Journey to the cutting edge of the world: Perspective on Indian Healthcare

It’s The Turn Of The Millennium

1 o’clock at night, I was sitting in the CT scan centre of Sion Hospital. As a first-year resident, it was my job to ensure the safety of the seriously injured patient while the CT scan happened. The scan that takes a few seconds today took more than half an hour then. It was infuriatingly slow, but I was still fascinated. In Raipur, where I came from, there was no CT scan at all. Even at Sion, getting an appointment for a scan could take days, unless it was a dire emergency.

India Struggles

I was young and green, of course, but I knew what we had at Sion wasn’t the best either. India was extremely backward in medical services. Our doctors were respected the world over, but our facilities were not. In 1990, India ranked 36th in the number of CT scan machines in the world, and 100th in the number of scans. Today we are in the top 10.

The early ’90s in India were a period of both struggle and promise in the healthcare sector. While ancient India was a seat of innovation in healthcare, we had slid after centuries of foreign rule. Hospitals were often under-equipped, technology was dated, and the disparity between urban and rural healthcare was vast. But change was on the horizon. Economic liberalisation, government initiatives, and a burgeoning private sector began to sow the seeds of transformation.

Tech Arrives

The new spirit breathed life into a system gasping for modernity. The number of CT scan machines leaped from a meagre 36 all over India in 1990 to more than a dozen in Raipur itself today. MRI machines, once a rarity, now number in the thousands. The landscape was changing, and it was changing fast.

Oncology Transforms

The transformation is perhaps most vividly seen in cancer treatment. The National Cancer Grid, aims to revolutionise cancer care, linking research and treatment across the country. Its member hospitals now number in several hundreds, showing how many hospitals value this approach. Linear accelerators (Linacs), essential for radiation therapy, have multiplied, with over 600 now in operation. Even proton therapy, a cutting-edge technology for cancer treatment, was brought to India ahead of the UK, a testament to India’s relentless pursuit of excellence.

In my field of Surgical Oncology, complex surgeries such as Microvascular reconstructions were only available at a handful of centres. Most patients with large oral cancers had unsatisfactory reconstruction. Most patients with breast cancers were given no choice except Mastectomy (removing the entire breast). Radical surgeries were the norm even when conservative surgeries were possible.

This was partly because of a lack of facilities, like a microscope for vascular surgeries. But also because training for many kinds of procedures was not available at the time in our country. Today, in my practice, breast conservation, Microvascular surgeries, and Oncoplastic surgery have become routine. In abdominal cases, Laparoscopic surgery was invented in the 1980s but didn’t become routine in India until after the turn of the millennium. All this has led to a huge difference in the quality of life of our patients in the last 20 years.

Human Endeavor

But it wasn’t merely a story of machines and gadgets. It was a tale of human endeavour. As we look back, we see that the number of doctors grew, albeit slowly, from 0.5 per 1000 people in 1990 to 0.86 by 2021. Nurses, the unsung heroes of healthcare, saw their ranks swell by over 50% since the turn of the century.

Accessibility, once the Achilles’ heel of Indian healthcare, began to shift. Over 25,000 Primary Health Centers sprouted across the rural landscape, a beacon of hope for those far from the bustling cities. Telemedicine, growing at a steady 20%, brought healthcare to the remotest corners, breaking down barriers that once seemed insurmountable. Ayushman Bharat has made treatment in private hospitals an affordable reality for hundreds of millions.

The investment in medical education has also been remarkable. More than 100 new medical colleges have opened since 2000, nurturing the next generation of healers. Dialysis centers have seen growth of over 20% annually, underscoring the nation’s commitment to combating chronic diseases. Yet, the road is not without its bumps and bends.

A Long Road Ahead

The urban-rural divide persists, a haunting reminder of disparities yet to be bridged. Out-of-pocket expenditure, a staggering 62%, still burdens the common man. But the future, however, is bright and beckoning. The vision is clear, and the will is strong. India’s healthcare system, once languishing in the shadows of neglect, now strides forward with purpose and pride.

Journey Well Begun

In the grand tapestry of India’s healthcare evolution, the image of our young resident, waiting patiently by the CT scanner, serves as a symbol of a nation’s journey from scarcity to abundance, from despair to hope.

A journey, it must be said, that has only just begun