VOLUME 17 NUMBER 2 MARCH/APRIL 2004
Trouble in Andhra . . .
In 2003, there was a major increase in the number of undergraduate
medical seats in Andhra Pradesh. The entrance examination was
marred by hi-tech copying, followed by an ongoing muddle regarding
the paid seats.
There are reports of a bizarre incident involving a person masquerading
as a medical student at two government medical colleges for nearly
two years who could not appear for the university examination
and pursue further studies because of financial problems. When
charitable organizations came forward to help her, it was learnt
that she did not clear the entrance test in the first place and
was probably suffering from a psychiatric illness. With the stress
of fierce competition for medical seats on the rise, counselling,
guidance and family support need to be organized more systematically.
Meanwhile, medicos in Andhra Pradesh appear to be on the path
of confrontation yet again. Rebellion is brewing against privatization
and commercialization of medical education. The Andhra Pradesh
Junior Doctors’ Association has given a call for an indefinite
strike from 12 December 2003. They are demanding, among other
things, scrapping of the self-finance seats under the development
quota, which are presently 3% for the MB,BS course and 25% for
the postgraduate courses, and filling up of vacant teaching positions
in the medical colleges. With the postgraduate entrance examination
scheduled on 31 December 2003, the medical admissions scenario
seems to be hazy.
Alladi Mohan, Tirupati,
Medical tourism in Maharashtra
. . .
On 19 November 2003, the Government of Maharashtra, in collaboration
with the Federation of Indian Chamber of Commerce and Industry
(FICCI), launched the Medical Tourism Council of Maharashtra
(MTCM). The Council will project the state as a healthcare tourism
destination and chalk out a strategy to improve domestic and
international medical tourist traffic. To accomplish this goal,
it would rope in both private and public hospitals and tourism
sectors. At the inaugural function, the state government also
launched a dedicated website for this project (http://www.mahamedtour.com).
According to Mr Digvijay Khanvilkar, the state health minister,
quality healthcare is available in Maharashtra at one-fifth the
cost in western countries. Maharashtra has excellent doctors,
state-of-the-art hospitals and ‘breathtaking tourist spots’,
but has failed to exploit its medical tourism potential fully.
What has spurred the state government on is the CII–McKinsey
report which predicts that the medical tourism industry, expected
to grow at the rate of 30% a year, could bring in Rs 1000 billion
every year to the state from 2012 onwards.
The Maharashtra government believes that by offering ‘first
world healthcare facilities at third world prices’, it
can attract a lot of patients from the West to visit corporate
hospitals in Mumbai. The state government also plans to spruce
up public hospitals to cater to middle-class tourists from the
West. For those wishing to combine their treatment with leisure,
it would offer sightseeing tours of well-known tourist attractions.
These customized packages would deliver the twin benefits of
medical facilities along with a leisure holiday plan.
Health activists in Maharashtra were not amused with what they
felt was ‘a publicity stunt by the government to increase
bed occupancy of Mumbai’s under-utilized corporate hospitals’.
By promoting medical tourism, the government was not acting in
the best interests of rural and poor patients who might receive
short shrift in the public hospitals, the activists warned. They
were also concerned that user charges in public hospitals may
go up and there was no guarantee that the revenue created by
medical tourism would be ploughed back into the public health
S. P. Kalantri, Sevagram,
. . . following medical tourism
Maharashtra, it appears, is following in the footsteps of Tamil
Nadu. Over 10 000 patients of foreign origin were treated by
the Apollo Hospitals Group alone in 2002 in Chennai. Other hospitals
that get a steady flow of foreign patients, largely from the
Gulf countries and Africa, are Sankara Nethralaya for eye problems
and the Madras Medical Mission for heart problems. The Apollo
Hospitals have been offering services in all specialties including
dental care. The relatively low prices (compared to Europe and
the USA), high quality care and the absence of long waiting lists
has made Chennai an attractive destination for paying patients
from abroad. On the downside, the poor general infrastructure
and the obvious and pervasive poverty have acted as brakes on
the growth of medical tourism in Chennai.
Thomas George, Chennai,
Bhopal gas tragedy: A trauma
While politicians were speculating on the possible outcome of
the Madhya Pradesh assembly elections held on 1 December 2003,
the nineteenth anniversary of the Bhopal gas disaster passed
peacefully on 3 December 2003. The city quietly wept for its
dead and rallied around the survivors of the tragedy. Various
non-governmental organizations held protest meetings outside
the site of the Union Carbide factory. In Bhopal, activists of
the International Campaign for Justice burnt effigies representing
individuals and organizations held responsible for the catastrophe.
The disaster had killed thousands and maimed hundreds of thousands.
Non-governmental organizations alleged that chemical toxins from
the sealed Union Carbide premises were still seeping into the
soil, contaminating drinking water supplies. Spokespersons of
the state government reiterated that all possible efforts were
being made for the socio-economic, medical and environmental
rehabilitation of the gas victims.
As an aside, the Bhopal Memorial Hospital and Research Centre
(BMHRC)—a superspecialty hospital with 350 beds—was
started in 2000 following a Supreme Court directive. Along with
its 8 outreach centres, it provides free primary and tertiary
care to the survivors of the Bhopal gas tragedy. More than 230
000 gas victims have received free treatment so far. On the occasion
of the nineteenth anniversary of the disaster, the Department
of Cardiology at BMHRC put up a series of oil paintings depicting
the lingering trauma of the victims.
Prabha Desikan, Bhopal,
Asylum-seekers and communicable diseases in the UK:
A political issue
Asylum-seekers in the UK are currently in the news. Are they
really the source of communicable diseases, particularly AIDS
and tuberculosis in the UK? Whether they transmit these diseases
to the native English seems to be a burning issue for the country.
The stories put out by the media are seldom positive—asylum-seekers
are seen by them as a drain on welfare and NHS resources, and
are ‘swamping’ general practice (GP) waiting rooms,
at the expense of ‘our own’, living in luxury at
the taxpayers’ expense in ‘soft touch Britain’.
The reality however is different: many refugees are being made
ill by the awful conditions they encounter once they reach the
UK, due to poor housing, below subsistence level of income, severe
anxiety and inaccessibility to a GP, all of which form a poisonous
cocktail for asylum-seekers in the UK.
The issue has become a political one and politicians strive to
make political capital by blaming refugees in the hope of getting
more votes from anti-asylum voters of the UK. In fact, there
are no data about genuine asylum-seekers and illegal entrants
in the UK. The number of refugees who are infected with HIV or
suffering from tuberculosis or other communicable diseases is
not known, making it difficult to compare non-asylum seekers
and low income Britons.
Chitta Ranjan Choudhury,
Poole NHS, England, UK