Rejuvenating the Rural health care system with AYUSH and 2 Mins doctor approach

What India can implement in Rural Areas

India fares very poorly when it comes to providing affordable health facilities, this is especially seen in rural areas where number of health facilities are no match for the burgeoning number of patients . More than 70 % of health ailment can be mitigated by healthier lifestyle and including AYUSH ( Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) as part of health facilities. These traditional systems have no or little side effect , but also promote health in addition to fighting diseases. Besides boost to AYUSH will also be shot in arm for livelihood of tribals and farmers who are engaged in production of medicinal plants. Ayurveda merely does not work towards disease alleviation but works for positive state of health.

For the diseases for which AYUSH offers no cure or if the patient so desires, can be handled via allopathic medicine system. We need to train attendants who will assist the doctor and the "2 minute doctor" approach can be implemented and  large number of patients are served in  India. We will also be providing more jobs to attendants and also trainers to train them. In case you are curios what 2 mins doctor is please read on.

So the incident of "2 Mins doctor" and "20 Minutes doctor"

The Two Minute Doctor

Since some days my eyes were getting exhausted at the end of Day. I checked my diet and i was getting sufficient nutrition, also had controlled my avoidable activities in front of computer and mobile but still tiredness in eyes persisted. Curious as i was and planned my trip to an eye doctor for the first time in my life.

As i walked in the clinic, There was a dedicated cashier who was there to issue a receipt to me. I was asked to wait and and soon was called by an attendant who conducted a visual test and noted his observations in the paper. Soon a second attendant came and asked symptoms from me. He noted the symptoms and told that an additional test which will capture the strength of dilated eyes would be needed. I was administered medicine and reading for this was taken and incorporated.The second attendant also gave some general suggestions and patiently answered my queries.

Now the time came came to meet the doctor, he looked  at observations and also verified the symptoms. He gave his recommendations and i was satisifed at the thorough examination that was conducted on me. In this entire process the time that i spent with the doctor was not more than 2 minutes and i was satisfied. The total time for which i had to wait was around 10 minutes before my turn came and the entire process was probably conducted in an hour.

The Twenty Minute Doctor

Since  returning from Germany i was experiencing recurring cough which had persisted since days, i initially ignored it to allow my body immune system to deal with it. ( i have not visited any doctor from almost 8 years and rely more on ayurvedic health system). Since  i wanted to check whether its normal cough or anything serious, i decided to visit a ENT (Ear Nose Tongue) specialist. He was famous in my town for his attention to detail and it was not easy to get his appointment. 

When my turn came the doctor patiently enquired the symptoms and details. He himself conducted the tests and wrote suggestions. After a close examination that lasted for around 20 minutes , he gave his prescription and medicines. I was happy that it was normal cough and satisified with the diagnosis and personal attention that i received. Strangely even the receipt creation was also done by the doctor.

Total time for which i had to wait was around 2 hours and time spent with doctor was 20 minutes.

Learnings from the above Episodes

In the first case of "2 minutes doctor", the sub tasks were carried out by skilled attendants. They tried to help and ease the task of doctor. Entire process felt like a production belt where the prescription form has to pass through various stages before meeting the doctor.

This eventually resulted in doctor able to advise a large number of patients during the day.

In the case of "20 minutes doctor", Every activity was carried out by doctor and he just had one attendant. I waited for around 2 hrs for an appointment and later he perfectly satisfied me after the meet. However the doctor will only be able to give prescription to some patients and i saw many patients leaving as there was no appointment left. 

P.S: I appreciate the warm heartedness and love for work which kept monetary considerations away ( A quality rarely seen these days , 20 Mins doctor) , but this article has been written in mind to meet the needs of rural population of India. 

I am aware that doctors are not the only scant resource and hospitals too need to be established, but human capital is most important and takes sustained time and effort to develop.

2 Mins time is just an anology, It is the minimum time that doctor would need and cant be filled in by trained attendants. 

Horn Not OK Please!

Few months ago, i was travelling in my friend's car in Frankfurt and at a circular turn a car which was coming from the front honked. While i was wondering what message was the driver trying to give to us, remark by my friend Raman, that its for the first time more than 7 years that he has heard a honk surprised me. My own experience in Frankfurt was limited to driving cycle and skates and i dont remember ever been honked at.

Yes honking in Europe and specially germany is to give a message to someone and honking without purpose is considered a bad road etiquette at least. People who drive on road get their license after a practical exam and after training under supervision of certified trainers. I have seen some of my friends failing the test too and very few passed in first attempt. Needless to say everyone follows road etiquette to the latter and feeling of trust is there on road which leads to cars running at top speeds. Yes in Autobahns (Germany's highways) there is no upper speed limits and i have seen cars speeding at high speeds which i presume was atleast 220 Kmph (Because even the car in which i was sitting achieved a speed of 180 Kmph).

The Government takes intense care of the needs of public and no flight is allowed in night from 11 PM to 4 AM as it can disturb the sleep of the residents during these peak sleep hours. Also in Autobahns which are near to residential areas, an acoustic wall is provided which prevents residents from loud noise of the speeding vehicles.

As India is still currently in developing stage so the standards of roads can not be expected to match those of developed nations. We have recently constructed some good quality highways but by and large they are exceptions and not rules, nevertheless the user road experience can still be improved by regulating the driving license regime and making it more transparent and stringent. In my city Aligarh, it is not difficult to find people who always keep their hands on horn and press whenever they want. Worse still there are some young friends who drive at top speed with their horns always on. (Yes its very painful). I say with full confidence that if any of my German friend manages to drive for some hours in my city he will stop complaining about anything in life and would thank God for all the blessings that he has got :)

Too much horn creates noise pollution and makes it difficult for people to live. It leads to hypertension, ear problem, irritation and also is leading cause of rising road rage in India (My view). Indian government should put in place stringent norms for traffic including issuance of automatic challans on jumping red light and implementing wearing helmets mandatory. When person breaks a rule of not wearing helmets more rules are broken in sequence. So its also going to have a psychological effect on us.

The recent Maharashtra government initiative to remove Horn Ok might appear a meaningless initiative to some but for me a man who knows the values of ideas and symbols, its going to have a deep effect on driver psyche and make them realise that honking is for a purpose of warning and should be used sparingly. Besides too much honking leads to people ignoring honks and may lead to more fatal problems in case a genuine warning is missed.

Horn NOT Ok, Please!

Indians monkeys and European Langoors

He he. I seek your apology for this catchy title but allow me to explain myself a bit.

The Incident

This incident dates back to 2010 when i went to Neelkanth shrine which is located in deep jungles of Rishikesh. I went via  the 12 km trekking route and passed through dense jungle heavily inhabited with monkeys and langoors. A passer-by informed me that around 2 decades ago even leopards could be seen in this area but have now moved to inner recesses of the jungle.  

As i moved on, i was greeted with gang of monkeys who were trying to snatch food articles from passer-by's. As it is a great satisfaction and entertainment to see monkeys eating grams and biscuits, i bought  a big supply from the nearby seller. All the grams were intented for the monkeys but i had a hard time distributing them to monkeys. All i wanted that all monkeys should have the gram rather than everything be snatched away by one monkey. Situation was getting uncontrollable and their was a danger of me being attacked by a monkey so eventually i ended up carrying the unexposed bag of grams with me and could not distribute everything as i planned.

As i walked for around 5 to 6 kms, i saw some langoors eating food from the passer-by pilgrims. I too started distributing my enormous supply of grams and later on ended up surrounded by 2 dozen langoors. The langoors were patient for their turns and i felt like a headmaster distributing copies to school children :). It was a memory of lifetime. Contented me, i ended up distributing my entire supply of food  to them and even bought more from local sellers. 

Learning Part

In the former case of feeding the monkeys, they were rowdy and fighting among themselves to snatch food. This resulted in me getting pissed off and leaving the place, distributing less than what i originally intented.

In the second case of feeding the langoors, they were peaceful and patient for their turn to arrive and did not try to snatch the bag from me and eventually i ended up buying and distributing more than what i intented.

Attitude of Monkeys/Langoors

Monkeys suffered from "me first and i dont care about others attitude" as they wanted to have everything for themselves without caring for their fellow monkeys.

Langoors has the attitude that "I will get it later but am happy that you are getting it now" attitude as they had the patience to wait for their turn.

Explaining the title

if you have ever observe the traffic jams in India, everyone without waiting for traffic to clear wants to go first and sneaks in through every short opening that one sees. Due to lack of dividers and road etiquettes, we even encroach  on the area of road which is reserved for people coming from opposite direction. This eventually results in complete blockage and long jams.However in Europe, No one tries to take his vehicle ahead and waits for the vehicle in front to move. Road is clear and eventually traffic jams clear in less time and due to trust vehicles too move fast.

A similar attitude could be seen in queues from train tickets in India , where some are clamouring to take their ticket first and jumping the queue . Thankfully it has improved over the past years but still lot of improvements are needed.

Conclusion

Dear fellow friends, lets make the monkey mind calm and lets take up this initiative to adopt the attitude of langoor in life. We can even inspire others to be patient at queues and respect the rights of others as we respect our own. This is another experience i had while dealing with queues in India http://antarikshbhardwaj.blogspot.de/2015/04/indians-and-queue.html

The writer Antariksh Bhardwaj is a software engineer , yoga teacher and loves to travel. His hobbies has led him to travel across more than 15 states of India and 16 countries across the world.