`Hardly one per cent of the GDP is al­lo­cated to health­care'

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MC Mishra, direc­tor of All In­dia In­sti­tute of Med­i­cal Sciences, Delhi, says that trauma care cen­tres should have ef­fi­cient pre-hos­pi­tal ser­vice. But pre­ven­tion of ac­ci­dents should be on the top of gov­ern­ment's pri­or­ity list. Edited ex­cerpts from in­ter­view

How is our health­care sys­tem pre­pared to take care of ca­su­al­ties re­lated to road ac­ci­dents?

We must heighten aware­ness and re­duce road ac­ci­dents. Three per cent of the coun­try's GDP is go­ing to trauma care whereas hardly one per cent of the GDP is al­lo­cated to health­care. Pre­ven­tion should be our first pri­or­ity. Then we should think about having a ro­bust trauma care sys­tem. At present, it is avail­able but in bits and pieces. We need ef­fi­cient pre­hos­pi­tal ser­vice, and trauma and re­ha­bil­i­ta­tion cen­tres.

Is the re­port­ing sys­tem of in­juries and road ac­ci­dents in In­dia sat­is­fac­tory?

At present, in­juries are not no­ti­fied the way po­lio and other dis­eases are. We need to have a strong data­base. The US has a very good re­port­ing sys­tem of in­juries and road ac­ci­dents. The coun­try

col­lects all data re­lated to in­juries the way it does for dis­eases like can­cer. This can be­come pos­si­ble in In­dia through hos­pi­tals or com­mu­nity-based mon­i­tor­ing. It is def­i­nitely not easy but cer­tainly not im­pos­si­ble.

Do you think we have enough doc­tors to deal with trauma care?

No, there is de­fi­ciency of both med­i­cal and paramed­i­cal staff. The prob­lem is not just in In­dia, but across the globe. We can­not pro­vide doc­tors overnight. It takes 11-and-a-half years to pre­pare a spe­cial­ist like neu­ro­sur­geon. If we think of get­ting doc­tors to­day, the re­sult may come in 20 to 25 years.

Apart from pre­par­ing doc­tors, what needs to be done to pre­pare the en­tire sys­tem?

We can­not cre­ate stand-alone trauma cen­tres the way AIIMS has; it would nei­ther be fea­si­ble nor func­tion­ally rel­e­vant. If we cre­ate stand-alone fa­cil­i­ties how will we get a good num­ber of ex­perts? The idea is to des­ig­nate hos­pi­tals, med­i­cal col­lege hos­pi­tals and in­sti­tu­tions as level one, two or three trauma cen­tres based on their fa­cil­i­ties.

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