Unleashing the community potential of Indian villages

4.5 Medical Care
A village should be self-sufficient in meeting its basic healthcare. It must also build a strong connect with specialized facilities that are available at the higher levels of administration. It must ensure that the poor are adequately covered through the various systems of medicine available. The burden of medical expenses must be lightened on the individuals by getting them access to the various facilities and schemes available through the government and the various types of insurance.
Relevance:         A medical system is an inevitable part of a system’s health arrangements and is definitely ... not all of it. But even among medical systems, not all are effective for all illnesses or affordable to all sections of society. This poses a challenge and an opportunity. While saving traditional forms of medicine that are integral to the vast riches the various cultures possess, we can balance it with the goods that come from modern Allopathy. The present system is monopolized by Allopathy and is individually effective, but collectively, it is not affordable to a vast majority. Moreover, Allopathy is not culturally well-integrated with the Indian traditional system. Alterations are in order, but more than that a revolutionary departure in thinking is required if the agenda of freedom is to be met in all its dimensions.
Detailed Rationale:         There should be an arrangement to achieve a smooth link that can transfer critical patients ... from the villages to specialists at a hospital at the PURA or mandala level. The idea is that this higher-level hospital should be of such standard that even serious cases need not go any further. Every neighboring village must contribute to the building and maintenance of this central hospital.

The village should diligently work toward getting a medi-care policy for the entire village with the specific goal of targeting those illnesses that end up draining the resources of families with such patients. The fine print for such deals should be negotiated with the concerned insurance company, and this should be a village effort.

The village should also have a set policy to sponsor its health workers for value addition through higher studies. They should regularly be sent for higher courses. Such further education should not be burdened on the health worker’s personal finances.

The village should also achieve a quick response coordination with all health care initiatives of the government. It should be tuned for quick responses during times of epidemics and medical emergencies. An arrangement to fight diseases is a necessary component of a village community. Freedom in this sphere consists of having an arrangement for taking care of the ill health of every member of the village if and when a sickness occurs.

People will definitely fall sick, and they also need support for the physiological changes that happen to humans from when they are born to when they die. Hospitals, therefore, are inevitable. However, recognizing that medicine is a universal need for both, the poor and the rich, arrangements must be made such that no individual is left out of the net.

Though a systematic amalgamation has not happened between the various systems of medicine at the national level and a proper coordinated system has not been established, the village teams are not to feel constrained by this. They can show the way by promoting various options/solutions within their own jurisdiction. Only time and situation will decide the best solution for each village team. The primary responsibility for making medical facilities available to the members of a village must lie squarely on the village itself and not on any other external agency, including the government. However, that will not absolve the government of its responsibility of ensuring that the needful happens. It must actively facilitate this move.

Success Stories and Action:
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From the assortment of traditional medicines like Ayurveda, Allopathy, Unani and Homeopathy, a village should have a minimum of at least two available within its boundaries for basic medicine. Citizens must have a choice of affording at least one low-cost option which is reasonably effective for treating basic illnesses. Basic medicines should be readily available at hand. Each village should preferably have its own dedicated nursery of required medicinal herbs and should be able to obtain the rest through purchase or barter from neighboring villages. A facility for physiotherapy should be an integral part of the sports traditions in a village. The local units must have very strong links with specialized institutions at the next level, and this should be supported either through a corporate movement, the government itself or through insurance so that medical care for everyone is assured.

It is important to watch over healthy individuals through regular visits by a family doctor and have the citizens closely monitored for maintaining their good health. These family doctors must serve more like ‘maintenance doctors’ than ‘repair doctors’ though they are certified for the latter. A doctor should be paid for just being there to look after healthy people, not only when people are sick. A fixed monthly charge per family going toward the salary of the doctor should be an option that a village must implement.

Dr. Devi Shetty’s ideas as implemented in the chain of centers set up under Narayana Health appear to be a very good solution in the present context. Anand Eye Care is another model that is doing great service to rural areas and the poor. But in some way, if these can also incorporate the riches of traditional medicine and/or if similar systems can be set up for other systems of medicine, then even these other systems can be preserved and kept relevant to civilization. A healthy mix must be patronized by the government at all levels so that no monopolies operate in this sector.

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