At the outset let me state that we are fooling ourselves by referring to these ‘units’ as polyclinics, when they barely qualify as primary health centres. By definition, a polyclinic should have at least a few basic specialities like cardiology, ENT, orthopaedics, gynaecology, medicine plus a dentist’s chair – forget the super specialities. The polyclinic in the suburb of Kanjur of Bombay boasts of one GP and an occasional dentist, two pharmacists, a peon and a female attendant who doubles as the receptionist and nurse. There is no nurse or nursing assistant and the lone GP is doing a brave job handling the large number of patients on ‘sick parade’. To make matters worse, even those who only come to collect their monthly quota of medicines (but have no need for a consultation) are compelled to “consult’ the doctor, just to get a prescription for medicines that have been already prescribed by a specialist. This further reduces the time that the doctor can spend with genuine patients
There is no waiting room – just a dozen cane chairs scattered in the verandah at the entrance where the receptionist sits. One is forced to wait for one’s turn by propping up the walls of the corridor opposite the consulting room or pharmacy. I understand the situation at New Bombay is even worse. If this is the condition of the ECHS in a Class A metropolis which is host to a Command HQ and an Area HQ, I wonder what it is like out in the smaller towns in the boondocks. So let us call a spade a spade and refer to it as a ECHS - PHC (ECHS - primary health centre).
Six or seven years into the scheme, proper PHCs (sorry polyclinics) should have been operational. In both these places, land is not a constraint: the Navy has more than adequate land where the present polyclinic is located. In fact, recently the Navy handed over a large parcel of land on which the CDA has built quarters for CGDA personnel in the same locality. In New Bombay, the CIDCO (equivalent of DDA) would be more than willing to provide land for the facility if asked. If Delhi and the NCR can have 5 or 6 polyclinics, there is no reason why Bombay and its suburbs cannot have one or two more. The Army has several pockets of land at Juhu, Santa Cruz, Malad, Kandivli that can be spared as they are lying unused. But this requires initiative of the Oi/c’s of the polyclinics who are largely lethargic.
The problems of Bombay are very unique. The peculiar geography throws up problems of jurisdiction and coverage which leads to arguments. At the end of the day, it is the poor ESM patient who is the sufferer as he is made to run from pillar to post. These and the solutions thereto are set out in the attachment(s) to this email – since I did not want to clutter up the text for those who are not interested. I would however suggest that you read it just to improve your general knowledge.
With regard to calling for volunteers at various centres, I agree with Anil Heble that this scheme was not set up as a “self help scheme”, even though it is a “self contributory” scheme. The scheme already has a consultative mechanism involving the user (ESM) built into it, which regrettably is not functional either due to ignorance or indifference. If this mandated consultative mechanism of advisory boards is activated and vigorously pursued by the Regional Centres it would adequately serve the purpose now being advocated by the ECHS Cell – there is no need for volunteers, who are in any case not entertained or encouraged by the Oi/c who considers them a hindrance.
There is also a need for the local formation HQs responsible to take a more proactive role in the running of the polyclinics by having monthly inspection visits and initiating action for improvement, apart from setting in motion the wheels for construction of proper infrastructure/facilities as per scales laid down.
Cheers,
CHG.
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