Poverty in India

Earlier or even now for most of those who are poor, poverty had been mostly accepted as their fate or inevitable; the most important reason of poverty being the insufficiency of the traditional modes of production to give an entire population a comfortable standard of living. After the industrial revolution, mass production in factories made wealth increasingly more inexpensive and accessible. Of more importance was the modernization of agriculture, such as fertilizers, in order to provide enough yields to feed the population. Also improvement in agriculture remains the core method to eliminate poverty, more so because three quarters of the world’s poor today are farmers.

The World Bank defines extreme poverty as living on less than US $1.25 per day, and moderate poverty as less than $2 a day. According to Indian Planning Commission a daily expenditure of Rs. 20 on essential requirements for those living in urban areas and Rs.15 for those in the rural India was enough to keep them out of poverty. As per planning commission allocation of expenditure to different category are, a monthly expenditure of Rs. 31 on rent and conveyance, Rs.18 on education, Rs. 25 on medicines and Rs. 36.50 on vegetables! A minimum intake of 2,400 calories daily is essential for a physically active person to sustain life. This required an expenditure of at least Rs. 44 per day (at the rate around few years ago) — excluding expenditure on shelter, clothing, education, and transportation. Another big aspect which is essential for healthy living and specially population control is entertainment which is remarkably absent!

After going through this data, If I consider the health aspect, I dont wonder the way people feel troubled when they come across the medical expenditure. If I presume that the person has only one episode of most trivial medical attention every year, he has just Rs 300. The cheapest antibiotics Co – trimoxazole costs 2.56 Rs per tab of which 14 tablets means 35.84 Rs, other supportive medications included (I wonder who uses co - trimoxazole now a days) I will be surprised if any medical bill is less than 300 Rs! If it’s a family of 5, it comes annually just 1,500 Rs annually! Even if its a single episode of diarrhea with dehydration for one out of 5 members of the family every year, its inadequate! If we take average life expectancy of 60 years and life time chance of tuberculosis as 40% at least two out of five will have tuberculosis so (as per WHO India has highest TB prevalence in the world), for five people, life time health expenditure as per our planning commission is 5 X 60 X 300 = 90, 000 Rs! So, just 45, 000 Rs per patient! Is it sufficient for treating Tuberculosis even if that’s the only ailment for whole of life of the five people (no pregnancy, no trauma and no dehydration episode - a highly imaginary and synthetic situation!).

I leave the cost of medical bill for the people to decide. But I clearly remember one of my colleagues a fourth grade employee (earning four thousand per month and he was not the only earning member of the family) coming back to me with the prescription for antibiotic as the medicine was costing him 800 Rs!

There are so many aspects of health care in our country which need attention like facilities available at the government hospitals, spurious medicines, availability of doctors, inadequate vaccination and other preventive measures, inadequacy/ failure of different disease control programmes, but when I looked at the definition of the poor by the planning commission specially the allocation of fund in a family budget for health, I was pained. The pain was so severe that if I don’t laugh to forget it, to come out of thinking, I will become inhuman!