The dichotomy could not be more stark. At one end of the healthcare spectrum, private hospitals are expanding their footprint into newer regions and services, as the funds pour in.

At the other end, is the reality being reported from Nanded, Maharasthra, involving over 30 deaths, more than half them being children, in about three days. The images from the hospital are distressing, but not entirely unfamiliar.

This hospital will be in the eye of the storm, as it should be, as reasons for the deaths and unacceptable levels of hygiene are investigated and addressed, now that it makes prime-time news. But, for a country with a large population and priding itself as “pharmacy to the world” — to have hospitals struggle for the lack of staff or medicine is a cruel irony. And it reeks of an absence of willingness to address the problem at political, administrative and individual levels.

Government-run hospitals spill over with people, because they are more accessible and affordable. But public health voices have been long demanding an increase in healthcare spends, so hospitals can be spruced up, staff can be paid, more can be recruited and medicines and devices are available in good supply and working condition, respectively.

Besides the overall budget, local hospital administrators can most certainly ensure that their operations are running efficiently, and premises are clean. While it is easy to put the blame on a few pigs or dogs, make no mistake, the problem lies elsewhere - the dumping of garbage. Someone is not doing their job of getting the garbage cleaned and that at a micro-level will bring in disease and scavengers.

The most important reason that hospitals are expensive or over-crowded is because of “we the people”. Only when people start demanding that their local, elected representatives pay attention to their problems and demand better hospitals and schools — will the tide turn.

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