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India today: computers in dowry
‘Men may come and men may go, and governments and empires may lord it awhile and then disappear into the past; but the old tradition continues, and generation after generation bows down to it. Tradition has much good in it, but sometimes it becomes burden which makes it difficult for us to move forward.’
- Jawaharlal Nehru
In ‘Glimpses of World History’
What the first prime minister of independent India wrote to his much-famed daughter of January 14, 1931 from Nainy Central Prison is an eternal truth and an inbuilt characteristic of an Indian’s mindset. Having a long past which has its own highs and lows, India today is walking with a shipload of traditions, customs, rituals, beliefs, superstitions and taboos on her head. India has the highest number of cases tuberculosis, leprosy, malaria, preventable blindness and neonatal tetanus in the world[9]. More than 50% of all deliveries are conducted by untrained persons which results in more than 100000 maternal deaths every year: 1 maternal death every minute[10]! 33% of all children born are with below than normal weight[11]. There have been successive changes in governments at the center but allocations to the field of health from union budgets have always been poor. The great Indian mindset has refused to change at the speed the external world has been changing. Sam Pitroda, often regarded as the telecom man of India, recently expressed his anguish against this attitude:
‘The knowledge industry has arrived in India, but we still like to hold on to the Brahminical and Shudra based structure of work. It is time we give up this kind of mindset.’ [12]
‘Often we try to impose our thoughts on our children, building them like us. But we fail to realize that we need different mindsets to build a nation.’[12]
Community use of information and ICT has developed in a piecemeal fashion as a series of rather unconnected initiatives. Extremely high rate of growth of ICT has surpassed any other technological innovations in India, at the same time it has posed a formidable challenge in front of institutions in adaptation to it and co-coordinating and controlling complex health services and in training healthcare professionals for it. This has led to lack of availability of competent healthcare professionals to manage telecommunication networks and information flow in healthcare management. Increased demand and limited supply of trained professionals in medical informatics naturally increase their market value and many institutes have come into being claiming of teaching bioinformatics, including a college degree in the field. So far, they have been working without clear uniform guidelines about education or without a proven scientific theory of how informatics can improve healthcare[13]. Moreover, existing information available on the World Wide Web is largely due to efforts of western medical experts and therefore is based on the data generated from western population and on issues more concerning to their health needs. Such information is not a tool of substantial strength, which can deal with grass-root healthcare adversities observed in rural India, comprising 70% of Indian population.
Primary health care in India
Concept of primary health care has its roots deep in Indian health system. Dating back to around 1400 BC (circa) Manu prescribed his codes of personal hygiene, dietetics and rituals of hygiene at the time of birth and death. Ruins of Mohen-jo-dero, Harappa (both in Punjab) and Lothal (Gujarat) show some of the systems of roads, buildings and drainage that are even today seldom available in Indian towns and villages. Old Indian treaties mention, ‘Sarve santu niramaya,’ meaning ‘may all be free of disease.’
Gradually with time, changes came into population and concept of positive health and hygiene disappeared from the people’s psych. British invasion of India helped in formalizing laws and rules, many of them observed even after 100 years. A look on the chronology of primary health care development in the country[14]:
1864 – Sanitary commissioners appointed
1873 – Birth and death registration act
1880 – Vaccination act
1881 – First all India census
1897 – Epidemic disease act
1909 – Central Malaria Beauro at Kasauli
1930 – All India Institute of Hygiene and Public Health established at Calcutta
1943 – Health Survey and Development Committee formed under Sir Joseph
Bhore
1946 – Report of Bhore Committee
The Bhore committee report was a major step towards achieving goal of basic health care for all in a huge nation with limited resources. It had a certain kind of futuristic vision, which still today is continuously guiding health planning and implementation in India. This report had not only proposed the idea of primary health care but also given a road map to achieve that goal. Subsequent reports by other committees and individuals only strengthened importance of bhore committee report.
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Maulik Baxi
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