EDITIONS

Taking healthcare to the hinterlands of India

5th Apr 2018
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When I started my medical practice in Latur, then a small town in Maharashtra, everyone asked me what motivated me. Few speculated that I was not driven or motivated enough to break the boundaries of my hometown and go to a city. Plastic surgeons like me would earn much more in a city like Mumbai or Delhi.

But having grown up in areas where even basic healthcare was a luxury, I knew the difference I could make in my local community. That was what motivated me. Over the next 13 years, I devoted my energy and time, in serving my local communities in healthcare, and treated over 7500 cleft patients free of cost, in partnership with NGO Smile Train.

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This World Health Day, World Health Organization announced the theme for 2018 as Universal Health Coverage- health for all. It is no revelation that those living in metros have access to proper medical infrastructure. However, for many affordability becomes a challenge. But affordability and accessibility, hence health for all is a luxury in many tiers 2 and tier 3 towns in India. 

Patients have to sometimes travel thousands of kilometres for surgical care, which demands not only a huge investment of time and money but also may lead to loss of their earnings! Secondly, smaller towns have limited access to comprehensive care. Many ancillary services are unheard of, which serves as a barrier towards health for all.

Hence, World Health Day serves as a reminder that as medical practitioners, we must have this inner calling to dedicate ourselves towards health for all. Having worked closely with underserved communities in and around my town, I am sharing 5 ways in which we can work within the ecosystem, leveraging the existing machinery, to make a difference.

Provide care in your local communities

It starts with you. A conscious decision is required to continue working in your local communities to provide healthcare, then moving to another city or participating in medical missions. When we work with our local communities, we are able to establish a sustainable healthcare system, and build trust amongst the communities as well. By doing so, I aim to change the common belief that plastic surgery is only for the rich.

Health state machinery to identify patients

The government has a very important role to play in spreading awareness about birth anomalies like clefts especially amongst the people living the peripheral regions of the country. In such situations, the Anganwadi and Asha workers can be the ears and eyes on the ground. Their strong network reaches hinterlands of the country and if they are trained to identify patients, they can not only sensitize the community about the health issue but also guide them to the nearest treatment centre. 

Similarly, workers of Rashtriya Bal Swasthya Karyakram and National Health Mission, jawans from Sashastra Seema Bal and Border Security Force, can also be involved as they access remote areas of the country which may not be accessible for us otherwise. Once they are trained to identify patients, especially with physical deformities, they can play an important role in mobilizing patients. It is also important to provide the right infrastructure for specialists to practice in isolated regions of the country.

Training staff in comprehensive care

As a surgeon myself, I won’t shy away from saying that we often get all the glory in medical care. However, comprehensive medical care, which really helps transform lives of patients, needs equal focus on caregivers such as nurses, speech therapists, orthodontists, pathologists and nutritionists. Training them in safe medical practices is equally important. We must remember that they interact with patients on a day to day basis, and their reassuring attitude will help instate confidence amongst patients and their families. For this, it is imperative to have an infrastructure which supports ancillary care.

Partnering with medical charities

Partnering with charities working in the health sector, such as Smile Train or UNICEF, also helps in strengthening programs. These charities not only bring the required financial assistance but also a global experience which helps in upskilling medical capacities in tier 2 and 3 towns, and more importantly, build a sustainable ecosystem.

We can truly create a positive impact in the lives of many people. For instance, a 30-year-old woman with an untreated cleft came to my hospital. A mother of two daughters, her husband had divorced her as she was born with a cleft. She was brought to my hospital through a former cleft patient and post-surgery, her husband now regrets his choice and wants to come back to the family. Her story shows how in my own capacity, I have been trying to create an ecosystem to spread awareness about cleft care in rural regions.

I know many doctors who are practising in towns such as Akola (Maharashtra) and Burdwan (West Bengal using similar principles to reach out to communities as far as 500 km from their hospitals. With World Health Day serving as a reminder for health for all, I hope everyone comes together to make a difference in this world.

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