Interview with the Health Minister: Priority to improve rural health

[Guest guest]

Priority to improve health care in rural areas: Ramadoss

by Vibha Sharma

Union Minister for Health and Family Welfare Dr Anbumani Ramadoss is

the young face of Indian politics who believes in reforms to

streamline the system. A member of the regional Pattali Makkal Katchi

(PMK), he was elected to the Rajya Sabha last year. He is now trying

to revise the curricula of medical colleges to make it more modern

besides holding examinations for medical practitioners after every

five years for re-registration as in many developed countries.

The 38-year-old minister is an alumnus of Madras Medical College. " A

doctor can understand the problems at both ends and serve patients

better " , he tells The Sunday Tribune in an exclusive interview.

Excerpts:

Q: Are you satisfied with the total allocation for your ministry from

Rs 8,420 crore to Rs 10,280 crore in the next year?

A: I am happy but we need more funds to address many areas in health.

Q: How will the National Rural Health Mission (NRHM) help the rural areas?

A: The NRHM will provide comprehensive preventive, promotive and

curative healthcare services to people, especially the poor in rural

areas and urban slums in 17 states. The budgetary increase will

finance training of health volunteers, provide more medicines and

strengthen the primary and community health centre system.

Q: How is the NRHM different from the earlier schemes?

A: It envisages people's involvement at the grassroot level. What is

unique is enlisting the Accredited Social Health (ASHA) workers,

trained and paid by the Centre. An ASHA worker, at least a

matriculate, will be trained to tackle health problems in her village

like post-delivery check-ups, post-immunisation etc. She will be in

touch with the nearest private practitioner in the area, whom she can

approach for complicated cases. The NRHM's aim is to bring down the

infant mortality rate and maternal mortality rate. The ASHA worker

will link up with the nearest primary health centre and have funds for

exigencies like transportation of the patient etc. To deal with

emergencies, 1,700 block hospitals have been identified, to be

operational round the clock.

Q: How is the response from the states?

A: Good. My Ministry has been working on the project for seven to

eight months now. Lot of coordination and hard work has gone into it.

Taking health to rural areas is a big challenge.

Q: How will the scheme reach the people?

A: I plan to visit all states. We plan to involve private

practitioners, to be paid by the Centre for their services. The

process of grading the cost of services, like delivery, sterilisation

etc, for private practitioners is being worked out. We plan to involve

chartered accountants too. I want complete accountability of how and

where the money is being spent. Besides, basic drugs for common

ailments like cold and cough, fever, diarrhoea etc will be provided to

ANMs at the sub-centre level.

Q: What about shortage of doctors and health workers in rural areas?

A: We are short of male health workers by 40 per cent. We need trained

manpower in villages. In some countries it is compulsory for medical

students to work in rural areas for two to three years before they

graduate. Such a condition is necessary in India also. Students must

work in rural areas for at least a year before they graduate and again

after they apply for post-graduation. We plan to make the curricula of

medical education in the country more modern with minimal invasive

surgery its essential part.

Q: What about internship in medical colleges and hospitals?

A: It is only when there is a shortage that interns become a part of

the system. In most institutions, work is assigned according to the

hierarchy and interns are relegated to odd jobs like performing blood

test. They need practical experience and the best way is through

hands-on experience by working in rural areas. Indian doctors are the

best but their practical knowledge is not sufficient when they

graduate from medical colleges.

Q: What about quackery?

A: I want to eliminate quackery. Quacks operate because most doctors

are reluctant to work in rural areas. In India, quacks treat 75 to 80

per cent of the population despite over six lakh doctors of modern

system and an equal number of Indian systems of medicine. Quackery

gets highlighted only when a patient dies. Most quacks generally

prescribe basic drugs and at times steroids like doctors of modern

medicine.

Q: Why is there a lot of hype on HIV/AIDS at the cost of equally

deadly diseases like cancer and malaria?

A: The media is ignoring the good work being done. The National TB

programme is one of the best programmes covering 85 per cent of the

country. By April end, the coverage under DOTS will be 100 per cent.

Our focus is on preventive health. As regards AIDS/HIV, the National

Aids Control Organisation (NACO) will be re-structured, defining the

basic functions of the state governments. We will survey the HIV/AIDS

scenario in six months. I want to know the exact situation in Tamil

Nadu, Andhra Pradesh and the North-east. I do not want India to become

another South Africa.

Q: What are your other priority areas?

A: There are no enough trauma facilities in the country. This is also

a major flaw in the golden quadrilateral project. I have requested the

Transport Minister to build trauma centres with the cess on petrol. A

Rs 20-crore pilot project for setting up trauma centres in all the

states is on anvil. Stem cell research is equally important.

As for cancer, 7 to 8 lakh new patients are added to the figure every

year. I admit the government machinery is not working efficiently to

deal with the situation. There is no cancer screening system though

the treatment is costly.

We plan to launch a cancer control programme in every district. The

ministry plans to identify and fund NGOs to screen patients and refer

them to regional cancer centres.

Punjab will be one of the nodal points for cancer control and research

in the country. We also need to buck up the national vector-borne

disease programme and eradicate Kala azar by 2015. Besides, we need

better programmes for management of senior citizen-specific diseases.

Indians are predisposed to cardio-vascular problems. Diabetes is

increasing rapidly and about 8 per cent of the population is suffering

from one mental disorder or another, of which 1.5 to 2 per cent needs

hospitalisation. Though two crore people should be hospitalised, there

is woeful lack of facilities. These areas need urgent attention.

http://www.tribuneindia.com/2005/20050320/edit.htm#1