By Dr. Limatula Longkumer, Serampore |

COVID-19 is a wakeup call to healthcare system all over the world because no country is equipped medically to face this pandemic. All the countries spend more money on defence – military, procurements of arms and ammunitions, warships/jet planes, nuclear weapons but too less money is spent on health care which is life-saving facilities. As per the latest report, India is on the 3rd top biggest defence spending country in the world, next to USA and China. This current year (2020) India’s defence budget is ₹4,71,378 crores -that is 15.49% of the total budget (US$ 65.86 billion), whereas healthcare budget is only 67,484 crores for the entire nation. According to report, govt. of India spent about 1.3% of total GDP on health care in 2018 and this year budget 2020 is 1.6% GDP which is one of the lowest in the world. More money is spent on security and defence – for killing humans; but for saving people less amount is allocated, which is not fair. How much Nagaland govt. allocates budget for healthcare each year? May be too negligible amount for public healthcare! COVID-19 should be a turning point to invest seriously on healthcare facilities.

It is a fact that the preparedness of our State Nagaland for this COVID-19 is not satisfactory.     The only equipment to fight COVID-19 is to maintain strict vigilance of the lockdown! Negligence on the part of govt. to procure the testing labs machines and other kit tools for corona virus is a serious matter of concern.  Nagaland does not have even one Medical College and hospital whereas State like Assam have 7 medical colleges. The maintenance of the Govt. run hospitals and dispensaries in most of the districts in Nagaland are very poor, unhygiene, poor infrastructures, shortage of equipment, and supply of medicine. Whose fault is this? It is the collective failures of successive ruling governments in the State. There is a sharp disparity between rural and urban healthcare system. The distribution of health care resources in the rural villages is pathetic, no proper infrastructures, absence of medical staff because many healthcare workers do not want to go to rural places or “remote areas”! Many people with treatable diseases die pitifully in the villages due to lack of healthcare facilities and poor communication system. Poor healthcare is a sharp pointer to acute corruption and mismanagement by the politicians, govt. bureaucrats and the public in general. COVID-19 pandemic should raise critical question on the slackness of public healthcare system in our State.

Health care is highly commercialised and urban-centred and therefore, it is not accessible and affordable for rural peoples. Good hospitals are located in Dimapur and Kohima, both govt. run and private hospitals including Christian hospitals. There is a mushrooming of private hospitals and nursing homes in Dimapur and Kohima mostly, which is a good sign but we should also realize that hospitals are one of the fastest growing industries in the world. It is a profit-oriented business that the value of human beings is no longer counted as important, not patients’ friendly but money-oriented. Many poor villagers have no means to come to Dimapur and Kohima for treatment. The rich and elites can go to big metro hospitals in India and even abroad. Sadly, there is a sharp division in healthcare system in our society between rich and poor; and between urbans and rurals. Health disparities affect the physical illness, psycho-social and emotional well-being of persons in the community. We also need to know that socio-economic structures, political and environment systems incur serious health issues but this area is never addressed as a health care problem in the past. There may not be COVID-19+ve in Nagaland thus far, but it has created fear phobia or fear psychosis among the people and many are suffering emotionally and psychologically. This fear psychosis is equally dangerous for wellbeing of persons in the community. Hence, healthcare should focus on holistic wholeness and wellbeing of all persons in the society.

The right to health is a fundamental right of all citizens. It is about equal distribution of healthcare facilities, making accessible and affordable for all people. Poor public health care and sanitation demands that Government should come up with a long term public care system.  The present health disparities between the poor and rich, rural and urban dwellers are due to human made unjust social systems and structures, corruption and mismanagement. This can be prevented or eliminated through human’s interventions by developing honesty, sincerity, transparency and good governance. COVID-19 should be a lesson to transform health care system in Nagaland.

Better healthcare system demands efficient planning, implementation and monitoring should be the priority of all governments.  Adequate sufficient budget should be earmarked for public healthcare facilities in both rural and urban areas. Establishment of at least a medical college and hospital in the State is already long overdue and speed up. Fair distribution system for the welfare of the community should be promoted. Ensure that quality medicines reaches the rural primary health centres.

The well-being of a person in community can be measured by life-span expectancy, low infant mortality, good maternal and children health care, clean environment, food security, access to safe drinking water, adequate sanitation facilities and good transport and communication. These are the pressing needs for the health of a community. Unfortunately, we are failing in almost all these areas and COVID-19 calls us to restructure and rejuvenate our healthcare system for the good of all citizens.