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Battle brews over barefoot doctors
G.S. MUDUR

New Delhi, Feb. 2: India’s largest association of doctors and the country’s apex regulator of medical education appear poised for confrontation over a government proposal to create a new cadre of healthcare providers for rural areas.

The Union health ministry has announced a plan to create a group of health practitioners who could diagnose and treat common illnesses and injuries and prescribe medicines to patients in rural areas plagued by shortages of doctors.

The health ministry has asked the Medical Council of India (MCI) -- the apex regulator of medical education -- to design the syllabus for the proposed three-and-a-half year Bachelor of Rural Medicine and Surgery (BRMS) programme.

Proponents of the plan say the health ministry backing now appears to have pushed India closer than ever to the idea of an alternative health education plan that emerged nearly a decade ago, and has been pursued only by three states -- Chhattisgarh, Assam and Bengal.

The MCI has called a meeting of state medical education officers and senior faculty in New Delhi on Thursday to discuss strategies to implement the plan.

But the Indian Medical Association (IMA), claiming to represent some 180,000 doctors across the country, is launching a campaign to oppose the alternative health education programme.

“This plan will only produce substandard, half-baked doctors who will be able to deliver poor quality of healthcare,” Goparaju Samaram, a general practitioner in Vijayawada and national president of the IMA, told The Telegraph.

The IMA has pencilled a memorandum criticising the alternative health education proposal, contending that it would promote dual standards of medical care -- superior care in urban India and substandard care for the rural masses.

Surveys suggest that three-fourths of India’s estimated 700,000 MBBS-graduate doctors live in or around urban areas, serving less than 30 per cent of the country’s population. None of India’s 145,000 rural health sub-centres has any doctors.

“The rural health practitioners will fill a total vacuum,” said Kunchala Shyamprasad, a cardiothoracic surgeon and member of a government task force on medical education that resurrected the idea of an alternative course three years ago.

Although the Union health ministry has in the past often discussed the option of mandatory rural service for doctors before they earn a MBBS degree, the plan has remained unimplemented.

Proponents of the alternative health education plan point out that several countries in Asia and Africa have addressed doctor shortages through similar plans. India itself used to have a short-term course but it was abandoned.

“All we want is someone who can diagnose and treat severe respiratory infections, diarrhoea or malaria to be within 30-minute walking distance from every village home,” said Meenakshi Gautham, a public health specialist who has filed a petition seeking the implementation of an alternative health course for rural health practitioners.

“MBBS graduates are clearly not interested in rural areas,” said a mission director with the National Rural Health Programme. Health officials cite their recent experience in Chhattisgarh which had advertised for nearly 1,200 posts of MBBS graduates to fill positions in primary health centres. The state received only 400 applications.

“We aren’t able to spend the funds allocated for doctors’ salaries,” a state official said.

Education regulators concede that India's medical education system has failed to prepare its medical graduates to work in rural areas that lack infrastructure and facilities available in urban hospitals.

MCI president Ketan Desai said even students from rural India preferred to stay back in cities. “After nine to 13 years of medical education in Delhi, which graduate would want to go and work in Gorakhpur?” asked Desai.

I fully support the government in its effort to supply a life-line to the village people through alternate medicine.
I know the doctors (MBBS) will never agree.
They have been taking the people of India for a ride for the last 62 years and they will not give up their hegemony easily.
The MBBS doctors, except for a few, are a bunch of crooks.
1.They prescribe unnecessary tests as they have a commission agreement with the test labs.
2.They prescribe unnecessary, high value drugs, as they are given perks which include paid holidays to foreign countries by the pharma companies.
3.They give referrals to other doctors, you scratch me, I scratch you.
4.They hospitalize patients unnecessarily so that they can earn there too.
5.They keep dead patients under the respirator, although the patient has expired, so that the hospital bill mounts.
6. They remove vital organs like kidneys from poor people and children without informing the patient and sell it to the rich at astronomical prices.
7. The conduct tests to check the sex of the unborn foetus and abort the female foetus.
8. They bill each and every patient of theirs in any hospital, everytime he visits the hospital although he spends hardly 15 seconds with the patient.
The IMA which is spearheading this opposition is a useless organisation just for the benefit of the MBBS doctors, to protect their rights but unmidful of their duties.
How many guilty doctors have they punished in the 62 years of our independence for all the above crimes.
What have they done to provide medical facilities to the villages by sending MBBS doctors?
They will find a thousand excuses, why doctors don't go.
No, they have not been able to organise anything and when the government is doing something it opposes.
At least the poor villagers will get some treatment, presently they get nothing.
They had even opposed Swami Ramdeo when he started teaching people pranayam and yoga to keep them healthy. However, in Swami Ramdeo, they found a force who would not buckle down under their blackmail.
Brinda Karat also found that out the hard way.
Their evil deeds could fill whole books and yet they will not allow alternate medicines to develop.
Homoepathy, Ayurvedic medicines, Unani medicines name them and any effort to promote them are quashed under their strong arm tactics.
We are fed-up of their blackmail.
Let the government promote all the alternate medicines and encourage them.
90% of the health budget in our country has till date been used to promote only allopathic medicines.Let the government reduce their allocation and increase the allocation for alternate medicines.
As it is, the villagers die for not receiving treatment. At least 75% of those unfortunate people may be saved by the bare-footed doctors.