A hospital in Guwahati. Image: Northeast Now

Exposed with the fact that not only our education system in health but also our healthcare system except some pockets in the country are in shambles (with reference to handling an epidemic), what are we left with except that we learn to live with the virus?

And what are the consequences of living with the virus? We know that the people above 60 yrs of age will suffer the most in terms of mortality.

A conservative estimate would be around few millions ending up dead and around few lakhs of dead being young also, but what is most fearful is that the spectre of those lakhs overwhelming the already in shambles health system, which is mercilessly unraveling in front of us.

Presuming that when we start living with the virus, the consequences will be the same for everyone is another fallacy which needs exposure here. It is well known fact that just an increase in socio economic status makes people escape from not only many infectious diseases but also diseases like cancer. Likewise data from other countries shows that the people from the lower socio economic strata have succumbed disproportionately more to the virus.

With rising disparities in socio economic indicators, the consequences for a large section of population who don’t even know what is in store for them will be devastating when it strikes. The administration knows this and has managed to drive down the fear, but not able to muster up the infrastructure and manpower needed to tackle the same. If it was some other country with which this can be compared then the administration at centre can shed off the responsibility by giving the excuse of our country being poor and hence this consequence for the poor.

But the fact stares clear in our face that there is a huge difference in mortality rates within the country.  For example some states showing lowest in terms of numbers dead even though they were the first to get infected people from abroad. It has proved that education, public health infrastructure and manpower managed to stop spread of disease but also important is a sense of equal access to health care which is needed so that people don’t hide the disease.

But in rest of the country the health care is largely private corporate, profits-driven with the money earned reaching the top brass who just manage the brand and sub-lease their brands to smaller capitalist for-profit managers.

This capitalist buy the brand and run it with huge costs into advertising and exploit the relaxed labour laws to use the staff.

This staffs are outsourced to other exploiters who as a pack of greedy collaborators just run the hospitals as a business like any other famous brands selling in a mall, with utter disregard to the health of its own workers, and of course forget about the society at large.

For example Indira IVF doesn’t do the blood and other crucial investigations for its patients on its own. It has outsourced it to another brand known as SRL and in the same way housekeeping and security services to another John Peter company.

The workers under these brands practically have to work as a team with the Indira IVF (but technically come under some other administration) so as to deliver the health care necessity for the patients, but to my dismay what I found was that the employees of SRL had not got basic benefits like ESI even after serving in it for more than a year.  On the other hand, John Peter Company has no idea where its employee got treated for head injury and didn’t bother to give him leave for recovering from injury and instead threatened him of layoff.

Few such outsourced company employees functioning with Indira IVF underwent a harrowing experience with employers who denied ESI benefits even after keeping them as a trainee for over a year. The person needed a medical service and was asked to pay Rs 30,000 for the same by indira IVF. They approached Indira IVF because being employed in the same premises but had not got the ESI benefit (which they had to get it by the time they had to undergo the treatment). Finally after months of running around from pillar to post they finally had to get the treatment done in a different place.

The security and housekeeping are mostly guest labourers (as they call them in Kerala instead of migrant labourers) and are having language barriers to be surpassed before they become the team with the primary service like Indira IVF (which maximizes its profits by outsourcing such crucial services) and disposes them off easily when it comes to inability to either retain them or incapacity to treat them free of cost.

Another reason why such brands as Indira IVF work inimical to its own team members involved in healthcare is that most of the centers are sub-let out by the owner through its network of cronies for a specific amount of money which may run into crores of rupees, after paying which the cronie is in now charge of running the branch clinic. Such cronies target sufficient profit to enrich not only themselves but also the brand manager(owner/MD/ CEO / director), in the bargain the employees like the ones belonging to the SRL do not get even basic rights of getting treated in the very hospital they work for.

In such a system of loot in the name of healthcare, there are also helpless doctors who have no option but to go on uncomplaining until it becomes something which diverges to harms the brand name.  And that’s when the top cronies in collusion with the lower cronies decide about what is safe for their business and take decisions to expel some, the decisions which are usually again more in favour of the brand than for the poor and their health need sake.

Flash points with such crony managements are rare because most of the doctors are more busy improving their professional skills (which was intentionally depreciated in the medical college to promote their business).  Only some have got into a direct confrontation with the so called directorial staff (crony owners) who are nothing but self aggrandizing capitalist farts.  As a consequence, the management cronies unilaterally violate the contract and start harassing by not paying the doctors or more cunningly use the marketing and call centres to divert patients to others who are more compliant to them.

When health care sectors run like this, where can we expect them to be of any help during an epidemic?

Welcome to crony capitalism in health care for Indians (into which government intends to spend money).