Minimum health care for maximum city, Mumbai

By 2020, Mumbai is expected to become one of the largest urban agglomerations in the world. The much-touted health care infrastructure in the megalopolis has, however, failed to cope with the exponential population growth.

According to the 2011 census, Mumbai and its suburbs are home to 1.2 crore persons. Projected calculations estimate that more than 13 lakh people will be added to the population pool by 2021.

According to BMC figures, the island city has seen a reduction of two lakh persons and recorded negative growth in past ten years and upto seven lakh persons have been added to suburbs. To add to the woes of this migrating population, the health infrastructure in the suburbs continues to be poor. “In the past 10 years, the population in the island city has decreased substantially.

There are numerous reasons for this demographic shift. “Clearly, former residents of the island city are giving up their erstwhile small houses in search of cheaper and spacious properties in the suburbs,” said a senior BMC official.

Researchers have pointed out that there is a glaring deficiency in public health infrastructure in the suburbs as health care facilities continue to be concentrated in the island city. This, in spite of the area seeing a negative growth of population. Increase in slum population and migration of city islanders to the suburbs has led to the mushrooming of numerous small-time nursing homes and private hospitals.

The Mumbai Human Development Report 2009, points out that, on an average, only about 21% of city households use public health services. The rest approach private doctors or hospitals. To add to the problem there is a huge scarcity of public dispensaries and health posts in Mumbai, which compels a majority of people to depend on private physicians. All this creates the breeding ground for quacks or bogus doctors and vulnerability of the poor to their mercy.

While, tertiary care hospitals like KEM hospital in Parel, Nair hospital in Mumbai Central and Sion hospital are among the top-notch medical colleges in India and they produce among the best doctors in the country, the load on these three hospitals to cater to a humongous influx of patients is beyond comprehension.

Patients throng the hospital corridors not only from Mumbai but also from satellite towns of Thane, Kalyan, Mira Road, Bhayander and Navi Mumbai. In totality, KEM, Nair and Sion Hospitals, see a footfall of up to 14,000 patients a day. This has led to the hospitals’ infrastructure to crumble.

BMC’s health committee member and NCP corporator Dr Saiyeda Khan explains that there is an acute disparity in distribution of hospital beds across Mumbai. The island city (Colaba to Mahim) is home to three super specialty hospitals - state-run JJ Hospital, KEM Hospital and Nair Hospital with capacity to hold more than 6,000 patients at any given point of time. In comparison, the bed capacity at Sion Hospital which caters to the population from the far suburbs is merely 5,000. “This disparity exists even as many of are migrating to the suburbs from the island city in search of better living conditions,” said Khan.

“It is imperative that basic health care and treatment be provided in the 16 peripheral hospitals across the city that are run by the civic body. Apart from this, the bed capacity in peripheral hospitals and Sion Hospital, which is the only tertiary care super-specialty hospital in the suburbs, should be strengthened,” said Khan.

Cure and care
In the ’80s, over 60% of the city’s population relied on public hospitals, says independent health researcher Ravi Duggal. “The condition of public hospitals was not as pathetic in the ’80s as it is today,” he says.

In the 1960s, the Zakaria Committee formed to develop national guidelines for core municipal services in cities and towns, had recommended that up to 30% of civic budgets be set aside for health. In the late ’80s, budget allocation for improving health services was close to 30% and this has been on the downside over the past 30 years.