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Praveenkumar Aivalli on the status of AYUSH doctors in the government healthcare delivery system in India

26 Feb, 15 | by BMJ

praveen_aivalliAYUSH—an acronym for Ayurveda, Yoga, Unani, Siddha, and Homeopathy—is a system of medicine that has been integrated into the Indian national healthcare delivery system to strengthen public health in rural India. In 2005, when the Indian government launched the national rural health mission (NRHM) to improve healthcare delivery especially for the rural population, integration of AYUSH was an important strategy that was adopted. This was done with the objective of offering treatment choice to people as well as a strategy to overcome the human resource shortage in the government health facilities. The planning and implementation of AYUSH differs across various states, depending upon the existing level of development of AYUSH services in the state and the development emphasis of the state. more…

Richard Smith: A global university for healthcare workers

24 Feb, 15 | by BMJ

richard_smith_2014WHO estimates that the world is short of 12.9 million healthcare workers, and Devi Shetty, the cardiac surgeon and chairman and founder of Narayana Hrudayalaya Hospitals, thinks that radical steps are needed to provide these workers. Money for healthcare for all will come, he believes, but it cannot be achieved unless healthcare workers are available to provide the care.

India, for example, needs three million doctors and six million nurses in addition to millions of community health workers. The country needs 500 new medical colleges, and Shetty is keen that the very poorest who have “magic in their fingers and passion in the hearts” should be able to train as doctors. more…

Richard Smith: Surgeons spend their time putting a price tag on human life

24 Feb, 15 | by BMJ

richard_smith_2014Physicians and surgeons across Asia, Africa, and Latin America spend their time putting a price tag on human life, said Devi Shetty, cardiac surgeon and chairman and founder of Narayana Hrudayalaya Hospitals, at the World Summit on Innovation in Heath in Doha last week. His mission is to reduce the costs of health to make healthcare available to as many people as possible. more…

Tushar Garg: India needs to teach its doctors more about the care in healthcare

16 Feb, 15 | by BMJ

Tushar_Garg.2kbI was taking a patient’s blood pressure in a clinic when I heard one woman—who was poor, uneducated, and a first time attendee there—being asked a question by a resident doctor. When the patient kept murmuring something inaudible, perhaps trying to remember, the resident told her to return when she knew the answer to the question.

After a few internship postings, I realised that such encounters were not uncommon and certainly not limited to a specialty. more…

Aditya J Nanavati: How do surgeons reflect on surgical complications?

11 Feb, 15 | by BMJ

Aditya J NanavatiLosing a patient in the operating room is probably every surgeon’s worst nightmare. I recently happened to experience such an event. Not my first and probably not my last. Yet every time it happens it is accompanied by a troubling few hours or days afterwards. I know the operating surgeon of the case that day to be a very good and compassionate man. Even after years of experience he was visibly moved. How good a person he is, probably was evident by the fact that he discussed his feelings honestly with all the team members. What happened in the operating room that day made me think quite a bit. How does a death or a bad outcome in or after surgery affect a surgeon? What philosophy guides the surgeon’s response to a complication? A part of me was sad for the patient and his family. Of course it had to be, part of being human and having a good value system meant that I was wired to feel bad. But another part of me wondered, if I were the operating surgeon, would that be all it made me feel? It brought in a flood of thoughts. I reflected on all the surgeons I have worked with as well as I tried to recollect my personal experiences. In terms of reacting to complications arising from surgery I believe different surgeons react differently. In my personal opinion I believe I would be able to classify them into four types. more…

Jocalyn Clark: Are slums creating equality?

30 Jan, 15 | by BMJ

Jocalyn_Clark1When you fly into Mumbai from the east, there is an extraordinary descent passing over mounds of lush green foothills reminiscent of Hawaii. It’s quite mesmerising. And then even more so is what lays at the foot of these foothills: a vast sprawl of tin roofed shanties, which I later learn is a slum of over 300 acres housing nearly 100 000 people. The slum literally encroaches upon the airfield, creating the illusion of a patchwork carpet leading on to the runway.

Inside the international airport are all the flashy trappings of a modern, bustling air and shopping terminal. Perhaps, I wonder, this is how the pace of development in South Asia is to be measured—not by absolute economic measures, but instead by how wide the gap is between the slum and the slick. more…

Jocalyn Clark: How to avoid predatory journals—a five point plan

19 Jan, 15 | by BMJ

Jocalyn_Clark1Increasingly, I’m asked to advise and assist with the problem of predatory journals. While it’s probably only an annoying nuisance to many in the developed world, the increasing number of spam emails inviting articles and conference participation is beginning to feel like a potentially serious problem for developing world scientists and institutions. This demands action, as Richard Smith and I argue in a recent editorial in The BMJ. more…

Abhishek Bhartia: What can a hospital in India learn from a vineyard in Spain?

15 Jan, 15 | by BMJ


A lot, it turns out, about healthcare transformation.

A fifth generation wine producing family in Spain faced the challenge of transforming itself in the late 1990s. The family vineyard in the region of Priorat, south of Barcelona, had been losing money for many years and past attempts to turn it around had failed. One day in September 1998, when Ramon and Valenti Llagostera, two brothers from the family, were on the wine estate helping with harvesting, one of the brothers tasted some of the grapes and was struck by how good they were. He asked, “What if we only produced the best grapes and sold a high quality wine?” more…

Sandesh Kotte: Reviving the public health system in Telangana, India

13 Jan, 15 | by BMJ

sandeshThe first budget for India’s newly formed state, Telangana, was presented amid a lot of hype and media attention. A cursory look at the budget shows that the allocations reflect the Telangana Rashtra Samiti (TRS) party’s promises made in their election manifesto. From the waiver of farm loans, to creating a drinking water grid, to making Telangana state the “seed bowl” of India by developing seed chains, all were part of the party manifesto. more…

Shinjini Mondal: Reframing the challenge of urban slums from Cape Town to Mumbai and beyond

9 Jan, 15 | by BMJ

Shinjini_MondalRecently, I had the opportunity to visit South Africa and learn about the health system in Cape Town and the health issues of Khayelitsha, an informal (and notorious) township in Cape Town. I was part of the 2014 Emerging Voices for Global Health group of young health systems researchers, who were attending the third Global Health Symposium on Health Systems Research in Cape Town.

We were given a brief but thought provoking presentation on the numerous challenges in these informal settlements, which was followed by a visit to Khayelitsha. Our tour guide, a self-declared “experience expert” of the settlement, “entertained” us with lively stories about his past in a local gang and by detailing what life was really like in a tough place such as Khayelitsha; for example, for kids trying to go to school. We learnt a great deal from his insights, in a way that dry statistics and figures can never achieve. more…

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