When it comes to the common man in India, living in underserved areas, there are many reasons as to why the healthcare system isn’t benefiting the people the way it should. The main reason is a lack of awareness. Even today, in rural areas, a doctor in a white coat with a stethoscope around her neck is perceived as someone to be feared. Often, illnesses, either trivial or concerning, are left without being addressed, because of several reasons ranging from complacency, ignorance, fear, lack of time for self-care and also reluctance to take part in check-ups and invasive tests. The most commonly heard stories are from dental interns who visit these people in their meagre dwellings and have to coerce them to have their teeth examined.
If there is very little knowledge of basic oral hygiene then one can only imagine how much there is to tackle, in just one home, consisting of a joint family of 6-8 individuals.
While physical ailments, as obvious as they are, may fail to get addressed, there is almost minimal or nil care when it comes to mental well-being. Something which cannot be ‘seen’ is perceived as non-existent. Mental care is still perceived along the lines of insanity or as a person not being lucid or in his senses. Even if they are marginally literate, it is a well-known fact that people living in the underserved areas rarely ask questions to educate themselves about what is ailing them. They lack confidence and also are of the opinion that medical jargon is best left to the doctor.
As a result of this manner of soliciting medical intervention, it often just results in pills being swallowed, injections administered and treatments followed in a disinterested and not thorough manner. It is always the symptoms which are looked at and most often, not the cause of the symptom. “I have fever and the doctor gave me an injection” is the standard reply when asked about their recovery.
How can this continue to go on? Should we not introduce them to the concept of symptoms being different from the actual ailments?
“Oh they won’t understand”, would be the counter argument; but how do we know? We cannot make assumptions of people’s lack of awareness just because we do not have the time or inclination to patiently explain the issue.
If, for example, Lalitha wants to know why her baby is not gaining weight despite being well-fed, she can’t be hushed away with nameless medication. That is not what healthcare should be! As a human, every one with a cognitive mind, has the right to be made to understand the basics of their right to informative healthcare.
If Jose fell off the tree, he can’t just be sutured up, but must also be informed to watch out for other symptoms relating to head injuries which can be detrimental to life. This is where offering healthcare can make a real impact and reduce unnecessary loss of lives.
Without generalizing, it isn’t wrong to state that most medical personnel deployed to these areas work in a mechanical manner with little interest in personal care from one patient to the other. The brusque bedside manner is a very real problem faced by the hapless folk when visiting these centers.
Moving from a Provider-Centric to a more Patient-Centric approach
While the health demands of the population at large have undergone a change with the influence of many factors like changes in the environment, food, lifestyle etc, there hasn’t been any kind of significant analysis or study done to see whether the centers are catering to the needs of the people or simply providing the kind of care which has become stagnant.
The world is changing at a rapid pace. There are gaps which need to be filled by way of communication, cost, accessibility and time management. A medical camp, for example, has people standing for long queues in the hot sun with scant regard for age, health condition or proximity to reach.
Those who can barely make ends meet will not be able to understand the need to forgo a day’s wages to get checked and would rather resort to country medicine.
While it may be enough to have a single midwife at one sub-center, it may not serve the purpose at another SC, which caters to a larger settlement. Such requirements need to be ascertained and changes made accordingly to provide care which matters.
Improvement can start with educating people to not be afraid of visiting the medical facility and having simple step by step processes which can minimize waiting time and help to effectively diagnose the problem.
Updating systems will help the visiting doctor to view the problem and provide the solution at a faster rate.
Filling in lengthy forms can also be an intimidating factor when seeking aid and these too can be simplified.
Self-care made easy
Strangely enough, where we as a country, lack in development, we more than make-up for our quick acceptance of digital technology. Smartphones of all sizes and pocket leanings are available in the market and are in high demand by people of all income levels.
This can be used to a great advantage in taking healthcare to a digital platform. Forms can be made accessible online (in the vernacular language), to be filled in the comfort of their homes or prior to the visit. Offering self-care interventions like self-test kits, counselling on understanding individual wellness patterns, while the centers keep track of individual and collective wellness data, will not only save time and money, but will also provide better quality of healthcare.
Patients and their families can be taught the importance of checking vital health parameters. Short animated videos can be shared while also educating them about how and when to understand the need for urgency. The difference between indigestion discomfort and the pain due to an appendicitis attack can be taught in a simple and effective manner and can save lives. The action of performing CPR or averting choking incidents are some of the most common emergencies which fail to be addressed.
Another positive of a holistic approach is that, the patient and his family feel empowered to make a decision pertaining to their own health. If one succeeds in replacing fear with a checklist of sorts, there will be less panic in dealing with folks from underserved areas.
Diseases like cholera, typhoid, foot-and-mouth, and so on, most often arise from a lack of basic adherence to clean living practices. In addressing these, it may lead to deeper underlying problems, which point in the direction of inadequate natural resources like clean drinking water, space to maintain good personal hygiene and affordability for self-care products.
To conclude, the obvious solution would be to use the existing framework available and to enable a change for the better in providing a more reliable Government Healthcare System. What we can also focus on, is accountability of the care provided. The famous Hippocratic Oath, which is a promise taken by the medical fraternity at the start of their career, focuses on service, irrespective of caste, creed, financial status, literacy, age etc. The underserved segments of India are where this service can be done whole-heartedly with the intent to make lives lived: better, longer and happier. The rewards lie in the smiles, the full-hearted hospitality and the return of affection from communities which do not forget good deeds.
Welcoming Mental Wellness with open arms
Stress management is a grave concern. Feeling ill in the mind, need not be a demon, which is linked to insanity or lunacy. A hand-holding approach to wellness will be a successful working model which can have a positive ripple effect. True healing happens when the emotions come into contact with the rest of the treatment: be it antibiotics, IV infusions, surgeries etc. Such stories do the rounds on a global platform; “miraculous recovery” or “unbelievable change for the better” or “complete remission”; the human connection can work wonders and we should allow it to happen .
A solution which will tackle all of these health concerns and be a successful working model to implement, is indeed the current healthcare need in India. We need to practice adding a large dose of kindness in the syringe.
CoHeal.ai is a smartphone enabled wellness platform enabling real-time measurement of vital health indicators. CoHeal.ai focuses on making wellness accessible, affordable and easy-to-use, using existing technology coupled with recent advancements and human expertise to provide a smartphone-based, AI-enabled, non-invasive, quantitative, point-of-care-testing platform.