Rural healthcare a priority to avoid adverse economic impact

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Rural healthcare a priority to avoid adverse economic impact
A rural health worker cooks a meal before going to a health centre to receive her vaccine. RURAL India is in dire need of adequate healthcare facilities to protect it against the pandemic’s second wave.Courtesy: Reuters

RBI governor’s unveiling of a special liquidity package of up to $6.76 billion for banks to lend to the healthcare sector should ensure a renewed focus on healthcare as well to safeguard against a fresh pandemic wave.

The Indian government’s efforts to cushion the blow effected to the country by a deadly second wave of the Covid-19 pandemic, were made public by RBI governor Shaktikanta Das on Wednesday.

In announcing relief across small businesses and financial entities Das also made a made an effort to bolster the country’s healthcare sector which has received a severe battering from the pandemic in terms of laying bare the lack of essential necessities.

According to a report by Reuters, India accounted for nearly half of the COVID-19 cases reported worldwide last week according to the World Health Organization. In that context, the governor’s unveiling of a special liquidity package of up to $6.76 billion for banks to lend to the healthcare sector has come as a relief of sorts.

India’s stock markets reacted with optimism specially the pharmaceutical stocks which received a boost. The Nifty Pharma index closed 4.12% higher. Sun Pharmaceutical Industries jumped 5.9% and was the biggest percentage gainer on the benchmark Nifty 50.

Das was reassuring when he stated that the Covid-19 second wave was not insurmountable, and the future remained “bright.”

A healthcare worker checks the temperature of a passenger who arrived at Charbagh Railway Station in Lucknow. Rural India houses nearly 70% of India's 1.3 billion people.
A healthcare worker checks the temperature of a passenger who arrived at Charbagh Railway Station in Lucknow. Rural India houses nearly 70% of India's 1.3 billion people. Courtesy: ANI

Focus must also be on health of rural India

While it has now been established that the country’s healthcare has been caught unawares by the pandemic leaving gaps that will take some time to fill the focus must also be shifted to the rural areas which are the engines that drive India’s economy.

Despite the farmer’s protests in the country a record 34.5 million hectares of wheat was planted, resulting in this year's bumper crop estimated to be worth more than $40 billion. This huge harvest has actually posed problems for the Food Corporation of India (FCI), which is committed to buying more wheat if production rises under the country's generous food welfare programme - the world's biggest.

In a crisis today, even though I have my limitations, I have to make that extra effort, find some way by which I can respond to today’s crisis. If somebody is sick, if somebody is looking for oxygen, if somebody is looking for Remdesivir, they are not going to listen to policy explanation. They want to see practical answers on the ground.
- Dr. S Jaishankar, Indian Minister of Foreign Affairs

Reuters reported that trade and industry sources said the FCI's wheat buying was going to exceed even last year's record procurement of about 39 million tonnes, at a time when the warehouses are already full. Wheat stocks at FCI's warehouses on April 1, when the new marketing season began, were a record 27.3 million tonnes, nearly four times the target. Rice inventories totalled 49.9 million tonnes, compared with a target of 13.6 million.

Labourers dry the wheat after harvest. This year’s bumper crop is estimated to be worth more than $40 billion.
Labourers dry the wheat after harvest. This year’s bumper crop is estimated to be worth more than $40 billion.Courtesy: ANI

Last year, FCI had to store more than 14 million tonnes of wheat in temporary sheds, and will have to find more makeshift storage in 2021/22. Quite naturally, rising prices are adding to India's food bills.

Health is wealth and the residents of rural India are buckling under the lack of inadequate medical care exposed by the pandemic. Rural India houses nearly 70% of India's 1.3 billion people but the access to inadequate public healthcare is becoming a problem that might soon spiral out of control.

Hospitals are in need of equipment, there is a shortage of trained medical personnel, lack of connectivity and effective public awareness campaigns make it hard for patients to get access to treatment even as infection rates continue to soar. This actually means that even while cases are being counted and documented they could actually be the tip of the veritable iceberg.

In announcing relief across small businesses and financial entities Das also made a made an effort to bolster the country’s healthcare sector which has received a severe battering from the pandemic in terms of laying bare the lack of essential necessities.

This is not to discount the fact that healthcare is not entirely available. It is and has even increased under the administration of prime minister Narendra Modi – thanks largely to the programmes, Ayushman Bharat, launched by the government – with more health centres, clinics, access to government hospitals and private practices but the core points of quality, cost and ethics will need to be addressed.

COVID-19 patients getting treatment at an orange farm after a shortage of space in hospital ward. Prime minister Narendra Modi’s scheme of Ayushman Bharat was designed to support the country’s healthcare sector.
COVID-19 patients getting treatment at an orange farm after a shortage of space in hospital ward. Prime minister Narendra Modi’s scheme of Ayushman Bharat was designed to support the country’s healthcare sector.Courtesy: ANI

Does India Have A Plan? From Survival To Revival

To this extent, India’s foreign affairs minister Dr. S Jaishankar commented on the country’s healthcare system, in an exclusive interview with India Inc Group Chairman and CEO, Manoj Ladwa - https://www.youtube.com/watch?v=zwAnko-KvO4 - during which questions poured in from audiences, including concerned overseas Indians, worldwide.

“The short answer is absolutely, the healthcare system stands exposed,” said Jaishankar, while putting the issue into perspective saying, “it is very clear that over the past 75 years we have underinvested in health. Maybe there were reasons. It is very easy to say today that we should have put in more money….

“But I can tell you that it’s not as easy as it sounds. This is not a defence of today’s situation. It is over 75 years, and in fact it is that realisation which is why the prime minister was pushing for Ayushman Bharat. Because we had reached a stage where the prime minister genuinely believed that we cannot leave our people to the vagaries of the private practitioners however good they may be. There has to be a strong governmental system - beyond roti (food), kapda (clothing) and makaan (housing). Healthcare is a basic right of the people….

“In a crisis today, even though I have my limitations, I have to make that extra effort, find some way by which I can respond to today’s crisis. If somebody is sick, if somebody is looking for oxygen, if somebody is looking for Remdesivir, they are not going to listen to policy explanation. They want to see practical answers on the ground.”

Dr. Jaishankar’s candid discussion was titled Does India Have A Plan? From Survival To Revival, part of India Inc’s Global Dialogue Series and can be viewed here.

Migrant workers board a bus to reach their native places during lockdown amid a countrywide spike in coronavirus. The pandemic’s second wave has been brought about due to a combination of the three basic preventative layers compounded by other problems.
Migrant workers board a bus to reach their native places during lockdown amid a countrywide spike in coronavirus. The pandemic’s second wave has been brought about due to a combination of the three basic preventative layers compounded by other problems.Courtesy: ANI

The Swiss cheese model

While the government is pulling out all the stops to curtail the infection rates from spiralling research has shown that most countries have used what is known as the Swiss cheese model while planning their response to Covid. It is a risk-management model and in this each preventative measure is represented by a slice of cheese. No slice on its own can stop the virus from spreading because it has holes (flaws). But many slices, stacked one in front of the other, are enough to stop the contagion. In India – to continue the analogy – some of the holes were too big in three of the most important layers.

  • Physical distancing. An almost impossible task given the dense populations in cities and towns made even more crowded by the arrival of millions of migrant workers.

  • Proper use of mask and enhanced sanitation. This has been a perennial challenge, owed largely to awareness and social compliance, and unbearably hot weather conditions in parts of the country.

  • Mass vaccination. There is the issue of vaccine hesitancy and vaccine shortage. The government’s plans to vaccinate the entire population was a challenging task from the beginning.

The pandemic’s second wave has been brought about due to a combination of the three basic preventative layers compounded by other problems. The government is now focusing to ensure that the healthcare system will be able to withstand the shock of a potential third wave. The long-term solution will no doubt be to build the healthcare sector from the ground up.

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