Saturday, October 19, 2013

Health camps: Are they needed?

-Dr. Amit Jha, ENT Resident, NMC, Birgunj

To any question like this, there is never an absolute answer. There’s always a fraction that supports with a yes and the remaining objects with a negative answer.  Moreover, no study has been carried out on this subject so as to get a reference answer.

I, occasionally, browse through the photos folder on my laptop and this is how the idea of writing this piece of article came to me. I found a few folders of photos of the health camps that I attended. As a doctor, I was a part of several health camps over last few years. So are all the doctors in Nepal. Most of the camps were one-day-health-check-up camps while a few of them spanned over days. I have mixed experiences of health camps and hence, my answer for the above question is neither a yes nor a no. This might sound diplomatic but it’s true.

The benefits of health camps:
There are benefits for both the organizing team and the patients. For the organizing team members, it’s an opportunity for them to travel to new places, meet new people and learn a few health issues and diseases prevalent in that particular community. For the organizers, they get a platform to advertise themselves. For the patients, they get to see a doctor, probably for the first time in their lives (for many of them). The most remarkable of such camps are the eye-camps. Thousands would have to live as visually impaired if these camps were not organized.

The drawbacks of health camps:
Every year a lot of money is spent by government, NGOs/INGOs and individuals for health camps. But the benefits do not reciprocate the amount of money spent. This can be justified by the fact that regular health camps usually do not make a remarkable difference in the lives of the people of the community. A large number of patients usually visit just to get free medicines or visit just because the checkup is free. Hence, genuine patient number too few in camps. Next, if any patient needs hospital admission or operation, the patients are referred to the camp-organizing nursing homes or private hospitals. Getting admitted, treated and/or operated in a nursing home or private hospital could be unaffordable for most of the patients.

What does a rural community in Nepal need?
Nepal is an undeveloped country with little chances of improvement in near future. Because there has been no stable government over last few decades, all the sectors of the country including the health sector lie in the doldrums. A typical rural community in Nepal, if not deprived of, has just poorly developed and maintained schools, health posts and other infrastructure. All they need is regular access to basic needs of life including regular access to health services. Health is not a one day affair. A community is going to need health services round the year. And this is what I mean by regular access to health services.

The solutions:
Rather than organizing general free health camps, camps should be slightly modified.
1.       Organizing screening camps where a patient in a community is screened for a particular disease for eg. DM, TB, HTN, HIV, UV prolapse, Hernia etc. and all those identified with disease managed promptly either in their community or by the referral to higher center.
2.       There are a few foreign hospital based organizations that come to Nepal each year with a team of doctors, nurses and paramedics and operate on the patients of a particular locality in a week long or more camps. Nepalese doctors are not allowed to practice even in Nepal without an NMC number and abroad without having a medical practicing license of that country. In such a scenario, how do we trust anyone from abroad just coming and operating on our countrymen? The manpower in Nepalese health sector has increased several folds over last ten years when such organizations first came to Nepal. Hence, rather than coming to Nepal once or twice a year and operating, they should rather focus on developing the infrastructure and collaborating with the local community to have a health service provider round the year and specialist visiting on a routine basis.
3.       The same goes for the medical colleges or private hospitals organizing camps. Rather than having health camps, they should establish a community based center in the peripheral areas with ample facilities and manpower. This would benefit patients requiring emergency attention as well as the patients with chronic disease and those requiring follow-up.
4.       If having community based health centers (point no. 3) are not feasible, given the vast rural area and its remoteness, health camps should be organized at regular intervals. Once, a health camp concluded, the date for next camp should be announced so as to benefit the patients with chronic disease and those requiring a follow-up. Nobody is happy to wait, but once a person knows how long he should wait, waiting could be agreeable.

An optimal level of health is not a destiny but a dynamic process. To achieve this, institutions, individual and the community should work together in close co-ordination. The time, effort and money should be invested in the best possible way to have the maximum benefits. Nevertheless, the government policies play a major factor.

This article is written by Dr. Amit Jha @amitjha086,  ENT Resident, NMC, Birgunj. He blogs at 'Amit Jha blogosphere'

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