A shanty beside the road, bottles of pills upon a small desk and a banner of Mr Doctor festooned above gives a fair picture of rural health services in India. The clinic is a sure indication of its owner’s degrees and abilities. The government too has admitted that out of the total number of allopathic doctors in India, 57.3% are quacks and so practice without a degree.
A Bengali dawakhana (clinic) operating in Zalim Nagar, Behraich keeps medicines of all sorts. Its owner, a self-proclaimed doctor, told Gaon Connection over phone: “I treat minor ailments and give only those medicines which do not affect the patient adversely. I have to shell out a fixed monthly amount to the health department people in order to operate my clinic. I may be called a quack, but it is also a fact that without people like me many will perish for lack of medical care. The reality of government hospitals and doctors is open to all.”
The World Health Organization in its 2016 report had informed that about 57.3% of the doctors practicing in India are quacks and have not undergone any medical education. Erstwhile Union Health Minister JP Nadda had put down the report as erroneous, but now the Health Ministry is admitting it to be true.
One may be able to explain the deluge of quack in the country especially its rural region. Requesting anonymity one such doctor revealed: “I was a science student till 12th. Due to economic reasons I could not finish my education and took up a job in a medical store in town. Slowly I gained the knowledge of various medicines and learnt to use a syringe. After sometime I opened up a medical store in the village, here people come to me in routine illness. They get cheap treatment and I my daily earnings of 4-5 hundred rupees. I even do farming when time permits.”
Quacks such as these can easily be found in every village and town because of our ailing government health services system. As per National Rural Health Mission (NRHM), Uttar Pradesh has only 3,692 primary health centres (PHCs) as against the required number of 5,172. The condition of the existing PHCs is another matter of concern.
Indian Medical Association (IMA) Lucknow’s president Dr GPSingh told Gaon Connection: “Many lives are lost at the hands of quacks and fake doctors. It is been often observed that people prefer being treated by quacks as it saves them time and money.” He added, “few people work as compounders with doctors for a couple of years and thereafter set up their own clinics with no degree and experience of a doctor. Such person may not even know how to give injections. The government policy and public both are to be blamed for mushrooming of such malpractices.”
As per a report of India Spend, Uttar Pradesh had witnessed a fall in the number of PHCs by 8% in past 15 years while its population has increased by 25%. From past 25 years till 2015 small sub centres (first point of contact with public) have not seen an increase of more than 2%. As per Ministry of Health and Family Welfare, India has 1,23,655 health sub centres, 25,308 primary health centres, 5,396 community health centres, 779 district hospitals and 1,108 sub divisional hospitals.
Delhi High Court’s senior advocate and working for Right to Public Health, Ashok Agarwal,said: “India has neither the adequate number of hospitals nor doctors. There is a huge gap in the quality of healthcare facility as well as its availability. The gap exists not only within states, but also between rural and urbanregions. Due to unavailability of government doctors, public is forced to seek medical help from the fake ones as the only alternative.”
Working in the field of health services an NGO Jan Swasthya Abhiyan’s National Coordinator-Sulakshna Nandi told Gaon Connection over phone, “Our country’s public health system has totally gone kaput.The country’s primary health is itself ailing especially in rural areas. No MBBS doctor wants to go to a village so a large portion of Indian population is left at the mercy of quacks. Sometimes misdiagnosis even takes away life of hapless people whohave but little choice. The government needs to first pull up its primary health care services.”
As per report issued by the Union Ministry of Health’s Central Bureau of Health Intelligence, in India there is only 1 doctor per 11082 citizens whereas it should be a doctor per thousand as per set standards. This ratio is 11 times less than the set standard parameters. Bihar presents even scarier scenario with 1 doctor per 28391 citizens. Uttar Pradesh, Jharkhand, Madhya Pradesh, Chhattisgarh too face a grim situation.
Often in desperation and in lure of cheap treatment people, resorting to doctors without degree, put their lives to risk. “I suffered from piles. Despite showing to the doctors I could not find a relief. Then one of my relatives told me about a doctor in town who claimed guaranteed treatment. When I approached him his clinic boldly flashed his so called ‘MBBS’ degree,” said Manoj Mishra, 38 years from Gorakhpur.
He added: “Initially he put me on some medication for two months but to little effect. He then broached the topic of operation. My condition aggravated after the operation-the operated spot became infected and started oozing pus. With my condition turning critical I was taken to a big hospital in Delhi for treatment where it was told that the operation was not done properly leading to infection. Had there been any further delay the spot may even have turned cancerous.”
At the same time a quack puts the blame on the system, “The country has several fake institutes handing out innumerable fake medical degrees each year. Any untoward incident happens, the government penalizes us and embarks on a tirade against us, but no one acts against those fictitious institutions. It is because they have vested interests.”
The Delhi High Court’s advocate, Ashok Agarwal,said: “We have strict laws against quacks. If an untrained or unqualified person treats a patient, he can be severely penalized for fraud under Section 419,420 besides Indian Medical Council Act’s Section 15 (3). This Act provides for upto 2 years of imprisonment. For holding a fake degree, one could be prosecuted under Section 468, 47.”
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