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Statesman News Service |

Big no longer beautiful
VIOLENT protests in several cities in Brazil ~ even if triggered by increased bus fares ~ are actually raising the same question asked around the world on the eve of major international sporting events. Are these extravaganzas played out to the detriment of the common folk in need of better social services like education, health care, housing, unemployment relief, old-age pensions and so on? It was asked in New Delhi before the 2010 Commonwealth Games, in South Africa ahead of the FIFA World Cup, and in London before that last Olympic Games. No, it was not an issue in Beijing, because the People&’s Republic accords no space for public protest ~ the thousands whose homes were demolished, the beggars who were banished from the city (that happened in Delhi too) just suffered in silence. Forgotten has been the self-financing effort of the Los Angeles Olympics, and only token consideration is given to the IOC&’s insistence on “after-use plans” being incorporated in the “bid”. South Africa now has under-used stadiums, the facilities created in Delhi have gone to rot ~ as had most of what had been developed for the Asian Games in 1982. Of course there was added cause for anger in the Capital in 2010: the shameless loot ~ as yet hardly punished.
Obviously the public outcry ~ that Brazil&’s passion for the beautiful game has not doused the protests speaks volumes for the angst ~ in “developing countries” is extremely high because there are other areas in which public funds could have been more usefully expended. The real problem is that the authorities in such countries overdo the use of such events to convince the world that they have “arrived”. Beijing was brazen when making that essentially political statement, London was thus pressured into upgrading its plans so as not to “lose face”. And despite some comprehensive planning, London has not been able to rework all its Olympic venues for regular commercial use. The vicious circle of opulence and “showing off” is another manifestation of how commercialisation has taken a toll on what were the “original” sporting values. Sportspersons now earn megabucks, and they expect the very best. Exemplifying that perfectly is the fact that the accommodation provided in the “Games Villages” in Delhi in 1982 and 2010 became prestigious, exorbitant, high-end units once the athletes returned home. The riots in Rio should convince the IOC, FIFA etc that splurging on sporting sambas is increasingly turning “sick”.

And the spin-doctors of Trinamul
THIS isn’t an issue over which Mamata Banerjee can make a strident pitch for federal rights. The irony is bitter. For all its willingness to set up an “AIIMS-like” hospital in West Bengal, the Centre&’s proposed project is set to flounder on the rock of political rivalry within the state, indeed the increasingly strained equation between the Trinamul Congress and the Congress. As much is apparent from Union health minister Ghulam Nabi Azad&’s renewed pitch for an AIIMS prototype in the state. Any other state would have welcomed this initiative pertaining to public health; but this is Bengal where political opposition can hinder development ~ from the industrial (people&’s car) to the realm of public policy (a sophisticated hospital). The reason proffered by the state&’s health department ~ under the Chief Minister&’s belt ~ is quirky and would have been laughable were it not for the care of the sick and the dying. The government would rather the hospital be set up in South Bengal, the Trinamul&’s turf however withering, and not at Raiganj in North Bengal, still the bastion of a decimated Congress, indeed a region where the ruling party is yet to make inroads despite odd electoral victories. Furthermore, Raiganj happens to be the stronghold of Deepa Das Munshi, Miss Banerjee&’s bete-noire. Sad to say, inter-personal equations have also come into play.  Carried to what the Trinamul might perceive to be a logical conclusion, the risk of Darjeeling being deprived of special health-care facilities is substantial. The Centre&’s plan is to put in place an AIIMS-like hospital in West Bengal. As a development paradigm, this is critical enough. It would be worse than parochial to advance a political division of the state, one that has been contrived and now threatens to blight the development of public health.
That division along political lines appears to have held up the acquisition of land for what they call “public purpose”.  The state has been dragging its feet to acquire the 100 acres, for which the Centre has agreed to compensate the farmers. The Chief Minister would not have been so intransigent had the Centre agreed to her plan to set up the Rs 823-crore facility in Kalyani. That the hospital can be set up only in a politically agreeable site is a wholly unacceptable twist effected by the spin-doctors of the Trinamul Congress.

Beyond the Madhya Pradesh template
FOR a state that boasts the highest number of rural health centres ~ and ironically without doctors ~ the National Rural Health Mission&’s initiative in Madhya Pradesh will be welcomed both by the medical fraternity and the public. That said, the scheme suffers from two shortcomings ~ it addresses only the needs of the doctors and it offers little or nothing in terms of sprucing up the infrastructure. And beyond MP, the NHRM has stopped short of planning with a pan-India perspective. In the absence of fundamental medical equipment, it remains open to question whether the doctors will be professionally attracted despite the remarkably hiked salaries ~ Rs one lakh in “difficult areas” and Rs 1.25 lakh in the “very difficult” regions. Salary isn’t the singular deterrent. Public health services are almost uniformly decrepit across the country, and any attempt to project a particular state as a template for reform is very likely to be resented by the rest and not the least because it is a Centrally-sponsored endeavour. The lacunae are as acute in other states as in MP, chiefly the dearth of doctors and sub-standard hospital infrastructure. Both problems have hobbled the functioning of Community Health Centres and Primary Health Centres.  Public health, in a word, is a national concern. And to underline the inadequacies is not to sound parochial, only to emphasise that the NHRM ~ with an all-India remit ~ is expected to plan and function on a far wider canvas, indeed to make public health services in rural India professionally fulfilling.
It might be less than fair to hold the NHRM alone responsible for a revamp of rural health services. Equally does the task rest on the respective states which, if West Bengal is a case-study, have failed and failed abysmally. The facilities that exist are an apology for medical science. Both the NHRM and the health authorities of the states must ensure that medical treatment is not only for those who can afford it. To attract doctors with hefty salaries will address only part of the crisis; those in search of treatment must be attracted and not repelled. The medical paradigm, therefore, must go beyond the mercenary.