An Umbrella Approach to Make Public Health Accessible and Affordable

Being a development practitioner and a professional social worker, I am keen to explore and learn the different fields of the development sector. Over a period of time, it is important to develop a holistic mindset that encompasses the 360 degrees of work because somewhere all the issues are interlinked with each other, and will surely intersect at some point of time in your journey in one way or the other way. On the occasion of Gandhi Jayanti on October 2nd, 2023, I proudly joined the 23rd cohort of the American India Foundation’s Banyan Impact Fellowship (formerly known as the William J. Clinton Fellowship for Service in India). I am excited for the opportunity to serve the people of my home state of Bihar. I am also looking forward to working at the grassroot level at the intersection of administration, policy, and governance in the domain of Public Health, and in a hospital setting which I have never undertaken before.

I have been placed with Doctors For You (DFY) as my host organization. DFY is an India-based humanitarian organization that has been working for the past sixteen years in various disaster-hit zones. DFY focuses on providing medical care to vulnerable communities during crises, and non-crisis situations, and emergency medical aid to people affected by natural disasters, conflicts, and epidemics in more than 21 states of India.

I believe that health, education, and livelihood are very important aspects of anyone’s life. And these three are interconnected and interdependent on each other. When it comes to health in the Indian context, Article 21 of the Indian constitution guarantees (1) The right to life and (2) The right to personal liberty. Article 21 also includes the right to health and medical aid. Despite having many public and government-aided healthcare institutions, they aren’t enough to cater to the population of the country. On the other hand, India has many private healthcare institutions which are too costly and unfortunately, not affordable for everyone.

Bihar has the highest population density in the country (1006 people per square kilometre) according to the Indian Census of 2011.  It is far behind on the scale of different parameters of development in comparison to other states in India. And the same goes for the health sector in the state. As per the data from NITI Aayog – National Institution for Transforming India (formerly known as the Planning Commission), in the overall Health Index Report of 2019-20, under the category of larger states, the overall performance of Bihar stood at the 18th rank out of 19. It clearly outlines the need for intervention of various other stakeholders such as civil society organizations, and individuals with collaborative and cooperative approaches to bridge the existing gaps in tier 2 and tier 3 cities, and that is where I witnessed the pivotal role played by Vistex-DFY. Perhaps it is fate or meant to be that I had the opportunity to write this blog when the hospital completed its 4th foundation day on the 21st of November 2023.

It has been around 6 weeks since I started working with DFY at one of their big dream projects named Vistex-DFY charitable hospitals based in a village named Masahri in Fatuha block of Patna district. I have been actively involved in learning about how this particular hospital operates and functions. This involves understanding its day-to-day activities, facilities, and services, as well as focusing on cleanliness and hygiene. I have also explored the challenges the hospital encounters in serving patients and the difficulties patients may face in accessing services. As a third-party observer, I used tools like observation, transact walks, and investigative journalism as well as undertaking formal and informal talks with various stakeholders involved in the project from top to bottom which gave me a significant amount of information that helped me to understand things in better detail.

One thing that struck me was the sustenance of the project since healthcare needs a lot of investment and manpower. When I delved deep into it, I came across their working model based on the 3Cs – collaboration, cooperation, and commitment. This collaboration is all about the various stakeholders coming together in support of the journey from the donation of the land by the people of the community to receiving funds under corporate social responsibility and other support from national and international agencies. Cooperation from the local community to the government authorities, and commitment from the employees have played a pertinent role in the establishment and running of the hospital. 

As this hospital runs in a rural area, it operates 24/7 and for 365 days. Usually, it is seen that in charitable ventures, it is difficult to run and provide all the facilities up to the mark because of conflicting allocation of resources and manpower, I was surprised to find that here it has been possible despite those challenges because employees are cooperative with each other.  There are many other features of the hospital that make it unique and pocket-friendly for the patients. A few of them are that the hospital is very economical and budget-friendly. At a moderate amount of Rs 5 to 20 INR, anyone seeking services can get consultations from general physicians, surgeons, or gynaecologists. The hospital has in-built pharmacies, and laboratories, and provides digital X-ray services, along with provisions of ECG (electrocardiogram), ultrasound & CT scan machines. The hospital also provides facilities like ICU (intensive care unit), IPD (in-patient departments), OPD (outpatient departments), day-care, HDU (high dependency unit), dental care, physiotherapy, surgery, emergency, private ward, and ambulance services, Oxygen plant, etc at very subsidized rates and in some cases free of cost. 

Since the hospital is functioning in a rural area near an agricultural field,  I was also curious to learn where the hospital was disposing off its waste. I learned that they have tied up with government departments in Patna which send their vehicles to the hospital to collect all the medical and non-medical waste and dispose it off at the designated places as per the government norms. This also showcases that the approach of the hospital is environment and people-friendly. Apart from the use of electricity, the hospital also uses solar panels to generate solar energy as an alternative source of energy. The hospital employs staff from different parts of Bihar and India and offers them accommodation in the same premises. They are also provided hygienic food through a canteen set up by the hospital that is also utilized by the patients.

Along with providing treatment, the hospital also organizes health camps and awareness programs in the surrounding villages. The project has also taken steps to ensure the empowerment and integration of the local community within the hospital by training and hiring employees from the local rural communities as professionals. I was also glad to see the inter-departmental convergence being undertaken by the hospital through continuous collaborations with other agencies for resources to ensure the delivery of quality services to the people. 

The project is especially a pioneer in its creation of a comprehensive ecosystem since its location is very remote, and considering the fact that it was started in around 2015 when the area had limited resources in terms of availability of electricity, security, roads, and infrastructure and its transition and service to the people during the COVID – 19 pandemic. It is commendable to see the kind of growth it has achieved in the past 7 years as was also understandable during my numerous conversations with the local community, and by going through the dearth of available literature and media on this project.

I see this hospital as a trailblazer for people, especially those from low-income groups and under-resourced communities for whom access to quality healthcare seemed like a far away dream before the establishment of this project. Since this project is still in its developing stages, I am excited to grow and learn with it and document more interesting stories to share with all of you.

References:

 https://social.niti.gov.in/hlt-ranking

https://niti.gov.in/sites/default/files/2023-08/India-National-Multidimentional-Poverty-Index-2023.pdf

You, D. F. (n.d.). Welcome to Doctors for you. https://doctorsforyou.org/

Vistex Hospital. (2020, October 1). About The Hospital Project – Vistex Hospital. https://www.vistexhospital.org/about/