The Brihanmumbai Municipal Corporation’s health budget was Rs 6309.38 for the year 2022-23. Mumbai is home to 1.2 crore people. Moreover, its healthcare is accessed by Mumbaikars and a huge number of people coming from outside.
Mumbai has 16 municipal general hospitals, six speciality hospitals, 29 maternity homes, 175 municipal dispensaries and 183 health posts. Besides this, the state government has established one medical college hospital, three general hospitals and two health units located in Mumbai.
Citizen Matters spoke to the recently appointed additional municipal commissioner, Dr. Sudhakar Shinde, about the state of public health facilities, monsoon challenges and future plans. Below is an edited interview.
You visited hospitals incognito to check how hospitals are working. What inspired you to do this?
It’s been two months since I joined and I am trying to understand what are the priorities and what are the challenges in Mumbai city. The Honourable Municipal Commissioner sir is giving his guidance to me in the process.
Whatever planning, expenditure and strategies are made at the head office level, are ultimately for the last man on the street, the person who is coming for the healthcare facilities. I thought it would be a good idea to go and understand whether the people are getting what they are supposed to get. Whether the citizens are getting what we intend to deliver them. That is the basic idea of going incognito.
I felt that it is better to visit places and interact with the end beneficiary to understand the pros and cons of the entire system.
What did you find after your surprise visits to hospitals?
I observed that despite spending a lot of funds on cleanliness and sanitation the upkeep of the hospital did not match the set standard. The hospitals are not as clean as they are supposed to be. That was something I could identify immediately.
What are your priorities as an additional municipal commissioner of BMC?
Firstly, I would like to upgrade BMC’s healthcare system from primary to tertiary healthcare in such a manner that it becomes one of a kind. The intent is to provide the best healthcare facility to our citizens.
The second challenge that I would like to take up is ‘solid waste management’. I think there is a lot of scope to improve the solid waste management in the city. Right from the generation, to segregation, to transport, to use and to also take care of the legacy waste that Mumbai has piled on.
These are the two top priorities I’d like to focus on.
Monsoon diseases spiked this year. Leptospirosis cases were much higher than last year. What was the reason?
Before June, we had only 22 reporting units for all monsoon-related diseases. But I insisted that we should be more aggressive towards detection and capturing positive cases. That is why the number is higher. This year we have widened our reporting system and widened our net. That’s why the numbers have increased.
We need to learn from what the city experienced at the time of COVID-19. Whenever there was delay in reporting, patients died within six hours to 12 hours of admissions, because they came in a very serious condition.
When we detect more, we can report early and start treatments in time. This also helps in finding out the source of infection. If there is leptospirosis or dengue spread in any area, we can take preventive action in that area and tackle it better.
Half of Mumbai’s population lives in informal settlements. How accessible is healthcare for them?
People do have knowledge because BMC is one of the few corporations in the country that has done its extensive outreach initiative program in terms of door-to-door healthcare assessment. Also, we are becoming more accessible to the citizens with the new initiative of ‘Aapla Davakhana,’ started by the chief minister. It functions like a mohalla clinic, and is a more mature model than the previous one.
Other factors like socioeconomic strata and literacy, impact late detection, poor awareness about diseases. For example, leptospirosis spreads through cuts in the body. If people prevent themselves from going in the water, it can easily be prevented. Despite awareness, due to occupational compulsion, they get exposed and contract these diseases. They cannot afford to use the gumboots, when there is water logging in the area.
I would not blame the corporation or citizens or any particular area because we have to take a comprehensive approach to deal with these issues.
Has Mumbai overcome the problem of open defecation? How are you planning to educate people and provide proper facilities?
We are certified as open defecation free city, but I cannot guarantee that open defecation does not happen at all. Mumbai has two issues; one is the huge population. More than 1.2 crore people stay in Mumbai. Secondly, it has a lot of migratory population. During peak hours, 40 lakh people are entering the city for various purposes.
Because of the high migratory population and its own issues, there could be some possibilities that open defecation happens in some places, but we are dealing with it.
Are there enough toilets in the city?
The honourable guardian minister looked into the issue of toilets. There is a need to have more toilets and there is a need to maintain them better. The day before yesterday only we approved Rs 500 crore for building more toilets in Mumbai. Work is going on and it will take care of some gaps. NGOs are also involved in this project through CSR activities and some urban planners are also helping us.
Have the various plans related to public health being implemented?
I am sure that the policies are being implemented and things are moving on the ground. Mumbai is one of the most desired destinations for the healthcare system and so are the municipal hospitals. There is a gap in the demand and what is being delivered, so that gap has to be filled. But we have a pretty good system.
I have worked in the urban development sector for the last seven years. The BMC has a very good healthcare infrastructure as compared to other corporations. Nevertheless, we should raise our standards and aspire for even better infrastructure and provide better facilities in our city.