RURAL DEVELOPMENT
Eradication of Poverty in Rural India –
Health
1.
SIGNIFICANCE OF
THE STUDY
India’s rural poverty is like a multi-hooded octopus.
Poverty lays proper road to health. Ill-health can lead more and more poverty.
The innocence of the rural people, lack of knowledge of things, not knowing the
ways of the urban people, unaware of how fast the world is changing,
backwardness, etc. are some of the self-defeating-hoods of the rural people.
There are some more things, about which the people are not aware of, lack of
whose knowledge; the people are frequently losing the battle of life. They are
medicine, exploitation, latest techniques in agriculture, facing market to sell
their produce and so on. One among many is medicine, which keeps the people healthy.
Health, defined as the
state of complete physical, mental, social and spiritual well-being and not
merely absence of disease and infirmity. The basic objective of human
development is to improve the quality of life. Healthy population plays a key
role in achieving the developmental activities as health helps to improve the
productivity of mankind both directly and indirectly. The health situation of
India is worse. Two thirds of our population lives in worse condition. The
developments in science and technology brought drastic changes in medicine, but
in the same ratio the prices are shot up. The common man is again far from
medical provisions. Health does not exist not alone. For poor health condition
of life there are many factors responsible. To name some,
Bhore
Committee 1943
Bhore Committee felt that
1.
no individual
should be denied adequate medical care on grounds of inability to pay,
2.
special emphasis
should be given to preventive work.
3.
focus on rural
population.
4.
active
co-operation of people must be secured.
5.
a living wage
for all workers,
6.
improvement in
agriculture
7.
Industrial
production.
8.
elimination of
unemployment,
9.
suitable
housing,
10.
clean
environment.
The
First Five Year plan. 1952
In this plan various health plans are enunciated.
1.
medical care,
2.
control of
communicable diseases,
3.
maternal and
child health,
4.
collection of
vital statistics,
5.
protection of
water supply and environmental sanitation,
6.
conduct of
school health programme,
7.
family planning
services which were added on later
8.
PHCs are envisaged
as a nucleus for all health activities in the area.
Mudaliar
Committee 1961
Mudaliar committee
recommended
1.
consolidation of
the then existing services before taking up any expansion.
2.
strengthening
staffing in the then existing PHCs.
3.
the each PHC should
serve a population of 40,000 instead of 60,000.
4.
not to open any
new PHC without ensuring the full staff component.
5.
strengthening of
the district hospitals with mobile clinics to cover non-PHC populations.
Kartar
Singh Committee. 1973.
This committee reviewed the functioning of the
PHCs. It observed that there is little co-ordination among the various health
workers.
It recommended that,
1.
one male
multi-purpose worker for a population of six to seven thousand people.
2.
one female
health worker [ANM] for a population of ten to twelve thousand.
3.
integrated
training for all workers, and
4.
co-ordination of
programmes and personnel.
National Health Policy.[1980-85]
This was adopted in the Sixth Five Year plan
[1980-85]. The Policy emphasized
1.
the need to
re-structure the health services.
2.
provision of
network of primary health care services,
3.
curative centres
according to the size of the population,
4.
large scale
transfer of knowledge, skills, and techniques,
5.
to buildup
individual self-reliance and community participation,
6.
referral system
to support family health care,
7.
establishing a
nationwide chain of sanitary-cum-epidemiological stations to provide integrated
service to eradicate/control diseases,
8.
support
voluntary agencies in health services,
9.
establishing
centres for specialized treatment wherever required,
10.
make special
efforts in the areas of mental health and rehabilitation work,
11.
priority to the
provision of services to people living in tribal, hills, backward and disease
prone areas.
HEALTH
CARE PROGRAMMES
The Government takes concerted measures to combat communicable and
non-communicable diseases at the national level. For this purpose, the Centre
organizes various National Health Programmes.
1.
National TB
Control Programme
2.
National
Programme for the Control of blindness,
3.
National Leprosy
Control Programme,
4.
National Malaria
Eradication Programme,
5.
National Filaria
Control Programme,
6.
National Iodine
Deficiency Disorders Control Programme,
7.
Medical Care for
Remote and Marginalized Tribal and Nomadic Communities,
8.
National Mental
Health Programme,
Medicine is not a word, but
a universe of many branches. It itself is a system. From medical point of view
rural health can be decided by many factors;
1.
Potable water,
2.
Good atmosphere,
3.
Tensionlessness,
4.
Nutritious food,
5.
Chemicals used
in fields,
6.
Superstitions,
7.
Ignorance,
8.
Illiteracy and many more.
India is a country of villages. The
largest percentage of our population resides in rural India. If the rural India
is strong, then the nation will be strong. Rural India is like our mother.
Mother always sees the needs of the children and gives what is needed to them.
The farmer is the back bone of this nation. That farmer is not strong
financially, in health, and knowledge. He has been exploited for generations.
He is a very hard worker, but his lack of knowledge of other things is making
him weak.
The farmer, who was self sufficient
once, has become dependent on others for everything. For seeds, fertilizers,
agricultural implements, and many other things the poor people of India have to
depend on the multinationals. Many plants, roots, ashes, and other Ayurvedic
items which saved the rural people also have lost their prominence. For small
or big items the poor have to depend on the corporate for treatment. That is
why, treatment has become costly and beyond the reach of the common man.
“India
is in need of many things. You choose one problem, think it, discuss it, and
dedicate your life to it.” Swami Vivekananda. This inspired me to learn
medicine, which is one of the common problems of rural India. It is a skill that never goes waste. Wherever
such people reside,-- Baba Amte, Norman Bethoon, Kotnis, Puchalapalli Rama
Chandra Reddy, Jetty Sesha Reddy, -- their ideas can help an ordinary man.
Secondly, in China, Mao
implemented bare-foot doctors. Generally what are the health problems of common
people in rural side? Fever, motions, headache, cuts, and many types of
first-aid treatments are the common ailments. For ladies delivery problems,
menses problems, and other general ailments.
To give minimum treatment to such diseases, one need not study M.B.B.S.
It is time consuming and lots of money consuming. If the knowledge to cure such small diseases
is imparted to those volunteers who have interest in medicine, a major problem
can be solved. This idea was used and lakhs of volunteers were given training
in common diseases and sent to the rural China to serve the people. Mao was
successful. This thought of Mao inspired me to learn medicine, a valuable skill,
needed by the people.
In 1978, in Alma Ata city a world
conference was conducted on “Health’. Keeping in view of the suggestions, our
government formulated a National Health Plan. In 2002 the then NDA government
modified and reformulated the same plan.
Health
for all is the basic objective of Primary Health Care and proper planning
was initiated to achieve it.
The amount that is expended on ‘health’
in USA is 15% of GDP, in England it is 8% and in India it is 8%.
As per government’s Macro Economic Commission
on Health, the per capita expenditure required is 34 dollars, but we get Rs.215
out of which only Rs. 120 are allotted.
As WHO commission the per capita
expenditure in America 4,900 dollars, England 4500 dollars, but in India it is
only 250 dollars.
The life expectancy in USA and England
75 years, China and Sri Lanka 74 years and in it is 64 years.
71% of rural families do not have
sanitary latrines.
In tribal India, 80% people are
suffering from nutrition problem.
20% TB patients of the world live in
India.
The number of doctors per 1,00,000
people in USA 279, England 164, China 162 and in India 48.
The number of nurses per 1,00,000 people
in USA 972, England 479, China 99 and in India 45.
Brain drain of doctors is more in India,
that is out of 31000 doctors who come out of 271 medical colleges only 6 are
living in India.
During Mao’s thousands of volunteers
were given training to treat various diseases. They were called ‘barefoot
doctors’. Those barefoot doctors served the rural areas and contributed a lot
in nation building.
Substitutes, false drugs and unnecessary
medication are some other problems to rural India.
Drastic changes have come in medicine
but they are so costly, the common man cannot afford it.
Medicine to all is of four
types.
1. Promotive-
giving balanced nutritious diet improving hygienic and immunity power.
2. Preventive
– safe drinking water, sanitation, cleanliness of surroundings, protection from
atmospheric pollution, vaccination, and bringing changes in living conditions.
3. Curative
– prevention of diseases, hospitals, medicines, operation facilities.
As of now there are 1,37,271 Health
Sub-Centres, 22,975 Primary Health Centres, and 2,935 Community Health Centres
in the country. Besides these, there are
5,435 Family Welfare Centres functioning.
4. Rehabilitative
– prevention of polio, measures after eliminating a disease.
Poverty is the main thing that is paving
way for ill-health.
State of Rural Healthcare in India-NRHM
Report
India's
rural health centers are critically short of trained medical personnel. The
country's 22,669 primary health centers are in sorry state of affairs
increasing people's suffering. According to the recent National Rural Health
Mission report nearly 8% PHC don't have a doctor while nearly 39% were running
without a lab technician and about 17.7% without a pharmacist. The PHCs are
supposed to have one medical officer supported by paramedical staff.
To
compound the problem PHCs in some states donot have adequate labour rooms and
operation theatres.While not a single of UP's 3,660 PHCs have either a labour
room or an operation theatre,the number stands at 208 labour rooms (13%) and
218(13%) OTs in Bihar's 1,641 PHCs,105 (20%) Lrs and 50 (10%)O Ts in Chattisgarh's
518 PHCs and 131 (4%) LR s and 108 (12%) O Ts in Kerala's 909 PHCs.
The
condition of 3,910 community health centers supposed to provide specialized
medical care is equally appalling.Out of the sanctioned posts, about 59.4% of
surgeons,45% of obstetricians and gynaecologists,61.1% of physicians and 53.8%
of pediatricians were found to be vacant. Moreover there is a shortfall of
70.2% specialists at the CHCs. The report says there is a huge challenge to
meet the shortfall for rural health infrastructure specially the manpower.
According to
Planning Commission figures India's CHCs require 3,910 surgeons. While only
2,372 are sanctioned, just 972 are in position creating a vacancy of 1,381
posts for surgeons and a shortfall of 2,376 surgeons in CHCs. As for physicians
CHCs require 3,910 of them. There are only 832 in position with 1,296 vacant
posts and a shortfall of 2,516 physicians. Of the 3,910 pediatricians required
only 1,951 posts are sanctioned of which just 837 are in position. There is a vacancy
of 953 posts and a shortfall of 2,511 pediatricians.
Can technology be the route to bring
affordable healthcare to millions of rural Indians? This question was explored
during the session on healthcare at EmTech2009 in New Delhi. Telemedicine had already
touched 2,000 villages and a foundation had been laid for a health superhighway
to make the promise of universal healthcare a reality at last. The health
superhighway envisages connecting a chain of hospitals -- both government and
private sector -- through applications like telemedicine, mobile software and
wireless networks so that doctors can connect with villages in India. Every
single doctor in every corner of the country through a telemedicine network
should be met so that patients can not
only get access to healthcare, but can get a doctor of their choice. Other
prescriptions to bring 'good health' to a billion Indians included the adoption
of a more 'pre-emptive' strategy. The doctors should focus on awareness so that they can postpone
the age of lifestyle diseases: if a man is getting a heart attack today at the
age of 40, his age can be pushed to 60 by an awareness drive.
The allopathic medicine, homeopathic
medicine, Ayurvedic medicine and many other systems have entered the market on
a large scale.
India is one among the developing countries in
the world. It is in the third world countries.
India is the largest manufacturing
country of intellectuals. Brain drain is more in India. Then what will be the
alternative to serve the rural poor.
India is a country, which gave great
prodigies in medicine like Charaka, and Acharya Nagarjuna. And it also gave a
great and valuable medicine called Ayurvedam to the world. Every villager knows
something or the other of a medicinal value of a plant, seed, bark, or any
other thing. This is really wonderful. In those days people knew that Acharya
Nagarjuna knew how to make gold. When
requested by the students, Acharya Nagarjuna
explained the formula as;
Naagarasa
bandhanam, baala ravi chumbanam,
Hema
karo, hema karo, hema karo
The corporate world is also entering
this medicinal field in a large scale, in manufacturing Ayurvedic medicines.
For example triphala, alovera, massage oils and many other
combinations.
Now a days, beauty parlors are using
many Ayurvedic medicines manufactured by the multi-national companies.
There are many magazines, and books
which can help the common man, to know and understand the medicine for common
ailments.
- Andhariki Ayurvedam
- Amrutam
- Vydyudu leni chota
- Mandulu mana desa prajalu
and
many others.
These magazines and books also explain
the reasons why such and such ailments take place. So prevention is better than
cure. The medicine awareness of common man is enriching.
Seeds and other Food Items
in Health
Another important thing is seed. Hybrid
and HYV seeds really filled the bellies of millions of our people. But if we
take the health condition of millions of our Indians it is doubtful. Small
children getting Vandana Siva
Environmental pollution in
Health.
Water- rivers -
sentimental
Ganesh nimajjanam
Industrial wastes
Deforestation
Vehicular excretions.
Noise pollution on health
