Poor Sanitation in Hospitals in India

As you open your eyes you see your mom standing next to the bed you are in. When you look around there are many other people lying in beds waiting in pain. You try to get up, but you feel as if the world is spinning around you. You fall back onto the bed and hear your mom speak but you can’t tell what she is saying.

After laying down for a while a nurse walks in and gives you some medications and then tells you that you need to stay there for longer.

In that small room there’s more than 20 people crammed in, some on the beds and many on the floor lying on stretchers. The bed sheet on which you are laying looks like it hasn’t been changed in a year or two. There is trash everywhere. The equipment that the nurses are using do not look clean and they look like they have been utilized several times.

When you go to the hospital you don’t expect to get worse and in most cases you probably do not get worse. In India the reality is most people get worse in the hospital due to the lack of cleanliness and poor infection control and the hospitals not having enough equipment and staff. The sanitation in hospitals in India is inadequate and in order to change this the government needs to increase the amount of money they spend on public solution.

Lack of basic medical facilities and poor sanitation

In India, the lack of basic medical facilities and poor sanitation in public hospitals has added to the inadequate sanitation in India.

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The environment of the hospitals is very poor and unhealthy which causes the patients to get worse and not receive the care they need. The hospitals lack proper tools and equipment, such as beds and wheelchairs, anesthesia machines, diagnostic equipment, sterilizers. They don’t have the proper personal protective equipment (PPE) for nurses nor the visitors. The quality of the equipment they do have such as the beds are not so great either. They also don’t have a lot of staff. Ejaz Kaiser, Ruchir Kumar and Subhendu Maiti (2014) in the article “Trauma centres: How public healthcare failed people” state that “In Patna Medical College Hospital, for instance, carbolisation (a disinfection procedure) of cots and equipment is not done at all, not even in ICUs or operation theatres (OTs). Nor is microbial monitoring of asepsis (to prevent infection) done on the OTs, wards and mattresses, which is mandatory in all hospitals”(para.13). Because of the poor cleanliness, infection spreads like wildfire in the hospitals.This can lead to a large portion of the people dying. Most of the hospitals, especially the ones in the rural areas are not adequate enough to deal with infection spread. In India there are lots of private sectors and public hospitals are insignificant compared to the private sector so they private sectors set the standards of care and cost. The private sectors try to make profits so healthcare is very expensive and a lot of people can’t afford it. When this happens the people that can’t afford it go to the public hospitals where the environment is terrible and it causes the hospitals to be over- crowded too. Many NGOs have tried to spread awareness and educate people, but even though they did this it doesn’t really help the situation in public health because the people can only do so much. India has been trying to work on making health care more affordable, but they haven’t really focused on making the environment in hospitals more adequate in any way.

Poor spending on public hospitals

To deal with such a problem the government needs to be more involved. The government of India needs to increase its spending on public hospitals. India spends a little over 1% of its GDP on public health and the government should spend more and also spend it properly. The government should increase the percentage of GDP they use on public health to at least 5%. Vikas Bijap in the article “The Challenges Confronting Public Hospitals in India, Their Origins, and Possible Solutions” (2014) states “India’s public health expenditure fails to match even that of the least developed countries and sub-Saharan Africa”(para. 41). This demonstrates how little India is spending on public health. Not only is it spending so little, but the little money that does go towards it isn’t really being used as effectively as it should be. They need to spend more on primary care, healthcare workers, the facilities and on the equipment and tools.

Increasing the percentage of GDP spent on public hospitals will work because the hospitals have more money to spend on implementing and educating their staff about proper sanitation protocols and on the equipment and the environment of the hospital. The time it will take to do this will depend on how much they increase the GDP used on public health. If the government is more involved, it will be easier for the public hospital’s environment to improve throughout all of India and not just some hospitals. In order to do this we will need to raise awareness about this situation to the people of India. This can happen if people spread the words through social media such as instagram, twitter, facebook, and snapchat. The media can also write about it in the newspaper and talk about it on television. We would also need people that are well known to advocate for it because that will get attention from a lot of people. For example Modi, the prime minister of India ,even talked about increasing to 2.5%. PTI (2018) in the article “India to increase public health spending to 2.5% of GDP: PM Modi” states “India is set to increase its public health spending to 2.5 per cent of it’s gross domestic product (GDP) by 2025, Prime Minister Narendra Modi said on Wednesday, asserting that women, children and the youth will continue to remain at the heart of every policy, programme and initiative of the government,”(para.1) This quote shows us that Modi wants to increase the GDP too. He says 2.5 percent by 2025, which means that it is barely increasing and it would take a long time for things to actually work and be in place. If the government increases it to 5 percent, then they will be able to get the facilities in better condition faster and also give better care to the people.

In India, there have been many other attempts to solve this problem. The healthcare workers have done as much as they could to help make hospitals cleaner and prevent infections. They promote washing their hands and disposing waste properly and spreading awareness about cleanliness and its benefits. Although they have done this there are basic problems like the lack of electricity and water in hospitals. Sanjoy Sanyal, Sangeeta Rane and Auro Shashwat (2019) in the article “ Without Solar, Some Indian Doctors Must Operate in the Dark” state “A survey of rural public health centers in the eastern state of Chhattisgarh indicated that 90% of health clinics experience power cuts during operational hours”(para.4). This indicates that power outage in hospitals is normal To deal with this many of the hospitals use a diesel generator as a backup source for power but this can be cumbersome since it takes time to get maintenance to start it up. In that time a lot can go wrong in the hospital. Using a diesel generator hasn’t solved the problem because these generators are expensive and break down over time. Instead of using these diesel generators, they have come up with another solution, solar panels. Although this is a great way to deal with the power outage, solar panels are expensive and as a result many hospitals opt for the diesel generators. If the public hospitals had more financial support, they could implement the solar panels which, based on India’s climate , is the most logical alternative to electricity.These are structural issues that are beyond hospital personnel’s control, and until these basic conditions are improved, nurses and doctors can do little to improve overall care.

Advocating for increasing the GDP used on healthcare

Although these attempts have failed, the people of India can make sure that they make a change by advocating for increasing the GDP used on healthcare to at least 5 percent. I know you may be thinking, well how long will it take for this to even work if all these other solutions haven’t worked? Depending on how the government takes action it could take just 5-10 years or up to 20 years. An individual might also think raising it up to 5% is a lot(quadruple the % that it is now) but when the government does spend money on healthcare it involves health insurances and- a lot of other things which requires a significant amount of money. If the government spends more in building infrastructure in the rural areas of India and creating a better health workforce throughout all of India the percentage would go up fairly quickly. The government really needs to boost the number of healthcare workers there are because that is also a big problem with why the hospitals environment is so bad. PTI (2019), in the article “India facing shortage of 600,000 doctors, 2 million nurses: Study” states “In India, there is one government doctor for every 10,189 people (the World Health Organization (WHO) recommends a ratio of 1:1,000), or a deficit of 600,000 doctors, and the nurse:patient ratio is 1:483, implying a shortage of two million nurses.”(para.7)This conveys how bad the shortage of healthcare workers is in India. The hospitals of India are always overcrowded and with only a few workers they can only do so much. The wages are low for healthcare workers and studying medicine is expensive. Spending money on making the education more affordable would help increase the amount of healthcare workers. Most of the healthcare workers in India end up moving to the US or other parts of the world because they get paid what they are worth in other parts of the world. Increasing the number of healthcare workers would make the environment of the hospitals more efficient and healthier.

You might be thinking that the government wouldn’t raise the amount of money they spent on healthcare, but there is an effort already being made so the public just need to advocate for it and raise more awareness so the whole nation can create a change. Another concern you might have is about increased taxes. No, your taxes will not be increased significantly. It would only increase significantly if the percentage of GDP used on healthcare was raised significantly, but raising it to only 5 percent will not make the taxes shoot up. You might think that spending more on hospitals isn’t going to work because spending only 5% will not be enough to create a big change, but even with 5% of their GDP being spent on hospitals, it would make a big difference if the money is used effectively on hospitals. The money needs to be spent on public hospitals without corruption. Even though increasing it to 5% might not make changes right away, but it will slowly start to show. Also 5% of the GDP being spent on healthcare would be better than the 1% as of now.

As explained above, in order to help the situation in India with poor sanitation in hospitals the public should advocate for increasing the percentage of GDP from a little over 1 percent to at least 5 percent. Not only will the money help improve the quality of care of the people in India, but also the cost of healthcare. This is will be very beneficial to the middle class or poor people of India who haven’t been able to get good medical care or even any medical care. With the help of social media ,and the general public ,India can implement this solution and begin solving the health care problem of it’s citizens before it is too late.