14.06.2007 - Source: BBC News

Police arrest the owner of a clinic near Delhi on suspicion of illegally aborting female foetuses ("Medic held for 'female foeticide'") [ID 20903]

Document(s): Open document

10.06.2006 - Source: Hanns Seidel Stiftung

Strike: Patient's health in danger ("Indien Monatsbericht Mai 2006") [ID 17308]

"Ein Ärztestreik in Indien hat Teile der staatlichen Gesundheitsversorgung lahmgelegt. Ende Mai war der Streik der Mediziner noch nicht beendet. Mediziner wehrten sich gegen einen Regierungsbeschluss, die Quote für Studenten aus niedrigen Kasten in Medizin- und Ingenieurberufen zu erhöhen. Vor allem Patienten aus armen Verhältnissen sind von dem Ausstand betroffen. Ein Ausweichen auf private Versorgung können sie sich häufig nicht leisten."

Document(s): Open document

15.05.2006 - Source: BBC News

Strike hits Delhi health services ("Strike hits Delhi health services") [ID 15456]

Document(s): Open document

28.03.2006 - Source: UK Home Office

Report on general, political and human rights situation (Sikhs, Christians, Muslims and Hindus; land disputes, members of Akali Dal, domestic violence, prison conditions) ("Operation Guidance Note: India") [#48239],  [ID 8138]

"[...]
4.4 Medical treatment
4.4.1 Claimants may claim they cannot return to India due to a lack of specific medical treatment. See the IDI on Medical Treatment which sets out in detail the requirements for Article 3 and/or 8 to be engaged.
4.4.2 Medical care in India is free to all citizens, but most care is provided in the private sector. Private health care costs are less than in the UK, 98and there is a good availability of medications, many cheaper than in the UK.99 In the larger cities, particularly the State capitals, there are hospitals offering care in a wide range of medical specialities.100 Several reports note that better care is available in cities than in rural areas where treatment may be limited or unavailable. However, most districts are served by referral hospitals.101
4.4.3 The Article 3 threshold will not be reached in the great majority of medical cases and a grant of Discretionary Leave will usually not be appropriate, however where a caseworker considers that the circumstances of the individual claimant and the situation in the country reach the threshold detailed in the IDI on Medical Treatment making removal contrary to Article 3 or 8 a grant of discretionary leave to remain will be appropriate. Such cases should always be referred to a Senior Caseworker for consideration prior to a grant of Discretionary Leave. The Article 3 threshold will not be reached in the great majority of medical cases and a grant of Discretionary Leave will usually not be appropriate.[...]"

Document(s): Open document

04.03.2006 - Source: BBC News

Bombay: Suspension of nearly 350 doctors, who went on strike to demand better salaries and greater security for doctors inside the hospitals ("Indian doctors sacked over strike") [#45778],  [ID 8139]

Document(s): Open document

09.2005 - Source: Human Rights Watch

Report on impact of school fees and related education costs, global HIV/AIDS epidemic, child exploitation, violence, discrimination and lack of access on child's right to education ("Failing Our Children. Barriers to the Right to Education") [#36521],  [ID 8140]

Document(s): Open document

07.06.2005 - Source: Integrated Regional Information Network

Bhoplal disaster 20 years on ("Over 20 killed, 50 wounded in clan fighting") [#32664],  [ID 8141]

"[...]Twenty years after the Union Carbide Corporation’s (UCC) pesticide plant in Bhopal leaked toxic gases, the plant site had still not been cleared up and toxic wastes continued to pollute the environment and groundwater. More than 7,000 people died within days of the 1984 leak and 15,000 more died in the following years as a result of the toxins, while tens of thousands more were living with chronic and debilitating illnesses. Survivors continued to be denied adequate compensation, medical help and rehabilitation. No one had been held responsible for the leak. UCC and Dow Chemicals (which took over UCC in 2001) had publicly stated that they had no responsibility for the leak or its consequences. UCC refused to appear before a court in Bhopal and the Indian government agreed to a final settlement in 1989 which was inadequate and was not paid out entirely. In mid-2004 the Supreme Court ordered that the remaining compensation money for victims of the gas leak be paid out. AI joined with other campaigners and survivors to call for an immediate clean-up of the pollutants, site and the affected surroundings, a full remedy for the victims, and to demand that those responsible be brought to justice. [...]"

Document(s): Open document

27.01.2005 - Source: Amnesty International

Report focused on failures of the Gujarat state to prevent grave human rights abuses perpetrated against women (violence against women, justice, state responsibility for abuses by private actors, areas of state failings) ("Justice, the victim - Gujarat state fails to protect women from violence (Summary Report)") [#28565],  [ID 8142]

Document(s): Open document

16.11.2004 - Source: BBC News

Bihar: about 20,000 doctors continue their strike in protest at the killing of a colleague; last year, at least 10 patients died without treatment after doctors went on strike ("Bihar doctors rally over killing") [#26986],  [ID 8143]

Document(s): Open document

10.2004 - Source: UK Home Office

Medical Services ("Country Report - October 2004") [#28325],  [ID 8144]

"[...]5.63 As indicated in the World Health Organisation’s (WHO) Project Atlas Country Profile for India, 2002, the proportion of health budget to GDP is 5.2%(WHO, 2000). The life expectancy at birth is 60.4 years for males and 61.2 years for females. [62](p1)

5.64 In a letter dated 7 June 2001, the British High Commission in New Delhi outlined the standards of medical facilities in India. In the larger cities, particularly the State capitals, there are hospitals offering care in a wide range of medical specialities. These include: general medicine and surgery, obstetrics and gynaecology, paediatrics, neurology, gastro-enterology, cardiology, cardiothoracic surgery, neurosurgery, dental surgery, dermatology, ENT surgery, endocrinology, renal and liver transplant, orthopaedic surgery, nephrology, nuclear medicine, oncology, ophthalmology, plastic surgery, psychiatry, respiratory medicine, rheumatology and urology. Outside these cities medical care can be more variable, but most districts are served by referral hospitals. [7g]
[...]
5.66 The FCO advice indicated that there is good availability of medications and many are cheaper than in the UK. Some are imported from abroad but there are many firms now producing drugs under licence in India. The standard of nursing and social care is not as high as in the UK, but with support from family this can be overcome. There are very few medical problems for which suitable care cannot be found in India. [7g]

5.67 A BBC report dated 29 September 2003 noted that "Experts believe India is poised to become a major health care destination for international patients, offering quality medical service at low cost…. The other attraction is that there is no waiting period for major medical procedures. The Healthcare Mission highlighted India’s medical facilities and skills especially in the areas of Cardiology, Oncology, Minimal Invasive Surgery and Joint Replacement." [32ca]

5.68 As reported by the BBC on 10 February 2004, a Medical Tourism Council (MTC) was launched in Maharashtra by the state’s business sector and private health-care providers, aiming to make India a prime destination for medical tourists. The MTC plans to also work with state-run systems, such as the NHS. [32cv]

5.69 As stated in a BBC report of 6 August 2004, "As India becomes a preferred destination for cheap and good quality medical treatment, foreign governments are tying up with hospitals to send their patients who cannot be treated at home. The Tanzanian government, for example, has tied up with three private Indian hospitals to sponsor and send their patients for operations and treatment." [32dg]

[...]
5.80 As noted in the WHO Project Atlas Country Profile for India, 2002, there has been a national mental health programme since 1982 aimed at ensuring the availability and accessibility of minimum mental health care. “The Mental Health Act [1987] has provided with new definitions, simplified admission and discharge procedures, introduced licensing of psychiatric hospitals, separated state and central mental health authorities, separated facilities for children and persons with addiction and promoted human rights of the mentally ill.” [62](p1-2)

5.81 As indicated in the same source, the Government spends 0.83% of its budget on mental health. Financing for health services is provided both by the states and the centre. “There are about 40 mental hospitals operating in India with a varying amount of bed strength. They still have a large proportion of long-stay patients. Funding is poor and there is inadequate staff. All these add to the problem of stigma against mental disorders. During the past two decades, many mental hospitals have been reformed through the intervention of the judiciary (courts).” [62](p2-3) Over the years there has been a growth and development of general hospital psychiatry units. There is a growing involvement of the private sector along with different NGOs. [62](p4-5) [...]"

Document(s): Open document

04.2004 - Source: UK Home Office

Medical Services ("Country Report - April 2004") [#22427],  [ID 8145]

"5.37 In a letter dated 7 June 2001, the British High Commission in New Delhi outlined the standards of medical facilities in India. In the larger cities, particularly the State capitals, there are hospitals offering care in a wide range of medical specialities. These include: general medicine and surgery, obstetrics and gynaecology, paediatrics, neurology, gastro-enterology, cardiology, cardiothoracic surgery, neurosurgery, dental surgery, dermatology, ENT surgery, endocrinology, renal and liver transplant, orthopaedic surgery, nephrology, nuclear medicine, oncology, ophthalmology, plastic surgery, psychiatry, respiratory medicine, rheumatology and urology. Outside these cities medical care can be more variable, but most districts are served by referral hospitals. [7g]
5.38 According to the US Department of State report 2003, “Medical care is free to all citizens; however, availability and quality were problems, particularly in rural areas.” [2c](p28) But most care is provided within the private sector. Private health care costs are less than in the UK, but vary according to the type of ward and tests needed. The private hospitals are expected to offer free treatment to a proportion of poor patients, according to FCO correspondence dated June 2001.[7g]
5.39 According to FCO correspondence dated June 2001, there is good availability of medications and many are cheaper than in the UK. Some are imported from abroad but there are many firms now producing drugs under licence in India. The standard of nursing and social care is not as high as in the UK, but with support from family these can be overcome. There are very few medical problems for which suitable care cannot be found in India. [7g]
5.40 As reported by Reuters on 6 June 2001, under an agreement signed on 5 June 2001, the United States Agency for International Development (USAID) pledged to provide US$41.5 million to fight AIDS in the State of Maharashtra. The project aimed to focus on targeted interventions for high risk groups as well as broader-based prevention messages for the general population and capacity building among HIV and AIDS prevention groups in Maharashtra. It was the largest programme ever undertaken by USAID. [8q] According to a Reuters news report dated 6 august 2001, in August 2001, Indian drug maker Cipla Ltd said it had launched a three-in-one tablet to treat AIDS, the first combination medicine in the world of the three drugs stavudine, lamivudine and nevirapine. Cipla said in a statement that a month's supply of the newpill, Triomune, would cost patients 1,800 rupees, commenting that the price represented a five to six-fold reduction in the monthly cost of therapy. Cipla is allowed by Indian patent law to make drugs that are patented by other companies internationally, as the law protects only the processes by which drugs are made, and not the drugs themselves. [8r] Reuters reported on 30 November 2002 that a report in November 2002 listed Tamil Nadu as the State with the highest number of AIDS cases, with 18,276 cases reported until August 2002. [8s]
5.41 According to a BBC news report dated 30 November 2003, “The Indian Government is to provide low-priced drugs for treating HIV/Aids, it was announced in Delhi.” More than $40 million would be allocated from April 2004 to provide drugs in government run hospitals. More than 4.5 million people have been diag nosed as HIVpositive in India. The drugs will come from three big pharmaceutical companies in India. It was also announced that measures were planned to protect HIV sufferers in other ways, such as legislation to prevent discrimination against those with the disease. New laws were proposed to make it a criminal offence for situations such as doctors who refuse to treat patients and for children being banned from schools. According to the Health Minister, the budget would also help to fund free medication for children and the poorest patients, as well as people with HIV/Aids.[32ci]
5.42 As reported in the US Department of State report 2003, “According to NGOs, there were more than 60 million persons with disabilities in the country…Neither law nor regulations require accessibility for persons with disabilities. With the adoption of the Persons with Disability Act, a nascent disabled rights movement sl owly wasraising public awareness of the rights of the disabled.”[2c](p29)
5.43 According to the US Department of State report 2003, “The Government provided special railway fares, education allowances, scholarships, customs exemptions, budgetary funds from the Ministry of Rural Development, and rehabilitation training to assist the disabled; however, implementation of these entitlements was not comprehensive.”… [2c](p29)
5.44 According to the US Department of State report 2003, “The Disabled Division of the Ministry of Welfare had a budget of more than $46.3 million (2.13 billion Rs) for the 2003-2004 fiscal year for a number of organizations and committees at the national, regional, and local levels. The Ministry delivered rehabilitation services to the rural population through 16 district centers. A national rehabilitation plan committed the Government to put a rehabilitation center in each of more than 400 districts, but services still were concentrated in urban areas. Moreover, the impact of government programs was limited. Significant funding was provided to a few government organizations such as the Artificial Limbs Manufacturing Corporation of India, the National Handicapped Finance and Development Corporation, and the Rehabilitation Council of India. In June, the National Center for the Promotion of Employment for Disabled People launched an exclusive news service on disability in the country. The Persons with Disability Act established a Disabilities Commissioner who over saw implementation of the Act and its provisions protecting persons with disabilities. ” [2c](p29)
5.45 According to a BBC report dated 29 September 2003, it was reported in October 2003 that increasing numbers of international patients are travelling to India to seek quality health care at a fraction of the cost back home. Typically they are admitted at one of the many upscale private hospitals that have sprung up across the country. With state-of-the-art equipment and medical practitioners trained abroad, they are described as “five star” hospitals. Experts believe India is poised to become a major health care destination offering quality medical service at low cost. The marketing Vice-President of India’s Apollo Hospitals stated that their medical facilities are on par with any centre in the world and their surgeons and cardiologists are trained in the UK and US and can deliver results equal to those achieved by their global counterparts. In India, leading hospitals can perform open-heart surgery for less than $5,000 and the costs can be covered by most major insurance policies. The other attraction is that there is no waiting period for major medical procedures. The Healthcare Mission highlighted India’s medical facilities and skills especially in the areas of Cardiology, Oncology, Minimal Invasive Surgery and Joint Replacement. [32ca]
5.46 As reported by the BBC on 10 February 2004, a Medical Tourism Council (MTC) was launched in Maharashtra by the state’s business sector and private health-care providers, aiming to make India a prime destination for medical tourists. They argue that Bombay has private hospitals on a par with the best in the world. Many of the surgeons are leaders in their field. The average price of private heart surgery in the West is $50,000, in Bombay it costs $10,000. The MTC plans to also work with staterun systems, such as the NHS.[32cv]"

Document(s): Open document

25.02.2004 - Source: US Department of State

Country Reports on Human Rights Practices - 2003 ("Country Reports on Human Rights Practices - 2003") [#19765],  [ID 8146]

"[...] Medical care is free to all citizens; however, availability and quality were problems, particularly in rural areas. [...]"

Document(s): Open document

28.10.2003 - Source:

UN News: UN agency deplores infanticide of girls in India; praises government for study [ID 8147]

Document(s): Open document

02.2003 - Source: Asylum Aid

Report on domestic violence against women in India, Albania, China, Colombia and Kosovo (country background, legal framework, protection, situation of separated or divorced women, human trafficking, access to health service, minorities) ("Refugee Women and Domestic Violence") [#49019],  [ID 8148]

Document(s): Open document

08.2002 - Source: European Reintegration Networking

Background information on India (including procedures for entrance, supply and care, health, education, work opportunies,...) ("Background information on India (including procedures for entrance, supply and care, health, education, work opportunies,...)") [#28646],  [ID 8149]

"[...]Ausgaben für das Gesundheitswesen
Gesamtausgaben für Gesundheit:
51, % des BIP
US$ 22 pro Kopf
Öffentliche Ausgaben für Gesundheit:
18 % der Gesamtausgaben für Gesundheit
5,6 % der gesamten Regierungsausgaben
Einnahmequellen für öffentliche Gesundheitsausgaben:
0,0 % aus Krankenversicherungen
96,4 % aus Steuereinnahmen
3,6 % aus externen Quellen
Private Ausgaben für Gesundheit:
0,0 % der Gesamtausgaben für Gesundheit
Quelle: World Health Organization, http://www.who.int/country/en (abgerufen im August 2002)

Abriss über das indische Gesundheitssystem
Nach der Verfassung gehört das öffentliche Gesundheitswesen zum Aufgabenbereich der Einzelstaaten. In der Realität jedoch sind angesichts der großen Herausforderung, die das Thema dem Land stellt, sowohl die Zentralregierung als auch die Kommunalverwaltungen daran beteiligt.

Zuständig für das Gesundheitswesen ist das Ministerium für Gesundheit und Familienwohlfahrt, bei dem die Familienplanung miteinbezogen ist. Dieses ist neben der Entwicklung und Überwachung von nationalen Standards und Regulierungen für die Finanzierung von Programmen, die wiederum von den Staaten implementiert werden, zuständig. Die Einzelstaaten sind vor allem für die Bereitstellung von medizinischen Dienstleistungen verantwortlich. An der Ausarbeitung der Ziele und Strategien für das Gesundheitswesen sind die drei Ebenen durch ihre Teilnahme in einem "Central Council for Health and Family Welfare" involviert.

Das Gesundheitswesen ist weiterhin charakterisiert durch Zweiteilung in einen staatlichen und einen privaten Sektor. Der erste bietet alle Gesundheitsdiensteistungen an, und ist für die Patienten praktisch kostenfrei. Der Schwerpunkt beim staatlichen Sektor liegt jedoch in der Basisversorgung, Familienplanung und Seuchenbekämpfung. Ambulante ärztliche Versorgung sowie Behandlungen in spezialisierten Kliniken werden überwiegend vom privaten Gesundheitssektor gewährleistet, für den 78 % der gesamten Ausgaben im Gesundheitswesen erbracht werden.

Durchschnittlich kommt in Indien ein Arzt auf 2.440 Einwohner (diese Zahl berücksichtigt allerdings nicht die ebenfalls staatlich anerkannten Ärzte für Homöopathie oder Ayurveda (s. Kapitel Medizinische Versorgung). Für die Bevölkerung von einer Milliarde stehen 870.161 Betten in 43.322 Krankenhäusern und Polikliniken (dispensaries) zur Verfügung.

Die Ausgaben für das staatliche Gesundheitswesen bewegen sich auf relativ niedrigem Niveau, als Prozentsatz vom Bruttoinlandsprodukt sind sie von 1,3 (1990) auf 0,9 (1999) gesunken. Pro Kopf umgerechnet sind dies durchschnittlich 200 Rupien jährlich, die die Regierung für Gesundheit ausgibt. Die Gesamtausgaben im Gesundheitswesen betragen 5,2 % des BIP. Im Haushalt der Regierung in New Delhi machen die Zuwendungen für das staatliche Gesundheitssystem 1,3 % des Gesamthaushalts aus und sind in der letzten Dekade stabil geblieben. In den Staaten jedoch sind sie von 7 auf 5,5 % gesunken. In der neu formulierten National Health Policy von 2002 werden eine weitere stärkere Unterstützung der Staaten durch die Zentralregierung angestrebt und parallel dazu eine Erhöhung der Mittel, die von den Staaten zur Verfügung gestellt werden, anvisiert.

Eine Pflicht-Krankenversicherung nach deutschem oder europäischem Modell gibt es in Indien nicht, die Patienten müssen in der Regel selbst für die Kosten der Behandlung und der Medikamente aufkommen. Es gibt jedoch die Möglichkeit, eine freiwillige Krankenversicherung abzuschließen. Die Leistungen der "Mediclaim" sind jedoch stark eingeschränkt. So werden beispielsweise Krankenhauskosten erst erstattet, wenn der Patient mindestens 24 Stunden stationär behandelt wurde. Das heißt, ambulante Arztkonsultationen und einfache Diagnostik (z. B. Routine-Blutuntersuchungen) müssen vom Patienten selbst getragen werden. Auch jegliche Kosten im Zusammenhang mit Schwangerschaft und Geburt sind von der Versicherung ausgeschlossen. [...]"

Document(s): Open document