NE Health Knowledge Mission is an Urgent Need
- Part 1 -

G S Oinam *

Ms V.S. Rao IAS (Retd), the then secretary of DONER has a vision to establish a medical consultancy cum temporary shelter especially for North east people in New Delhi. The idea was considered and welcome by former DONER Minister Shri Manisanker Iyer. Both of them are south Indian, were serving for the development of North East. Unfortunately, the idea was unfinished, Shri, Manisanker Iyer was defeated in the election for the minister of wrong portfolio in wrong constituency.(He was the minister of Panchayati Raj ,well established system in Tamil Nadu and DONER, which is not related to Tamil Nadu ). Now, UPA-II has an agenda for health information network all over India by 2020 under National Knowledge Commission. There should be active involvement of private and public health entities to effective address the creation of this network, portal, electronic health records, health data value, security, privacy and other related issues. The ready availability of information will accrue enormous benefits to public health planning, medical education, cost control, medical research, drug development, prevention of fraud, disaster management and improved patient care and consultancy. Today, DONER ministry has both Secretary and Minister from North East. Will the DONER minister consider an urgent need of NE Health Knowledge Mission in right time?

India has registered a significant progress in research and development of medical sciences and improving life expectancy at birth, reducing mortality due to malaria, infant mortality, material mortality etc. over the last few decades. In spite of the progress made, a high proportion of the population, especially in rural areas, continues to suffer and die from preventable diseases, pregnancy and child birth related complications as well as malnutrition.

In addition to old unresolved problems, the health system in the country is facing emerging threats and challenges. Rural health care system in many states and regions especially in north eastern states is in an unsatisfactory state leading to pauperization of poor households due to expensive private sector health care. India is in the midst of an epidemiological and demographic transition-with the attendant problems of increased chronic disease burden and a decline in mortality and fertility rates leading to an ageing of the population.

North eastern India in particular is invading by HIV/AIDs, a threat which has the potential to undermine the health and development gains India has made since its independent. Non- communicable disease such as cardio-vascular disease, cancer, blindness, mental illness, and tobacco use related illness, diabetes etc have imposed the chronic diseases burden on the already over-stretched health care system in the country.

Realising the health problems of India and the need of immediate measures, Ministry of Health, Govt. of India now, launched a health mission "National Rural Health Mission (2005-2012)" all over India with special focus on north eastern states of India. National Rural Health Mission seeks to provide effective health care to rural India to undertake architectural correction of the health system to enable it to effectively handle increased allocations as promised under the National Common Minimum Programmes and promote policies that strengthen public health management and service delivery in the country.

National Rural Health Mission aim to reduction in Infant mortality Rate (IMR) and Maternal Mortality Ratio (MMR).Mission has special attention on controlling epidemic disease as well as common disease like malaria, Dengue, leprosy, Tuberculosis, cataract etc.

However, National Rural Health Mission do not cover to fight the disease like cancer, HIV/AIDs, Diabetes, cardio-vascular disease, neurological disorder, Liver problems, skin disease, orthopedics problems, ENT, mental illness etc. perhaps, a well equipped specialized hospital may be suitable for the treatment of such type of diseases mostly recommended at city. Unlike other states north east states does not have well equips medical research laboratory, super specialized hospitals and medical expert.

State Medical Board therefore often refers the patients to outside state specialized hospital to save the life of patient. The question of medical care and consultancy for outside visiting patients arises as north east people are majority non Hindi speaking people and north east peoples are different on fooding and living habits besides ignorance on big city expensive life style and medical treatment procedures.

Referring and visiting outside state has become a best option to save the life of patient however, it is a big burden to patient family in financial matter and attendant of the patient as well. Patient parties are often facing the problems of fooding and lodging and treatment procedures apart from financial and information guideline of a big city.

The State health profiles of north east has revealed the urgent needs of advance medical facilities like medical research laboratory, super specialist modern equipped hospital, medical specialist and practitioners as well. Though establishment of advance medical facilities is a long term prospective and capital intensive mechanism, states or central government is not in position to fill up the gaps at immediate time and budget.

State Medical Board referring patients to outside states for better treatment at an average of 500-600 per annum i.e. 600X 8 states i.e. 4800 State Medical Board refer patients and voluntarily visiting patients at an average of 900 per state per annum i.e. 7200 approx. patients per annum from north east beside, about 5 (five) lacs north east population residing, working, studying in Delhi. Our patients visiting outside state for treatment are often victimized and misguided by local gundas for a mare monetary benefit.

Fooding, loading and consultancy at low cost is a big problem in an unknown big city. Beside, North East people have the food habits of rice and curry only. Our people are also facing language problems as majority people of north east are non Hindi speaking people. Ignorance and inexperience of expensive big city life has becoming a big problem in communication and availability of law cost fooding and lodging for poor patients' party.

Information guidelines of low cost living at the city are not available at right time beside heavy procedures of hospital admission and expenses. Therefore, North East in particular has to deal with multiple health crises, rising cost of health care and mounting expectation from the people. Given the scope and magnitude of the problems, it is no longer enough to focus on narrowly defined project.

Keeping in views of the above problems, the question of help line to support north east people arises for information guideline, consultancy and services etc. Unlike other big communities, North east people have little idea to build up Dharmasala, Gurudwara (for Sikh), and Guest House to outside state except state guest house which is very congested and most of the time occupied by the government officials on duty.

Thus, North Eastern Medical Consultancy and temporarily shelter has become a best option to fill up the gaps in a way to medical consultancy, services, providing fooding and lodging to patients and information guidelines of the city and hospital procedures etc. of the patients referring outside north east states of India.

12. ANSWER TO FREQUENTLY ASK QUESTIONS (FAQ)

1. How many patients are coming to Delhi from North East?
Answer: State Medical Board References to outside state at an average of 350-500 patients per state per annum i.e.4000 patients (for 8 states), Manipur state alone recorded 2500 patients from 2005-08. Voluntarily visiting patients at an average of 800 per state per annum i.e. 6400 besides, patients of residing, working and students from north east about 500000 (five lacs).

2. Why are they coming to Delhi?
Ans: Delhi is the Capital. Hospitals are well advertised, more convincing, well equip, expertise, super specialized, more sensitive, better co ordination and understanding among staffs and patients satisfactions. Otherwise there are many good hospitals in Mumbai, Madurai, Chennai, Benglore, Kolkata, Chandigarh etc.

3. What type of patient is generally referred to Delhi?
Ans: Patients of cancer, neurology, neurosurgery, cardio-vascular patients, liver patients, dermatology, ENT, orthodontics, orthopedics surgery, stone and pile cases, HIVS and AIDS, burn injury, pediatric, gynecological patients etc.

4. What are the difficulties in Delhi?
Ans: Language problem, information and guidance problem, high cost of city life living, hospital procedures, patients attendant, lodging and fooding problem (North east food habits are generally rice and curry and way of living are different)

5. Are there any good hospitals in North East?
Ans: Yes, Regional Institute of Medical Sciences, Imphal, Guwahati Medical Collage, Guwahati, Tripura Medical Collage, Down Town Hospital (private)Guwahati, Shija Hospital (private )Imphal are good hospital. However, they can not specialize in all medical sciences therefore; they refer patients to other specialized hospital for better diagnosis and treatments. The disadvantage of North East hospitals are over crowded, outdated equipment, doctors are over duty, less expertise and less co ordination among the doctors and staffs and misunderstanding while dealing with patients. Another factor is that they love patients (they can not treat patients as a subject), therefore, they often referred to advance hospital to minimise the risk of patients.

6. What is the Position of the faculty members of North Eastern medical collages in quantity and quality?
Ans: Unlike other states, north eastern doctors are brilliant and topers in their academic carriers. They are very good for MBBS, MD/MS degree. However medical sciences are not in static position. It is growing and progress therefore; medical professional should buy and read more new edition, publications, books, conferences, seminars, refresher courses, research and development facility etc. Due to unavailable of well equipped super specialist hospital and medicine in time, doctors are facing difficulties for advance medical treatment and operation. Doctors of north eastern hospital are generally good however; numbers of doctors with comparison to population is very less. Government doctors have engaged more on practices, they do not have enough facility for higher study and super specialization .Beside there is no trend of charging handsome amount of professional fees from patients to encourage private medical practitioners. North Eastern doctors are truly humanitarian at their best. Financial positions of the north eastern states are poor. Only central government and international development agencies can initiate and establish medical research and development facilities. Therefore quantity and quality of hospital / institute of north eastern states are averagely poor.

7. Why Health consultancy (knowledge) is required?
Ans: Health consultancy is required to get right choice of doctor in right time; time and money save and minimize the risk of patient from unwanted treatment and incident.

to be continued....

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* The author is a journalist based in New Delhi and contributes regularly to e-pao.net. He can be contacted at gitchandraoinam (at) yahoo (dot) co (dot) in. This article was webcasted on September 02nd, 2009.

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