It is a welcome step that the state government is amending the Maharashtra Medical Council (MMC) Act of 1965 to now make it mandatory for undergraduate and post graduate medical students to serve the one year bond compulsorily. Earlier students got away from compulsory rural service by paying bond money. This new amendment ensures students passing out of Maharashtra University of Health Sciences (MUHS) will really serve in rural areas as per the bond.
This decision will be important to strengthen rural health services by ensuring presence of physicians and specialists in rural and district hospitals. Our public health is one of the most important sectors that needs to be revamped with diligence and foresight. We have neglected it for long and we should be reckoning our bearings especially since our HDI ranks lower than neighboring countries in two main social development sectors – health and education.
Public health service essentially differs from medical service in as much as the former has to reduce the population’s exposure to disease. This is done by managing health regulations through vector control, monitoring waste disposal, water systems, health education as also efforts at improving personal health behaviors. The latter is now increasingly being taken up by NGOs who are also building up citizen’s demand for better public health outcomes.
Responsible public health services can facilitate economic growth as also diminish poverty by creating healthy environments. For instance, because of lack of hygiene measures malaria continues to riddle us especially in rural areas. There are complexities in our malaria eradication programme. The continuous application of DDT has not proven to be effective as we all know that DDT is not effectual for malaria eradication due to increased resistance of malaria mosquitoes. Despite a worldwide ban of DDT we continue to use it.
Or for that matter take up the issue of over population. It is true that we have segregated our family planning programme from public health programme primarily due to myopic public opinion and a political culture that does not permit to work against public opinion. However limiting family size is an important public health issue that is a cause of grave concern. As rational development oriented people we should be addressing our population issue with our eyes wide open. USAID has been helping us tackle the issue in our more populated states and the methodology is worth emulating.