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Pandemic and Public Health: A Contradiction

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“I am a cardiac patient. Doctor suggested me an immediate cardiac surgery before 6 months. But due to lockdown I couldn’t even travel to Kolkata. Ambulance charges become so high! Even train services are not available yet. What could be done? Should I die?”, Moidul Chacha was speaking about his critical situation during a conversation with iKure’s Community Health Worker. The situation has become a common phenomenon in rural India. As per the Govt. of India data, it has been revealed that due to huge expense in health, approximately six crores thirty lakhs population fall under Below Poverty Level (BPL). The situation has even become worsened in the midst of lockdown. Primary Health Care Centers (PHC) supposed to be the first point of contact for Covid-19 patients. Taking experience from China and Italy, it has been suggested that of all patients with the disease, 5-10 percent of them become severely ill and need admission to a health facility. About 70 percent of these patients can be managed with supportive care and oxygen, which can be provide through PHCs. PHCs are the frontline health providers and also awareness campaigns could be deliver by the Primary Health Care Centers. But the real situation is truly bitter. ‘Good Doctors’ are not available in maximum number of PHCs. People have to travel so long to avail the health care delivery system. The coronavirus diseases (Covid-19) has created a huge pressure on the healthcare system in our nation. As per the orders of the Ministry of Health and Family Welfare, it has been revealed that the parental and vaccination of pregnant women supposed to take place at Primary and Community Health Centers. However, it was observed that these services were largely ignored during the lockdown. According to the Pradhan Mantri Safal Matritva Abhiyan (PMSMA), around 44,000 women die every year due to pregnancy-related complications whereas 6.6 lakhs children die within 28 days of birth. As per Gaon Connection survey, it has been found that only 29 per cent pregnant women confirmed check-ups and vaccination in West Bengal. While the condition of PHCs are down, even the situation of Govt. hospitals are also horrible. As per the recent data from World Bank, it has been estimated that only 0.7 beds are available for 1000 population and numbers vary in different states. For instance, 1.05 beds are available in Kerala followed by 1.1 in Tamilnadu, whereas 1.05 beds in Delhi and 2.25 beds are available in West-Bengal for 1000 patients. The ratio between doctors and patients is so alarming. Less than 1 doctor (0.857) is only available per 100 patients. The 21st century is witnessing the changes in travel and trade, urbanization, environmental degradation and other trends that increase the risk of disease outbreaks, their spread and amplification into epidemics and pandemics. At the same time, the science and knowledge around infectious hazards are constantly evolving.Now, India is about to reach fifty lakhs mark for Covid-19 situation. As per the data, India is the second worst hit country in the world. Renowned scientists and notable doctors are commenting that if we consider our population is 140 crores out of which, 60%-70% (approximately 60 crores to 70 crores) must be infected with Covid-19, so that herd-immunity would be creating among rest of the population before discovering and producing an effective vaccine to eradicate Covid-19.

In many cases, it has been witnessed that people are now shifted to contactless health check-ups during Covid-19 pandemic. Even in this critical situation, iKure is working effortlessly to helping the rural healthcare system in every single day. The organization has organised more than 100 camps during this lockdown period. Huge numbers of patients are visiting iKure clinics to meet the doctors and availing health check-ups. Community Health Workers of iKure is regularly visiting patients’ house and taking important vitals through WHIMS. The intervention from iKure has developed to fill the gap between PHC and a patient ten years ago. Practically, many remote areas are lacking behind in the distance between a PHC and a patient. In rural areas, a patient has to travel more than 20 kilometers to avail a service from PHC. The iKure team is collecting data through WHIMS and working in partnership model with research institutes, NGOs and healthcare partners to identify critical health issues in communities and design holistic approach to prevent disease maintaining utmost hygiene and provide nutritional components that treat the disease from its route cause.

Now, the question is how could the govt. system evolve this public health crisis in a different way? Whether technological revolution will come into place to provide healthcare for the underserved or infrastructure of PHCs could be developed to provide quality health-care services to the underserved?

Soumyadip Chatterjee
Manager-Research and Communications
iKure Techsoft

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