The Medico Friend Circle (mfc) is a nation-wide group of socially conscious individuals interested in the health problems of  people of India. Since its inception in 1974, mfc has critically analyzed the existing health care system and has tried to evolve an appropriate approach towards health care which is humane and which can meet the needs of the vast majority of the people in our country.

The existing system of health care, we have realized, is not geared towards the needs of the majority of the people, the poor. It requires fundamental changes. This would occur as a part of the total social transformation in the country, since the medical system is only a part of the total system.

To achieve this goal, measures however small have to begin here and today. mfc is trying to build a nation-wide current committed to this philosophy. Briefly outlined here is mfc’s position on the existing health-care system in India:

AFTER independence there has been a rapid growth in medical services organised by the government. Yet, private practice remains the dominant feature of medical care in India. Private medical care is widely available in India. However, like any other commodity in the market it is accessible only to those who have the money to pay. The medical profession now resembles any other commercial sector and therefore, has become dominated by concern for profits rather than for people. Commercial competition and personal interests of doctors lead to several kinds of malpractice.

This behaviour is encouraged and promoted by profit-oriented drug companies, which dump many useless or even harmful drugs on to the consumer by co-opting doctors through their sales promotion techniques. All the above tendencies will be exacerbated with further privatization of medical services and medical education.

Let us uphold the interest of the people and

- demand that medical and health care be available to everyone irrespective of her / his ability to pay.
- demand that medical intervention and health care be strictly guided by the needs of our people and not by commercial interests.

SINCE purchasing power is mainly concentrated in the urban areas, commercial medical practitioners are also concentrated in cities and towns. This overcrowding of doctors is partly responsible for the overgrowth of specialists. This has resulted in the denigration of the role of basic doctor to just a ‘cough and cold’ doctor.

The training of doctors has also been influenced by and is also partly responsible for this situation. Hospital based training by westernised and urban-oriented specialists produces a graduate conditioned to urban and hospital practice. Therefore, even after prolonged expensive training in a medical college, such a graduate is still not capable of dealing with the situation in rural areas.

Let us work towards
- a pattern of medical and health care adequately geared to the predominantly rural health concerns of our country and
- a medical curriculum and training tailored to the needs of the vast majority of the people in our country.

THOUGH there has been an explosion in medical knowledge on the one hand, a number of innovative field-experiments have shown that many common health problems in India can be taken care of by community-based health workers if they receive limited yet good quality training. A system of health care based on such health–workers and supported by referral services of doctors is more appropriate, more so far a developing country like India. This would also demystify medical knowledge. In India however, health care remains doctor-based and doctor-dominated.

Let us work towards
- popularisation and demystification of medical science and;
- the establishment of an appropriate health care systems in which different categories of health professional are regarded as equal members of a democratically functioning team.

COMMERCIAL interests demand a growing market for drugs and medical therapies and this is partly responsible for medical practice being reduced to curative services. This denigrates the primary role of preventive and social measures. Drugs, surgery and even vaccines have so far contributed only marginally to the improvement in people’s health in different countries. In spite of the primary role of socioeconomic development in improving the health of our people, a wrong belief is promoted that medical interventions – use of drugs, surgery, etc are primarily responsible for maintaining people’s health.

Let us
- give due importance to curative technology in saving a person’s life, alleviating suffering or preventing disability, and also
- stress the primary role of preventive and social measures to solve health problems on a social level.

THE government health sector is not commercial and PHC doctors are supposed to emphasise preventive medicine. However, this sector has not changed the basic pattern outlined above. The doctor working in a PHC is inclined and trained to do mainly curative work. Preventive and promotive measures, when undertaken, are therefore reduced to pure technological and administrative measures without any social content, and are then thrust on the people.

A large part of the resources of the PHC is spent on family planning programmes (read population control, which targets women and pushes invasive female contraceptives in a hazardous manner. Women are seen only as child bearers and health-programmes for women are geared only towards maternity and contraception. It is no wonder that people look upon PHCs mainly as centers for immunization or family planning. For their ailments, most people approach the private sector, whatever its quality and price.

Let us Lobby
- for a sensitive and comprehensive public health system which caters to all health-needs of the people, and;
- for active participation by the community in the planning and carrying out preventive and promotive measures.

MEDICAL practice in its existing form reflects and reinforces some of the negative, unhealthy cultural values and attitudes in our society, for example, glorification of money and power, division of health-workers into intellectuals and manual workers, domination of men over women, of urban over rural, and of foreign over Indian.

Let us build
- health care services based upon human values, concern for human needs, equality and democratic functioning.
 

IN the present medical system, non-allopathic therapies are given an inferior treatment. Allopathic doctors call non-allopathic practitioners quacks, without knowing anything about their system of medical care. Equally unscientific are the claims of success made by some non-allopathic practioners and by some drug companies. Prejudice, ignorance and self-interest have prevailed over open-minded scientificity in this important area of medical care.

Let us insist that
- research on non-allopathic therapies be encouraged by allotting more funds and other resources and;
- that such therapies get their proper place in our health–care

mfc thus tries the foster among health workers a current that upholds human values and aims at restructuring the health care system.
mfc offers a forum for dialogue/debate and sharing of experiences with the aim of realizing the goal outlined above and for taking up issues of common concern for action.