A Satire on Compulsory Rural Posting
by Dr Kiran Kumbhar
[On Dec 17 the Indian Health Minister declared that MBBS students applying for admission to PG medical courses from 2015-16 will have to undertake a compulsory one-year rural posting at a public health centre (PHC), to ‘give back’ to the society. This is a report of later events.]
Dr Kiran Sambhaji Kumbhar
A few days after India made the unique record of mandating a dilated six and half years’ MBBS course for doctors, the Health Department of the Sevanagar Zilla Parishad was a scene of frenzied party activities. We had gone there to interview the District Health Officer. He was on leave, but we managed an exclusive conversation with a peon and a clerk. (Those posts are in fact widely recognized as the most ‘sarkari’ in India.)
“All this is happening due to Arvind Kejriwal,” the peon announced. “Ministers are mortally afraid that their main source of income, corruption, will be swept away by AAP’s jhaadu. They are now trying to milk any remaining scam-worthy cows to fill in their coffers and also garner some vote bank points if possible. Exploiting doctors does both.”
Drinks were being generously distributed. The clerk chipped in. “I bribed the MLA one lakh rupees to get a posting here. And today, finally, God listened to my prayers. When helpless doctors will now come to our department requesting for their compulsory PHC posts, we will manipulate them any way we want, and start a stable source of income from them.”
Evidently, alcohol was pushing a lot of skeletons out of bureaucratic cupboards.
“Do you know that the Ministry is also planning a Compulsory Domestic Posting rule for MBBS doctors?”
We looked flummoxed. With a wicked smile, the smug clerk explained that since doctors are educated through govt money, which in India is actually politicians’ personal wealth, MBBS doctors in future would be made to serve at the homes of all MPs and MLAs. The remaining unallocated doctors will then be assigned to the homes of regular central and state government employees on the basis of hierarchy.
Here the clerk said, with a twinkle in his bloodshot eyes, “Maybe in a year I will have my own private doctor, possibly a young pretty girl, to look after my family.”
Elsewhere in the country, thousands of unemployed graduates from various streams like engineering, commerce, education, etc took to the streets demanding compulsory govt jobs for themselves just like for doctors.
“Do rural areas face only health problems? What about electricity, good roads, proper banks, proper schools? If doctors are given govt jobs just because their education was subsidized by the govt, why should we be ignored? Even we have received subsidized education. Even we want govt jobs!”
We talked to a few people on the streets to get the general public’s view. A very vocal school teacher said, “These young boys and girls always want an easy way out. I am appalled by the kind of doctors we are producing these days.”
“Exactly,” concurred a bank employee beside him.
On knowing that they both had completed their graduation from govt colleges with very nominal fees, we asked them if they had ever, in their youth, worked for rural people to ‘pay back society’s debt’. They mumbled some incoherent words and suddenly took our leave, taking out their mobile phones and talking importantly into them.
While most doctors are against this govt ruling, there are some who were elated at its announcement. We met one such doctor, Dr V Arun Patel.
“The medical profession is a noble profession and all doctors are born only and only to serve poor people. I feel utterly morose seeing that all my colleagues here in India just don’t have any ethics and conscience.”
We asked him if he would be ready to go to an Indian village and work there. “I don’t need to. Being an idealist doctor, my job is only to point out deficiencies in the system from a distance. And anyway that regulation doesn’t apply to me. I’m a foreign medical graduate, I was in a foreign country for 6 years and I recently arrived in India.”
We wanted to ask him how he could then understand the vast Indian health system in such a short time, but he was promptly whisked away by some of his friends.
To get a better perspective we decided to visit a govt doctors’ hostel and talk to doctors there. On reaching we were told that the doctors were all on the terrace. We thought they must be having some meeting regarding the protests. We went there, past stinking toilets and crammed corridors, but to our astonishment discovered that a wedding was going on.
We asked a doc what it was all about. “Well this is how we are protesting against the Health Minister’s decision. By converting MBBS into an almost seven years’ course, the govt is just relegating our entire youth to a stressful hospital-library-hospital-library life, and we may one day really have to marry in wards and operation theatres. This couple was scheduled to wed in a hotel today. So this is our Gandhian way of protest.”
We saw a few doctors arriving, drenched in sweat, in exercise gear. One of them told us that the govt had decreed another mandate two days back: one month of prior intense exercise ‘compulsory’ for doctors going to rural PHCs.
He read out the official govt notification.
‘All doctors going for rural posting need to be physically robust to tolerate the extremely harsh working and living conditions we provide at the PHCs and to recover from any physical attacks by our local politicians or their goons, which are common and unavoidable. For that we are providing free gym facilities at all Resident hostels, with attendance a must. To female doctors, we warn that molestation and rape are real threats in the PHC areas. To address that, we are providing a population-wise list of villages with special mention of the proportion of above-60- and under-15-aged male persons. Female doctors are encouraged to choose PHCs with a higher ratio of this age group to reduce the chances of interacting with young perversion-prone males. However, 50% of such PHCs will be reserved for backward classes.’
All in all, with significant notifications coming back to back, the government seems to be in a frenzy to make all sorts of things ‘mandatory’ for doctors. It now needs to be seen in what way doctors will counteract it.
Dr Kiran Kumbhar
Sassoon Hospital, Pune