Healthy Gram Sabhas Will Make For Healthy India: Dr George Mathew

PUNE || The Ministry of Ayush (Ayurveda, Yoga, Naturopathy, Unani, Sidda and Homeopathy) declared November 18 each year as the day of naturopathy. This year, leading up to this special day, the National Institute of Naturopathy, Pune, is holding a series of webinars on different aspects of health.

One recent webinar saw Dr George Mathew, founder of the Institute of Social Sciences, New Delhi, speaking about “Gram Swaraj and Gram Aarogya” – village republics and village health. Mathew reminded his audience that the self-sufficiency of the Indian village was recognised even by the British colonial government. Charles Metcalfe, who served as governor-general in the early 19th century, laying the foundation of a free press in India and introducing English as the official language, remarked that villages in India were “little republics”.

Mathew said that in matters of health, much depends on the local ethos, and the culture of the village must sustain the health of residents. For this, a level of independence and autonomy, the freedom to decide with knowledge of local conditions, is necessary. However, the dream of Gandhi – to see India’s villages as largely self-sufficient units, was not incorporated into the Constitution of independent India; it was not until 1992, when the 73rd Amendment Act was passed, that the gram sabha was given powers under the Constitution.

The Eleventh Schedule of the Constitution, created by this amendment, lists 29 subjects on which the gram sabha will have administrative control; state legislatures can make provision for them to impose taxes. The Act became effective from April 1993, but few state governments have made much headway in granting power to the people, he further said.

Among the 29 subjects listed as part of the panchayat’s domain, Mathew explained, is health and sanitation. When one is sick, one should ideally be able to avail help near one’s home – one’s community should be able to offer support; this is a crucial function of the gram sabha, and the Constitution makes provision for a primary health centre in each village – India has over two lakh villages.

Ideally, one well-equipped and well-staffed primary health centre ought to have been set up in each of these villages. However, over 25 years after the 73rd Amendment, this has not happened.

He explained, however, that some states have made great strides in decentralizing powers – Kerala, for instance, has well-equipped and well-staffed primary health centres in each of its 14 districts; there are also sub-centres, so people can access healthcare services provided by the government closer home.

Mathew said that 68% of Indians still live in India’s villages, and the quality of life of the rural population is a matter that must be of concern. The Constitution makes provision for proper training for the elected representatives at the village level. Such training sessions and exposure trips to other parts of the country would create a cadre of leaders in the village with ability and vision, Dr Mathew said, adding that what is needed, however, is political will.

Gandhi’s dreams are not shared by many people today, including some successful political leaders, Dr Mathew said, explaining that there are also vested interests – business interests who do not like power to shift to the people, whose interests in mining and other activities requires that power is not wielded by ordinary people who stand to lose from their operations; deeply entrenched caste hierarchy and the power of a class of landlords are difficult challenges.

Dr Mathew is in the process of attempting a study across the country, to understand decentralization in healthcare and the progress made in healthcare service provision, as envisaged by the 73rd Amendment.

Nature has the power to heal, Dr Mathew said, explaining that this was Gandhi’s belief. When Gandhi came into contact with Dr Dinshaw Mehta, who set up the facility in Pune that today is known as the National Institute of Naturopathy, he was impressed by the philosophy of naturopathy. Dr Mehta was also a body-builder, and used the money he earned to set up the facility in Pune.

Gandhi would visit the Pune centre, spending a total of 156 days there. The central building, where Gandhi would stay, is today called Bapu Bhavan. Dr Mehta would take care of Gandhi during the time he spent in jail in Yerawada. The doctor would also attend to Gandhi during his numerous fasts. The institute became a trust on Gandhi’s suggestion; it was a rare trust with Gandhi himself as founder trustee and signatory on its bank account.