The newly created Union Territory of Ladakh, which comes after seven-decade-long local demand, has one of the worst regional healthcare scenarios in the country which can improve only if the local medicos take the lead.
The sustained and strong struggle of Ladakhi people for region’s separate Union Territory status had the focused attention of local governance and administration at the heart of it besides the interests of its honour and dignity. That for its geographical remoteness, scattered population and tribal identity, Ladakh could never get adequate attention of the governments in Srinagar and Jammu, was one of the main premises for the demand of Union Territory.
Now since creation of the Union Territory has been celebrated and demands are also on the table for its further empowerment by way of legislature and other constitutional protections, it is also the time to ease the life of people, create jobs, improve educational standards and make healthcare facilities accessible all.
The healthcare scenario in Ladakh has always been one of the most challenged in the country, but the formation of Union Territory has also not been of any avail to improve the situation. It was never any better in whole of Jammu and Kashmir when the two Union Territories were together as one state, but in critical emergencies dependable connectivity makes it much easier to rush from Jammu and Srinagar to Delhi or other places for advanced treatment. Geographical remoteness, merely fair-weather road connectivity and periodic flights makes it imminent for Ladakh to develop its own dependable healthcare facilities.
The Union Territory administration, it is learnt, has not been successful to woo medical professionals from Jammu and Kashmir and other places in the country to serve in Ladakh. Doctors have not shown much interest in Ladakh despite offers of high incentives in addition to the regular salaries.
In these circumstances its becomes imminent upon the local medicos to consider serving in Ladakh as their own society needs their services. Much to the surprise, statistics on record suggest that not many Ladakhi medicos like to choose Ladakh as their service area. Disinterest of Ladakhi medicos to serve in Ladakh as much as the outsider medicos, makes the dream universal healthcare access in Ladakh an impossible proposition.
With this scenario known to the Ladakhi society, the only option that appears workable is that Ladakhi medicos must volunteer to serve in Ladakh till the region becomes self sufficient and reliable in healthcare sector.
The Ladakhi medicos can make Ladakh not only dependable in healthcare sector but also surplus over the next five years.
Currently, Ladakh sends at least 46 students to the Medical Colleges under the Scheduled Tribe quota. These selections are not entirely outside the parameters of merit but, as a matter of fact, are primarily based on the reason that whole of Ladakh is a Scheduled Tribe area and as such it has a reservation quota in the Medical Colleges of Jammu and Kashmir.
If the students are getting selected to the Medical Colleges primarily for belonging to the Scheduled Tribe area, they should also take it this as their moral responsibility to serve in the same Scheduled Tribe area, at least for a specific period of time.
It is in this backdrop that one could see Ladakh administration’s decision to take a bond from the Ladakhi medicos to serve within Ladakh for s specific period of time or pay penalty.
This bond commitment or penalty clause is nothing unique to Ladakh. There are a number of other regions in the country which have similar requirements of the medical and other professionals. Closer to home, the Jammu and Kashmir government under Ghulam Nabi Azad as Chief Minister had made the rural posting of doctors compulsory in 2006.
The Administration of UT of Ladakh has kept the Bond amount much lesser for MBBS and PG courses compared to many other States having similar compulsory service bonds.
In Ladakh the local commitment of healthcare professionals is needed much more than anywhere else. Take a look at this situation: the doctor to patient ratio in Ladakh is 1:1476 -one of the worst in the whole country. This ratio has also been achieved by the current UT administration by engagement of Doctors on contract under the National Health Mission.
Further, even if Ladakh achieves the WHO recommended doctor-patient ratio, the local conditions require much more human resource in the medical sector. Ladakh having scattered population across huge geographical area, makes this ratio more difficult for efficient patient care.
As per the current sanctioned strength, Ladakh needs 174 Medical Officers, while the department has only 98 available. This nearly half of the required strength is also possible by way of contractual engagements.
Similarly, against the requirement of 89 Specialists, the Union Territory has only 48 -again almost half of the required strength.
Official say that efforts are being made under NHM to fill the vacancies by engaging Medical officers and specialists from across India by giving them higher remunerations. But the response is very less for Specialists. So far, only four Specialists have agreed to work in Ladakh.
Against sanctioned strength of 263 Medical officers and specialists in UT of Ladakh under Regular cadre, only 117 Medical Officers and Specialists are working in UT of Ladakh currently. Which shows that there are 56% vacancies as per existing vacant regular posts.
The UT administration is already paying incentives over and above the regular salary to regular Medical officers who are serving in far flung areas of Ladakh through NHM e.g incentives of upto 75000 rupees are paid to Specialists /Medical officers posted in Zanaskar Area.
It is surprising to find some local political and other groups opposing the Government’s initiative of obtaining bond for the compulsory service of medicos for a specific small period in Ladakh. If the local medicos prefer outer destinations rather than serving in Ladakh, the Administration will have no option but to hire professionals from other parts of the country on much higher salaries. This will then be seen as an encroachment of local jobs.