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Medical Department should co-operate in providing the requisite curative
facilities for the people; otherwise there is a danger of the health units
losing their proper function and to become dispensaries rather than centres
for the practice and propagation of preventive methods.
3. The disinclination of the private practitioner to settle in rural areas
has been referred to in Section 2 of Chapter I and is not a state of affairs
peculiar to India. A professional man who has passed successfully through
an arduous and prolonged scientific education is not generally willing to
reside in a remote country area where amenities are few and earnings
meagre. The solution will, it is believed, be found in improving
c o m m u n i - c a t i o n s a n d i n c r e a s i n g u s e o f m e c h a n i c a l t r a n s p o r t b y t h e d o c t o r w h o h a s
initiative, while the sick man is himself by the same means able to travel
to the nearest dispensary or hospital with less difficulty than is often imagin-
ed. The real problem is to deal with remote sparsely populated areas where
the communications are poor and which are frequently almost inaccessible
during certain times of the year, e.g ., in the rains. That problem still
remains unsolved, but it should be stressed that every new road and every
improved communication is a gain to the sick villager and a step forward
in the solution of the rural medical problem. Some Governments, e.g.,
Bengal and the Punjab, have considered proposals by which only doctors
who have practised in rural areas for a certain number of years shall be
recruited in Government service, or to grant scholarships on condition that
the successful candidate shall serve for a prescribed period in a country
district. It is doubtful if such schemes can be anything but temporary
expedients, or that they will ever provide an efficient modern medical service
for the village. The most promising method will be to subsidize the prac-
titioner or to provide him with transport. or travelling allowance such as is
d one in the Highlands and Islands Services of the North of Scotland and,
under similar schemes, in certain Colonies.
4. The desire of the medical profession to improve the standard of
education of the Sub-Assistant Surgeon or Licentiate class will influence
the quality and methods of rural medical relief. In Madras, training for
this class of doctors has already been abandoned, and it is the intention
that entry to the medical profession shall be only the M. B. or Graduate
standard. In some other provinces the standard of preliminary education
is being raised to that of Intermediate Science of a University. Graduates
are willingly entering service in the Subordinate Medical Service, where
they are placed in charge of dispensaries, and such employment offers
great possibilities both to the Graduate of Medicine and to the village.
5. Rural medical relief is or can be afforded by one of the following
means :—
(i) Fixed dispensaries.— In every province there is a net-work of dis-
pensaries maintained by Government, local bodies or municipalities, con-
trolled by the Civil Surgeon of the District and located at suitable central
sites. It is a rare thing, except in thinly populated areas, to find a village
which is more than 10 miles from such a dispensary, the distance is
usually less, but a criticism, applicable to practically all, is that the
medical officer in charge is tied to his institution and is not permitted
to make use of the improved road or rail communication which is available.
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