Unacceptable ratio

That in Nagaland the doctor-population ratio currently stands at the staggering ratio of 1:4056 against the WHO recommendation of 1:1000 or the India public health recommendation of 1:2500 is shocking, scary and totally unacceptable. This figure was disclosed by Dr Sukhato A Sema, MLA, at the Annual Conference-cum-General Body meeting of Nagaland In-Service Doctors’ Association (NIDA) at Niathu Resort, Chumukedima, on November 23 last. And Dr Suhkato to should know ~ he served in the State Department of Health and Family Welfare for the better part of his life, finally retiring as its Principal Director. He also cites the 2011 census which says that Nagaland’s population was 19,79,000, so if the doctor-population ratio is worked out, then doctors should have been 1979, with the doctor-population ratio at 1:1979 against the present ratio of 1:4056. Further, he said in the Government set-up in Nagaland, the total number of doctors is roughly 396 and if doctors in the NHM, NSACS are counted then it comes to about 435. We have added thirteen more years since 2011, which means increase in our population, so with about 435 doctors, imagine how dire our Government health delivery system is. Dr. Sukhato also cited Arunachal Pradesh’s example, where the doctor-population ratio is 1:2417, almost matching the India public health recommendation. How did Arunachal ~ a State much younger than Nagaland ~ achieve this? The doctor-patient ratio of 1:4056 irrefutably underscores one of the major obstacles of our health delivery system because for all the infrastructures ~ state-of-the-art and all ~ without the required human resource, patients, and the public at large, are short-changed woefully. And here we are talking only about doctors ~ figures for nurses, pharmacists, paramedics and so many skilled and unskilled human resources vital for the health delivery system are yet to be discussed. At said gathering, Dr Sukhato highlights several issues that have been plaguing the Government medical and health sector for decades and makes suggestions, which not only NIDA members but also the State Government ought to act on if Nagaland is to have a vibrant public health sector. Inadequate human resources are a fact in all our Government Departments and agencies and issues that plague the Department of Health and Family Welfare are rampant in all other Government sectors too. This impedes effective and efficient development delivery across the spectrum thus rendering Nagaland a development-deficit State. Much as our State Government would like to project funds as the main road block to development it forgets the crucial role of physically, emotionally, psychologically and financially contented and robust manpower. Dissatisfied manpower in the Government sector results in dissatisfactory development delivery consequently a dissatisfied public ~ the very example of the State of Nagaland. All this brings to the fore the issue of governance because when governance is robust, it shows in the health of the human resources and reflected in our lamentable development status. The devil is always in the details therefore our Government needs to make time and the effort to look into all services in the State and put its finger on exactly where it hurts and humiliates. Besides impartial service rule for all sectors, it is also essential to acknowledge and reward service rendered, which demands strict adherence to the provision for entry into the IAS cadre for “other services”, as stipulated in the encadrement rules. Our Government talks about building infrastructure but much like a house doesn’t make a home, infrastructure alone is not development. This even the people know for a fact because across the State, schools, colleges, primary health centres, hospitals and numerous Government offices lay waste without the required man power and the necessary wherewithal crucial to function. Our man power in the public sector must also live in habitable houses with clean running water, regular power supply and the other basic requirements of human beings in the 21st century. It is also a fact that our people want Government jobs but are unwilling to work beyond Dimapur and Kohima ~ our Government ought to address and redress the reasons. Of course, generally our people also want jobs but are unwilling to work. Would our Government consider brainstorming to deal with this? It’s a part of governance, isn’t it? However, all said and done, by hiding under the cover of infrastructure development, our State Government has not been up front about the real picture of our health delivery system or any other development delivery system starting with governance.