The Healthcare System in the Country has been Ignored for the Last 75 Years: Dr. Kafeel Khan


  • July 4, 2021
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Dr Kafeel Khan has been travelling across the country since April this year and has already spent more than 80 days on the road. His #DoctorsOnRoad initiative is taking him to the villages and suburbs of different Indian states. Dr. Khan is trying to reach out to as many people as possible, making them aware of the Covid-19 virus and the disease, the healthcare measures to be taken, the importance of getting vaccinated, he is conducting health camps, distributing specially made masks. He conducted health camps in West Bengal from 1st to 5th July in North & South 24 Parganas, Kolkata, Burdwan and held a special camp for children too. In between his travel Dr Khan spoke to Sudarshana Chakraborty from groundxero about how the Narendra Modi government is ignoring the public health sector from the beginning, how the pandemic has brought forth the discrimination faced by the citizens of the country in accessing healthcare, how to make the State responsible and if there ever will be any public movement for right to health for all in the country.

 

Q: The Covid pandemic has exposed the sheer discrimination that exists in India’s health care system. How do you view this?

 

A : For the first time in the Indian history,  the elite and the privileged classes, who thought that health is a commodity, whenever we want, we can throw money & get the best health facility anywhere in India, for the first time they realized, it’s not there. They had to fight. We have seen – even in your media business, big editors of some big media companies, the ministers, the MLAs, the MPs, the industrialists – those who have billions of money, they also fought for one hospital bed. They didn’t get oxygen, they had to struggle to get Remdesivir. They fought for other medicines too. So, for the first time in Indian history they realize that this is the reality of the health system. Poor and rich divide was always there. This ideology that we talk about was always there in one form or another. But for the first time the privileged class also realized that health is also an ‘issue’. And it’s not only the Modi government, it’s not that only for the past 7 years our health system has been neglected. India has been spending only 1% of the GDP on health. And the whole world is spending 6%-8%. Post Covid the developed countries are spending more than 10% of their GDP and India is still not giving it importance; from 1%, they have come to 1.25%. We have to understand that health, education & employment are the main issues.

 

Wherever I go – I travel all over India – I ask the village people what are your expectations from your government? And they always say – “just two square meals earned with respect, a house of own, if the kids fall sick they get good treatment in a good hospital and if possible free, when they go to school they get admission in an English medium school and when the finish study they also become doctor, engineer and get some job. These are the basic things that they have been asking for the past 75 years. And what are we talking about? Even in your election (i.e. West Bengal assembly election 2021) what was there? There was no talk on health issues. Even if it’s not the BJP government here, the health condition in West Bengal is also not good. If you compare it with UP, yes West Bengal is good. But if you compare it with Kerala or other South Indian states or WHO norms – WHO says, every citizen irrespective of their caste, religion, region, socio-economic status, disability, gender identity, without any bias they should have an emergency health facility within 3 kilometers – but where is that in West Bengal? In Kolkata there are excellent medical facilities, but maybe just 60 km away there is nothing. So, if somebody has an emergency, like someone having a cardiac arrest, a mother going to deliver her child, maybe a baby is not crying after being born, someone with a kidney or liver failure – where will they go? They are facing the same problem every day. These people will go to primary health centers, primary health centers will be locked, you ask anyone in U.P., Bihar, these centres are closed after 2 o’ clock. Then they will go to the district hospital and they will say, ‘no, no this facility is not available here, go to a medical college.’ From a far away village they have to travel to the city, in between the patient may die or there can be complications. No heed has ever paid to these problems so far.

 

Q:  From the medical fraternity what do you feel should be the demands to the central government or to the States during this pandemic situation?

 

A: We have made the ‘Health for All’ booklet and we have collaborated with all the prominent doctors in India. The data we have got from WHO, World Bank, UNICEF. Can you imagine India ranking 155 out of 195 countries, India ranking 150 in 153 countries in female health, which indicates extreme gender bias. Every year 5 lakh people die of tuberculosis. India has become the second largest country in HIV & AIDS, India has become diabetic capital of the world. Every hour 100 kids are dying. Every second female is anemic. So, we have to spend a lot on public health. I told you, it’s not only the Modi regime, it is for the past 75 years, whichever government was there at the centre and in the states they have ignored these basic requirements. In the booklet we have put the solutions also. We ask them to spend at least 5% of the GDP on health. That should be the priority. How much is the current budget? 64 thousand crore. Out of which 40 thousand crore goes into paying the salary.

 

Q: As you were mentioning there is a lack of awareness and a kind of ignorance in the government machinery to improve the nation’s health infrastructure. Can you give an example in particular to explain the same?

 

A: See, health is a state subject. But the money is controlled by the Centre. The main money comes from the GST, which is the new taxation policy. And in the Covid-19 pandemic, since the beginning of it, you can see that everything is being controlled by the central government. All over the world, each & every country has gone through lockdowns. But in no country has anybody seen that the PM came to deliver a speech at 8 O’ clock & a nationwide lockdown starts from 12 O’ clock. U.K, U.S.A., all countries went through months of lockdown, but they paid their citizens. About 4000 dollars they paid to one family, i.e. 3.5 lakhs rupees per month. How much did we pay? 5 kg of wheat! Which means 20-25 rupees, maximum 100 rupees was spent for a family per month. I think state governments were also responsible for the mess that happened. They had to realize ‘health’ is an ‘issue’ which concerns each & every citizen and we can’t ignore it. Till now, the middle class, the privileged class, the MPs and MLAs used to go to big private hospitals and they used to get health facilities. They never thought health is an issue. There has been no JP like mass movement, there has been no leader, who is rooted in the soil of this country, who has seen & gone through the obstacles in life. Now is the time when somebody has to realize and take the responsibility. Now everybody has realized that health is an ‘issue’ and I hope the future will be bright.

 

Q: Though there is a lot of anger and frustration amongst the people of the country during this pandemic in particular and the list of complaints is long, the most general grievance is regarding the healthcare system in the country. There were many protests on particular issues here & there. But till date, there is no big movement across the country for the overall development of the public health infrastructure. Why so?

 

A: See, for building a movement you need a leader to move people, we are lacking in that. This is a reality. For the last 80 days I’ve been in the car only, I’m travelling to all corners of the country and I can see that people are in pain. I’ve travelled to UP & Bihar also. Everywhere people are not satisfied with their government, they are crying. They have lost their father, mother, someone from their family. But the thing is that they have to deal with so many of their personal problems, there are so many worries in their personal lives that they don’t want to be engaged with movement issues even for one day. They have to wake up early in the morning to get water in the household, some will get & some won’t. Then they have to look after their domestic animals. To manage two square meals for the family they have to work day & night. This is the reality for 70% of the population in our country. The rest 30% of the population – they just don’t care. The reality is – as a doctor, when I came from Manipal and joined BRD, I myself never realized the impact of the rise in the cost of petrol or diesel. I used to give my credit card to my driver & he used to fill my car tank. I never knew in my life what my electricity bill was. My manager used to ask for the cheque. Electricity bill paid, phone bill paid – everything paid! Now when I was put in jail, my salary was gone, everything had stopped, banks started asking about their interest on loans, electricity was cut in my house because we couldn’t pay the bill. Then I realized the predicament of the majority of the population in the country. 30% of the Indian population lives in a dream. I think the more educated & more intellectual people are becoming more communal. West Bengal is a bit different because of its culture, heritage, liberal views – not for the last 10/11 years, it is engrained in Bengal’s history.

 

Q: Do you feel after so many days on the road and through your extensive travel across the country that there is going to be a nationwide movement for the development of the country’s health infrastructure any time soon, after what the citizens of this country has faced & is facing during the pandemic situation?

 

A: There should be. There should be. This is an urgent need. But we need leaders. We need leaders to move these people whenever there is a movement or a movement will create a leader. Time will tell. But people are dissatisfied, people are suffering and one day there will be a revolution in this country, too.

 

Q: What made you take up this project #DoctorsOnRoad?

 

A:  Actually this was a coincidence. We were in Delhi with a few doctors including Dr Harjit Bhatti from Progressive Medical Scientific Forum. Suddenly we saw that in the middle of April, people started dying, these doctors were working in Delhi hospital, Rammanohar Lohia, Gangaram, AIIMS and they started reporting that suddenly there is a swarm of people with Covid-19 & people are dying in huge numbers. There was shortage of medicine, no oxygen, no bed. This ‘health for all’ campaign was started in 2018, since I came out of the BRD oxygen tragedy in 2018, I started touring all over India, I did more than 100 camps at that time itself. So at the time in April we had in mind – if this is the condition in Delhi, what is happening in the primary health centers? What is happening in the villages? Where are the villagers going for treatment, for medical help? Where are they going for the RT PCR test? There isn’t any ventilator support, oxygen support there. Then we decided that we will go to the rural area to these people. So, first we started in Valmiki colony in Delhi itself, which is a sub-urban area. There was no concept of wearing a mask or social distancing, people were dying without getting tested. Then we started this #DoctorsOnRoad initiative. We went to Rajasthan, Haryana, Telangana, Maharashtra, Uttar Pradesh, Bihar and West Bengal. Next I’ll go to Jharkhand & then Assam. I’m spending one week in a state & I try to go to the rural areas only. Initially we spent all our money. Then we got crowd funding support from ourdemocracy.in.

 

Q: We are talking a lot about the dearth of vaccination. What is the social scenario that you have seen so far?

 

A: I want to tell you one thing about vaccination, a lot of people are scared & there is also a lot of misconception about vaccination. I’ll tell you my experience in Rajasthan and UP which is very scary. I used to wear white coat while treating patient. People started to run away seeing my white coat, saying “Arey iye vaccine lagane aa gaye” (Oh, he has come to push vaccine). They still have this misconception that vaccination will cause impotency, during menstruation women should not take vaccine, even to the extent that – they think vaccine can cause Corona or that if you take vaccine you genetic line will be changed. Also some people have this strong belief that Covid-19 is nothing, people are dying because of 5G technology, these are all America’s conspiracy against India, this is all about politics – there are a lot of misconceptions. We tell them, we try to counsel them about the vaccination program also. I tell them that I’ve taken vaccine & Covaxin that is, you can be assured that even Covaxin is good.

 

Q: How can the central government & the State machinery be made responsible & answerable for the Covid -19 situation in the country & what can be the way forward?

 

A: The government has totally failed. They could not provide beds, they could not provide medicine, they could not provide oxygen, and finally they are faltering in providing vaccines also. The State and central government should not fight. They should come together. Health is one issue that they should not politicize, because it is a matter of life. So I think across the country both governments should work together & they should vaccinate each & every citizen by November. Because if we are expecting a third wave by November, whatever is being said about the kids are all assumptions, the fact remains if the parents are not vaccinated, they will take Corona to the kids. Whatever vaccine is there right now, we should give it.

 

Q: The way our health infrastructure has collapsed has shown the naked truth that the issue of health has been ignored in our country all along. The Modi regime is exploiting this all the more. How can it be repaired?

 

A: There is one thing that I tell everywhere, it is not because of Covid-19 that our health system has collapsed, Covid 19 has exposed our already collapsed health system. It can only be repaired by spending more money & by political will. All the state governments & and the central governments have ignored the health issue. There should be a will to provide more funds, the will to spend 5% of the GDP on health. Our ex-finance minister, Arun Jaitely, has promised to change all primary health centers to Wellness Centers. That promise should be kept. They have promised to open 1.5 lakhs Wellness centers, one in each village, that promise should be implemented. That was a good project. But one such centre costs around 4 crore rupees even if the land is given by the government. It means the total expenditure on the entire project will come to about 6 lakhs crore. And how much do you the government allocate every year to it? Only 4 thousands crore! So we need a political will, no political fight, every political party, all the governments should come on one platform and talk about public health. Health should be one of the main issues in each & every public discourse, more so, during the ‘elections’. The problem with Indian citizens is when elections come we forget about the basic issues and we cast vote on the basis of caste and religion.

 

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