Public health is an art and a science, a fine thread that links social determinants of health with long-term health outcomes to prevent disease, anticipate epidemics, and protect not just the rich and famous, but the poorest and most vulnerable. It draws threads between individuals, communities, States and countries. It anticipates, plans and budgets. Importantly, it does not discriminate and, most certainly, does not profit out of sickness.
In the context of the COVID-19 pandemic, a question that needs to be asked is “Was India prepared for the pandemic?” The answer is no. While Bengaluru may boast of some of the largest [and most expensive] hospitals in the country, these, unfortunately, don’t automatically transform into better health outcomes.
A visit to some of the tertiary public hospitals in the city will show how woefully inadequate they are. Public-private partnerships and health insurance schemes are no more than a smokescreen to deliberately route taxpayers’ money to schemes, which largely benefit private corporates and multinationals, forcing patients from remote rural areas to access centralised healthcare services.
All of us will surely know that the closer healthcare is to where someone lives, the better it is for a variety of reasons, expenditure being just one of them. In the context of COVID-19, one can see that centralised healthcare leads to patients being forced to travel long distances widening the geographic range of spread of the virus. Some possible lessons from the COVID-19 experience is that public healthcare has to be strengthened to be universally available and accessible at all levels.
While it is convenient to target frontline healthcare providers, one has to understand that they often have the least power, and are overworked and underpaid. More than individuals, the government should be held accountable.
(The writer is a public health doctor and researcher based in Karnataka.)