Covid-19 pandemic: Doctors cannot be blamed for flaws in healthcare system

The year 2020 will be remembered for not-so-good reasons by healthcare workers in India. Referring to them as corona warriors, 'gods in white coats' in hospitals, ringing bells, showering them with flower petals etc., did not flatter them. The men and women in white did what they were best trained for - to bravely fight the disease, serve the sick, research their way forward by analysing the behaviour of the virus, to upgrade the dos and don’ts. This probably is the only war where soldiers risk making their family casualties.

In the beginning, they were aptly encouraged by all, with tall promises of insurance cover, supply of PPEs etc., later on leaving individuals in private set-ups to fend for themselves. Never before did the deficiencies of the healthcare system emerge as prominently, as now. The government, which spends a minuscule amount on healthcare, sprang into action to cover its shortcomings by building overnight temporary hospital beds and beds with ventilators but manpower shortage stared them in the face. The private sector was thus compelled to work at these places and also coerced into agreeing to give away 80 per cent of its beds at unsustainable rates. Worse, these enforcements came in the forms of illegal diktats and circulars threatening cancellation of registrations and filing of FIRs.

Initially, the government forcibly acquired all the available PPEs for its own hospitals, leaving private hospitals to fend for themselves. The same government that lost no time in curtailing hospital charges did not find it necessary to curb the cost of N-95 masks till very late in the pandemic. These events have stamped an indelible memory, obviously not a good one, in the minds of doctors and nurses.

Needlessly blamed

A lot of distrust has been generated by these measures and WhatsApp forwards, as well as the actions of the politico-social brand building publicity-seekers. The same healthcare person, supposedly a martyr, was refused entry into their homes after work. The wounds inflicted are deep and will not heal without a scar. I hope the people of this country realise sooner, rather than later, that doctors at all the large hospitals are only treating persons and do not control any other aspects of the hospital, such as billing or paramedic services and hence, cannot be blamed for all that one feels is wrong with the healthcare delivery system.

While the corona warriors tirelessly continue their fight, others in society lose no opportunity to flout all norms of Covid prevention. Their right to protest on any, or every matter, overrules their duties towards the nation. Amidst the so-called lockdown and the unlocking, everything and anything that the men in power wished to do, has happened. Social distancing and masking have been taken on multiple rides at almost all political rallies and protest dharnas.

Best vaccine for now

Has a single politician or so-called neta of any sect been fined for blatant disregard of the guidelines? One can see people moving freely with ministers and outside police stations, without masks. The mask has become more of a chin cover or a necklace to be flaunted, flagrantly violating its purpose. The very same people who are eagerly awaiting a free vaccine as their right, do not wish to do their duty by wearing a mask and maintaining social distancing.

Paani-puris are being wolfed down in public places as though 'paani' has the properties of 'amrut'. Unlocking has been done to get the economy on track, provided guidelines are followed. Even a small percentage of mortality means that that many fellow citizens will not be amongst us, just because of one disease alone. The best vaccine available as on date is three-pronged and does not hurt: a mask, soap for handwashing and a small distance.

'Ayushpathy' surgeons

And in the meanwhile, as uproars happen over anything and everything, a deafening silence is being heard on matters which could affect their own health in the long term. A recent notification, allowing doctors from 'Ayushpathy' to perform specific surgeries, does not seem to have made anyone sick with anxiety other than the doctors of modern medicine. If the training imparted to these doctors is full and final, then why this restriction on all surgeries? Any sound mind can thus guess that the training imparted would be 'surgery-specific' and not 'surgeon-specific'. Is surgery only a cutting-and-sewing procedure?

A doctor of any 'pathy' or for that matter, even the public now agrees, after hearing corona stories, no two patients with the same disease behave similarly. Though a surgeon from modern medicine achieves a 24 x 7 x 365 x 3 years' training in surgery, built on a strong foundation of anatomy, physiology, pathology, microbiology and medicine, they undertake further training to achieve competence. The most important aspect of this exercise is to ensure – 'Do No Harm'. He/she acquires the skill to differentiate between patients and their seemingly similar conditions to decide whom to operate, how to operate, where to operate and most important, when not to operate. Gauging pre-operative safety, intra-operative anaesthesia, post- op uneventful recovery is all an integral part of this holistic approach.

Public health at risk

The notification is silent on the anaesthesia part or the post-op drugs. The display of the same degree, MS, as done by allopaths by these 'Ayushpaths' will falsely lure many innocent people to get treated by them without their will. Why has no NGO, no political party, or media taken note of such a blatant attempt to risk public health? Won’t it be too late to wake up if such a notification with long-term consequences is brushed under the carpet? The followers of modern medicine are obviously crying foul but their attempt to project it as a public health issue is being considered as their vested interest. Is that so? Does anyone reading this article have an iota of doubt that a more competent and trained person need not worry about such competition? Does 'atmanirbar' means promoting ‘Make In India’ or allowing 'desis' to use 'videshi' means?

The AYUSH Mantralaya, supposed to promote Indian methods of treatment, has, in fact, only concentrated on getting back-door permission for its graduates who could not make it to the allopathy stream due to lesser marks, to practise modern medicine after studying brief courses in the same. If Indian medicine is so good, why shy away from practising it? Why the crying need to be allowed to practise modern medicine? If it’s the numbers we are working on, then why not convert all AYUSH colleges into colleges of modern medicine and have more numbers of doctors per lakh of the population. There are many questions posed by these actions of the Government but will those affected ask them or continue to be silent spectators to the beginning of the death of a system of medicine that has saved so many of their loved ones at one time or the other.

The writer is Managing Trustee, Association of Medical Consultants, Mumbai, and Consultant Surgeon, Bombay Hospital.

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