After decades into the field of medicine, I am unable to come to terms with one of the most fundamental questions in our profession.
What does the term Public health means?
Have we erred, by defining health in terms of its delivery rather than a comprehensive biological definition? How do you compare a guy, who gets pride with glittering five-star care in a private hospital , with that of man who humbly accepts the same in a crowded public health facility?
“It’s 1 .30 AM past midnight. I am part of the COVID supervisory team on rounds. I could see a tired-looking corporation worker wheeling out an elderly man who had just expired in ward R-3, in one of the biggest Corona care hospitals that house 350 COVID patients. In the background, haunting sirens break the eerie silence of Chennai midnight. In the far end, I see a stream of ambulances wait in a queue to drop patients, which, they have ferried across from various private hospitals. Chilling thoughts of this grand old hospital might crumble looked real for a moment”. (This is exactly the time, I got the urge to write this piece)
When calamity strikes, the true colors of the capitalistic mindset are being exposed. It looked shamelessly obvious, that the responsibility of guarding even private health has been shrugged off and has become a public responsibility.
It’s a politico -Intellectual tragedy, that the private sector enjoys a right to ignore public health ,.. for the public hospitals, it’s a crime to ignore private health .
A 24/7 hour COVID control room in our hospital with an untiring, committed workforce
Few days later, the Times of India reports this.I wonder, what I am supposed to feel ?
The report is a shocking revelation.I wish its wrong.
When the sun shines, someone tends to thrive pathologically on public health. At times of natural crisis, they want a bailout from the public (state) sources. Why not we reverse the deal in normal times? Should the Government take over all private health providers and make it accessible to the public at all times?
We have a directorate of public health in every state of India, which has zero control over private health care in normal times. How can they get control over them only during pandemics and calamities? Wonder, should we consider a separate cadre of “Director of Private health”
Final message
So, after spending substantial time trying to find what is public health, I must say, I lost track. I don’t think any medical school has ever taught us, to differentiate two biological systems in the human body, one for the public and other for private.
The stigma associated with the word public should be erased once for all. It may sound strange, let us dismantle the term public health (How about Unified human health ?) . All private and public hospitals to be administered, regulated, and audited by WHO. I believe it may restore some sense in global health. United Nations and the World health assembly should work on this and usurp the required power
We should also ensure, the more powerful vectors of human disease, like climate change, air pollution, poverty, inequality, war, violence, all should enter first-year medical school along with Anatomy, physiology, and biochemistry to bring up a generational change. (I know very well, this crazy and cranky thoughts, is as good as a faded dream )
Dr.S.Venkatesan MD 