Mobile phone apps to order restaurant food and midnight hunger pangs are combining to increase heart diseases and diabetes victims said a news report of Dec 6. Late-night feasts may be fun in Billy Bunter’s Greyfriars School circa the 1930s, but it door-delivers lethal results to 21st-century lifestyles. India has already become an unfortunate world leader in fatal heart and diabetes ailments.
Leading India’s overdue battle for health are crusaders such as Devi Prasad Shetty. But as is often the peculiar feature of my journalistic profession, the good news of people doing good work often does not get as much attention as the bad news – and so too with Dr Devi Shetty. I was unaware of his existence until I recently met a former Statesman colleague Ashwin Kotian after 15 years.
So in a Nariman Point eatery, as early October afternoon sunshine lit green avenues and blue sea waters near Marine Drive, I heard from Ashwin the name Dr Devi Prasad Shetty – one of India’s leading cardiac surgeons, saviour of thousands of lives, personal physician to Mother Teresa, founder-chairman of Narayana Health chain of hospitals and pioneer of innovative health care in a country that desperately needs it.
Being awarded the Padma Bhushan in 2012, India’s third-highest civilian honour, understates the story of Dr Shetty paving a crucial, innovative path to sustainable cost-effective, high-quality healthcare in India. A population of 1.2 billion faces a critical shortage of hospitals and human resources, access to safe medical care and ability to pay for it.
India needs about 3.5 million beds, 3 million doctors and 6 million nurses in the next 15 years, estimated a five-year-old Price waterhouse Coopers report. More crucially, India needs to extensively promote health awareness based on the suffering-saving principle: prevention is better than cure.
“Mens sana in corpore sano (a healthy mind in a healthy body)”, famously said the ancient Roman poet Juvenal. A healthy mind needs the daily mind-purifying workout of Vipassana (www.dhamma.org) and a healthy body needs nutritious food and daily exercise. A mind-body fit workforce is needed for a healthier economy leading up to what I see as inevitable coming of India’s next Golden Age. Such is the cycle of history, in the impermanence of ups and downs, in the fall and rise in the lives of individuals and nations.
Compassion, innovation and striving for cost-effective excellence will revolutionize India’s health care. That is happening to some extent, as I realized when working on a small (health awareness) social media project for Narayana Health through their media partner Digital Strings.
After hearing so many cases of exploitation from corporate-hospitals (based on emotional blackmail, with families reluctant to bargain on bills to save a loved one’s life), I was very happy to know of this rule in Narayana Health hospitals: no patient is refused admission due to inability to pay. More than 50 per cent of patients receive free or subsidized care.
Dr Shetty has conducted surgeries free of cost for children after reading news reports of their parents unable to pay for life-saving surgeries. The costs are underwritten on scale, he says, a larger number of patients paying full costs generates sufficient income to offer free or subsidized medical treatment when needed.
Andrea Taylor, Erin Escobar and Krishna Udayakumar in their study ‘Spreading the Narayana Health Model beyond India’ (2017) observed: “Narayana Health has achieved savings through smart use of equipment, telemedicine, efficient staffing procedures…. Health system leaders worldwide are searching for innovative care delivery models that lower costs, improve quality, and increase access to services. India’s Narayana Health is one of the best-known examples of a health system that has achieved these goals.”
Narayana Health uses cost-saving methods such as pay-per-use agreement with suppliers for diagnostic equipment, centralized purchasing, barcoding stock for precise inventory counts that minimize storage expenses and prevent excess spending.
Narayana Health has optimized information technology to create one of the world’s largest telemedicine networks – with 800 centres globally connected. This helps 53,000 patients receive treatment via telemedicine without investment in hospital infrastructure. Mobile outreach vans also increase access in India’s semi-urban and rural areas.
Becoming better acquainted in recent weeks with Dr Shetty’s goodhearted work, particularly in heart health, I can call him “India’s Mr Heart”. I can recognize a man of destiny – the work of this tribe being revolutionary service for the welfare of fellow beings.
Dr Devi Shetty, born in a village in Karnataka, has conducted over 15,000 heart operations and has become a driving force to promote heart health care among children and young people. “Sons do not bring their elderly fathers for heart disease treatment these days”, Dr Shetty says in a YouTube video, “fathers are bringing their sons. This is unacceptable.” Growing incidence of heart diseases among India’s young population is part of the health challenges the country faces.
Health care leaders are promoting lifestyle changes to keep out heart attacks and diabetes: exercise daily for a minimum of 30 minutes, eat highfibre foods, green vegetables, include ancient Indian health treasures such as turmeric, ginger, methi (fenugreek) in the diet, have traditional Indian foods such as dals and less of delicious but dangerous junk food. Stop smoking (which also endangers health of people nearby) and avoid alcohol like poison (that kills the mind).
Health care innovators and Ayushman Bharat (www.pmjay.gov.in) will be game-changers in the next few decades. Ayushman Bharat, the world’s largest government-funded healthcare scheme launched in 2018, has hit hard at profits of the medical industry to which Narayana Health belongs. And yet Dr Shetty welcomes Ayushman Bharat as a revolution in India’s healthcare.
India’s Mr Heart told the Indian Express, “Ayushman Bharat will herald a dramatic and significant increase in the number of heart surgeries done especially on children in India.” On the annual World Heart Day on September 29, the Narayana Health-managed SRCC Children’s Hospital in Mumbai announced that it will conduct 200 heart surgeries each month for needy children.
Other governmental initiatives if executed well will propel India to a healthier future: the National Medical Commission Bill (2017) to upgrade medical education, the National Nutrition Mission (2017), the Jan Arogya Yojana (2018) to ensure health insurance worth Rs 5 lakhs (US$7,100) to more than 100 million families every year, Mission Indradhanush for immunisation coverage across India, central governmental efforts to reduce cost of lifesaving medicines.
The rest of the world benefits from India’s private hospitals. An open heart surgery costing about US$ 2000 in India costs about $80,000 in the US. Not surprising medical tourism in India booms with 25 per cent growth per year and expects to earn US$ 9 billion this year. India’s healthcare industry is projected to grow three-fold to Rs 8.6 trillion (US$ 133.44 billion) by 2022. How to ensure domestic patients also benefit from this growth? More health care providers need to follow the way of India’s Mr Heart – the mind-set of people of destiny who provide the good news.
(The writer is a senior Mumbai-based journalist)