Unshackling India: Barriers - Part 2

The last post covered Education and the lack of quality (skill and stance) and reach as a barrier to achieving India's goal of becoming #1 GDP country in the world. In this post, I'll explore Health as the 2nd big barrier.


Health is both a cause and effect of extreme poverty. And it's a very complex problem. Let me state the magnitude of the problem first.


25% of Indians do not have access to basic healthcare. Sometimes percentages numb our senses since they hide the people they represent. What this 25% means is that around 270 million Indians, when they fall ill, do nothing but wait. They wait for divine intervention or human fortitude or quacks or ultimately for...... death. These are people in remote villages, slums or shantytowns next to big construction projects - you can see them living each day on borrowed time.


With infant mortality of 34.6 per 1000 live births, 1 million infants die every year - laying waste 9 months of pre-natal investment. This is no small number. It means half of New Zealand dies as infants in India every year!!


For every 1000 adults of working age, 4 die of infectious diseases such as TB, Diarrhoea, AIDS and Malaria. That is 4.5 million preventable deaths a year!! More than the population of Singapore! Another 2 million die of nutrition related diseases. It's ironic that Singapore is trying to get up to a population of 6.5 million by 2010 to sustain its economic growth and we lose the same number every year to deaths that are preventable via sanitation, immunization and nutrition.


India has 25% of the world's population of blind people. Isn't that blinding infuriating?? 1/4th of world's blind people are in India!! - a direct result of Vit A deficiency and poor cataract treatment outreach.


With such vast swathes of people rendered economically ineffective, its not hard to see why India has not been able to harness its abundant human resources - a lot of them are just not fit to work!

What are the causes of this abysmal state of healthcare in India?

First is Poverty. Poor people just do not have the economic surplus to invest in nutrition, prevention and treatment.

Second is Budgetary failure. Indian Govt. has a) not allocated enough to fulfill its promise of universal healthcare and b) whatever is allocated doesn't reach the needy due to corruption and inefficiencies.

Third, is Lack of infrastructure. This happens on two fronts - 1) Lack of roads and refrigeration impedes reach of medication and vaccines, 2) Lack of sanitation compounds spread of infections.

Fourth is Lack of education. This again, works on two fronts - 1) The affected don't know and therefore don't take simple actions that can prevent a lot of infectious and nutritional diseases and 2) there are not enough doctors and health workers for our population.

Interestingly, most of the above are interlinked. And that's not surprising. Over the past 407 years (1600 - 2007) while the Western World went through its political, industrial and technological revolutions, India's GDP was stagnant for the first 340 years and grew at a meagre 3% for the next 30. Only in 1970 did we break into a more respectable 5-6% growth rate behind the Green revolution and from 1991, started galloping at 7%.

The first 370 years of the last 4 centuries made the pernicious factors of illiteracy, poor health and poor infrastructure intertwine into a massive ballast that keeps pulling the Indian ship down.

In my 1st post, I mentioned that in addition to Education and Health, the 3rd barrier is that we have not created conditions that allow our human capital to contribute. This primarily alludes to lack of Infrastructure but extends into 2 other vectors - 1) Governance and 2) Inefficiencies (corruption, intermediaries)

In my next post, I would explore this 3rd barrier in some detail