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Indian Healthcare System & Medical Brain Drain

By Vanshika Paharia

In India, there are only 1.7 nurses per 1000 population and a doctor to patient ratio of 1:1404, which is well below the WHO norms. The 2020 Human Development Report shows that India has five hospital beds per 10000 people, one of the lowest in the world. The healthcare expenditure has been less than 3% of India's GDP for quite some time, which does not seem enough to serve a huge population. 


Despite all this, the healthcare system was a well-oiled machine until the coronavirus's second wave struck the country. The gaps in the healthcare system are now evident and out in broad daylight for everyone to see. Around 69000 India trained doctors and 56000 Indian trained nurses working in the UK, US, Canada and Australia in 2017. In 2021, the number of Indian medical professionals in these countries has to be much more. This brain drain is huge because India produces only around 30000 medical graduates every year, which is not enough to close the doctor: patient gap. You may not see why this is not only a social issue but also an economic problem. After the offset of the second wave of coronavirus in India, the plot holes in the healthcare sector have become clear. India is badly placed to tackle any other health concerns because the tragedy of the second wave has demotivated the medical staff to practice in India and destroyed the faith of the citizens in India's health care system. For this upheaval of faith, not the medical facilities and staff, but the people themselves and the government as a whole are to be blamed. They are to be blamed for not taking better precautions. Prevention is always better than cure, and Indian citizens have failed to understand this. 


In April, India went through a scarcity of oxygen beds as well as normal beds in hospitals, acute shortage of vaccines and important medicines and medical staff were made to work nonstop for days at a time because of lack of personnel. Despite all this, no decision was taken to divert the funds from other sectors to the healthcare sector. No relief was provided to the healthcare workers, and the oxygen shortage remained for quite some time. To make matters worse, the number of deaths rose to the extent that crematories and burial grounds could barely accommodate the departed souls' peaceful farewell. Due to a lack of decisive leadership from the government, lack of immediate medical aid, slow vaccine supply and the country's crumbling health infrastructure, are not only medical workers motivated to leave the country but also are other professionals. The number of Indians living outside their homeland stands at 18 million, and more Indians are mulling a shift abroad amid the pandemic pain. 


This mindset of migration has been bolstered by the inhuman treatment of doctors and nurses. On 27th May 2021, a doctor in Assam was beaten up by the relatives of a patient after the patient was declared dead at Hailakandi Civil Hospital after some unforeseen complications.The doctor said that he and his colleagues are now afraid of going to hospitals for work. The videos of this assault have been floating on the internet for days now, and other student doctors are also scared and enraged. Such incidents have occurred on multiple occasions, but this incident amidst the second wave has infuriated the medical staff more. This is because the entire covid crisis was shouldered solely by the medical fraternity with little support from the government or other organisations. This is how the public has shown their gratitude.  Adding to their miseries, it has been reported that doctors and nurses have not been paid for the past three months at several hospitals.In Madhya Pradesh, doctors had gone on strike because they were unpaid, and the promise of a wage rise wasn't met. Their strike was called "illegal", and this resulted in the resignation of 3000 doctors. Their needs were catered to much later, after days of strike. Also, Ramdev "baba" has been spreading misinformation about modern medicine and allopathy. The entire medical community has been made into a mockery, and the Delhi high court has refused to restrain Ramdev from making these statements. This has put medicine and everything that it stands for in a terrible light as Ramdev's followers are huge and blindly follow him. The dangers of the job seem too much to parents of students and students still studying in medical colleges. 


A survey by IMA reports that 46.3% of doctors were found to fear violence, and this has been the cause of stress for them, and 57.7% have thought of hiring security in their premises. When asked, most students have relayed a wish to practice out of India or pursue masters in the US. The reasons were the lack of safety for doctors working in India and lack of respect and mockery of modern medicine by a large chunk of society. Many doctors have refused to provide consultations to their kin due to a lack of support. In a country where there is only one doctor for every 11000 patients, medical migration will lead to an irreparable loss. This is an urgent call for action. This brain drain will destroy the healthcare system further as the infrastructure will weaken. The third wave of COVID seems quite inevitable, and we need a good medical system. The lack of a medical system during the third wave will reduce India's revenues and drive other professionals away from the country who fear the poor healthcare system. 


In a way, this is not just a medical brain drain but will lead to an overall brain drain. Professionals from various industries would want to go and work abroad. Even industries like pharma will be heavily impacted. As a solution, not only can the government and ordinary people like us help prevent the further degradation of the healthcare system. As citizens, we can first make sure we are grateful to all doctors and nurses; we understand that doctors and nurses are not a higher power. We make other people aware of these wrongdoings towards the medical staff and educate everyone. We need to stop believing in fluff and superstition and respect the hard work of doctors and nurses. I am also of the opinion that the government can turn the situation around immensely just by making tiny changes at a time. For instance, during a crisis period like this, funds from the other sectors must be diverted to the healthcare sector. Doctors and nurses must be provided with hospital beds and proper care if they contract coronavirus on duty. Proper action must be taken against people who do not wear masks, break protocol and assault doctors. It should be a non-bailable offence. The selling of vaccines and medicines in the black market needs to be scrutinised as well. 



It was found that many deaths were caused because of the lack of timely medical help to covid patients. People did not know the correct time to seek proper professional help. Patients were admitted to the hospital late after a lot of damage was done, and this resulted in deaths. The government can hold national conferences on seeking medical help, diagnosing symptoms and making people aware of the right time to get admitted. Awareness of the vaccine and health insurance will also help people immensely. The government can fund health insurance for people who cannot afford them so that the lack of funding is no more an obstacle in timely medical assistance. Medical resources must reach hospitals on time after proper logistics planning. People who think they were a victim of medical negligence will help if they are directed to medical councils and forums. This will reduce assault towards medical staff. 


Maslow's Theory's first tier talks about needs like Healthcare, clothes, shelter and safety. Healthcare is an important need. If not met, it will definitely cause people to flee the country. The Healthcare sector needs to be paid attention to; otherwise, it will cause the collapse of an entire nation. If we want to prevent the third wave of covid, these steps are necessary. Good treatment of doctors and an efficient healthcare system should be the main focus. The foundation of a healthy and rich country is in its healthcare system. It is time we see it. Healthcare issues are as much an economic problem as they are a social issue because the impact can be massive.




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