BY OUR SPECIAL CORRESPONDENT

NEVER MIND the awards the Chief Minister of Goa is picking up! According to keynote speaker Javid Chaudhary, former secretary (Health), Government of India, speaking at the 35th Annual General Body Meeting of The Voluntary Health Association of India on September 11, 2009, it is not Kerala or Himachal Pradesh or Goa, but Tamil Nadu which has the best health system in India. But Tamil Nadu, Kerala and Himachal Pradesh are exceptions in the country.

Speaking on the subject of "Governance of Health Sector in India, Has the Government Abdicated Responsibility?" Mr. Chaudhary said that, on the whole, there is an urgent need for the country’s health sector to be upgraded for this sector is even inferior to other developing countries with worse economies like Indonesia, Sri Lanka or Bangladesh. The UPA government spends barely one percent of its annual budget on health and, although it has been promising to raise it to two or three percent, this has not happened so far. The country urgently needs an equitable policy vis-à-vis the health sector, especially in the primary health sector.

Mr. Chaudhary also criticised the Indian private medical sector, saying that it was not cost-effective and over-dependent on drugs, which make up 75 percent of the cost in any treatment. Interestingly, there are about 8,000 non-governmental organisations engaged in providing better health services in the country and, of this, the Voluntary Health Association of India (which has a Goa branch) is the world’s largest non-profit NGO with 4,000 NGOs affiliated to it. The VHAI, established in 1970, is now a federation of 27 state level voluntary health associations with the primary objective of making health a reality for the people of India. In this respect, it has been engaged in policy research, advocacy, intervention campaigns and need-based training and implementation of health and development projects. It has also published some landmark publications like Where There is No Doctor, Where Women Have No Doctor, The State of India’s Health, Health Promotion in India, National Profile on Women, Health & Development, and other publications in a series to educate the lay public.

Other speakers at the meeting were VHAI president, Dr. Nagesh Simha, and VHAG president, Dr. Gladstone D’Costa who, while speaking on the subject of health laws, observed that wherever morality ends, legality begins! Dr. D’Costa eloquently detailed that when it comes to health laws the story of the hare and the tortoise holds true in India - with the "hare" (medical technology) being market driven while the "tortoise" (health care and legal status) taking its own sweet time to catch up! With medical science progressing rapidly one can envision the bizarre bazaar coming up in the harvesting of stem cells, organs, wombs - someone is bound to come up to a specialist and ask if a daughter as beautiful as Aishwarya Rai can be fixed! A country’s laws must keep pace and be updated for justice to prevail.

VHAI chief executive Alok Mukhopadhyay observed that health in any country is not an expenditure but an investment and a government which does not make generous funds available for such things as water, sanitation, the health of women and the poor classes, can be accused of having abdicated responsibility. Government of Goa Chief Secretary Sanjay Srivastava defended the status of health care in Goa by pointing out that it was better than in many another states in the country. According to him, Goa spends up to 40 percent of its budget on social and healthcare and this is not duplicated anywhere else. By way of examples, he cited the 108 ambulance service which for a year now has been playing a valuable role in saving life; Goa has also taken the lead in screening new born babies for defects (this is apparently not done elsewhere in the country). Goans also have an enviable state-funded Medicare insurance for treatment worth Rs.1.5 lakh to as much as Rs.8 lakh for cancer patients. Soon a mobile van will be touring rural areas to reach out to patients in villages. Mr. Srivastava, in fact, appealed to the VHAG to critically analyse Goa’s healthcare status!

This year’s VHAI award winners include Anshu Prakash, an IAS officer in the Department of Health & Family Welfare in Arunachal Pradesh. Mr. Prakash has done pioneering work in setting up 16 public-private participation health centres in rural Arunachal Pradesh. A good NGO is hard to find, he said, but he has found good NGOs in the Karuna Trust of Delhi and the VHAI. Good NGOs can keep government agencies briefed about ground realities vis-à-vis primary health needs in any area. A government has to be discerning for if it is not discerning it cannot reward a performing organisation and cannot punish a non-performing organisation. A VHAI award also goes to Dr. Wilfred D’Souza, who both in his capacity as a surgeon and later as chief minister of Goa, upgraded health facilities in the state. Way back in 1963 when he came back to Goa to practice, Dr. D’Souza reminisced a bit while accepting the award, there were no surgeons in Goa. Goan patients depended on visiting weekend surgeons from the big cities like Mumbai! Thankfully, all that has changed now.