Ranchi – the city of waterfalls and lakes – is one of the fastest growing cities in India. Located on the southern part of the Chota Nagpur Plateau, Ranchi has a picturesque topography and was once considered a hill station. Rapid urbanisation, after Jharkhand became a separate state in November 2000, has turned Ranchi into an urban jungle and taken away the hill station tag. With investments pouring in from public sector undertakings (PSUs) and private players, Ranchi is gaining momentum as an economic centre. With six industrial areas, Ranchi, along with Jamshedpur and Bokaro, is an integral part of the industrial set-up of the state of Jharkhand. The city accounts for nearly 18 per cent of the national mineral production.
According to World Bank’s report ‘Doing Business in India 2009’, Ranchi stands at number nine on the ease of doing business in India. The report is the first country-specific sub-national report, which analysed 17 cities while measuring business regulations and their enforcement across India. That Ranchi is a city of opportunities becomes clear from the influx of investments in the area across sectors like infrastructure, retail, real estate, education etc. Sadly, the city with a population of about 30 lakhs that is bustling with consumerism, is lacking in good healthcare infrastructure, forcing people to travel to other cities for their healthcare needs.
Needy healthcare scenario
 “Because of the CNT Act it is very difficult to acquire land in Ranchi. Moreover owners choose to build commercial complexes, malls instead of hospitals.”Dr H D Sharan Medical Director, Santevita Hospital, Ranchi |
Before 2000, the healthcare landscape of Ranchi was dotted with trust-run charitable hospitals (Seva Sadan) and Christian Mission Hospitals (St Baranabas Hospital). Apart from these, there were a few doctor-entrepreneur run nursing homes that provided primary and secondary healthcare services. “In the seventies, there were only three PSU hospitals serving the people of Ranchi. Later, Seva Sadan and Raj Hospital changed the way healthcare was provided in this region,” informs Dr HD Sharan, Medical Director of Santevita Hospital, Ranchi. Until recently, the city lacked super speciality service despite increasing number of cardiovascular diseases, kidney ailments, cancer etc. “When we did a study of the region we found it was terribly under-served in cancer care,” laments Dr Ajaikumar, Chairman, HCG Hospital Bangalore.
 “Total population of Ranchi is 29,12,022, with huge catchment areas – Angara, Bero, Burmu, Bundu, Itki, Chanho, Kanke, Tamar etc.”Dr Raajiv Singhal Regional Director (Delhi I, Chhattisgarh and Uttarakhand), Fortis Healthcare |
Additionally, the city grapples with increased incidence of seasonal diseases like malaria, chikungunya, jaundice, typhoid and other communicable diseases like TB and AIDS. At the same time, it is combating high infant and maternal mortality rates as well as poverty and malnutrition. Surprising then is the lack of good network of healthcare facilities in this area which has a huge catchment population. “Total population of Ranchi is 29,12,022, with huge catchment areas – Angara, Bero, Burmu, Bundu, Itki, Chanho, Kanke, Lapung, Mandar, Namkum, Ormanjhi, Ratu, Nagri, Silli, Sonhatu, Tamar,” says Dr Raajiv Singhal, Regional Director (Delhi I, Chhattisgarh and Uttarakhand), Fortis Healthcare.
The patients in need of medical attention would then go to neighbouring metros like Kolkata or Delhi for treatment. Says Dr RS Das, President, Indian Medical Association (IMA), Ranchi, “The only option for treatment of patients requiring tertiary care was outside the state. While some chose to go to Kolkata, most of them went to Vellore. Those who were unable to afford private treatment went to AIIMS. Other destinations where patients from Ranchi seek healthcare is Sankara Nethralaya, Chennai, LV Prasad Eye Institute, Hyderabad, and Tata Medical Hospital, Mumbai.”
The reason for investors shying away from the healthcare sector in Ranchi may be hidden in the fact that healthcare was considered as a philanthropic activity and the existing hospitals were charging negligible fees thereby making it difficult to break through the price barrier. “Some of the hospitals charged as little as Rs 5 for OPD consultations and patients were accustomed to paying less,” says Dr Sharan. Any corporate set-up would have had a long gestation period with little profit margin. Besides, healthcare is a capital intensive investment and until recently Ranchi was a middle income, Tier-III city with slow growth rate. “Investors did not see healthcare as a viable investment option as compared to other business. Plus skilled manpower was difficult to find and retain,” informs Dr Sharan.
 “Political reality in the state is disappointing, and is not focussed on healthcare. Ranchi has potential but affordability is thin.”Dr Naresh Trehan CMD, Medanta – The Medicity |
Another deterrent in this region is the Chhota Nagpur Tenancy Act (CNT) of 1908 that protects ownership of tribal land. It restricts transfer of tribal land to non-tribals. “Because of the CNT Act it is very difficult to acquire land in Ranchi. Land in the city is already restricted and owners choose to build commercial complexes, malls instead of hospitals,” informs Dr Sharan.” “There are hurdles almost everywhere,” says Dr Naresh Trehan, Chairman and Managing Director, Medanta – The Medicity, “but cost of creation and operation is high in Ranchi.”
Changing for the better
However, the scenario is changing as Ranchi has gained not only political prominence but also enhanced its industrial, infrastructural and educational portfolio. Similarly, the healthcare sector is also turning a new leaf. The region has got one tertiary care super-speciality hospital and a cancer care centre. Following this, a few good secondary care centres have opened up in the city. Now, large hospital chains like Fortis and Medanta Medicity are looking at Ranchi as a favourable destination. Diagnostic facilities have also changed for the better. “There has been good amount of investment in the diagnostic sector, especially MRI, CT, USG and pathology-haematology and biochemistry,” reveals Dr Das.
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Game changers
The first wave of change in the healthcare scenario in Ranchi came when a decade back the Apollo Hospital Group, in association with Chota Nagpur Regional Handloom Weavers Co-operative Union, started Abdur Razzaque Ansari Memorial Weavers Hospital (ARAM) in Ranchi. ARAM is the only tertiary care hospital in the region with super-speciality facilities. With an aim to provide the latest medical technology to the people of the region and to stop them from going outside the area seeking treatment, the Union and the members of the family of the late Abdur Razzaque Ansari started the ARAM Hospital, located at the IRBA area of Ranchi, in 1996 with 130 beds.
Today, ARAM Hospital is the first hospital in Ranchi to do regular cardiac cath, dialysis and kidney transplant, advanced neuro surgery, gastrointestinal surgery and cosmetic surgery. “The hospital is fully equipped to handle cardiac, neuro, orthopaedic, nephro, gastroenterology and haepatology surgery among others,” informs SA Ansari, Chairman, ARAM. “All modern diagnostics and imaging facilities are also available at the hospital. The equipment includes a multi-slice CT scanner, high end ultrasound machines with Doppler and multiple dedicated probes, a mammography unit and static high mA X-ray machine with an IITV fluoroscopy is available for various examinations and procedures. A 1.5 Tesla MRI unit is also available,” he says. This centre of excellence has been conferred with many appreciations and awards from different societies including Mother Teresa Missionaries of Charity, Rotarians for excellent nursing, Jharkhand Ratna Award to Cardiac Surgeon, Bharat Ratna Nirman Award from All India Business Development Association Delhi for its contribution in providing medical facilities in the rural area.
 “When we did a study of the region we found it was terribly under-served in cancer care.”Dr Ajaikumar Chairman, HCG Hospital, Bangalore |
The hospital is associated with International Labour Organisation, Fujita Health University, Japan; Rotary International Confederation of Indian Industry (CII) and The Government of Jharkhand. In 2008, a joint venture of Bangalore-based Health Care Global Enterprises and SAC Hospital Management & Consultancy Services – a firm run by SA Ansari, started the Curie-Abdur Razzaque Ansari Cancer Institute, the only comprehensive cancer care provider in the area. “The 100-bedded facility with two operation theatres, linear accelerator, three dimensional conformal radiotherapy (3DCRT), intensity modulated radiotherapy (IMRT), brachytherapy (HDR) besides image-guided radiotherapy (IGRT) is the first in this region,” explains Dr Ajaikumar.
Kashyap Memorial Eye Hospital is another trendsetter. The present day state-of-the-art first tertiary care eye hospital was inaugurated in February 2008 but the roots of the hospital go back to 1966 when it started as a modest eye hospital. It is the only hospital in the region to get NABH accreditation and ISO 9001-2008 certification. The hospital offers cataract services, cornea and contact lens, glaucoma, paediatric ophthalmology, oculoplasty, vitreo retinal, medical retina and uveitis services, surgical retina and lasik laser in modern settings.
Creating new benchmarks
In early 2012, Orchid Medical Centre, a 100-bedded multi speciality hospital opened its doors for Ranchi, bringing swanky healthcare services to its people. Even though Orchid Medical Center’s services came at a premium rate, its OPDs were soon running to full capacity. The hospital provides new-age patient experience with unrelenting attention to clinical excellence and patient comfort. The hospital brought the air of consumerism to healthcare services with its centrally air-conditioned facility and hospitable staff. A multi-speciality hospital with comprehensive diagnostic facilities, Orchid Medical Center has expertise in the fields of cardiology, urology, oncology, diabetology, ophthalmology, dentistry, general surgery, gynaecology, obstetrics, orthopaedics, neuro-surgery, neurology, ENT, medicine, psychiatry, radiology, paediatrics, physiotherapy etc.
The trend soon picked up and many hospitals tried to repeat Orchid’s model. However, another hospital took it a step further. Santevita Hospital is the new age posh 80-bedded multi speciality hospital located in the heart of the city of Ranchi. It is a centrally air-conditioned hospital with modern clinical and surgical facilities comparable to the best. It has the state-of-the-art building infrastructure with tastefully done interiors and a very focussed and hospitable staff.
The hospital has an ultra modern modular operation theatre complex, well equipped and spacious ICU, neonatal ICU, dialysis services and 24 x 7 critical care ambulance service, pharmacy and diagnostic services. “We have the latest integrated hospital information system for patient billing and storage of medical records in digital format of our patients. We are proud to have introduced new healthcare concepts like natural birthing clinic with pre-natal and post natal classes, daycare facilities, a modern sleep lab etc to Ranchi and Jharkhand. We have a strong infection control team to minimise hospital acquired infections in patients,” says Dr Sharan.
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He further adds, “We are planning to get NABH accreditation shortly to ensure standardised and quality healthcare services. Santevita Hospital is committed to provide its patients with quality healthcare services at competitive prices. We aim to become one of the most advanced and progressive healthcare institutions in this part of India.”
On the other hand, established national hospital chains have also found their footing in Ranchi. Like the Fortis Escorts Heart Institute has a footprint in Ranchi through a Heart Command Centre in Alam Hospitals and Research Centre. Alam Hospitals and Research Centre (AHRC) is a multi-speciality 150 bedded hospital, primarily focusing in general surgery.
“The motive behind the hub-and-spoke model is to provide the same level of high quality cardiac care as the Fortis Escorts Heart Institute, New Delhi, but at a comparatively cheaper price. The Heart Command Centre is manned by highly qualified doctors who are a part of the Fortis clinical team,” informs Singhal.
The centre is equipped with the latest equipment and facilities as well as skilled medical teams that are adept at performing procedures such as angiography, angioplasty, fitting pacemakers, valve replacements and peripheral bypass surgeries. This is of great convenience to local patients and cuts down considerably on tedious travel time.
Government initiatives
Rajendra Institute of Medical Sciences (RIMS) is one of the biggest and oldest hospitals of Ranchi. Government hospitals like the Central Institute of Psychiatry (CIP) and Ranchi Institute of Neuro- Psychiatry and allied Sciences (RINPAS) are famous throughout the country for psychiatric treatment.
Private players’ enhanced activity in the sector has prompted the state government to revamp and upgrade its facilities. A testimony to this is Ranchi’s Sadar (district) hospital’s ambitious 500-bed expansion plan. Though the building is ready, the hospital which was supposed to be managed by a large private hospital from Gurgaon on a PPP model is yet to start receiving patients. However officials say that once completed, the revamped hospital will certainly help address healthcare needs of the downtrodden in a holistic manner.
“In district hospitals, there has been a gradual increase in the number of beds from 100 to 300. In fact, 24 districts hospitals have been sanctioned and an upgraded district hospital is also about to be inaugurated in the city soon,” informs Dr Das.
The state government has sanctioned a budget of Rs 90 crore for RIMS in the coming five financial years including 2012-13. Some of the proposed government projects are:
- Regional Cancer Centre at RIMS
- Pilot project for hospital waste management in Government hospitals.
- Financial assistance to selected government institutions for emergency care centres in towns and cities on National Highways.
- Establishment of blood banks in 19 district hospitals of Jharkhand.
- Regional Institute of Opthalmology at RIMS.
- Burn unit at RIMS, Ranchi.
- Trauma centres at the three medical colleges of the State.
- 10-bedded mental health units at three district hospitals (Ranchi, Jamshedpur, Dhanbad)
Projects in the pipeline
Ranchi’s dream to have a super-speciality hospital on the lines of New Delhi’s All-India Institute of Medical Sciences (AIIMS) may be fulfilled soon. Ranchi’s super-speciality hospital, also known as regional AIIMS, is among the seven ‘AIIMS-like’ hospitals proposed in the country. Patna, Bhubaneswar, Jodhpur, Bhopal, Rishikesh and Raipur are the other cities where regional AIIMS has been planned.
Situated in the sprawling campus of the Rajendra Institute of Medical Sciences (RIMS) in Bariatu locality of the State capital, the Rs 120 crore hospital would be of great help for the patients suffering from cancer, renal disease, cardiac malfunctioning and kids requiring specialised surgery.
The centre has already despatched critical medical equipment worth over Rs 50 crores to be installed in different departments of the hospital. Apart from oncology, the regional AIIMS will have separate departments for urology, nephrology, cardiology, cardiac surgery and paediatric surgery at the initial stage of its operation.
The Mission Hospital (TMH), a Durgapur-based group, is said to invest in a super-speciality hospital on Ranchi’s outskirts in the Tupudana Industrial Area. The state government is in the final stages of completing land lease formalities. Ranchi Industrial Area Development Authority (RIADA) is said to lease a 3-7 acre plot to the healthcare investor on a long-term basis to set up the 200-bed hospital, initially for cardiac and kidney cases. The project, estimated to cost over Rs 100 crores, will start construction soon.
Eminent cardiac surgeon Dr Naresh Trehan, who created a fountain-head of all new knowledge and therapy – Medanta Medicity – has expressed interest in opening a wing of the much talked about Medicity in Ranchi. His company has already held several talks with the state government on its intent. “We are happy to work with the Jharkhand government and very keen to partner with them but we need to align our interests,” Dr Trehan said.
Medica Hospitals, Kolkata-based super-speciality hospital, has also got Ranchi on its radar. As part of its expansion plans the company plans to have a super-speciality hospital at Ranchi. The company is in talks with Bhagvan Mahaveer Jain Trust to manage their hospital at Hotwar near Khelgaon, Ranchi.
Alchemist Group Chairman, KD Singh, who is a member of Rajya Sabha, has said that he will set up two hospitals in Jharkhand – one in Ranchi and the other in Dumka. The group’s multi-speciality hospital in Chandigarh is headed by P Venugopal, former AIIMS Director.
In the current scenario, while existing hospitals are introducing cutting edge technology and new players are rushing in to grab a pie of the market, the ultimate beneficiary will be the patient. Although, a sizeable chunk of the population resides in the rural areas around Ranchi and may not be able to reach these services, these new hospitals will have to find a way to reach this population. Similarly, paying capacity of the people has to be supplemented by large investments in the insurance sector. At present the insurance penetration in the area is minuscule. The government will have to look at increasing insurance penetration and devise schemes like the Yeshasvini health insurance scheme to help the BPL people avail super-speciality healthcare services. “Political reality in the state is disappointing, and is not focussed on healthcare. Ranchi has potential but affordability is thin,” says Dr Trehan. “The government has to address the cost of land, creation and operation,” he adds.
The government will also have to take care of power, water and other infrastructural needs of the hospital set-ups as the present availability may not suffice the future hospitals. Human resources are an integral part of successful healthcare delivery and three medical colleges producing 200 doctors a year may not be sufficient. The need for medical and technical colleges as well as nursing schools is gigantic in this area. Government should facilitate the entry of private institutes and invest in government colleges. In addition the existing medical, nursing and technical colleges have to be brought at par with existing standards. Better infrastructure and capacity of hospitals will also bring back talent, that currently seeks employment opportunities in the metros.
In time to come
In the past few years, Ranchi has grown at a rapid pace. The healthcare segment is just starting to take off but will continue to grow. But, there is a large divergence between healthcare needs, investment requirements, and the capacity to invest, maintain and operate. A more realistic plan and even stronger will is needed to enhance healthcare landscape of Ranchi.
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