Healthcare Challenges in India

The healthcare landscape in India is marked by significant challenges, including fake medicines, unnecessary surgeries, and unethical clinical trials. These issues are compounded by systemic policy failures that have resulted in rising risk factors for diseases. The consumption of ultra-processed foods has contributed to an epidemic of non-communicable diseases, while pollution and climate change exacerbate health issues.

Access and Socioeconomic Factors

• Access to quality healthcare remains limited, with socio-economic factors such as class, caste, and gender influencing health outcomes.
• Healthcare workers, including ASHA workers, face poor working conditions, particularly in public hospitals.

Impact of Privatisation

• The privatisation of healthcare has led to increased costs, with doctors expected to meet profit-driven targets.
• Medical education has become expensive, with private colleges charging high fees, shifting focus from social causes of disease to financial recovery.
• This has reduced the quality of medical training to MCQ-solving, producing doctors more focused on exams than clinical skills.

Role of Doctors in Social Change

Doctors have a unique capacity to drive social change due to their position of power and trust in society. They witness firsthand the impact of policy decisions on human suffering, giving them moral authority to advocate for change.

Historical Examples of Physician Activism

• Rudolf Virchow, a German pathologist, argued that disease was a social and political issue, not just biological, and advocated for structural changes in society.
• The International Physicians for the Prevention of Nuclear War highlighted the role of doctors in confronting global political violence and reframing security debates.
• In South Africa, physicians opposed apartheid-era racial discrimination in healthcare.
• India's Dr. Muthulakshmi Reddy used her medical authority to challenge social injustices and promote gender justice and public welfare.

Current Expectations from Indian Doctors

• Indian doctors are encouraged to question systemic failures, such as the prevalence of advanced-stage diseases and unaffordable medicines.
• Oncologists, surgeons, nephrologists, and other specialists are urged to address policy failures contributing to health issues.

Systemic Issues and Solutions

India's healthcare system is likened to an overflowing bucket due to public-private partnerships, unchecked privatisation, and underfunding. The focus should shift from managing symptoms to addressing root causes.

Role of Policy and Power Structures

• Effective policies need implementation, and existing policies should not remain confined to paper.
• Doctors are urged to advocate for policy changes and challenge profit-driven industries that prioritize profit over health.

Conclusion

Doctors carry a moral responsibility to advocate for those who suffer, leveraging their social standing and ethical obligation to challenge structural injustices. Silence is not neutrality but a choice to forgo influence, emphasizing the need for doctors to act as agents of social change.