|
A
war for the soul of India's hospitals
If we help save the dying missionary hospitals of the
Third World, we'll also learn much about the pitfalls
of for-profit health care.
By Lorna Dueck
Monday, August 22, 2005
When it comes to health care, a battle between heaven
and hell is unfolding across the globe. On one side,
there's compassion for the poor who are sick -- on the
other, the market and money drive the healing
industry. One of the earliest advocates of physical
wellness, Jesus, must have seen the issue as
important; healing the sick was the first job assigned
to the team-in-training that he mobilized.
It's a lesson not lost on Dr. Nelson Jesudasan. His
surname name literally means "Jesus
Devotee," and he's a good case study for a crisis
that is ripping the heart out of care for the poor.
Dr. Jesudasan has been using Canadian dollars and his
faith to stay viable in serving impoverished blind
patients in south India. As director and chief
ophthalmologist at Joseph Eye Hospital in
Tiruchirapalli, in the state of Tamil Nadu, he's just
finished spending more than $2-million in Canadian
donations to equip his centre. More than $1-million
came from one Toronto-area philanthropist, the rest
from the wallets of ordinary Canadians. Both gifts
came through the Canadian offices of the Christian
Blind Mission, the world's largest care provider for
the disabled poor, and Dr. Jesudasan's project is one
of their projects in creating viable "centres of
excellence."
But something's happening to their model of mission
care today. In India alone, hundreds of mission
hospitals are closing because they've not had the
leadership of a Dr. Jesudasan, nor partnership from a
donating agency.
India today is a medical-care factory with at least
two million Indian doctors and nurses serving more
than 18,000 private hospitals. Health tourism is
booming, growing by 100,000 clients a year. Media
reports estimate that a mitral valve surgery that
would cost $200,000 (U.S.) in the United States can be
done for less than $7,000 in India. If you have the
money, there's no limit to your access.
But unregulated private health care has gouged hope
for any equity, and government health care seems to be
in critical condition. It covers only 17 per cent of
all India's health expenditure, and the local paper in
Dr. Jesudasan's city of Tiruchirapalli reports that
tens of millions of Indians are too poor to go see a
doctor. The Hindu News says at least 21 per cent of
the population is no longer seeking any medical
treatment because of cost restrictions, and
"ill-equipped and crumbling government
hospitals."
Dr. Jesudasan's response to the crisis in his field,
eye care, was to retool his 70-year-old mission
hospital for "extreme competitiveness," and
to operate with a "take from the rich to pay for
the poor" sustainability plan. Canada's
$2-million contribution enabled the hospital to move
from 6,700 sight-restoring surgeries a year to 28,000;
to build wards for the poor -- and to buy equipment
that would attract paying clientele whose fees would,
in turn, support surgery for those unable to pay (UN
statistics report 35 per cent of India's people live
on less than $1 day.)
Ruthless entrepreneurs who profit from health care
dislike this model. Some working near the Joseph Eye
Hospital even threatened Dr. Jesudasan with death as
he carried out his plan to help the poor.
Given such ferocious economic and social pressures,
it's easy to see why more than half the mission
hospitals created in India by Protestant agencies no
longer exist. Dr. Jesudasan believes the Protestant
church community is "practising euthanasia on its
hospitals and because it's killing its hospitals, it
is also euthanizing the poor and elderly." The
most conservative estimates from India's Christian
Medical Association say at least 400 of 700 mission
hospitals have closed. Many of the remainder are
ailing. This is a remarkable loss of investment when
you consider that in the 1940s, mission agencies and
India's tiny Christian population supplied one-fifth
of all the hospital beds in India and created the
state's best medical schools.
Each developing nation has tragic evidence to show how
once-productive and cherished mission hospitals for
the poor have been wiped out by hostile governments,
changing patterns in North American donations, and
indigenous church leadership fraught with deficient
management skills.
As Canadians fight to guard our own universal health
care, we'd be wise to observe how even in the most
dire of circumstances, models of care can survive amid
forces of greed. This is just as Canada's founder of
medicare, Baptist preacher Rev. Tommy Douglas, warned:
"You're never going to step out of the front door
into the Kingdom of God. What you're going to do is
slowly and painfully change society until it has more
of the values that emanate from the teachings of Jesus
or from the other great religious leaders."
Christianity is abandoning a core mission if it
continues to neglect health care for the poor. Our
generation has the greatest ability in history to
communicate across the global village; the question
is, what are we doing with it?
Every country has its glimmers of hope. India's
Catholic church has a vigilant force of nuns managing
750 hospitals. Calcutta Mercy Hospital (created by
Canadian missionaries Mark and Huldah Buntain) serves
100,000 patients a year, and expatriate doctors are
using connections here to address the inequities in
their home countries. Regina neonatologist Dr. Abraham
Ninan spends up to six months a year away from his
Canadian job to help 20 mission hospitals in northern
India become centres that thrive under Emmanuel
Hospital Association.
We all know of agencies out there that can make a
difference. But we stand in a new age of
accountability and it should change how we spend the
resources we enjoy. It's high time that we reaffirmed
our tradition of investment in medical care for the
poor, both in India and in Canada. It's high time we
follow the steps of Jesus who reached with compassion
and said, "Be healed."
Lorna Dueck is the executive producer of Listen Up TV,
a spiritual view of news and current events seen
Sundays on Global TV, CTS, NOW, and Salt and Light TV.
|
