India’s health worries go deeper than brain drain


Instead of fixing the poor medical infrastructure, the government is trying to cover up the mess by blaming doctors yearning for greener pastures

By Anirudh Lochan

Illustration: Anand Naorem

UNION HEALTH and Family Welfare Minister Gulam Nabi Azad recently made public his plans for preventing the drain of medical brain from our country. From now on, as per newspaper reports, doctors wishing to go abroad for higher studies would have to sign a bond with the government, and later honour the same by coming back. If they don’t, the government would not issue a no-objection certificate, a pre-requisite for being considered for employment in most of the western countries.

The reason being given would make the patriot in me shake my head vigorously in agreement, if only I was a patriot with an empty head, or a patriot who believes that medical manpower is synonymous with only doctors, or one who believes that the only thing lacking in our crumbling primary and secondary healthcare system is lack of doctors, or for that matter, a patriot who believes that doctors have no families nor the right to aspire for a decent lifestyle.

Thankfully, I’m not. I’m a chest specialist. Most of my batchmates are working abroad. I don’t blame them for it either. I did not leave because I come from a family of doctors, and have a family hospital that employed me as soon as I passed out. Those who have left did not.

It took me 11 years to become a chest specialist. If, at the end of those years of studying night and day, of duties sometimes stretching over 48 hours (without sleeping), someone would come up to me and say that now, I have to work in a primary healthcare centre in some remote village with no nurses to administer the treatment prescribed, no technicians to do the tests requested, no pharmacists to render the drugs in the correct dosages as instructed, I would think. If I also found out that I would have to stay away from my family while I was there, or otherwise send my kids to some local school with no benches, and no teachers, I would think again. And last but not the least, if I was told that I would be given a quarter of the salary that I would otherwise have earned in an urban centre, I would simply refuse.

IS IT really a crime for a doctor to yearn for a decent lifestyle? True, we have a responsibility towards our country, but we also have a responsibility towards our families. Medical education is heavily subsidised in the country with almost 31,000 doctors graduating from 269 medical colleges each year, according to a Press Information Bureau report. The government has not done us a favour by making us doctors. If it is a question of the State money spent on making us doctors, well, the government is free to hike our fees, or impose a monetary penalty on doctors who do not wish to sign the proposed bond. It would be a price most of the doctors would be readily willing to pay.

And what if all the doctors do indeed honour the bond and come back? Will the government then sign a counter bond that promises them jobs, decent accommodation and opportunities for pursuing research activities? The health minister is, quite obviously, silent on that issue.

The Centre can impose a monetary penalty on those who don’t wish to sign the bond

Forcing doctors to come back would not help. We are not to blame for the pathetic state of our health infrastructure. India today faces a shortage of 1 lakh doctors, 2 lakh nurses, and an even higher number of technicians and other paramedical personnel. One visit to a government health facility is enough to make most affording patients swear never to do so again. It’s the government’s failure, one that it is trying to cover up for by making populist statements, and yes, by blaming it all on the doctors who have gone or are planning to go abroad.

Sadly, on the same day that this announcement was made, another report was made public. Forty seven percent of measles deaths (a disease preventable by vaccine) occurs in India. As per the World Health Organisation, the blame lies in our poor vaccine distribution network, and not on the shortage of doctors, as the Union health minister would have a patriot with an empty head believe.

The views expressed in this column are the writer’s own

Anirudh Lochan is a National Secretary, the young doctors Association of India.


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