India lives in its villages. All of us were taught that at school. What we weren't taught was that much of India does not live very happily.
If you look closely at the stunningly beautiful images of rice fields rippling in the wind and children swinging from Banyan trees in the village square, you realise that one third of those men and women working in the fields are chronically starved and one half of those children swinging from the trees are permanently stunted through undernutrition. One out of every ten babies born never makes it to its first birthday.
India, home to one-sixth of mankind, is also home to fully one-third of all tuberculosis patients in the world. More than 300,000 children drop out of school every year because someone in their family comes down with tuberculosis and an extra income is needed to make both ends meet. Families of 25% of all hospitalised individuals fall below the poverty line because of hospital expenses.
Crisis of Rural Health
Most of India's people, and most of its poor, still live in rural India. The burden of disease and its effects are disproportionately seen in the poor, with a clear gradient in illness and mortality.
Of all the forms of injustice, inequality in healthcare is the most shocking and inhumane.
Martin Luther King
There is a crisis in rural health which is becoming more complex and tenacious and it is worsening the crisis of rural life in India.
There is a widely prevalent myth that people in rural areas have small health problems which can be addressed by a minimally staffed and equipped health centre.
The experience of running the OPD has completely debunked this illusion. People come with a bewildering diversity of problems from HIV disease, advanced tuberculosis to severe malaria, uncontrolled diabetes with a low body weight and a badly infected wound to cancer of the cervix, a B.P. of 240/140 diagnosed for the first time in life, to burns sustained after falling in the fire after a convulsion.
The underlying stories are most often the same: profound susceptibility because of associated undernutrition, delayed health care seeking because of difficulties of physical access, dissatisfaction with non-functioning or poorly functioning public health facilities, problems exacerbated by irrational care by an unqualified practitioner.
In rural areas, there are massive levels of hunger and massive levels of morbidity, and a vast unmet need for curative health care. There are therefore high numbers of premature deaths, leading to the further marginalization of these populations and trivialization of their problems.