In a bid to show how high its reach is, the media prods a Minister with loaded questions whenever there is an outbreak of some disease or an epidemic, realising little that it’s not a Minister but a municipal health official who is supposed to have the answers
The National Health Policy was announced in 2002 — 19 years after it was first formulated. While its aspirations and prescriptions make a strong case for reducing regional iniquities and enhancing funding for health, it was only three years later in 2005 that the National Rural Health Mission attempted a gigantic leap forward in rejuvenating the primary health set up with funding and systems that could make paper orders spring to life.
Neither Health Policy, 2002, nor the National Rural Health Mission, however, addresses the specific subjects and situations that occupy the front pages of national dailies and television screens. Organ transplantation rackets, hazards of junk food, the net worth of anti-smoking fiats, seasonal diseases and cyclic outbreaks of dengue, malaria and sundry fevers are what constitutes the bulk of health coverage by the media. The reports are undoubtedly useful as they serve as news as well as warning cum health bulletins alerting people to be prepared and know what to do.
But preoccupation with localised news to the exclusion of the bigger picture is fraught with two dangers — first, the stories demand reactions from top health functionaries, thereby distracting attention from those directly answerable for the mess; second, they overlook the need for reporting about massive health programmes which affect millions of citizens and ultimately the well-being of the country.
In the present scheme of things, the media hardly reports on the success or failure in attaining health and family planning goals which are vital for improving overall health indices and without which sustainable development cannot take place.
Strictly speaking, the role of the Central Government under the Union List of the Constitution is limited to promoting medical research, setting standards for medical education and administering special Central institutions. Drugs, cosmetics, food adulteration, population control, family planning, are on the Concurrent List with shared responsibilities between the Centre and the States.
In contrast, public health and sanitation, hospitals and dispensaries are wholly on the State List of the Constitution but one hardly sees a Health Minister or Director General of Health Services in any State questioned for failure to control epidemics, equip health facilities adequately or get doctors to report for duty in primary health centres.
Likewise, we never see heads of sanitation and conservancy in the Municipal Corporation asked to explain their failure to perform direct obligatory functions. In the zeal to target the top, the mike is usually thrust before Ministers and senior functionaries of the Delhi Government when the prevention and control of malaria, dengue, cholera and gastroenteritis is directly a Municipal responsibility. The Delhi Government has little supervisory authority over the Municipal Corporation, which owes allegiance to the Central Government under a 1957 Act. So, why not ask the people who are directly responsible?
Why are public health doctors and engineers responsible for ensuring that sewage does not get mixed up with drinking water questioned why they remained unaware of the contamination? Did the Jal Board take sufficient samples and have them tested for purity as often as needed? Supervised by whom? Did they file for criminal action against known culprits who tampered with the water pipelines (since that is the usual excuse)? Why not? Was preventive action against mosquito breeding adequate? By what measure? Did the sanitary officers supervise the daily clearance of 2000 dhalaos and dustbins cascading with garbage and filth? Who inspected them and how often? Such questions are never asked from the real actors. Instead, sound-bytes spouting “everything under control” platitudes are what we get from senior functionaries while the real actors remain safe and dry.
It is time the people directly responsible are held accountable as generally happens when a building collapses or electricity fails. It is time that the functions and responsibilities of different echelons of the public health, drinking water, food hygiene and the mosquito control hierarchy are set forth on websites listing people responsible for prevention and control of health hazards, area-wise.
Equally, if extraordinary work has been done, nothing would boost the morale of workers more than giving a real performer a place in the sun while ignoring the vacuous worthies that mouth the “we are doing our best” baloney. Confronting the real culprits on camera or lauding their efforts, will heighten public awareness and the wrath and laurels will be directed where deserved, instead of giving free publicity to higher-ups having little direct responsibility.
On a wider scale, media should provide the lay reader an independent State-wise update on the final destination of thousands of crores of rupees spent on improving the condition of health care. Instead of recounting what World Bank and CAG enquiries reveal many years later, State Health Ministers and their battery of professionals should be made to respond to much larger current issues.
To start with to account for State-wise progress on achieving the specific numerical goals of the Population Policy 2000 and the Health Policy 2002.These questions can only be responded to by those at the very top, particularly in the low performing northern states, but unfortunately they are never asked.