What makes the Mohalla Clinic tick?

By Fauzia Rahman Khan

New Delhi [India], Apr.7 (ANI): We live in times when the lines between the 'local' and the 'global' are getting increasingly blurred. The world is seen as a global village and conversely the village reflects the world.

The Mohalla Clinics in Delhi have caught the attention of leading international figures. Kofi Annan, former Secretary General of the UN termed it as "successful and impressive" noting that the initiative was consistent with the Universal Health Coverage (UHC) goal of the World Health Organisation (WHO). The initiative came up for praise by yet another leading figure -Dr. Gro Harlem Brundtland, former Director of the WHO.

What is special about these Mohalla Clinics? On the occasion of the World Health Day, celebrated on 7 April every year, this merits a probe. The term Mohalla itself brings to mind a community, a sense of familiarity, an ease of living in close proximity to everything that makes up a 'neighbourhood'-the shops, the service providers, the facilities, everything.

Taking a leaf from this concept, the Mohalla Clinics were started by the Delhi government in 2014 to take diagnostics and treatment of simple ailments to people's doorstep and reduce the footfall in tertiary care hospitals. A quick study shows that in the period April to December 2016, an astounding 15 lakh people received medical treatment across 110 such clinics. The clinics are equipped to treat 110 kinds of illness and provide a range of medical tests -all free. There is a plan to open 1,000 such clinics by March 2017. Once all the clinics start running, most people will have a clinic within a 5km radius from their home.

Sobiya who has visited the clinic in Jugabai in Jamia Nagar says"Many women visit this clinic. The doctors are very considerate.

They give us time. listen carefully and only then prescribe medicines or tests, which are all free. I have been treated here and am fine." Shazia is also enthused with the services " Ever since the clinic opened in our mohalla, there is a sense of relief. Whenever my children fall ill, I just bring them here. "She says beaming. Then in a more reflective tone, says "What I like is there is no bribery, no playing favourites here, unlike other places I've been to or heard about. All the patients are given a number and each one follows it. Its peaceful."

For most women the previous experience of healthcare facilities has been frustrating. There was hardly any accountability of the service providers who did as they please, leaving the patients floundering.

Women in the Jama Masjid area speak of their experience at the Kasturba Gandhi Hospital about a year and a half ago. "Patients used to wait for two, sometimes three hours. Then suddenly another patient would be called in before them because they bribed those in charge." Many of these women now visiting the Mohalla clinics find it a refreshing change. Being open from 9.00 a.m to 1o'clock, the timings are suitable particularly to housewives. They can finish their morning chores at home and nip across to the clinic. Then return home in time to finish any pending household work and care for their family.

Bound by social norms, many women hesitate to step out into the hurly-burly of a city like Delhi. They find the clinics particularly conducive. According to Iffat Rehman, "Women should take good care of their health. This is really important as they have to take care of their children, husband and in-laws."

Still, there are some hiccups. According to an NRI who visited the clinic "Patients crowd everywhere, each trying to meet the doctor first. But this is useless as each patient is given a number and the doctor sees them accordingly" Often the patient-staff interface is fraught with tension. Sushma who works as a lab technician says, "Handling patients can be tough. Many of them behave badly, even get offensive. Sometimes I get so upset, I don't even then feel like talking to them or giving them service. "But she knows that she would be failing in her duty, and maybe face disciplinary action. It could even cost her the job which is nervous about.

There are systemic issues as well. The pressure is huge, says Sushma but there is a staff crunch. "When medicines are delivered I receive and then stock them. We need more staff for this. The salary is also not so great." Despite the hitches, there is a joie de vivre. The patient rush is demanding, but doctors are happy with the way this initiative has shaped up. As for the work load, they say, it just shows that Mohalla clinics are meeting a crucial need of the citizens!

The Delhi Government has taken a quantum leap by establishing the clinics. The experience has been a positive one, finding a resonance amongst the people. At the level of the Central Government, health is a priority. The National Health Mission envisages the achievement of universal access to equitable, affordable and quality healthcare services that are responsive to people's needs.

Localized efforts such as the Mohalla Clinics bring in unique benefit that are in tandem with the overarching goals at the national level, indeed at the international level. Will this prompt other state governments to take the cue; to replicate the model or evolve their own? This surely merits attention from stakeholders primarily from policy makers at the state level. (ANI)