For more than a decade, Indian bureaucracy has continued to inhibit efforts by Indian American physicians to help the ailing health care there. This was the message conveyed by Dr Navin Shah, former president of the American Association of Physicians of Indian Origin, to Health Minister Ghulam Nabi Azad during an hour-long meeting on the sidelines of the United States-India Strategic Dialogue held in Washington, DC in June.
Shah implored Azad and Health Secretary V M Katoch to remove these road-blocks to facilitate the various programmes ready for take-off in India if only the concerned bureaucrats would take a decision and allow the implementation of these efforts, instead of providing lip service every time Indian American physicians meet them and request the institutionalisation of these programmes.
He told Azad and Katoch that the US-India Physicians Exchange Programme, infectious disease specialty training in India, emergency medical services and trauma centers in Maharashtra and the reservoir of United States alumni of Indian medical colleges in improving medical education and health care in India were ready for implementation.
But firm decisions by both the government and the Indian Medical Council were yet to see the light of the day though every time Indian American physicians visited India and set forth these proposals, the powers that be lauded them for their efforts on behalf "of their motherland".
The physicians exchange programme envisages mutually agreed reciprocal visits between 63,000 US physicians of Indian origin and 70, 000 specialists in India to benefit both medical education and patient care.
The host provides free lodging, boarding and professional interactions while the guests travel at their own expenses. This is expected to benefit all regions across India. Such visits are also envisaged to create multiple joint projects and research programmes between the US and India.
The infectious disease specialty training in India has been approved by the government of and the Medical Council of India in 2008, but the courses are yet to begin due to bureaucratic lethargy. Already, over 20 teaching institutions in India have expressed their willingness to undertake this programme and enroll qualified candidates, and Indian American infectious diseases specialists have been on the blocks to conduct these programmes, but no action has been taken by the powers that be to translate this into action.
Shah said Indian American physicians working with US medical groups and universities had gotten approved funding for Indian teachers to come to the US on scholarship for training and 10 leading Indian American infectious diseases specialists have already expressed their commitment to visit India over a period of one year to teach this specialty in India, but action has not been forthcoming.
Shah said Indian Americans physicians and medical groups have promised to provide scholarships for surgeons from Maharashtra to visit the US and then replicate the American template to save lives, but for all the enthusiasm expressed, movement on this front too has been glacial or none at all.
According to Shah, Azad and Katoch had taken all of his suggestions and recommendations under advisement, but he was not holding his breath about the implementation of these programmes because his earlier meetings with these senior health ministry officials had not yielded any results.
He said, "There are inherent unfavourable anomalies in the bureaucratic procedures in India which leads to prolonged delays in its multi-step decision process and also creates painful impediments in the execution of decisions."
Shah bemoaned that "event for projects like Infectious Disease specialty training and emergency medical services and trauma centres, which will save the lives of tens of thousands of Indians and for which US-based physicians had come up with funding for the scholarships and the training of Indian medical personnel, the government actions are dangerously sluggish."
He said he had impressed upon Azad that "the US has successful practice models in health areas which can be easily replicated to benefit millions of patients in India, more so with help of US physicians volunteer's services and expertise if only there is an institutionalisation of the decisions that had already been approved."
Shah said some of these problems were compounded "by the other intriguing factor, which is the lack of demand and enthusiasm of Indian medical officials and medical bodies in instituting state-of-art healthcare that can be accessible all, mainly to the more than 500 million members of the lower strata of the society who cannot afford modern medical care or private hospitalisation."
Shah told Azad, "It is only through the government's efficient, transparent and accountable decisions and prompt actions along with robust public and medical communities' demand for improved medical services that India will be able to
drastically reduce mortalities and morbidities in patients, and that thousands of Indian American physicians are waiting for the green light to implement these programmes, most at their own cost."
Some Indian American physicians have become so frustrated that they have given up on such altruistic programmes for India and decided to work within their communities in the US.