Lessons from last month

"World needs Revolution" we used to say when in College, while responding  to the question what does world need today when the global peace is threatened, poverty and inequality are on the rise? But do we really need revolution? Or we need to address the basic needs of the people?

I have just come back from a journalism workshop in Rajasthan; where team was suppose to cover various aspects of free medicine scheme of the government. Teams went to cover Udaipur, Bikaner, Bhaswara, Jaipur and Chittorgarh.

The scheme incubated in 2012 under Mr Ashok Gehlot government, emerged out of will to provide free medical care to the people who are deprived of the access health care facilities because of their socio economic status. Dr Shamit Sharma, then District collector, was moved when his maid's son died because she could not afford the medicine prescribed by the doctor .This incident acted as the seedling for the free medicine scheme. Rest as they say is history. In the month of August a team was there in Rajasthan to cover the impact of the Free Medicine scheme.

It was for the first time, I visited Rajasthan. As I mapped the city of Udaipur every day, I found green trees and bushes hugging the Aravalli hills, until then Aravalli hills were, in my mind synonymous with deserted hills where only simooms blow. Terrace farms could be spotted along with hutments on the traces of the Aravalli hills. 

Romanticizing aside, we were there to learn about how free medicine scheme works, what were its benefits, what were the circumstances under which it operates and what the loop holes in the scheme were. Were there any new challenges experienced after the scheme became functional?

We spent First two days in Jaipur where we were inducted on the scheme and public health care system in India. Dr Narendra Gupta, doctor-activist introduced participants to the civil society movement that acted as catalyst behind the scheme. My Partner Chris and I went to Udaipur to report on doctors' role in the scheme.  Chris was an undergraduate student of International Relations at Tuft University. 

Udaipur happens to be the best performing district of Rajasthan. The government hospitals there were filled with patients especially those who till now did not come to the hospitals. Maharan Bhuwan Medical College's over occupied floors tells the density of the patients in the hospitals.

I also visited karcha kela which is home to local by tribal population, was about eighty kilometers drive away from Udaipur. With development, there are certain fallouts that marginalised and oppressed always witness. Coming of a National Highway has led to the mushrooming of roadside hotels which in turn had resulted in the sex trafficking in the region and thus HIV infections are on the rise. Girls as young as in eighth standard are getting infected by HIV, told the doctor in the region. Doctors do not want to come here and work as the land did not provide for personal growth and development.

Primary Health Care units see lesser patients but it was encouraging to see tribals visiting local hospitals, who hitherto relied only on faith healers. The only motivation for them was the availability of free medicines in their vicinity. Medical colleges and satellite hospitals were crowded. Generic drugs have proved boon for the people, especially the ones who were suffering from the chronic diseases like cancer etc. Patients' out of pocket expenditure has come down starkly.

Mostly entrants into the government hospitals were daily age workers and working class. Women have also started coming in large number as, they did not have to run to get their medicines from far off places. Beneficiaries of MNDY (Mukhya Mantri Nishulk Dawa Yojna) were not just people of Rajasthan, but patients from nearby states like Uttar Pradesh, Madhya Pradesh too come to get treated.

Backbone of Scheme-Drug ware Houses                                                                                                                             

To meet the incessant supply of medicines, hospitals rely in drug ware houses located in various parts of the State. Drug ware house stores nearly 600 types of generic medicines including surgical aids. Tertiary hospitals have their own warehouses. Primary Health Center, Satellite and Community Health Centres, get their stock from drug ware houses monthly. The warehouses were neatly kept; all the failed samples were returned. The expired medicines were sent for disposal. They try maintaining stock however medicines fall short in supply at times and there were certain medicines which were still not procured by RMLC.

Restoring trust in public system

Long queues of people at Drug Distribution Counter and empty medical stores are the strong visual evidences for the success of the schemes. The scheme might have flaws like not every medicine is available all the time, shortage of doctors in hospitals, but glitches like these cannot take away the credit of the change it has brought in the public health care. It has also set an example for other states that it is possible for a state to provide free health care to its entire people.

We are in times when public structures are destroyed and being written off and private players have stated capturing the welfare fields of education and health. Access to quality education and heath has become more of a privilege than a   fundamental right; such schemes give hope in the existence of the welfare state. State has resources and reach, which no NGO or CSR wing of any organization has. While need to criticize government and point out its failures but we what we also need to do is -engage state in public welfare and make it accountable.

 A moment for the memory and a lesson for the mind

If I were to recall the most unforgettable moment from my trip, that would be one rare sight of a 'reading' servant at my hotel in Udaipur. I was facing his back, when I was about to call him to fetch me some water bottles. His right hand was resting on the desk; under his left hand he held a mopping cloth. He was reading newspaper loudly by joining words; I was reminded how children learn to read, by joining letters. I did not have courage to utter a word thereafter. I took steps back into my room and stared staring at the half filled water bottle.

On my way back to Delhi, the fairy tale idea of revolution, its verbiage oriented solutions, its rhetoric and its theatrics got blurred because talking to people will let you know that people want quality education, good health, employment, equality, love and a peaceful life, not revolution.