How Communist-Led People’s Polyclinics Are Tackling the Health Crisis in India
By: Tricontinental Institute For Social Research
Tags: Healthcare, Barefoot Doctors, Polyclinics, Communism

FOR IMMEDIATE RELEASE:

Contact:

Srujana Bodapati (Coordinator, Tricontinental: Institute for Social Research, Delhi)

srujana@thetricontinental.org

February 4, 2020

Tricontinental: Institute for Social Research releases a new dossier that shines a light on a unique experiment to bring modern medicine to the people.

India: Every year, millions of Indians and their families slide into poverty due to health care-related expenses. The emotional burden of these illnesses — and the deaths they often lead to — is further aggravated by the high costs and debt that most families are forced to incur for hospitalisation and medicines. In sharp contrast to private, government-subsidized schemes, people’s polyclinics — led by India’s communist movement — offer a highly cost-effective and efficient people-centred solution. The polyclinics treat large numbers of patients in rural and semi-urban India, educating patients during the process about the practices of modern medicine and how to prevent common illnesses. The existence and the success of the polyclinics give people the idea that an alternative to the capitalist system of health care delivery is not only possible; it is realistic and necessary.

However, instead of strengthening and expanding public health care, the Indian central government and most state governments have been encouraging private and corporate health care. Under most of these schemes, poor families can access free treatment in private hospitals, but they are often pressured to undergo unnecessary surgeries and seek tertiary care in order to further the hospital’s profits through public subsidies. This is despite the fact that only 10 to 20 percent of all health needs require tertiary care or surgical intervention; the bulk of medical problems can be treated by primary and secondary care, which are underfunded as a result of the private hospitals’ profit-making schemes.

The Nellore People’s Polyclinic is a showcase for an alternative and affordable medical care system. The People’s Polyclinic was started by the Telugu communist movement during the same time as the Telangana Armed Struggle (1946–1951). It is the result of a philosophy that stresses that building alternatives is an important part of the communist movement that should go hand in hand with political struggle against the ruling classes. The People’s Polyclinic has trained hundreds of doctors in the Telugu region, who go on to provide affordable health care in their regions. The Polyclinic has brought people closer to the communist movement by showing them an alternative to identify with.

Doctors who work at the people’s polyclinics understand that their work is political. Through their practice, they help shape people’s ideas about the left movement and the possibilities of socialist health care, and they bring people closer to the movement. Robust communist values become material forces in the practise of these clinics.

“This dossier on the people’s polyclinics initiative of the Telugu communist movement should become an essential reader for all medical students. It provides an essential briefing on a worldview that is often lacking amongst policymakers and medical leaders, and a model for practical solutions to India’s health care crisis. It should be read by students and youth alike — the leaders and policymakers of tomorrow — who are already leading the way to the future on campuses and streets across the country.” — Dr. Brijesh Sharma, Faculty at Ram Manohar Lohia Hospital

Read Tricontinental: Institute for Social Research’s new dossier, “People’s Polyclinics: The Initiative of the Telugu Communist Movement.”

Jana Vignana Vedika, the People’s Science Movement, rallies for communal and religious harmony.

Key information from the report:

Indian government data reports that the cost of out-of-pocket health care is the highest in the world. For the average Indian, 67.78 percent of health care costs are out-of-pocket, which compares unfavourably to the global average of 18.2 percent. Each year, 57 million Indians are pushed into poverty due to such medical costs.

The polyclinic in Nellore began at the request of the Telugu communist movement in the 1940s as a small clinic in a thatched house with just three doctors. Today, it has grown to be a hospital with 60 doctors and 250 beds for inpatients.

Since its founding, the Nellore People’s Polyclinic has trained more than 500 doctors who now provide health care across the Telugu-speaking region, and who — over its 75 years of existence — have played a key role in providing health care to those who need it most.

The Nellore People’s Polyclinic provides a three-year training for MBBS doctors in all branches of medicine so that when they go out and establish their clinics in rural areas, they can independently perform versatile surgeries that usually require care from specialists. The training programme prepares doctors to practice in remote, rural areas, where doctors have to provide health care across a range of specialisations — often by themselves.

The Polyclinic, along with the left-wing science movement Jana Vignana Vedika (JVV) and others, has also played an active social role, fighting against issues such as alcoholism and religious fundamentalism that adversely impact health.

Today, the Nellore People’s Polyclinic alone treats 312,000 patients annually. There are 13 outpatient departments, five gynaecological departments, and one surgical department, all managed by the senior doctors. There are 18 units for inpatients, each headed by a senior doctor who is assisted by two junior doctors.

Despite charging 40 percent less than the private hospitals in Nellore, the Polyclinic is able to function at a high level and is able to pay salaries (including a bonus of one month’s salary) to its workers that are on par with those of major corporate hospitals, a practice unique to people’s polyclinics. Not only does the clinic provide services to the general population; it has also become a centre of training.

Tricontinental: Institute for Social Research is an international, movement-driven institution that carries out empirically-based research guided by political movements. We seek to bridge gaps in our knowledge about the political economy as well as social hierarchy that will facilitate the work of our political movements and involve ourselves in the “battle of ideas” to fight against bourgeois ideology that has swept through intellectual institutions from the academy to the media.

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