Thursday, January 31, 2008

How confident we should be about Indian health system and doctors?


India was once regarded as having one of the best medical professionals in the world. Indian doctors are still in high demand in many countries. But what is the actual situation of health system and condition of that lot of professionals in India? Not very encouraging, to say the least.


Since last few decades urban India has seen an unprecedented rise in cesarean delivery of pregnant women. There is hardly any normal delivery, mainly in urban India ( who has access and can afford health care) these days. This menace is fast spreading in rural India. World Health Organization (WHO) states that, "both very low and very high rates of caesarean section can be dangerous, but the optimum rate is unknown. Pending further research, users of this handbook (2009) might want to continue to use a range of 5-15%".

Unnecessary and sometimes downright harmful pathological and others tests are being recommended by doctors is a norm. Unnecessary prescribing vitamin tablets and tonic formulations is a very routine phenomenon. Doctors are increasingly being influenced and bribed by drug and other companies involved in medical practice (drug or equipment or technology/kit business establishments). Illegal and selective girl child abortion by majority of private clinics and nursing homes is routine now. Substandard blood donation camps (a good source of earning for local clubs/youths) and highly profitable illegal business involving that blood is no more restricted to private clinics or nursing homes but has spread its tentacles in govt hospitals. No wonder infected blood, such unhealthy blood donation camps and business involving such tainted blood are a big source for AIDS infection and its spread in India. India is now among the major hubs of illegal human organ trade on a global scale.

Undertaking dubious clinical trials (mainly, but not exclusively, using semi-literate and oppressed section of our society as guinea pigs) of drugs developed by multinational drug companies is a highly flourishing business involving many high profile Indian private companies, nursing homes and hospitals. Doctors and so-called scientists are increasingly entering the domain of crime using their noble profession and lack of effective consumer protection as a shield. Sometimes angry mob beat up suspected doctors and vandalize nursing homes/clinics. But that is neither enough nor desirable for a civilized society. Most of the time doctors involved in such crimes are not punished. Many high profile doctors in cities like Mumbai, Kolkata etc regularly pay “hafta” (protection money) to local mafias and politicians to cover their crimes. Considering the ground realities in India, it’s not surprising that our so-called "educated" people, other doctors, scientists are just silent spectators to tolerate such corruption by many of their "successful" colleagues.

It raises the following questions:
1. Can we really perceive the extent of damage it does to not only to our present but also to our future?
2. How far we can tolerate such crimes?
3. And what should we do?


Some relevant stories and links:

“In India, poor and illiterate patients are being used to test new drugs for the West and some are unaware they are even taking part in clinical trials”.

"By 2010, some estimate there will be two million patients in India on clinical trials....Six years ago, an experimental drug from the US called M4N was injected into cancer patients in India without being properly tested on animals first".

Clinical trials claimed 25 lives in 2010, only 5 paid compensation. Families of five of these victims received "compensation for trial related death" — the amount ranging from Rs 1.5 lakh to Rs 3 lakh.

According to one BBC report, 10 million female foetuses may have been aborted in India over the past 20 years.
"He has discovered through a survey of people in the West Midlands who bought kidneys abroad that one in eight died within a couple of months of their operation and two-thirds returned with serious complications. India is one of a number of countries in the world with a thriving black-market, dealing in the sale of human kidneys". A BBC report on illegal kidney racket in India. A NDTV video and Indian Express report on the same.

A milestone case involving the murder of the wife of a US based Indian doctor in West Bengal, alleged by deliberate negligence by doctors. Indian Council of Medical Research (ICMR) supported the alleged doctors, as expected (2, 3, 4).
“Thousands of people may have been given contaminated blood that was tested with kits whose expiry dates had either been tampered with or which had passed their use-by dates during the past one year” (1, 2) .

A number of states might have bought faulty blood test kits from the Sarda-owned Monozyme India, chief minister Buddhadeb Bhattacharjee revealed today.

A mob ransacked four wards and the superintendent’s office at the famous RG Kar Medical College.


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