Article Source : The Times of India
Date of Issue : 17th september, 2015
Title of Article : Dengue crisis exposes gaps in health system
The current dengue outbreak in the national capital region has lifted the veil from the gaps in the healthcare system. There are more than 100 cars per 1,000 population in Delhi but the number of hospital beds available for the same number of people is less than three, data shows. World Health Organization (WHO) recommends five beds per 1,000 population.Also, public health experts say, the state of primary healthcare centres and the tertiary hospitals run by the government is pitiable.
“There are more than 228 primary health centres in the city that are run by various government agencies. These could have been used extensively to screen patients with febrile illness (fever) to lessen the burden on the big hospitals. But what you see today is that all top hospitals, including the private ones, are flooded with patients while many clinics go vacant,” said a senior doctor. He said government hospitals, particularly those run by the Delhi government, have become the last refuge of the poor and the lower-middle classes who cannot afford private treatment.
Delhi has a bed capacity of 48,096 in 1,105 health institutions. Of this, the maximum beds (46.10%) are with institutions operated privately, followed by those run by the Delhi government (22.85%), Central government (22.45%) and others (8.6%).
Experts say there is no plan for emergency situations such as this. “In government hospitals, two patients lying on the same bed and waiting endlessly for the doctor to come is not an uncommon sight. Emergency services remain the worst affected, especially at odd hours. And, there is no specialization in the field of emergency medicine in the country yet,” said a senior doctor at AIIMS. He said they see more than 400 patients daily in the casualty wards.
“There is one doctor for 20 patients. We still give our best.There are four doctors to deal with 600 cases arriving in six hours. How do you expect us to treat them all in the given time frame? The government and the administration have conveniently agreed to not refuse admission to anyone but they have failed to rationalize the distribution of patients or increase the manpower accordingly,” said a resident doctor working in the casualty area at Safdarjung Hospital on Thursday. The hospital has been flooded with dengue patients over the last few weeks.
“The pressure on health infrastructure in Delhi is even higher because of the large number of people from surrounding towns and cities who come to the capital for treatment,” said Dr Anoop Misra, chairman, Fortis C-Doc Center for Excellence for Diabetes, Metabolic Diseases and Endocrinology.
Komal Ganotra, director, policy, research and advocacy at CRY (Child Rights and You), said the health system in its present design is not equipped to deal with crises.
“Gaps in infrastructure and hospital personnel are creating an obvious dent in addressing the problem. If we look at doctor availability across government and private hospitals, there is one doctor for every 1,998 people in Delhi, which falls far short of the WHO recommended doctor population ratio of 1:1000,” she said.Ganotra added that children, especially from the most underprivileged sections of the society, are invariably the most vulnerable to mortality and morbidity, particularly in such emergencies.