Healthcare · 05 April 2024 · by Hritan Foundation
Access to healthcare is a fundamental human right, yet many vulnerable communities face significant barriers in obtaining quality medical services. Financial constraints, geographic isolation, cultural differences, and l
The problem is proximity, not medicine
Most of the conditions we encounter at our camps are not medically difficult. Uncorrected refractive error is solved by a pair of spectacles. Cataract is a routine operation. Anaemia, untreated hypertension and early diabetes are all manageable with drugs that cost very little. What is missing is not the treatment. It is somebody bringing it within reach.
A district hospital forty kilometres away is effectively closed to a person for whom the bus fare is a day’s wage. And it is two fares, because an elderly patient cannot travel alone, plus two lost days of earnings. Before a single rupee of treatment is paid for, the arithmetic has already said wait.
Four barriers that have nothing to do with health
Distance and fare. The single largest filter. People do not refuse treatment; they cannot get to it.
Lost work. For a daily-wage household, the consultation is the cheapest part of a hospital visit. The expensive part is two people not earning.
Paperwork and confidence. Forms, queues and being spoken to briskly in a register that is not quite yours are enough to send people home untreated. We watch it happen.
Silence. Mental health, gynaecological complaints and disability are still not discussed. People carry them privately for years, and by the time they surface they are much harder to treat.
Why we started with eyes
Eye care is the clearest case of a large problem with a small solution. An elderly farm worker who cannot see properly stops working, stops going out, and is frequently written off by his own family as confused rather than short-sighted. Cataract and uncorrected refractive error account for an enormous share of avoidable blindness in rural India.
So we run free eye check-up camps, dispense spectacles on site, and refer surgical cases to partner hospitals. It is unglamorous work with a startling return: people go back to work, back to reading, back to being trusted with the grandchildren.
What a camp actually involves
Mostly logistics. We work through a local school, temple or panchayat rather than arriving unannounced, and word goes out a week ahead in person and by loudspeaker — because the people who need us most are rarely the people reading notices.
Every attendee is registered by name, age, village and complaint. It is slow and it is the only way to follow anyone up, and the only way to learn what a district is actually suffering from. Then vision testing, blood pressure, blood sugar, general examination and a consultation. Medicines and spectacles are given on the spot where possible.
There is no eligibility check. Anyone who turns up is seen. Asking a person to prove they are poor enough to deserve treatment is not something we are willing to do.
The referral is where people are lost
Camps have an obvious weakness: a patient who needs surgery still has to get to a hospital. This is the step at which most outreach quietly fails, and where the numbers in an annual report stop corresponding to anything real.
So we treat the referral as part of the camp rather than the end of it. Cases are recorded, partner hospitals are arranged in advance, and somebody follows up afterwards to check the referral was acted on. It is tedious work and it is the difference between a camp that helps and a camp that merely happened.
Continuity, not events
A chronic condition is not solved by a Sunday. Registered patients are followed up, and can be seen at our Ayurveda and naturopathy centre at the Gurukul, where treatment is free or heavily subsidised for those who cannot pay. Residents of our old age home receive continuous care.
If you are a doctor with one Sunday a quarter to spare, or a hospital willing to take referrals at reduced cost, that is worth more to this work than almost any donation. Volunteer with us.
Want to help this work continue? Donate or volunteer with us.
