Public Health Ironies, Contradictions and Challenges

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A Perspective on Public Health Issues

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Public Health Ironies, Contradictions and Challenges:

Public Health Ironies, Contradictions and Challenges Dr. Naval Asija M.B.B.S. D.H.A.

Will My Job Stay:

Will My Job Stay The biggest irony not only specific to PH but to all development programs, (as said by somebody in context of food security) is that, If goals are achieved then the jobs of professionals who are involved in programs will be over. This is especially true for projects. Though institutions try to fit in those professionals into new programs based on new public health goals but not all can be fit in keeping into account the programme practicalities and sensitivities

Public Health Caste System:

Public Health Caste System Public health though an umbrella term does not has public health loyalists. It has fragments like maternal health, child health, communicable diseases, non communicable diseases, mental health, environmental health, nutrition, occupational health, etc. The experts in the fragments of PH have their loyalties to the respective sub specialty.

Public Health Caste System:

Public Health Caste System There are not enough professionals who have loyalties to public health as such. Instead the few some such people, mostly they are sidelined by the sub specialty experts or they are lured to choose one such specialty and become another expert like them. Those who resist such cartelization are pushed out to medical colleges to teach young budding medicos where they end up being most disrespected department of medical college and develop inferiority complexes Or the last resort is to leave the system

United we stand; Divided we fall:

United we stand ; Divided we fall There is no cadre of permanent public health professionals The Projects and budgets for projects have led to enough infighting within the PH domains for funds, NCD Vs CD, RCH VS others mental health and disability trying to secure any budget that it can as they are the most ignored Most of the time all such professionals end up being manipulated by politicians and administrators

Slide 6:

One can be a malaria administration expert, a falciparum expert, a malaria vaccine expert, a malaria drug scientist, malaria IEC expert, malaria trainer, malaria fundraiser, and so on Everybody cares about their expertise and nobody cares about malaria which is the winner always United we stand ; Divided we fall

Publications! AHA !!!:

Publications! AHA !!! Volume of Publications is most sought after Intellectuals are weighed in terms of number of papers in a particular context More the papers, more the respect in field, more the loyalties, more the networks

Law/Vidhi:

Law/ Vidhi Division of healthcare related subjects across Union list, state list, Local Self Govt list and Directive principles of state policy further adds complexities to legal and policy framework of public health Foot-balling of health care related files across governments and within departments and experts No fixed public health policies outlined in legal framework The organizational set ups are temporary and follow the loyalties. Often there are various organizations for the same cause leading to duplicity , wastages and inefficiencies

Education and Training:

Education and Training No council or regulatory body Some course affiliated to MCI, some to AICTE some to Distance Education Council, some directly through UGC, and some through Institutions of National I mportance . Some certificate courses by Associations with no regulatory approvals Confusing and complexities within the system

Challenges of the Field and Employment:

Challenges of the Field and Employment Annual/ semiannual renewable contracts, No PF, Health insurance and other benefits, Threat of project funding and job loss Endless work related travel Security issues in the field, conflicts with vested interests and muscle and money power Indian societies fragmentation along fault lines of caste, religion, language Lack of a work-life balance

Challenges of the Field and Employment:

Challenges of the Field and Employment These are enough to drive one crazy if one does not conforms to the loyalties and cartelization and giving up PH cause One may have to leave the sector at all if refusing to be loyalist For an illustration, for a worker in polio programme , the choice would be as simple as “Eat Polio, Sleep Polio, Drink Polio or Leave Polio”

Thank You:

Thank You

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