural doctors? Is it possible to switch to Urban?! medicine in the future?
7. The Union Health Minister had boasted that the system of rural doctors is a great success in the states of Jarkhand, Uttranchal. He had forgotten one thing that there are no doctors at all in those states which are newly created recently. Hence it was a run away it in those states. India is a diverse nation with each state posing different problems that same result cannot be expected in all states.
8. Also already in most of the rural areas in South India especially in Tamilnadu doctors are doing great service to the people. I don't know how many of you know that there is an "Association Of Rural Surgeons of India" for years together in our country which itself shows that there are like minded doctors who are dedicating their life to people in villages.
9. Again there are lot of doctors who had enrolled their names in Executive and Professional Employment Exchange and waiting for the governments call. They can very well be called for posts in rural areas. This point was endorsed by Director of Public Health of Tamilnadu in a weekly. He had also said that the system of rural doctors is not suitable for Tamilnadu.
10.A great joke is that the rural doctors will treat common ailments and refer the complicated ones to cities. That is what happening now at PHCs. PHC has to give primary health care and health education and do a timely referral if the case warrants. No doctor can treat decompensated liver failure at a PHC.
Of reading the above story one can judge that creating rural doctors will create confusion in our society.We don't know whether people will know the qualification of the doctor treating them. Where will I go? My own doctor or the one at town?, will be his question.It will create confusion among the rural doctors. Who am I? A doctor? A nurse?, will be his question.It will create confusion among the government. How much we have to pay?, will be its question. How long will it go we don't know.
We hope that before implementing this system govt will analyse the pros and cons and act judiciously. As for as I am concerned there are lot of cons than pros. What is your view?
its controversial and i wonder whether this would takeoff, in the first place.....!
ReplyDeletefirst and foremost, we in tamilnadu tend to think this idea queer coz we have a very good rural health service and we dont need a 1/2 doc to take care of our villages...but its not the case in many parts of india esp.., north india...! so, i feel this mere concept is justice for those unfortunate ones and mockery for the rest of the ppl ( say south india??!!)
and ya, we have a long way to go with regard to public health and our health indices ( even in TN)are still pathetic with regard to international standards ( even asian stds as a matter of fact)....
i think this system will curb quacks to some extent in such underdeveloped areas....on the whole , its ok if planned n executed properly... !
Since some ministers have attention seeking behaviour they propose plans like this with half baked knowledge.They realy don't have a strategic analysis and long term plan.
ReplyDeleteThere was something called as RIMP in those days for basic ailments management during war and emergencies. lot of people pracice with the same degree till now. now they can neither be blamed completely as quacks nor called as physicians.I donno which village people they are talking about. only half the proportion of village people in south will go to doctors in their hometown. Rest they go to nearest town.
Instead they can strengthen the ASHA's
Another comedy is that the department of AYUSH.nowadays there AD's in TV that homeopathy is best without side-effects. (? effects)
why dont they produce this so called Indigenous medicine doctors (who the MOHFW considers best)for rural services.
A health minister from Karnataka in a public forum made a statement that Allopathy and people who are practicing that are harmful.
One request to our honourable ministers, if you go to our rural areas (atleast during election campaign)and you have some basic ailments, you should be treated only by a BRMS.
Yureka why dont we produce something called as rural ministers. afterall the village people are suffering because of non availablity of administrators. I am serious...........
Happy to see you friends in my blog page! Please continue your visits often and leave your valuable comments.As for as the idea of 'Rural Ministers', there are already minister for rural development in every state as well as at the centre. But I am not sure what they are doing. I think only they should voice their concerns that villager is not inferior to anyone that he will be treated by a half doc( thanks to Jawahar for this beautiful usage).Many of the professional bodies have raised queries over this issue. Where is the answer?
ReplyDeletemay be those who get treated by these docs come out n say "something's missing" ( courtesy indica manza advertisement)
ReplyDelete'rural doctors'!!! that's funny... how about a 'rural engineers' with a two year course... how about 'rural teachers' so its enough to have passed 5th standard to take class for rural high school kids... 'rural minister'... as suggested by Arun, just thinking about them tickles me... how about 'rural actors' ... they would act only in film based on villages, even if they doesn't acting no problem... they should learn to wear exact fitting half trousers properly... any way there is another proposal soon called 'kuk grammam' doctors all they have to do is a one year course as an intern in a PHC ...
ReplyDelete