The centralized way India developed helped larger cities in recent decades to develop. This growth is mirrored by growth in the number of hospitals and hospital beds in urban centers. Hospitals and specialized clinics are lacking in many parts of many states. When I was in Amritsar, Punjab, the city had just opened its first trauma clinic. Before that, patients had to be taken to another state for such care.
Similarly, hospitals of all types are not distributed evenly in India, e.g. the state of Kerala has 2,053 hospitals while a state with 7 times its population, Utter Pradesh, has only has 735 hospitals.
This phenomenon has partially been because the private hospitals (normally NGO or non-profit care giving institutions) have come from urban living dwellers' inspirations-while rural areas, which are underdeveloped in terms of educational and economic infrastructure, have had to rely fully on the centralized states planning of the health care delivery in India.
To be sure, Indian health care has continued to have successes over each and every decade. For example, just in the last ten years infant mortality rate went down over 20 percent between 1994 and 2004. However, infant mortality rates in rural areas are over 35% higher than in urban centers.
SOSVA-like AGENCIES & NEEDED PARADIGM SHIFT IN INDIA
SOSVA is an impressive group that works with health care NGOs and clinics throughout the states of Maharashetra and Haryana. SOSVA has also helped create its own regional pharmaceutical firm to keep the costs down for its 250 cooperating institutions. Alas , India has nearly 30 other states and territories and horizontal and vertical integration of healthcare and educational programs is needed throughout the subcontinent. (India is by constitution a federal state and needs to act more like one.) All the holes in health and educational programs need to be filled in during the coming decade. Local groups need to be banded together to work with (a) government agencies-, (b) other NGOs, and (c) even for-profit health care organizations more effectively in the future.
NOTE: This in no way implies that traditional medications, holistic treatment, and aruvedic-like techniques shouldn't be fully integrated into patient therapies and in community health education settings.
The problem is that horizontal and regional health care developments have been hindered by the vertical history of India's three-tiered medical care system, which simply centralized training and prowess while transporting patients and physicians to urban areas, i.e. when things got a little too complex for the ill-trained local health personnel to handle. There was little incentive for people to expand their knowledge or improve local facilities effectively.WHY NOT A C.L.A.I.R., like JAPAN HAS?
It might be good for India to decentralize rural development a bit more by creating a Council on Local Authorities and International Relations as Japan has done, to facilitate rural and international developmental relations in terms of economic, education, and technical exchanges. Such a program works not only in health care, but across the economic and educational exchange spectrum to empower countries around Asia. It also empowers local communities to reach out to the world like never before. If India's 600,000-plus villages can learn to work with other Asian countries on Asian-solutions to the log-jam of local and regional underdevelopment which has plagued India (rather than depending on the gifts of political party monopolies at center and regional levels), perhaps more substantial development can be achieved more quickly.
Such an increase in exchanges of people-to-people (in rural and local community development) and know-how among cultures and concerned volunteers around the globe can only help India. International development exchange means simply linking local communities across the globe directly to one another and bypassing a lot of the centralized politics and purse strings of misguided bureaucrats and party leadership, who are afraid to allow local people to shape their own destiny (and afraid of giving local people the purse strings and educational tools to grow on their own.)
CLAIR is just one of many ways to help India, like the need to create other regional SOSVA's which can further empower villages in India and eventually change Indian, and the world, for the better.
The world wants to see India do better. It is the planet's largest democracy in this millennium and we want to see it succeed. But politically, socially, economically and educationally, India needs to do better and think outside the box that sixty years of mediocre governance has wrought.
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