Web based Resources on Violence Against Women
90. David, Siddarth; Contractor, Sana and Jain, Anita (2014). Hospital Preparedness and Response: 2008 Mumbai Terror Attacks. Mumbai: CEHAT. [ISBN: 978-81-89042-65-3].
The nature of the health system in India is such that the primary and often the only health responder during mass emergencies is the public health sector. This makes it critical to develop systems in this sector respond from the pre-hospitalization phase right up to discharge and compensation.
Documentation, research, and sharing of the experiences, lessons and challenges related to such events is critical in policy-making and planning of hospital preparedness. However, such work today exists mainly in the international sphere with little in India despite the fact that India has had a history of responding to mass-casualty events like terrorism and riots.
During the 2008 Mumbai Terror Attacks, which left 172 dead, the hospitals that responded were the state-run public hospitals. Using in-depth interviews of the healthcare providers on duty in these hospitals during the attack, this study seeks to identify strengths and gaps in the response capacities of public hospitals in Mumbai city and the procedures that were followed in the wake of the attack. The insights it provides would be of value to the government which has continuously been trying to review and rethink its health services, administrative procedures and systems in order to keep pace with the rising health care needs of the population especially during emergencies, moving from impulsive reaction to proactive response.
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88. Kurian, Oommen C., David Siddarth (2013). Free Medical Care to the Poor: The Case of State Aided Charitable Hospitals in Mumbai. Mumbai: CEHAT, 2013 [ISBN : 978-81-89042-64-6].
Charitable Trust Hospitals get various benefits from the government such as land, electricity at subsidised rates, concessions on import duty and income tax, in return for which they are expected to provide free treatment to a certain number of indigent patients. In 2005, a scheme was instituted by the high court formalising that 20 per cent beds set aside for free and concessional treatment at these hospitals. In Mumbai, these hospitals have a combined capacity of more than 1600 beds. However, it has been brought to light both by the government and the media that these hospitals routinely flout their legal obligations. Considering that charitable hospitals are key resources for provisioning of health services to an already strained public health system it is vital to ensure their accountability.This study by CEHAT intended to look at the literature on the history of state aided charitable hospitals in Mumbai, and appraise the nature of engagement between the private sector and the state aided hospitals. It critically reviewed the data submitted by the state aided charitable hospitals of Mumbai to the Charity Commissioner on free and subsidised patients, to estimate the degree of compliance to by the hospitals and also to monitor them. The study found that a substantial number of state aided charitable hospitals do not comply with the scheme, and the degree of non compliance is quite high. Most state aided charitable hospitals never allotted the mandatory 20% beds for treating the poor and instead complained that they were treating too many patients. Data reported to the Charity Commission by the state aided charitable hospitals is inadequate, inconsistent and unsystematic. Charitable hospitals predominantly treat indigent or weaker section patients at the outpatient level because outpatient (OP) admissions can be passed off as in patient (IP) admissions in the current scheme of things and frees an extra bed that can earn thousands of rupees per day. State aided charitable hospitals invariably underreported donations and bed numbers at the office of the Charity Commissioner. No matter how serious the allegations were, no kind of penalties were levied on the offending hospitals. There was not a single instance where disciplinary action was taken against an offending hospital in Mumbai.
We hope that the findings of the study would be useful in making key recommendations for effective implementation of the high court scheme, especially for guaranteeing access to the poor to the 20% beds that are set aside.
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