Health is a fundamental human right and the World Health Organisation (WHO) has been relentlessly working to make this right available to all. The right to health for all means that everyone should have access to the health services they need, when and where they need them, without suffering financial hardship. WHO’s central mission is Universal Health Coverage so that health facilities reach all humans, irrespective of their age, gender, race, religion, sexual orientation and financial status.
This year, for World Health Day (April 7), WHO has chosen Universal Health Coverage as the theme. Medical and healthcare professionals across India tell us how they are already working towards it but a lot more needs to be done to eliminate all kinds of inequalities when it comes to health services.
EDUCATING YOUNG MINDS
When it comes to health in India, what I have noticed is that there are a lot of services that are made available and, as a matter of fact, are beneficial for people and their health, so providing healthcare is not at all difficult. What is nerve-wracking is to convince people to make use of these services,” says Dr Vaibhav Kumar, dental public health specialist and faculty at Terna Dental College, Navi Mumbai.
As a public health sector dentist, he mostly works with people at the grass-roots level. “Now, we need to understand that these people, who are in the age group of, say, 40+, are the ones who have never seen a toothbrush, let alone having used it. So how do you convince them?” points out Kumar.
If you want to inculcate good, healthy habits among people, the level at which it needs to be taught are young children.
Sharing his experience of school visits and teaching children the need to maintain good oral hygiene, Kumar says, “The kids do go back home and share this knowledge with the other family members, which is the first step towards a healthy life — having a conversation about it.”
The most basic thing is to motivate them to have a conversation and create awareness among people on preventive healthcare rather than treatment. However, Kumar believes that people in India are skeptical about taking steps towards preventive healthcare and they also shy away from talking about their illness. “They often consider sickness to be something that is not normal, so they never open up and seek help to solve these issues,” he says.
This is the reason why health education should be made mandatory in schools. “It is an opportunity to secure not only their future but also the future of others,” says Kumar further mentioning that healthcare is one such sector where it is important to involve a lot of people and make use of multimedia tools to make them aware of certain life-saving skills.
During camps held in schools basic health-related things are taught to children like how to brush the teeth, how often one must consult/ visit a doctor, how to figure out symptoms and so on. Healthcare can reach children and even adults through such efforts.
SOCIAL WORKERS CAN CREATE AWARENESS
There is an essential and immediate need to provide healthcare to all sections of society, be it through government schemes or private sector services. “Combining knowledge, experience and passion in supporting initiatives that help build healthier communities is something that is at the centre of our CSR (Corporate Social Responsibility) activities,” says Joy Chakraborty, COO, P D Hinduja Hospital.
However, Chakraborty says that CSR activities shouldn’t be a compulsion for organisations. “Healthcare activities should be born out of passion and have a meaning to them,” he says adding that healthcare is a social responsibility that needs people to come up with the best and impactful health-based programmes that bring about a change and transform the lives of millions.
“Such initiatives can bridge the enormous gap and disparity between urban and rural healthcare,” says Chakraborty pointing out that it’s not only the responsibility of doctors and healthcare experts to spread awareness and knowledge about health services and programmes.
Social workers play an important role here. “They are the true backbone of these initiatives and camps because they are the ones who fill in the gap and are actually successful in getting people out of their homes to make use of the health campaigns,” says Chakraborty.
He strongly believes that non-medical intervention could probably solve problems of healthcare facilities. “While they cannot talk much about the medicines, what the non-medical people can focus on are the parameters of nutrition and hygiene to maintain a healthy life,” says Chakraborty adding that these parameters have a direct impact on the health of people.
If relevant education is provided, be it in schools or even at the community level, a number of health problems can be tackled all at once which will eventually reduce the number of sick.
LOCAL CONNECT
Healthcare facilities and services are available in plenty, but the people who can benefit from them are not making use of these facilities,” says Dr Manish Soni, who, in the past, has worked in the remote areas of Rajasthan, to spread awareness of fluorosis.
Soni says that the government and private hospitals have undertaken a lot of drives for healthcare to reach more people. “But we have observed that some people willingly don’t take advantage of the services because they are of the opinion that it might cost them a lot. But what people fail to understand is that preventive measures are actually cheaper than cure,” he says adding that these camps are being undertaken with a thought of making healthcare easily available to the people that need them by identifying the diseases that are prevalent in the area, so that maximum number of people should be able to benefit from the services.
However, people in rural areas are quite skeptical when doctors from hospitals or NGOs set up camps in villages, asking them to come and get themselves checked and treated for illnesses. “Obviously, they will not trust people who they have never seen or met in the past,” points out Soni who thinks the only way to get more people involved is by getting help from the local people and getting them to convince the others on a larger scale. “Anganwadi workers and midwives are actually the ones who can bring people out of their homes and convince them to get themselves enrolled at health check-up campaigns,” he says.
When local people, be it teachers or even the panchayat, start a conversation regarding healthcare, people will actually pay heed and come forward to avail the facilities.
IMPACT OF INNOVATION
Over the past few years, a lot of technological innovations have been taking place in every field, be it the food industry, the banking sector and even healthcare for that matter. Healthcare changes dramatically because of technological developments, be it nano surgery, gene therapy and so on.
Professor B Ravi, who heads the BETiC division of IIT-Bombay and recently authored The Essence of Medical Device Innovation, says, “We need to rapidly traverse the path from idea to invention to innovation to impact in healthcare domain. This requires all relevant stakeholders to come out of their comfort zone and work together.”
He says that innovative medical or healthcare technology is not something that is limited only to the super powers. “India too is ready for this kind of technology that would cater to all kinds of medical needs of patients and this is happening because of the tremendous market pull by doctors, technology push by researchers and conducive environment created by the government for entrepreneurs.”
He strongly believes that technological innovation will transform the healthcare sector and will make health services available for all. However, we still have a long way to go. “Stating the fact that the ratio of doctors per thousand people is very low in India and taking into consideration the state of medical education and poor working conditions in government hospitals, this ratio is unlikely to improve in the near future,” he says that this challenge needs to be taken up as an opportunity to develop innovative devices, methods and policies by academia, industry and government. “They must consult and collaborate with each other, which has already started. Take the large number of healthcare startups that have come up in the last five years, they promise to lower the skill level, time and effort required for screening, diagnosing and monitoring various diseases, thereby making healthcare more affordable even to the poorest,” he says adding that many of these are supported by the Biotechnology Industry Research Assistance Council (BIRAC), a not-for-profit public sector enterprise set up by the Department of Biotechnology, Government of India.
“Innovations like smart stethoscope, diabetic foot screener and glaucoma screener being developed by such startups are enabling early detection of common diseases, enabling more effective and less expensive treatment which is definitely a dawn in the field of healthcare and this will enable healthcare to reach more people in India,” Prof Ravi concludes.
GOING DIGITAL
Digital technology has made a lot of difference. It has made life easy — booking a cab, ordering food, watching a film — all can be done with the help of a mobile phone. “Because of this nature of digitisation, if we channelise healthcare in such a way, it could be made available to more and more people who are in need of it,” says Dr Ruchi Gupta, who founded H3Care.com, a website that allows patients to maintain their records, book appointments for labs or pathology tests, and also lets users consult a doctor online.
“It is a known fact that the internet has penetrated through all levels of society, so why not invest in it in a way that will be beneficial for the needy?” she says adding that there is infrastructure that is being developed to run hospitals remotely because doctors cannot reach those places, but they can offer their services digitally.
She is of the opinion that if doctors go digital along with their regular practice, second opinion would be easily available, and patients could get opinions from specialists in no time without having to travel to a different city, state or country. “Usually, those living in cities have access to second or third opinion, but people in rural areas don’t even have the means of getting a first opinion,” she adds.
“When we talk about healthcare in India, be it in rural or urban areas, people will not consult a doctor in the preventive stage, but throng to a clinic once the sickness starts getting out of control. Healthcare perception needs to improve,” she says pointing out that there is a small change in this behaviour though, because slowly people are now becoming aware of a lifestyle that is healthier in terms of nutrition and exercise.
“What we have realised is that when people read about certain preventive measures and sicknesses online on trusted health portals they do take up measures to live in a certain way, which leaves it to us to develop content that is responsible,” says Gupta.
