Republished from Shillong Daily
The health sector in Meghalaya is marked by many centrally funded programmes and through these programmes the Health sector in Meghalaya tries to portray a living, working and action-based health scenario in Meghalaya. But there’s a bitter truth behind it all. The fact of the matter is that many of these Central National Health Programmes are usually ‘data’ driven. Which means that the programmes and the authorities are concerned more on ‘Quantity of the data’ gathered rather than on the ‘Quality of services’ provided.
It’ll be quite a confusing affair if someone actually has to gather all data and try to get an accurate reading of the degree of health issues in Meghalaya.
Why would it be confusing and why is Meghalaya health scene in such shambles?
Well firstly, there is an overlapping of the gathered ‘data’ between different programmes on a single health issue/problem/disease that gives out inaccurate readings of the said problem that is being sent to the centre via different national health programmes.
Secondly, majority of these health programmes also function as a contract base programme, which means the implementing state would get a ‘trial version’, hiring all staff on contracts and its survival depends on “performance” or data gathered, which forces the contractual staff to gather as much data as possible without the human touch of caring or providing quality services.
Thirdly, as we’re all aware, nepotism and backdoor entry of unqualified or under qualified individuals to these programmes due to examinations and interviews not implemented through proper channels result in favouritism and influence by influential people to hire and alter the fair and just process of short listing candidatures to said programmes.
Fourthly, the Government at the different levels and the Health sector also at every level seem uninterested and unaware of the functions that different professionals play. As such, we can often see that a post that requires a certain type of professional often has to compete with other non-professionals who would get the job simply because they are willing to compromise on professional and ethical practices as they are not aware of the proper procedures to do the work in the first place.
Fifthly, the process and procedure in evaluating and short listing the candidates also need a re-look at as questionnaire usually has nothing related to the candidate work operation. Also, the panel that the health sector usually has would only compromise of people in the physical medical field only which is totally unrelated to the kind of work the respective candidate has to engage in after the selection has been made like data entry operators, lab techs, counsellors, coordinators etc.
Sixthly, Usually what happens in the health sector especially in Meghalaya, is that the important executive and operational posts are held or nominated by doctors who have either little or no knowledge in the Administration of a programme or Office administration as such. Most of the time or maybe all of the time, high Administrative posts either in the state or district level are given to those that have seniority but the problem with that method is that they are usually those who are about to retire or lack the willingness to open a new file in their name for fear that that may hamper their social standing in society. Health Programmes are also passed on to different doctors who would hold many such programmes at one time and hence will not be able to manage time to any particular programme to see to its growth and overall functioning.
Seventhly, With Contractual, Casual, Temporary (CCT) being the norm of hiring Labour, the impact of it can be seen on the efficiency of work. The CCT kind of work has increased the stress levels of its workers because at low incomes, high return is expected. CCT’s are ignored and their rights and freedom is curtailed by the powers at the different district and state level.
While other countries are taking Labour Rights seriously and are ensuring that basic amenities are given as studies has shown that a happy and well rested worker is more efficient and more productive, India in general and Meghalaya in the extremes, are taking away the rights and ensuring that those who dare to speak out are also tamed and taken care of.
Apart from the seven deadly sins mentioned above, isn’t is a curiosity as to why the health sector does not link with the educational sector and provide necessary education and counselling on sex and sexuality?
From what can be seen, many of Meghalaya’s Health Awareness Programmes and IEC programmes would usually end up with giving long boring lectures from doctors and health educators and bombarding the people with the DON’T but would not touch on the emotional and psychological impacts that sex and human sexuality has on the individual. Perhaps because the so-called Mental Health professionals in Meghalaya are really not Mental Health Professionals but as mentioned in point number four above, are individuals who maybe professionals in their field like social workers and community health professionals but not necessarily professionals who can comprehend the various dynamics of the psycho-social and emotional needs of an individual in dealing with sensitive issues of sex, sexuality or human behaviour in general.
These individuals also cannot understand the importance of having and adhering to a certain code of conduct and ethical practices as they do not have it in their professions and as such Counselling and psychotherapy in Meghalaya has a long way to go before even being recognised as a necessary requirement in the field of health.
Problems are aplenty in Meghalaya but this should not be an excuse to have so many issues in a single sector out of the many public sectors especially when this one deals with one of the most basic requirement (i.e. health) of every citizen. It’s no excuse that “things run this way because that’s how it is.” (Quoting from a conversation with an Administrator).
This can go on and on, and people in the health sector know about it. Such things are an open secret and some try to resist it and failed and others loved it because it feeds their greed and others are still resisting and maybe we’ll win someday.
We are witnessing ‘maximum sponsored programmes achieving minimum results through maximum community involvement’ and we need an end to it and it can be achieve only if people start to wake up, form unions and association and speak out against the injustice, the exploitation, the class divisions and against anti workers policies that Meghalaya can maybe start to see changes especially in providing Quality services over Quantity driven services.