In the din of the political noise we sometimes miss the real voices. Of patients in the GMC desperate for a drop of water as if they are in the middle of the Sahara. Of families of patients who haven’t slept for days keeping vigil of their relatives who lie on a cold floor on the passage because there are no beds. Of the horror in the eyes of a wife whose husband is being rolled into the Operation Theatre for a critical operation when the power goes and there is no immediate back up for the surgery to start. These are real day to occurrences in the corridors of Goa’s largest and most important health care facility.
And while it is important to see these problems for themselves and demand and extract solutions, one can’t help pitting this next to the priorities of the state government. The priorities are to sell off Goa’s land to bidders to create massive amounts of real estate, and to hoteliers to boost tourism. The priority is to change laws to bring in investments where there is no guarantee of Goan jobs. The priority is to ensure that more people come into the state to have agreat time and spend. While no one is grudging the priorities but the manner in which they are being executed at the cost of Goan interest, makes one wonder why the same enthusiasm is not shown in critical areas of health.
As our ‘perspective’ package in this edition highlights, the institution that is the GMC is crumbling. Where will you find the state’s premier health care facility without water where patients need to go out and buy water to brush and wash? The picture of a little girl near an almost non- functioning water filter trying to fill her water bottle is heart rending. Images of patients lying on the floor, casualty patients hunting for a wheelchair and stretcher, suggests that it not just the GMC, the system has gone rotten from within.
It is important not to start a blame game and point fingers at the inefficiency of the GMC’s administration. But when the Dean of the institution says that he is not aware of the acute water crisis since he “doesn’t handle day to day affairs”, there is a serious cause for worry But the broad picture cannot be missed. GMC is crumbling because of sheer overload. It has burst out of its seams and is taking in patients far beyond its carrying capacity. For instance the beds in each ward were initially equipped with 40 beds. They now have 70 beds squeezed in. But this is still not enough for the patient influx with patients spilling over.
Health planning is not a joke. During the earlier Congress government, modernisation was the mantra with investments made in equipment. Health care was sought to be semi-privatised through the PPP mode. The Mapusa district hospital was supposed to be the first to be built in this mode. At the same time, there was a mushrooming of health centers at the taluka level, but this was overdone, especially in the Sattari belt, the backyard of the then Health minister.
The solution to this is a midway path. Primary health care needs to be augmented with better facilities in each PHC. Most importantly it must be made absolutely mandatory for a percentage of government doctors to live in villages and remote areas and run health care centers. These personnel need to be given special allowances for these postings plus a house rent allowance to cover the cost of housing both in the big towns for their families and in the remote areas where they are posted.
Once this happens, the load on GMC will drop by more than fifty percent. That is half the battle won. Secondly, the government must find ways of bringing in revenue for GMC and other state hospitals. It must have a private wing with rooms, separate OT’s and staff meant for those who can pay for these services. The amounts generated from here will help subside the rest of the general hospital and cover many of the costs. And lastly, there needs to be an independent financial probe and audit of the GMC to look serious allegations of misappropriation and reckless spending and malpractices which has further eroded the health of this once great institution where some of Goa’s finest health professionals still work.
