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HIV cases in Unnao: Unlicenced doctors flourish as their numbers surge in UP

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Quacks are flourishing not just in Unnao, the Uttar Pradesh town 60km from Lucknow that has been in the news, but across the state despite an Allahabad HC order of 2012 prohibiting unqualified and unregistered medical practitioners from practising modern medicine.

The number of unqualified and unregistered medical practitioners increased from 32,245 in 2006 to 75,656 in 2015, according to data from the state’s health department. The number is likely to have increased even more since. The health department no longer maintains data on unlicenced or self-styled doctors, but an officer at the department who spoke on condition of anonymity estimates that their number is around 80,000. Some, he adds, actually run unlicenced clinics.

Quacks, especially those in UP are on the radar again because of claims that one of them is responsible for infecting over 50 people with HIV (by treating them for assorted ailments and using the same syringe), although there are enough gaps in this story to question the claim. Not that UP is the only state with a quack problem.

Only 42.7% of self-styled allopathic doctors in India had a medical qualification, with 57.3% practising without medical training, according to the 2016 report on The Health Workforce in India by the World Health Organisation that used data from the 2011 Census of India.

There are 7,000 vacancies in the 18,382 sanctioned posts for government doctors in UP.”The unavailability of registered medical practitioners in the rural areas forces people to take the services of quacks,” said Sanjay Singh, a social activist.

In UP, there have been several efforts to address the problem.

In 2010, the Supreme Court directed the state government to launch a drive against unqualified and unregistered medical practitioners. And in 2012, the Allahabad high court directed the chief secretary, as well as the principal secretary, health and family welfare, to take action against quacks. But nothing much happened for several years. There are several reasons why Chief Medical Officers (CMOs) of districts hesitate to act against quacks.

According to Dr AK Singh, a retired Provincial Medical Services officer, one is the need for them to appear in court for the court hearing for every complaint. “According to the rules, a First Information Report against an unlicensed or self-styled doctor is lodged in the name of the officer posted as CMO. Whenever the case is taken up for hearing, the officer has to appear in court even if he is posted to another district or promoted to a higher post,” said Singh.

There’s also the fact that such quacks usually function as informal business development executives for private clinics in large cities. “The quacks are virtually working as deliverymen, carrying patients from remote areas to private clinics in cities. Along with the money, they get protection from the local officials,” Singh claimed.

In UP, CMOs also have another problem. In recent years, the health department’s decision to involve quacks and healers in the fight against Japanese Encephalitis and Acute Encephalitis Syndrome after outbreaks in Gorakhpur and adjoining districts have muddied the waters further with CMOs unable to decide whether they were expected to take action against unqualified practitioners or permit them to run their clinics. In recent weeks, though, the administration has decided to get tough with quacks.

On January 10, the UP health department directed the CMOs to register cases against quacks.

“CMOs have been directed to identify the unqualified and unregistered medical practitioners in the respective districts and register cases against them,” said Dr Padmakar Singh, director general, medical health, Uttar Pradesh. Though the health department does not maintain a database of quacks, the CMOs of all 75 districts maintain records at the local level, he added.

Still, it’s an uphill battle. Dr Hukum Singh, a health directorate officer who is monitoring the action against the quacks, says 20 of the state’s 75 districts sent action-taken reports to the health directorate. “The CMOs were told to expedite action against the quacks,” he said. (With HT)

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