(At the moment, India is woefully unprepared to tackle the predicted rise in cancer cases; the need of the hour is more cancer specialists and better treatment options in the existing infrastructure. With economic development a focus, improving healthcare must be a priority too. This World Cancer Day, here’s hoping the government wakes up and takes note.)
By the year 2025, the number of cancer cases in India will multiply five times, with a higher spike in women than men, according to the World Health Organisation. That’s not all, currently, there are only 2,000 cancer specialists in the whole country to take care of more than 10 million cancer patients.
It is tough not to notice that India’s public healthcare system is already in shambles. Bollywood, perhaps the great mirror to our society, uses the phrase, “sarkari hospital ki tuti hui bench” (Welcome, 2007) as a legitimate insult. Indians are mortally afraid of just three edifices: the police station, court room and a public hospital.
To cure the ailing public health infrastructure, the Union Health Minister announced 20 new advanced cancer treatment centres like AIIMS. But it’s a race against time. A cancer hospital is not a bakery item, produced at will, like roti from a tandoor or a double roti from an oven. Moreover specialised edifices are not the panacea for India’s ailing public health crisis; the need of the hour is more cancer specialists and better treatment options in the existing infrastructure.
But can more AIIMS-like hospitals really be the panacea for India’s public health crisis?
There are several reasons to be skeptical.
India: Only 2000 Cancer Doctors To Treat 10 million Patients!
You will be shocked to know that every year India adds just one specialist in gynaecological oncology – this branch includes cancers of the cervix, endometriosis, ovaries and vagina.
Just four paediatric oncologists pass out of medical colleges every year and only six blood cancer specialists.
The situation is likely to worsen with an expected 20 percent jump in the number of cancer cases by 2020, according the Union Health Ministry.
It is almost impossible to bridge the doctor-patient ratio gap soon unless dramatic measures are taken to increase the number of seats in medical colleges. Cancer is not just one disease, it’s a group of more than 200 diseases and the seats in these super specialities are limited.
There are only nine hospital beds per 10,000 people in the country and a severe shortage of paramedical staff and lab technicians. India spends an abysmal less than 1 percent of its gross GDP on healthcare.
The biggest challenge for new hospitals is the acute shortage of human resources, especially the senior and junior residents.
According to the Union Health ministry’s own admission, out of more than 300 cancer hospitals in India, 40 percent are not even adequately equipped with advanced cancer care equipment. India will need a minimum of 600 additional cancer care centres by the end of this decade to meet the requirements of an ailing population.
The 6 new AIIMS-like institutes with elaborate cancer wards, which were announced in 2006, started in 2011 and despite offering the same salary structure as AIIMS Delhi, just about a fourth of the faculty posts have been filled. And it’s more alarming for the paramedical staff.
Figure this: AIIMS Raipur has only 64 clinical faculty members out of the sanctioned 305. Out of the required 1,800 nursing positions, there are just 200 nurses working on contract. Similarly, at AIIMS Bhubaneswar, only 68 faculty members have been hired.
The Challenge Lies Beyond Hospitals
Contrary to popular perception, healthcare is in the ICU in India, not just because of a lack of doctors, corrupt doctors or dilapidated hospitals.
1) Last year, a study done by Tata Memorial Hospital found that nearly 30 percent of cancer patients discharged with from the hospital in 2014 died from failure to get proper post-op care and hospice facilities.
2) The excessive attention on curative medicine takes away from the importance of cost-effective preventive health care, which will also improve the nutritional outcomes in the country.
3) Ironically, cell phones reach the deepest rural pockets in the country but not healthcare. If shortage of doctors is one problem, their unwillingness to work in the rural hinterland is another, creating artificial scarcity in the area and high concentration in another.
Sar salamat toh pagdi hazaar is a popular proverb in Hindi. It means: in times of crisis, first get the basics right, embellishments can wait. Our policymakers should dwell on this ancient wisdom. Perhaps with the “Make in India” initiative, the PM should also embark up on a “Treat in India” drive.
After all, investing in health works wonders for a nation’s economic progress, or ‘development’, as the current government buzzword goes.
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