From the previous article it was clear that the testing kits of dengue fever which is also a RNA virus (like Covid 19) was found lacking in the study by IJMR scientists whereas the website of the test kit manufacturer says it is the largest seller of such a product.
Does that mean that people are using these kits without much scientific evidence to back it up? Or is it that just like Chinese kits for Covid -19 which were found lacking, these dengue rapid test kits which the manufacturer was supplying since a decade was getting exported to unsuspecting countries (or states) ?
The lack of adequate and reliable testing kits and its quality has hampered the epidemiological accuracy with which we are presently dealing with the virus, for example if one knows that there is a testing kit available in the neighbourhood clinic which costs a few hundred rupees, then anyone who wants to know, would get it done and isolate himself or prevent spread on his own will, or even the local authorities would also have a knowledge about where all the disease has possibly been spreading.
But instead what we see is that any patient with symptoms have to undergo a bureaucratic exercise of going through multiple echelons after which the test would be possible, over and above the lack of PPE makes many health care workers averse to reporting to duty, and few who are working and risking their own bodies to infection are in dark about whether their patients may be infected.
All the districts have been divided into containment and green zones and the government seems concerned about the economy, restriction of movement and preventing spread seems more of a forceful measure from the administration rather than a voluntary exercise by the people to prevent spread.
In such a scenario there could be secretive behavior and corrupt practices going on which may be aiding the spread of disease, for example when the central government blames a state government of not reporting on disease statistics, it gives a ominous message to the rest of people who depend on the honesty of the others out there in the world to entrust their lives in the time of a pandemic.
Better would have been the scenario in which, people at community level should have been empowered to tackle the disease in their full capacity, and if sufficient testing kits and PPE kits would have been available, that would have been possible, but unfortunately it has not been so until now.
As if these deficiencies were not enough. In some red zones there has been ongoing preparations to make a thousand bedded hospital with cardboard beds, and doctors in private sector have been asked to get attached to these temporary set ups to manage the epidemic failing which they have to forego the privilege of being registered with the medical council, this makes it obvious that along with other crucial infrastructure, the manpower of motivated doctors is also found deficient now.
It would be pertinent at this point of time to draw attention to the medical colleges which produce doctors in our country, few years back there was a sting operation by a news channel on MVJ medical college (near Bangalore) wherein it was exposed that there were fake patients, fake case files, fake documents and false statistics which was produced before the MCI, so as to get more management seats which would fetch more money to the management.
But even if it is presumed that only a few medical colleges are running like MVJ medical college, and others are not in charge of medical education in the pretext of making money, the overall picture of the health sector belies that assumption, strengthening the notion that exposure of corrupt practices in one particular medical college may be just a “tip of the iceberg” phenomenon.
Medical colleges in the country have largely become mass producers of subservient non-inquisitive unquestioning rote learners in the name of doctors (most of them rich enough to afford long periods of waiting of a phase of entrance exams), the colleges conspicuously lack atmosphere of free thinking and learning as a part of a scientific discourse, because the management usually has a overriding motive of something else other than science.
The lack of scientific atmosphere at the very roots of the system of health science leaves the next best thing sought after by all of us in our country which is “money money and money” as the prime motive and driver of the system, which subverts everything else including science and makes it just a show business, evident in the form of science-unrelated people becoming speakers in national conferences of medical societies and not using “testing testing and testing” as a strategy to control the pandemic.
To unravel the rot, as a study case MVJ medical college was whistleblowing long before the sting operation by TV channels (which might have counterproductively made it even more famous as a degree certificate seller) in the form of letters to MCI and central vigilance and ministry of higher education which all might have fell on deaf ears, in one such letter when I was in the department of OBG of MVJ medical college (2011-12), I had written to the administration to provide additional infrastructure in the form of a lab so as to serve a subset of the patients with infertility(who may need assisted reproductive technology lab) which was not granted even after a reminder (after six months) with signature campaigns of students studying over there.
Presently the draft assisted reproduction technology (ART) regulation bill on the ICMR website agrees to the fact that there is lack of training facilities for the various staff requirements of such a lab, and exploiting such a situation unscrupulous profit oriented private ventures like Indira IVF have been using the pretext of training in ART to bond doctors into serving their private for profit venture for minimum of 5 years failing which the doctors may have to pay huge sums of money as damages.
The example above (though unrelated to an epidemic) is pertinent to the fact that we can deduce that our system of medical education is anti science and more pro- business, this conclusion is further reinforced by the fact that none of the science institutions including the medical colleges which suffix their names with “Research center” figure in the top 300 science institutions of the world.
However, the above fact of un-scientific-ness built into our medical education system would not be exposed unless such challenging times as the epidemic hits us and makes it threadbare that we were never anywhere near to tackling it scientifically and it was all an eyewash of months of lockdown after which a bureaucrat from DELHI announces that we must learn to live with the virus.
But what he intends to tell with much more love is that we the labourers have to get back to business as medical education teachers, medical practice as business, pharmaceutical manufacturing as business with a hope that some maverick may invent a vaccine or a drug against all these odds.
Welcome to business as usual with the virus.