Every Child Matters
It was a cold New Year’s Eve. I was cramped between an eight-month-old infant and her 5-year-old brother, acquainted only in the last eight hours, in a small hospital bed of one of the biggest and crowded government hospitals in Delhi. This was not the way I had planned to celebrate the New Year’s Eve. Yet, there I was watching this acutely emaciated baby regain some strength after having had some milk from a feeding tube.
Earlier that morning, my friend and I were giving away some food and clothes to patients in a government run TB hospital, something we did every Christmas. As we were heading back to the exit gate, we spotted a young boy and what looked like a bundle of clothes kept near him. We could hear a feeble cry coming from the bundle. We approached the boy and learnt that his mom, suffering from TB, was admitted in the hospital. His uncle, mother’s brother, had left him and his baby sister there promising to be back in a short while.
We picked up the baby and uncovered her face. What met our eyes was absolutely gut wrenching. A tiny human being in just skin and bones barely surviving. This baby obviously had not been fed or cleaned for weeks. When their uncle returned we consulted him and admitted the children to Safdarjung hospital. They were both suspected of tuberculosis in addition to acute malnutrition. I volunteered to attend to them for the night. The next day, I left the hospital hoping that the doctors and the nurses in the hospital would be kind to these children.
Public healthcare facilities in India are overtly burdened with a multitude of patients, we all know, but knowing and experiencing are two different things. India has less than one doctor for every 1000 population which is less than the World Health Organisation standard. The doctors in the emergency ward, mostly interns, are overworked and generally in a foul mood. When one such doctor was examining the baby, I had meekly requested him to be gentler when he gave me this ‘how dare you’ look and screamed, ‘Someone, get this woman out of here!’ It was very intimidating. I couldn’t imagine how old, weak, illiterate and poor people could cope with such intimidation.
Well, human dignity and respect is not a priority here, people are simply grateful they get to consult a doctor at least. They didn’t make this long journey from a rural district to the capital city for nothing. We, the city dwellers, don’t quite understand the struggles of 68% of the population living in rural India with limited access to healthcare services. And their complete reliance on the government run clinics and health programmes which, despite good intentions, are grossly inadequate. People end up selling their houses, land or livestock to get treatment for serious illnesses. Indians spend 62% of their health expenses from their personal savings, called “out-of-pocket expenses”, as told by P. J. Kurien, deputy chairman, Rajya Sabha, compared to 13.4% in the US. Those who live hand to mouth, poor health can completely derail their lives like this family I had met.
I kept in touch with the uncle to get an update on children. Sadly, on third day their uncle took the children and left the hospital without proper treatment. Back in the T.B. hospital, their mother had passed away. And the phone number of their uncle became unreachable. I could never know what became of these children. Did they get the help they needed? Did they survive? I don’t know. Collectively, we failed these children. We failed to give them the basic human right to health. In 2016, nine lakh children under the age of five died in India — the highest globally, more than some of the poorest countries in the world (A global disease burden study). The Director General of World Health Organisation said, “No one should have to choose between death and financial hardship. No one should have to choose between buying medicine and buying food.” Yet, this is the dilemma millions of poor people in India face on daily basis.
This year’s World Health Day theme is Universal Health Coverage (UHC), health for all (WHO/UHC). UHC is a widely shared global health agenda as United Nations member states have agreed to work toward worldwide universal health coverage by 2030. UHC essentially means healthcare system that provides healthcare and financial protection to all citizens in a country. UHC is an important part of the 3rd Sustainable Development Goal of good health and wellbeing. In India, UHC was included in the 12th Five Year Plan (2012-2017). However, the integration of public-private healthcare services, health insurance providers and government healthcare programmes is still a big challenge.
There is a ray of hope as the present government has stepped up the health expenditure from 1.2% of GDP to 2.5% in 2017 even though it is still nominal compared to its neighbour China that spends 5.5% of the GDP (WHO/Countries 2014) while the United States spends 18.3% of the GDP (Fortune.com/Sandro Galea). However, India has made exemplary progress in curbing HIV/AIDS and tuberculosis epidemics in the last two decades. The recent nationwide campaigns like ‘Swachh Bharat’ and ‘Make India Defecation Free’ are also steps towards improved sanitation and hygiene which directly contribute to better health of the entire population.
The author of this blog is Tara Rana, Communications Associate: Digital and is associated with End AIDS India Campaign, India HIV/AIDS Alliance.
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