Missing Health Care

Health Care Ideas and Issues International

New Orleans: Yesterday returning to New Orleans – and home – seemed full of surprises.  Spring was everywhere.  Pink and white azeleas were blooming around the house.  New growth had the bright green unique to the season.

 Another pleasant surprise was a dear note from a companera, Terese Bouey, who sent along some of her favorite – and long promised – pictures from a trip we both shared as part of a delegation assembled by the Organizers Forum to New Delhi and Kolkata, India.  (Check out www.organizersforum.org — where one can find other pictures from the trip and a full report of the activity!)  Looking through the pictures of our group meeting the CITU – the Central India Trade Union – in Kolkata brought back memories, as did one of us receiving flowers and ceremonial welcoming marks on our foreheads at the Great Eastern hotel owned by the city government there.  What a trip and an education!

 All of which made my eyes immediately hit the bottom of the front page of the New York Times this morning as I awoke to an article entitled “Deserted by Doctors, India’s Poor Turn to Quacks.”

 The article turned on two different, but related problems, one of which a World Bank report argued was widespread throughout the underdeveloped world, and that was huge and devastating absenteeism and abandonment of the health infrastructure in these countries by health care professionals – doctors and nurses – themselves.  The study found that in India, Bangladesh, Indonesia, and Uganda medical personnel were off premises 35 to 40% of the time.  Peru was only slightly better with a 25% absenteeism rate.  The article indicated that India was spending about $2.00 per person (compared to $2000 per person in the U.S.) and in another twist of fate had increased the expenditures recently for raises – among other things – for the docs and nurses who are not on the job. 

 A cruel and expensive irony, it would seem.

 The second problem was bred partially by the first.  When Indians cannot find the public health professional, they go to whoever and whatever is available, and that is an untrained amateur trying to make a living.  Interviewing some of these folks was a tragic picture of put upon working stiffs, who felt that they were meeting the demands of the market for shots and glucose drips, because that’s what the patients wanted:  medicine on demand in other words.  The pros partially were no-shows because they didn’t have any meds to work with much of the time and were suffering from bad morale because their patients wanted remedies more symbolic than real, which they could not provide.

 A catch-22 from hell that leaves one caught between laughing and crying, made all the more terrible because it ends up about nothing but another way of dying.

 Every spring still seems a pleasant surprise, though nearly identical to the previous year, while India – and too many other “hard done by” countries and peoples, seem still staggering in the immense magnitude of the unimaginable chaos and catastrophe of a constant and continual shock surpassing any reasonable expectation.