Netai’s story has no climax. He is a man like any other, but more enterprising. He has not been keeping well. He wheezes often and has a lot of trouble breathing.
“So, now what?” I ask him.
“Nothing, now I wait. Fate cannot be planned or anticipated didi,” he tells me dismissively. “I can’t afford a good doctor- I have nothing left to sell. I go to the government hospital sometimes, but you should go see it. Maybe then you will understand our fears.”
According to a recent study, 28% of India’s population- its urban residents- access 66% of the country’s hospitals. There is a lot than can be said about the state of urban health care, but at least there are hospitals, there is an element of choice. The urban poor suffer too, but in rural India, with no one to account to and very low visibility on what actually goes on within the four walls of a hospital (if at all there are four walls) the state of healthcare is a nightmare.
72% of India’s population- its rural residents- get just 33% of the hospital beds across the country. 60% of India’s rural population also has to travel for more than 5 km to reach a healthcare centre.
Going for a long walk when you don’t feel too well, is not exactly pleasant. But so someone does travel 5 kilometers and tries to get a hospital bed. Then what? Most healthcare providers lack medical qualifications. Clinical check-lists are unheard of and correct diagnosis rare.
These are numbers. These are statistics. But they give an idea of the dismal state of affairs. The rural health care condition in India is in a dismal state. Every bit of these statistics is a person with a predicament. The 72% in the statistics cited above suffer a very bad one.
Falling sick for the rural poor is a curse. Death becomes more affordable than cure.
Till last year Netai was assured that there were good things coming his way. But all it took was a tug, and like a badly knit sweater, his life started falling apart.
The man has a ceramic-like fragility. White hair, sunken eyes, and toothless cheeks sagging inwards like a collapsing tent. When he walks, stick in hand, you wonder how his spidery legs keep such steady balance on the undulating and sometimes treacherous farmlands.
He is enterprising- the first in his village to try the progressive SRI rice-growing technique, a break away from traditional rice growing methods. Using SRI improved his food sufficiency.
Straying away from generations of hand-me-down wisdom was a leap of faith for Netai. Following his lead, the entire village is now an SRI convert. His pride is evident in his stories of how he was a man in demand with neighbors constantly checking for advice. To supplement food availability and income, Netai also started growing tomatoes, potatoes and mustard.
Typically his farm would yield enough rice for his family to eat it for 5 months. At the end of the first SRI year his rice yield improved to last him 8 months. With just 4 months of food left to fret about, 8 months of food sufficiency is considered very good. Small farm-holding patterns of East India and the persistence of inefficient farming techniques result in sub-optimal harvests. The harvest is meant for consumption, not income. And it isn’t adequate for year-long consumption either. Being able to sell wheat or rice in the market for income? Forget it. It’s a distant prospect.
Last September he fell ill with a breathing problem and was bed-ridden for a month. “If someone falls ill, they either die, or leave their families weak and poorer. We are very scared of falling ill,” he tells me. “We can’t afford private hospitals and the government hospital is not really a hospital. No one attends to us, and they misbehave a lot. I think the hospital people forget that we are human too. So unhygienic, our cattle sheds are cleaner.”
No hospitals, no money, no insurance.
Netai sold his cows last year for money to cover medical costs of a private hospital. This year he couldn’t plough his fields properly. The harvest has been low. He hasn’t recovered, and needs medical attention.
I hope Netai survives. It’s a more reassuring thought.
– Sharmila Ray
Post script: We came across a very good activist blog on rural healthcare called Gramvaani. Do check it out here to know more about what they do. http://www.gramvaani.org/?p=1629