PAUL MURPHY reports from New Delhi on the Catholic Church's involvement in health care in present day India
BISHOP CYPRIAN Monis, astride a motorcycle, finally reached the dispensary — the only one for many miles. Down dusty paths, we had roared past villages with mud-huts, watched by Santali tribal men with matted hair and distended stomachs — a sign of chronic malnutrition. Chronic diarrhoea is another killer and villagers in this eastern part of West Bengal would have to travel many miles for treatment were it not for small health centres set up by the Catholic Church, many of which are run by India's 67,489 religious Sisters.
Across India, the Catholic Church runs 1,792 dispensaries, a lifeline for many destitute villagers in remote regions. "Because of malnutrition and lack of proteins villagers lose their immunity and catch diseases such as tuberculosis and leprosy," said Bishop Monis, who travels twice a week from Calcutta to visit villages within a 75mile radius.
"Sickness is one of the main reasons many tribals become Christians. When the witch-doctors can't help them get better they come to us for help, and find dispensaries with Western drugs, but also herbal medicines that can be equally helpful."
There are more than 21,300 Catholic diocesan and religious priests in India and many of them are as involved as the Sisters in bringing health care to the villages. Fr Robert d'Souza has worked with Santalis for 18 years, living alongside them in their straw-roofed huts. If one of them falls ill in a remote village, he will race there, sometimes slithering along the sides of rice paddies on his Enfield Bullet motorcycle.
"I have helped run a clinic and on average each year will personally treat around 500 TB patients," he said.
" Sisters of the late Mother Teresa's Order sometimes come here to help leprosy sufferers in my villages, and have also advised me about treating health problems. We get no money from the government to run our dispensary and have been getting tribals to make rope from a long wild grass to raise extra funds."
I asked him about the criticisms that have appeared in the Western media about the quality of care at Mother Teresa's Missionaries of Charity health centres in India. His automatic response was the same as that given by everyone else I have spoken to in India. "The Missionaries of Charity centres are respected by all poor Indians because they know they are clean and wellrun, and that they will be well looked after. The same is true of our dispensaries." Across the whole of India, the Catholic health ministry has earned a great deal of respect. "Its quality is based on selfless service, motivated not by profit but the spirit of Christ," said Fr George S Pereira, one of the main figures responsible for coordinating Catholic health care through the Catholic Bishops' Conference of India (CBCI) in New Delhi. "Because of the large numbers of Sisters and priests involved in health care, we provide many training facilities, and also reflect on the theological and biblical basis for health care."
THE HEALTH policy document produced by the CBCI makes reference to a point known by everyone in India: the government-run hospitals for the poor in India are a subject of frequent criticism and scandals relating to them are often reported in the local newspapers here.
It also alludes to "considerable dissatisfaction" over the training of doctors. Along with the dispensaries, the Church runs 704 hospitals in India, each with up to 1,000 beds, 111 leprosy centres, and 455 homes for the aged, destitutes and the handicapped, many nursing schools, and in 1963 set up St John's Medical College in Banga
lore, which trains many physicians and paramedics who work in Catholic health centres and also many Religious Sisters and priests.
Since the death of Mother Teresa, some stories in the Western media have questioned the quality of care at Mother Teresa's centres in India, suggesting that it is inadequate. But none of these reports have given the wider context, including the general health mission of the Catholic Church in India, the government's health policy, and the complexities of treating sufferers in a country of 700 million poor people, which teems with killer diseases, and a frightening variety of viral illnesses that infect hundreds of thousands of poor villagers every year.
The biggest killers are caused by viruses, bacteria, parasites and worms. India has the world's largest number of leprosy sufferers and blind people.
Other afflictions spread from slums across the big cities — infecting the better off. Mother Teresa herselfsuffered from malaria, but that is not so surprising when you consider that Calcutta was hit by a malaria epidemic last year.
You need to see and experience India's general hospitals, which are supposed to help all poor, but often fail to. My wife, who is a nurse, worked for some months in New Delhi for a private clinic that airlifted foreigners who fell ill in different parts of India.
She would venture on airflight rescue missions to help foreigners who were desperate to escape hospitals where patients are often left to fend for themselves, with virtually no nursing care. Many of these public hospitals are so overtmwded that patients are laid out on the floor. Those allocated beds are rarely provided such basic items as sheets.
They would feel fortunate to be given a cup of tea. Inadequate medical equipment is another common complaint and corruption and bribery are other criticisms. Rats were spotted in Indian hospitals treating patients who contracted plague symptoms in September 1994. After the plague scare ended, Indian officials claimed the number of plague deaths was less than 60 — a tiny, insignificant number compared to the tens of thousands who die each year from malaria, gastro-enteritis and tuberculosis.
But the reason the plague sparked fear psychosis was the inability of the medical system to deal with the problem: it took weeks to prepare the first doses of anti-plague vaccine; many doctors admitted they didn't know how to treat plague; and criminal charges were filed against 71 physicians who fled Surat, the city in Gujarat where the plague was first detected.
Distrust in the health system hit rockbottom in Surat, sparking mass panic. Out of 12 hospitals in New Delhi, most plague patients were herded into cramped wards at the Infectious Diseases Hospital where they were allowed to wander around causing the infection to spread.
If Western critics of the late Mother Teresa had compared her centres with general health care in India, their conclusions would have been very different.