Tuesday, September 26, 2006

Rural Service for Doctors.

Out of Blue, doctors who are going to complete their internship this year, are asked to work for a year in Primary Health Centre in Rural Area. They have signed a Bond when they took admission in Medical College, but for last 4 years this bond was not enforced.Now our enthusiastic Health Minister in Delhi want to enforce the Rural Service clause in entire country, so in next 5 yrs not a single village in India will be without the services of trained MBBS doctor. Predictably Doctors who have faced this farce off and on for last 30-40 years have not taken kindly to this dictate from govt. In Maharastra about 50% have paid the Bond amount of Rs. 1 lac and will not do this Rural service. State is richer by Crore or so and has found out new avenue to fill up state's treasury. Next they will increase the Bond amount so that they can get more money.

But it is more pertinent to try and find out why Doctors are not opting for Rural stint.Usual perception is that these citybred doctors don't want to serve Rural poor inspite of getting expensive Medical Education -paid for by the state. This impression is reinforced by media ,especially Print media. Reporter dont finds it necessary to talk to those who have done Rural Service and find out ground realities. This year those graduates who were preparing for Post Grad.CET for a year would not like to go to Rural area for a year and then appear for CET. Its better to give CET when you have just passed MBBS and have prepared for CET. But others are refusing job that will pay them about Rs. 17000 P.M. There must be reason for that.Past experience shows that many Rural Posting don't have adequate basic facilities to stay. The food is another problem. One can imagine plight of a Lady Doctor in Rural PHC. There is pressure from the local politicians. Many Govt. M.O. dont want them to interfere in the local set up they have established. Sometimes they are asked to do work they are not trained for -like performing Post Mortems. Unavailability of Medicines, Pathological Lab, X Ray and Sonography and other items is another big problem. Just posting a Doctor in PHC doesn't always solve the health problems of rural areas.

Solution to this should be provided by preparing a Model Action plan. This can be done as project by IIM's. Doctors are available and if given just basic facilities they are willing to work in Rural areas.Govt. has no clue about how to carry out project to provide medical help in rural areas and may be they don't have necessary funds to do so.As in past ,for 2-3 years Doctors will be forced to go to Rural areas and then govt. will discontinue the scheme, which will result in great mess for Post Graduate admissions as happened just 4 years ago.