Meeting healthcare needs

By Dr Liz Grant

Director, Global Health Academy, the University of Edinburgh

Dr Pankaj Pankaj, the University’s International Dean for South Asia, asked the question, “why do we want to engage and collaborate with India?” His answer is that Indian institutions share our vision of advancing knowledge for public good. These last few days I have listened to colleagues in a number of Indian institutes. From the private sector and at the wonderful Kala Ghoda Arts Festival in Mumbai, I have heard speakers talk about the public good, present the public good in vivid images and show the public good in acts of kindness and generosity. The questions we have been looking at together are how to strengthen the health system so that healthcare becomes available, accessible and affordable to all those who need it, and how to deliver care for those who are coming towards the end of their lives in a way that is effective, and respectful.

While working with partners in the private sector in Mumbai, who provide a significant proportion of healthcare in India, we have discussed what are the benchmarks of a quality family medicine practice. The answers from staff are doctors who have the skills and knowledge to manage the majority of illness themselves without referring patients to join hospital queues; doctors who know what good prescribing is and who prescribe ethically, making decisions about what drug a patient needs, based on what the patient’s illness is; doctors who have a vision to improve wellness and good health and stopping diseases from developing in the first place.

The Masters of Family Medicine, a unique University of Edinburgh degree run in conjunction with Christian Medical College Vellore (CMC) and International Christian Medical and Dental Association (ICMDA) embeds these principles. It employs innovative blended learning methods of teaching, both face-to-face and online. It is exciting to speak about the opportunities to build on this Masters training to many Indian doctors who have a vision for a healthcare service that is the leader in South Asia.

In a country with 1.27 billion people, growing at 1.6% a year, it might seem strange to say that building services for people who are dying is essential. Yet at the All India Palliative Care conference at Pune, where the University is represented with various presentations from staff linked to the Global Health Academy, care of those living with life-limiting illnesses such as cancers, severe chronic obstructive pulmonary disease (COPD), cardiovascular diseases, HIV and multi drug-resistant TB is being discussed. Dying is costly; care towards the end of life can drain families of everything they own especially when they are encouraged to keep seeking help form different hospitals even though the illness can never be cured.

Good palliative care can be transformative. It can change the way a family manages illness, it can relieve fear and suffering from patients and it can help healthcare staff deliver care. Examples of great practice are found in Pallium India – a charitable trust led by Dr Rajagopal. This is practice that we can share, and that can we at Edinburgh can help to deliver across India, and bring back into Scotland. Global sharing to meet intimate local needs.