Professor Pranab Kr Bhattacharya MD(Path) Cal, FIC Path (Ind.), Professor and Head, Dept. of Pathology,
School of Tropical Medicine Kolkata[ course Coordinator of Diploma of clinical
pathology(DCP) of West Bengal University of Health sciences(WBUHS) Kolkata,
Member Board of Studies of WBUHS, In-charge of Diploma of laboratory
technology] 108, CR Avenue,
Kolkata-700073
Email=
profpkb@yahoo.co.in phone no- 91- 9231510435 2)Miss
Upasana Bhattacharya, student & Daughter of Prof.P.K. Bhattacharya 3)Mr. Rupak Bhattacharya Bsc(Cal),Msc( JU) 4) Mr. Ritwik Bhattacharya Bcom (Cal ), 5)
Miss Rupsa
Bhattacharya Resident of 7/51 Purbapalli, Po= Sodepur Dist=24
parganas ( West Bengal )Pin
743178. India .
6) Mrs. Dalihia Mukherjee BA (Hons).Cal. university,7) Mr.Debasis
Mukherjee Bsc(cal) both resident of Swamiji Nagar; south Habra 24 parganas(north)
West Bengal’ India
8) Dr. Jayanta Dasgupta MD(cal), DM(Gastro) Professor, Dept. Of Gastroenterology,
All Correspondances must be to first Author= Professor. Pranab Kr. Bhattacharya
Corresponding
Address= Professor & Head
Dept. Of pathology, 2nd floor, Room No10C,
In 2000 the United Nations set out eight development goals to
improve the lives of the world’s disadvantaged &poor populations.
The goals seek reductions in poverty, illiteracy, sex inequality, malnutrition,
child deaths, maternal mortality, and major infections as well
creation of job , environmental stability and a global partnership for
development. One problem of this itemization of goals was that it separated
environmental considerations from health considerations. Poverty
still could not be eliminated while political motivations & environmental
degradation exacerbated
malnutrition, disease, and injury. Food production & food supplies
needed better cultivation system,
more cultivator, more cultivation land &fertile soil continuing soil fertility, climatic
stability, freshwater supplies, and ecological support (such as
pollination). Infectious diseases cannot be also stabilized in circumstances of climatic
instability, refugee flows, and impoverishment.
The Economic growth of
a state or of a country is usually measured by economists in increase of GDP
and GDP per capita. GDP per capita per year is also a very important key point
of human development index used by UNDP. Health care expenditure of a country
is also measured by percentage of GDP spent for it & GDP spent by Indian government
for health care is<3% ,despite gross domestic product growth rate of India is
9% in2007-09. But a very big question often strikes me does GDP per capita in a
real sense reflects the poverty status of any state or of any country? It
appears before me to imagine or to calculate a decline in poverty unaccompanied
by a simultaneous improvement in aggregate economic performance- my 83 years
old father Mr. Bholanath Bhattacharya commented me few years back. The determinant of economic growth of a state,
we people use the denominators like Life expectation at birth, Infant mortality
rate [57 per1000 live birth in India in2007], Crude birth rate, Crude death
rate, Maternal mortality rate [301 per 1 lack live births in India in2007] etc
does really reflect the economic progress of poverty laden families of the
state or of a country? I myself don’t belief that now. I see daily so large
rushes in public tertiary medical colleges hospitals [in the year-2006 Total
OPD 1,42,51,407 cases, Total indoor admissions 1,88,8121 cases Total1,61,39,528
of 8.5 cores population (19.69%) of the state]
& most of them belongs to so poor and bellow poverty line families.
But our government still says economic growth of India is 9%.
Rather state level growth of real Net state Domestic product (NSDP) may be a
good determinant factor. In west Bengal, PCNSDP in 2000-2001 is Rs9778/= per
year, per person which means per person capacity to purchase essential goods or
calorie for living is Rs 814/= only at poverty level when central govt.
definition bellow poverty line is Rs1500/= and people still at BPL level in
West Bengal is 27.09% & when poverty line considered Rs 1500/=Pm per
person. If PCNSDP criteria is considered to define poverty line then people at
poverty level in 2008, at West Bengal will be more then 62%.Over last
3-4 decades , there had been tremendous
out break of unemployment in West
Bengal amongst the educated
younger generation of age range 21-45 yrs the productive age group. This picture of
unemployment is not only in West Bengal but through out India . The number of registered unemployed in India
through employment
exchange is about 8 cores, whereas in West Bengal the figure is about 1.5 core. Though
LEB during the period of 1970s to 2008 period raised from 49.7 to 61.7
years & Bihar state which is one of
the lowest NSDP of Rs 4123/= is in better
position then MP,UP as per these conventional health indicators. But the fact
also says that LEB Per capita GDP & per capita expenditure for health shows
better growth. In India Poverty line is decreasing & so in West Bengal !
Then what should be
the denominators of an economic growth of a family of a state of a local
society of a country?—can this be an issue of a discussion?
Growth of physical labor!
Stock of physical capacity! Technological labor class advancement! Quality and
quantity [skilled and unskilled ratio] of human resources and human capital!
Their living standard, their nutrition, their education and their mental health-
physical labors are
related to economic growth of a province or of a country. As for example, physical labors are related
to production in any industry, or in paddy fields, or in agriculture or in
roads or other civil sectors, in construction works or in surface, Rails, in
water transport works, in home guards industries and in electricity sectors. The development of a state, in a country is thus dependent on mostly on” lower socioeconomic
class and poor class people “my old father replied
me. My father through out his life led his life in extreme poverty and was a
Marxist by his heart and action. He worked directly in fields for economic
uplift & fought for settlement of refugees of Bangladesh
war-1970s settled at a colony areas of my native village sodepur, 24
parganas(north) W.B, India .
How much was he true? If his views are correct then two elements come in
questions in my mind. 1) the economic growth of a family and thus of a state in
larger sense depends on 1) that how much labor forces are present in a family
and how much they are educated at high school level or at university level 2)
the health of these labor class forces as a big capital- Both these elementary
determinant level has been neglected since freedom, in West Bengal provinces of
India. The role of human health in influencing the economic outcome of a state
is well understood at macroeconomic level. But health deals with microeconomics
at the same time._ healthier workers are likely to able to work for longer
period, becomes more productive then their relatively less healthy counterparts
and are able to work for longer periods, able to secure higher earnings then
the later. Illness and diseases shorter the working level of people. Health has
thus a positive significance effect on the rate of growth of GDP per capita.
Higher income permits individuals to achieve better nutrition and better health
care improvement of them results probably improvement of net domestic
products(NSDP) of state , thus increase of national income and can thus decline
poverty level. So it is very important to give priority that towards which the
health care should be directed! Rich or poor?
In Indian open health
market, in health tourism market, in West Bengal
provinces improvement of health care delivery is mainly directed towards whom? Obviously
not a pro poor health care delivery system it is now in 2K! –existed in 1970s!
What should be focus in health care in 21st century? It must be
patients cure and care both. Every patients must have sufficient accesses to
safest and highest quality of health care regardless how much they earn, where
they live and how seek they are!- A patient, a citizen must be the first
priority and not the health industry and profitable health financing. Then why
to step for privatization of health in west Bengal ?
Why opening accesses for so many & mushrooming Private health care institutions
including private Medical colleges?
Improvement of health
care through public health care delivery when directed at poor, it contributes
more directly to poverty reduction and serve as pro-poor growth strategy. In
west Bengal Provinces of India out of 8.5 cores population 27.09% population is
bellow poverty line( Rs 1500/= pm I.e. < $1-1.5 per day per person) and 62% population
is at poverty line (Rs 1500/=)even after 61 years of Independence! . In India,
tuberculosis kills 364,000 people and diarrheal disease and other infections
kills 3 million people every years .700-800 million people in India lives with
daily income<us$1-1.5. These poor bears disproportionate burdens of illness,
psychiatric illness, Suicides and various under nourishments, infectious diseases
including T. B, HIV, sanitation &
sewage disposal problems, water borne infections, mosquito borne diseases then
upper middle class, middle class and rich people[300 millions in India]. The
poor suffers from ill heath due to mainly of causes of poor nutrition that
reduces their ability to perform works due to weakness, due to threaten
Tuberculosis, their defective immunity and resistance for diseases, frequent
treatment expenditure, frequent doctors fee, nursing home charges and loss of
economic forces. Poor families thus exhaust their earnings, their savings,
their assets and take re curse of borrowing leading to more poverty, poor
health status & drop in school & colleges.
There always remained inequalities between rich and poor
population within a state within a country or between rich and poor countries. In case of state of West Bengal, in India ,
the same is also true. No doubt there happened a systemic (in hands of few
percentage -<20% population) economic growth and number of middle class
economic families or people increased in the state. In India , now< 300 millions people
may be classed in middle class economy. Their physical or labor contribution
for economic growth of the state is negligible and their life style is really
most unhealthy one, that they are eating too much of fat, eggs, milk products,
cheese, packed dry foods, meat, consume much
cooking oil & carbohydrates, drinks alcohol, consume cigarette and
tobacco products, but they are reluctant to burn their calorie by physical
labor. They lost all their physical activities including daily one hour
walking. City middle class and upper middle class population mostly drive their
cars every where they go. As a result, I think, they suffer from obesity, high
BMI, metabolic syndrome, diabetes mellitus type-2, high blood pressure, renal
failure, atherosclerosis and cardiovascular diseases. As a teacher doctor’s state government salary in a reputed public
post graduate teaching hospital of kolkata, my unit family belongs now in upper
middle class family and possesses all these ill effects. Are not these people themselves responsible
for their diseases and early death if occurs? Why the state health services
policies pays priority for these people’s illness, opening marketing accesses for business houses like mushrooming
private health institutions/hospitals[
never show any human face] in healthcare system, neglecting the real needs of
poor?. we need a renaissaue in health care driving force towards an effective
and strong primary health care in state of west Bengal particularly targeting
poor people in regard immunization, proper food care, nutrition, safe water, sanitation,
maternal and child care, prevention and quality treatment of local diseases, provision
of essential drugs, laboratories diagnostic facilities extending from secondary
health care tire to primary health center level. In 1983 the India ’s national health policy adopted the alma- atta definition of
primary health care to mean the provision of curative, preventive and rehabilitative
health services and accesses of health services to rural areas. A large three
tire health care system developed in all provinces including in state west Bengal . Primary health centers are units that provide
integrated health care in rural villages [30,000 populations] and provide
referral to secondary and tertiary care in an almost non effective referral
system. But problem of PHCs remained, are unavailability of human resources
[doctors, nurses], essential medicines,gazates and forcing poor people to get
treatment in private chambers and often before quack doctors, on whom villagers
depends on much
The fact is that for
last 2, decades, in the state, there was dominance of profit making
health insurances industries, a new wave of investor-owned specialty or super
specialty hospitals, and profit-maximizing behavior in west Bengal
provinces including in India
.The involvement of private companies any where always generates some
controversy. Some health policy maker people believe that only
commercial interests can bring health innovation and efficiency and can modernize
the health system. –the idea is not a default . I rather assume that the profit
motive is incompatible with the pursuit of excellence in health care
system. The government of west Bengal so planned
to establishing at least 60 primary
health centers, diagnostic laboratories services in secondary and
tertiary level health care including in medical colleges of the state to be run by private companies in the name of
public Private Partnership in Health care system. Health care is the
responsibility of a state government. It must be free and must not afford profit
at expense of poor and what I feel
Copy Right- This article is the Intellectual Property of Authors and Copy Right of this letter belongs to Professor Pranab kumar Bhattacharya and his first degree relatives only as per copy right act & rules of Intellectual Property Right Rules 3D/107/1201a,b/ RDF Copy Right rules/ SPARC copy Right rules-2006/ and Protect intellectual Property Right(PIP) copy right rules of USA-2012. No Person, No NGos, No Researchers , No Health planner who ever he/she may be from India or Provinces like West Bengal provinces, except the first degree relatives of Prof PKB & authors, is entitled to implement any things any syllable even any Idea out of contents present in this article. Please do not Infringe, restrict yourself and be enough carefull for your own safety if you are not direct Blood relation to prof Pranab Kumar Bhattacharya
Copy Right- This article is the Intellectual Property of Authors and Copy Right of this letter belongs to Professor Pranab kumar Bhattacharya and his first degree relatives only as per copy right act & rules of Intellectual Property Right Rules 3D/107/1201a,b/ RDF Copy Right rules/ SPARC copy Right rules-2006/ and Protect intellectual Property Right(PIP) copy right rules of USA-2012. No Person, No NGos, No Researchers , No Health planner who ever he/she may be from India or Provinces like West Bengal provinces, except the first degree relatives of Prof PKB & authors, is entitled to implement any things any syllable even any Idea out of contents present in this article. Please do not Infringe, restrict yourself and be enough carefull for your own safety if you are not direct Blood relation to prof Pranab Kumar Bhattacharya