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Protecting the protectors

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India’s abysmal doctor/nurse-patient ratio is set to get worse as the toll of COVID-19 positive healthcare workers rise. However, the National Health Profile 2019 could have some solutions

India’s allocation for defence during the fiscal year 2020-21 stood at Rs 471,378 crores amounting to an increase of below seven per cent. In contrast, Finance Minister Nirmala Sitharaman allocated Rs 69,000 crores to the healthcare sector in the 2020-21 Union Budget, slightly up from last year’s allocation of Rs 62,659.12 crores. Of this, around Rs 6,400 crore would be for Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) scheme, flat from last year.

As Ramanan Laxminarayan, Founder, HealthCube, succinctly puts it, “We spend as much on a single fighter aircraft as we do on the ICMR budget.” (https://www.expresshealthcare.in/archive/cover-storya/understanding-the-relevance-of-healthcare-research/417442/)

Doctors and nurses across the world are going to battle with no bullets and hardly any armour. Most often, they just have prayers to protect them from an unseen enemy. Many have died, many more are in quarantine and more will follow their path. While there are heartening instances of five-star hotels like the Taj Group offering their empty rooms to house medical staff so that they do not have to travel home to their families, there are also cases of paramedical staff and cleaners being denied personal protective equipment (PPE) due to the crippling shortage.

While it is understandable that hospitals are forced to ration out PPE to doctors and nurses who perform the high-risk procedures like intubations, etc., it is now evident that this is one reason why hospitals themselves have become hotspots.

India’s abysmal doctor/nurse-patient ratio is set to get worse as the toll of COVID-19 positive healthcare workers rise. However, the National Health Profile 2019 could have some solutions.

As per the report, an average population served by a government allopathic doctor is 10,926. The report reveals that based on registrations with the state medical councils, here was a dip in the number of registered allopathic doctors, from 43,581 in 2017 to 41,371 in 2018.

In contrast, there is a steady rise in the total number of registered Ayurvedic, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) doctors in India from 7,73,668 in 2017 to 7,99,879 in 2018. In the past, all attempts to harness this health resource to bridge the shortage of doctors have been controversial, with fierce turf wars.

But COVID-19 has changed this, at least to some extent. The Ministry of Health and Family Welfare’s advisory on HR management mentions that in isolation areas, in addition to training all hospital staff, dentists and AYUSH practitioners available should also be trained. The nine-page document also gives links to the training resources. AYUSH students can sign up for field surveillance, while AYUSH doctors as well as dentists, physiotherapists, veterinary doctors can sign up for field supervision.

While these measures will help to some extent, it is a Band-Aid on a more serious wound. How can we get more doctors and nurses to stay back in India? Or return? The MoH&FW, along with doctor associations and the National Medical Commission (NMC) will need to find more lasting solutions, so that the next time a virus comes knocking, our protectors are protected and prepared to protect us.

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