Providing health services in remote and rural India has always been taxing for governments and that too with limited result. Donning the cap of a good Samaritan, few NGOs and civil societies are providing access to good health through their mobile units, reports Mohd. Mustaquim
Although India is a major supplier of doctors and nurses to the developed countries, but the domestic scene is not encouraging at all, as the country stands 67th among the developing countries on the availability of doctors.
According to a health ministry data, the doctor-population ratio in the country is approximately 1:2000 while the nurse-population ratio stands at 1:2950. The figure is more miserable in the rural areas. In a country of 1.25 billion in which 840 million are residing in the rural hamlets, providing health services to the entire hinterland is a gigantic task for the governments.
Healthcare in India, particularly for the underserved sections, has always been a difficult area owing to various factors. The health checkup behavior of people, affordability of health services, poverty, poor infrastructure and growing population are some of the factors. Although, the sector is gaining attention and importance, yet it is far from being what it should be.
“India is a huge country and government alone cannot meet the healthcare needs of its entire population, particularly when it comes to serving the poorest ones. This means there is a yawning gap between the available healthcare services and their accessibility to a large population of our country,” said Santanu Mishra, co-founder and executive trustee, Smile Foundation.
Sensing the need, apart from governments’ initiatives, some NGOs in the rural areas are raising a ray of hope through their innovative services. Health services through mobile clinics are one of them.
The Mumbai based, Impact India Foundation (IIF), which is promoted by United Nations Development Programmes (UNDP), United Nations Children’s Fund (UNICEF) and World Health Organisation (WHO), acts as a catalyst to bring together the government, corporate sector and the NGOs in mass health programmes.
In July 1991, the foundation launched an innovative health service through a fully equipped train, Lifeline Express (LLE). The train, consisting five coaches made available to the foundation free of cost by the Indian Railways. The LLE is customised, equipped and operated by the foundation which became the world’s first hospital on rail.
The movement of the LLE from one rural camp to another is conducted by the Indian Railways and with the IIF meeting the maintenance cost.
The LLE projects are conducted in rural areas of the country based on the need of the location and requirement of the sponsors. The train has already covered the 139 locations in the remote and rural interiors of India where medical facilities are scarce.
The foundation provides free of cost services to the people by this train. “We have Lifeline Express train, the world’s first hospital on tracks. Through this train, we cover rural and remote areas of India. This train has, as of now, treated about 7 lakhs patients free of cost. 150,000 medical professionals have volunteered their services so far,” said Zelma Lazarus, chief executive officer of the foundation.
The LLE coaches consist of two operation theatres - which perform all kinds of surgeries - auditorium, medicine stores, drawing room, sleeping berths for staffs, generator sets and others.
In November 2006, the foundation introduced the diagnostic vans, Lifeline Express Mobile Clinics (LLEMC). The vans travel to far off hamlets located in distant villages, poorly connected by roads. Particularly for hearing and vision disabilities, the mobile clinics are fully equipped to diagnose vision and hearing impairment.
The foundation operates five LLEMCs; these are being used for community outreach with partner hospitals in Maharashtra. These LLEMCs have treated 230,200 people so far in the various rural interiors of the state. The vans have special focus in Nashik, Gondiya, Miraj, Satara, Pune and Thane regions of the state.
On the issue of funding, Lazarus said, “The money is raised from Rotary International in Great Britain and Ireland.”
SMILE ON WHEELS
A national level development organisation, Smile Foundation works towards the education and healthcare of underprivileged children and youth of the country. The foundation operates in the 25 states in the country through more than 185 welfare projects in areas of education, healthcare, livelihood and girl child and women empowerment.
“Smile on Wheels is an effort to supplement and complement the government services as we believe in the proactive roles of the civil society in making the government efforts successful,” Mishra added.
As part of its healthcare projects, the foundation operates mobile clinics across the country and brings healthcare services to the doorsteps of people living in slums and villages and also promotes healthcare awareness among the underprivileged. This programme has so far benefited around 500,000 people directly across the country.
Each mobile hospital is equipped with an examination table, ECG, a Calorimeter, first aid kit, IV fluid transmission hook, nebuliser, centrifuge for pathological tests, Oxygen cylinders, stretcher, small chiller cum refrigerator, public address systems among others.
The programme, at present, is providing services through its 18 mobile hospitals in the states of Gujarat, Jharkhand, Uttar Pradesh, Rajasthan, Bihar, Maharashtra, Andhra Pradesh, Karnataka, Haryana and West Bengal as well as in the slums of National Capital of Delhi.
KARUNA – SHECHEN
Karuna – Shechen is a France based non-profit organisation which works with a network of local people and volunteers to provide education, healthcare and social services to under privileged section of the society in India, Nepal and Tibet.
The trust runs Shechen Mobile Clinics in the villages in the radius of 60 km of Bodh Gaya in Bihar. “Currently we have two mobile team including, doctors, nurses, medical assistants go together every day in the villages,” said Shamsul Akhtar, managing director of the trust’s India activities.
Providing healthcare services to the remote interiors in the country has always been a major challenge due to lack of doctors, infrastructure and connectivity. Even in the public health centres in the villages, doctors do not wish to provide their services. It adds the troubles in this service as well. The government alone cannot meet these challenges in a vast country like India. It is the need of the hour that corporate houses, with their social activities, need to join hands with the NGOs which are working in this sector.