Written April 19, 2013
To my friends and loved ones in Boston,
I could never have imaged that Boston would be a more dangerous place than Delhi. You are in my thoughts, and I am sending you all love from this part of the world. Please stay inside until this scary situation blows over, and I do urge you to keep in contact. Even though I might be halfway across the world, I am available as a resource for anyone who wants it.
So, I thought I might write a blog post to distract you all from your worries. I apologize for the prolonged hiatus. Computer problems and traveling have stunted my blogging. I know I’m behind on posting, but I’m working really hard to catch up. Be on the lookout for more posts within the next few weeks.
The first excursion, towards the beginning of the program, was to Aligarh, Uttar Pradesh. Aligarh is a small village in rural India, known for making quality locks. This was my first time escaping Delhi, and I absolutely loved being away from the crowds, the excessive noise, and the black smog and pollution of the city. Rural India was magical. Fields filled with grains, sugar cane, and drying cow dung (used for fuel) spanned as far as my eye could see. The air was so fresh, that for the first time since being in India, I could take in deep breathes to let my lungs expand.
While we were in Aligarh, it was sugar cane harvesting season. As we drove to and from various locations learning about the healthcare system, I chewed / sucked on sticks of sugar cane. Yummy! The trucks transporting the sugar cane had destroyed the dirt roads, making our travels very bumpy. I enjoyed it though, cause I got to eat my sugar cane!
We went to Aligarh specifically because it is the home of Aligarh Muslim University, one of the premier Muslim universities in India, and the alma mater of two of my professors on the program (basically, my professors have a lot of connections with the university, and connections are everything in India). The purpose of this excursion was to expose us to the various levels of the healthcare system. We spent the week visiting three levels of the system, and learning about the factors hindering its effectiveness.
In India, health is a state subject. Funding comes from the government, but specifics concerning how those funds are allocated and determined by the state. Unfortunately, the government only spends 2% of its total GDP on healthcare, a percentage which is amongst the lowest in the world. On the opposite side of the spectrum, the United States spends over 15% of its GDP on healthcare. Technically, India has a universal healthcare system, meaning that everyone supposedly has equal access to the healthcare system. This is not the case; factors such as caste, socioeconomic status, gender, education, geographic location, political connections, superstitions and spiritual beliefs, and corruption hinder people from accessing care.
The healthcare system is divided between the public and private sector. The private sector provides care to almost 70% of people residing in cities (the wealthy). The remaining segment, mostly rural populations, depend on the government to provide care. A huge problem plaguing India’s healthcare system, especially in rural areas, is a lack of doctors. Although India produces the greatest amount of doctors in the world, few decide to practice in India. Of the few who decide to stay, very few want to practice in rural settings. The government attempts to combat this problem by making mandatory placements, for new doctors as well as those in need of punishment (usually because of political altercations), in rural locations. Although the government attempts to place doctors in rural locations, most refuse to live in such harsh conditions. Unfortunately, many doctors avoid this “punishment” by paying off government officials. Corruption in India is everywhere. I would say, although its not politically correct, that nothing in India is illegal: some things just have fines.
The current focus of public health within India is on mothers and newborn children. There is minimal, if any preventative care available for anyone else. The system is divided into three levels. The first level is the sub-center. The sub-center is “suppose” to cater to a population size between 3000 and 5000 people. The center that I visited provided care to nearly 12,000 people. An Auxiliary Health Nurse (ANM), resides at the sub-center.
Continue reading and see more pictures on Hannah’s blog: http://hdiamondblog.wordpress.com/2013/04/19/first-excursion-aligarh/