THE tragic suicide by the parents of a seven year old boy who died due to dengue in Delhi is a shocking reminder of the dismal state of the health care system in the country.  30 million Indians are infected by dengue fever every year and 80 percent of them do not get medical care, or, are refused admission in hospitals on the plea that no beds are available. This illustrates the public health crisis facing the country.  Dengue epidemics break out in Delhi frequently, but the government and the health system have regularly failed to cope with the outbreak. If this is the situation in Delhi, which has comparatively better resources for health care than other states, the plight of the people elsewhere can only be imagined.

The public health system has been consistently degraded and starved of funds. This has become worse after the neo-liberal prescriptions about privatisation of all basic services. India has one of the most privatised health care systems in the world as a result. The expenditure on public health system is a scandalous 0.9 percent of the GDP. The Modi government has further cut the allocations for health in the last union budget.

The deaths of the seven year old boy Avinash and a few days later, of  six year old  Aman, were the result of the refusal of private hospitals to admit them. In the case of Avinash, five private hospitals refused to care for the critically ill child. This is against all medical ethics and criminally negligent behaviour. The Delhi government should initiate action against them. Many of the corporate run hospitals and private nursing homes have received hefty subsidies in the form of free or, cheap land and other concessions. They are supposed to provide free beds to the poor, but violate this scheme in various ways. They have a virtual license to fleece patients.  The privatised health system can never be the substitute for an extensive public health care system.

Dengue is very much a product of an insanitary and unclean environment in the city. The main precaution for this disease is to ensure clean, sanitary conditions and regular spraying to check mosquito breeding. The dengue outbreak has shown up the hollowness of the Swachh Bharat campaign conducted with much fanfare over the last year. It has made no impact whatsoever in ensuring a clean environment even in the capital city. In Delhi, the problem was compounded by the municipal workers having to strike work due to the non-payment of wages by the municipal corporation.

What this episode of the failure to tackle the dengue outbreak underlines is the urgent need to expand and strengthen the public health system in India.  That is the only way the right to health care can be ensured for all citizens.

(September 16, 2015)