Who did this Rural Carnage?

By Ramana Annamraju

"Decentralize-Distribute-Democratize"- The next generation Healthcare Model

The pandemic did not cause the eco-crisis, but it lays bare the truth about it. The pandemic exposes the social ills accentuated by the eco-crisis: social inequalities, weak health systems, food insecurities, economic and racial disparities, and incompetent governments.

India is in a perilous situation. More than 65% population of India, lives in rural areas. The smell of death everywhere in both rural and urban areas. No family is untouched by the scourge of Covid-19, including my extended family in India. CNN’s Fareed Zakaria’s mother was buried without him and Dr. Sanjay Gupta’s favorite uncle was cremated in a moment of notice without loved ones nearby in India. The crisis is not over and Covid still ravaging the country without mercy. The puzzle for western journalists is, how remote villages are increasingly becoming centers of death. But it is no mystery for Indians. 

I was born in a remote village of southern India located just 10 miles away from the Bay of Bengal. It is a tropical and picturesque place full of coconut and palm trees. Farming is the main source of income for survival. The time and place I was growing up, India is a different place altogether. My village is part of a cluster of villages, connected by dirt roads. We do not have running water and no electricity. We do not have a hospital or clinic. There are no doctors either in modern-day qualifying terms. The typical model of transportation is bullock carts and the occasional sight of horse buggies. 

You might be thinking this is like in the 18th century and life must be awful. To your surprise, it is less than 40 to 50 years back. Life has a different meaning at that time. It is minimalistic living with the tranquility of village life. The drinking water comes from wells. I can still remember the sweet taste of that pristine water with rich minerals. . I studied under the oil lamp, in fact, my entire family of brothers and sisters studied under the oil-lit lanterns. The curiosity of the mind has no limitations,

 I used to ride along with my friend's bullock carts carrying rice paddies from my village to other villages and towns during the nighttime.. Those are the times I pondered about the universe, the relationship between blinking stars and humans.

Health care in rural India in 60 s and 70s.No Hospitals, no clinics. No doctors in the western sense. But there are self-taught healers, who provided basic care to the village people. There are only two such doctors in my village during the time, I was growing up. My late father is one of them. 

My father is an English Teacher in High school. My father is the personification of what Albert Einstein said about himself, “I am no different, just curious”. My father is curious to the point of annoying. He is one of the very few who can read and write English in my village. He got interested in medicine given the dire situation in my village. He used to spend one-fourth of his salary on medical books against my mother’s wishes. He is a vivacious reader. I have never seen him without a medical journal on his hands. One of my distant uncles is practicing medicine in another village a few miles from our place. My father used to visit him often, to get practical training. On occasion, I used to ride along with him on a bicycle.. My uncle has a little more diagnostic equipment if you call that at all. For the first time in my life, I have seen an X-ray film at his clinic.

 My father is relentless and tireless in his quest for learning medicine. His unbounded curiosity made him a brilliant doctor. 

He had a small cabinet. that he is used for storing penicillin injections and first aid kits along with other small essentials.

Johnson & Johnson is the only company we know of. They used to supply first aid kits and other essential items. I have such high regard for Jonson & Johnson, which is the only foreign company that cared about the poverty-stricken villages of India. Those supplies are precious. My first exposure to America through Johnson & Johnson. My father is a savior and true healer for my village. He defined the meaning of Physician irrespective of he gets paid or not. 

Payments to doctors are uniquely different, those days in India. In a poor village like ours, the only time, people have money after their crops are sold, usually twice a year.  Doctors perform “Puja” a religious function and invite all their patients to this unique occasion. . Patients bring cash, Vegetables, fruits whatever they can afford. No chickens or meat since we are strict vegetarians. It is not a money-making scheme just to make enough to get by. It is a pure noble idea to serve. My father is a teacher, doctor, and extraordinaire in every sense. He inspired many students to pursue medicine in his lifetime.  

That was India in the 60s and 70s, now let me bring you back to present reality. Covid-19 is ravaging rural India. Bodies are laying on the roads and floating on the rivers. Most of them are old who are left alone with chronic conditions. Children left villages and their parents, moved to big cities to work in big tech companies. .It is to serve American and other western countries never-ending cravings for buying. America stopped manufacturing and started buying, things that are made in China. Technology companies cashed on that addiction. They used a liberal face mask and started hiring young Indians and Chinese in droves. Silicon Valley was born. 

Silicon Valley bypassed 12 miles away, the city of Oakland which is home to a large number of African Americans. Silicon Valley, instead of investing in their own communities went for ready-made workers abroad. Completely bypassed rural and urban Americans. African Americans are once again discriminated against and disenfranchised. I am not complaining about my fellow Indians, who are beneficiaries of this process. India’s overpopulation turned into rich human capital. 

India’s young are mobilized and transplanted to big cities around the world in millions. India from a poor stricken country suddenly shot into superpower status. With Nonresident Indian cash pouring, India whatever left of manufacturing sent to China like every other country on this planet. Disaster in making!

There is a price to pay. That is at the cost of rural India. The villages are left alone with older parents and poor farmer's families.. Since the children are far away, the loneliness is eating the old. There is no account of their emotional suffering. 

. The farmers without assistance from their governments went into more debt and financial losses. One bad monsoon can destroy their lives. Without Government help, they have no place to go. Thousands of farmers committed suicide and still an ongoing problem.

Rural Healthcare is completely abandoned and the patients are transported to nearby towns and cities. The big city hospitals are branded themselves as only saviors. Village doctors are discredited and disbanded. The City doctors and hospitals made crooked financial arrangements among themselves with the absence of regulations. No Stark laws no rules. The healthcare costs skyrocketed. India‘s rural poor and old are left alone to defend themselves.

 The second Covid wave came to India like a storm!

The asymptotic children who visited their parents brought Covid, passed on to parents and other village residents. This is double jeopardy to already poverty-stricken farmworkers. Scammers started selling saline injections in the underground market as remdesivr, a drug known to be at best, a mildly effective treatment for Covid.  These factors combined result in horrifying scenes of floating bodies in rivers and unbelievable suffering in front gates of overcrowded hospitals in rural lands. 

My village is no more like the one I grew up in. Doctors like my father are driven out. Once a self-sufficient and tranquil place became a cemetery of older people. Rural Public education became a laughing stock. With no choice left, farmers sending their children to private schools hoping better future for them. It is understood, there is nothing left in their villages other than working for multinational companies. They took more loans to send the children to private schools. It is no point of return, financial hell for poor farmers. 

There is a systematic destruction of life in village after village. 

It is the ultimate form of human cruelty. 

Human morality and our cravings for materialism are at the center of this carnage, If we justify ourselves, God won't forgive us!!! 

If you trying to understand the fallacy of present economic arguments watch this video by Dr Matthias Ruth, Professor, School of Public Policy & Urban Affairs and Department of Civil and Environmental Engineering, Northeastern University

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PS: Not all is lost In my next column I will propose some specific solutions!