Ailing healthcare fighting swine flu!

They once said, when a Black man becomes president of the US, pigs would fly. Sure enough, 100 days into Obama’s presidency, swine flu…’ This joke was making the rounds when swine flu was still a distant disease in India. But now that it has arrived with a flourish, the joke is on us. Between the fatal flu and government hospitals, the flu seems less scary.

This H1N1 virus has killed almost 150 around the world and spread to 74 countries. Deaths in the US, Canada, UK and Europe have proved that not just poor countries like Mexico, but even the word’s best medical facilities are humbled by the virus. The death toll in New York alone is 23, and counting. The WHO has declared H1N1 a global pandemic.

Yet in India, we the urban upper middle class fear government health care more than the swine flu. Our travels for work or fun have brought the flu home (almost all the 31 cases till now were contracted abroad), and we are not always behaving responsibly to stop the virus from spreading. Because we are terrified of being quarantined in government hospitals.

Last week, a Delhi businessman’s 34-year-old son brought it back from New York, stayed at their farmhouse refusing hospitalisation, infected his mother and after much persuasion by government authorities moved to Ram Manohar Lohia, one of the best sarkari hospitals in Delhi. But shortly after being admitted, the mother and son changed their minds and fled. The Delhi government launched a manhunt to locate them and bring them back.

Then it invoked the Epidemic Act, which allows the government to forcibly quarantine anyone testing positive for H1N1. Soon after, a 38-year-old back from Germany with swine flu symptoms ran away from the same hospital. Increase security at hospitals, roared the Health Ministry, don’t let anyone escape!

Sure, faced with a crisis the government can force us to do stuff in the national interest. Epidemics need to be urgently contained. Given the dense population, unhygienic living conditions of the masses and our miserable health care system, once an airborne infection like H1N1 spreads, it will kill with a vengeance.

So the sarkar can confine us in what the privileged consider hellish conditions. But it must do better. It must recognise why those who have a choice avoid government hospitals, and attempt to improve conditions. It’s not just the lack of air-conditioning and clean bathrooms.

It’s also the appalling lack of hygiene, the absence of doctors, the dysfunctional equipment, the rude and inhuman staff and the dearth of services.

And for the terrified elite cowering under their beds as quarantine cops come knocking, this is a wake-up call. Our public health system is seriously sick and we need to help nurse it to health. We, who offer state of the art medical tourism to foreigners.

If things are so bad in the best of the Capital’s government hospitals, what could the rural health care units be like? In a word, ghastly. In spite of the National Rural Health Mission, these are crippled by the lack of medicines, qualified doctors and diagnostic equipment. The rural poor are forced to depend on the parallel healthcare system powered by bribes, quacks and private clinics.

 “I chose the All India Institute of Medical Sciences because I have confidence in your ability and to encourage the general public to come here for treatment,” said Manmohan Singh after his heart surgery at Delhi’s premier government hospital. “I hope every patient receives the same care as you have given me.” Unlikely, especially since doctors and equipment were flown in from Mumbai for the PM.

We, the privileged do have a stake in public health. Here’s our chance to tell a different story. ‘They said, the rich in government hospitals? When pigs fly! Sure enough, there they are, after the swine flu…’