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`Big changes begin small'

Cardiac surgeon Devi Shetty and doctor-turned-social activist H. Sudarshan check the pulse of the Indian healthcare system

HAND IN HAND Devi Shetty and H. Sudarshan say that collaboration is the new buzzword Photo: Bhagya Prakash K.

"King of Hearts" is what the media called him when this cardiac surgeon opened Narayana Hrudayalaya to dozens of children in need of surgeries. When Devi Prasad Shetty treated children from Pakistan for free and built heart-to-heart bridges with a neighbour India has loved to hate, Bangalore seemed to have arrived as the new healthcare destination.

The road from Kasturba Medical College, Mangalore, to Britain's West Midlands Cardiothoracic Programme and London's Guy's Hospital, through the Research Institute he set up in Kolkata, Manipal Heart Foundation in Bangalore to his very own Narayana Hrudayalaya has been a heady roller-coaster ride for Devi Shetty, who still likes to let the heart rule the head — in some matters.

So when there was the prospect of talking shop with H. Sudarshan, founder of the Vivekananda Girijana Kalyana Kendra and winner of the "alternative Nobel Peace Prize", the Right Livelihood Award, and finding where their paths met, Dr. Devi Shetty agreed with alacrity to come to where his guru and hero was.

For Dr. Sudarshan, who wears another hat as the Vigilance Director of the Karnataka Lokayukta (and so happens to be one of the reasons corrupt government officials need to keep looking over their shoulder) has been doing quietly what Dr. Shetty had always wanted to.

Dr. Sudarshan, the man who lost his father to cancer and decided he would work only where no doctor has gone before, is the first and virtually the only medicine man who could coax the Soliga tribe to come out of the forests of B.R. Hills and learn to bridge the millennial gap between them and the rest of the world.

Here they are, one elated to have found his hero — who has already started him on his journey to achieve his personal mission to make cardiac surgery affordable, to make every village heart disease-free, to make every Indian in the village prioritise his healthcare needs, and rest in the comfort of knowing that a doctor is just a telephone call away...

The other, who staunchly defends his beloved tribal community's right to live off the forests and its right to access healthcare on its own terms, to keep profiteering firmly out of rural healthcare, to guard the bankers of bio-wealth against piracy and take a forgotten people along on the journey to development...

ALLADI JAYSRI was all ears at the heart-to-heart.

Devi Shetty: (To us) If I had a choice, I'd only treat poor patients, but economic realities do not permit that. But here is Dr. Sudarshan, using his place in the policy-making process to harness available resources for productive, effective delivery of healthcare in the backwoods. Having joined forces with him, I have already seen telemedicine working for the rural poor, in Chamarajnagar, and we are going places.

Sudarshan: Yes, working in the public sector, looking at the small things and trying to find their place in the big picture is challenging. The big dream to settle the question of service or profit was gnawing away when Devi Shetty's offer to provide surgery for the tribal people came by. Seven surgeries, and then it was possible to set a goal, to eliminate one disease entirely from one village. What he had done at Suttur, with the Swamiji's encouragement, is nothing short of a miracle. He wanted a registry of congenital heart diseases created, and that has meant we know just how many people need surgery or may be vulnerable.

Devi Shetty: That is my aim: to eliminate one disease at a time. Monumental changes begin small. It was Margaret Mead who said: `Who says the world can't be changed by a small thing?' When the Yeshaswini Health Insurance Scheme for farmers was launched, everyone was sceptical. Now there is a chair in Harvard to study the idea.

Sudarshan: The scalability of these ideas is what makes them different. We are now taking the Arogya Raksha to more villages. We are going to work in Anekal taluk. Can you imagine what a difference it makes to the villager to know how far his Rs. 5 goes in getting medical care? Again this is a collaboration, between Karuna Trust, Narayana Hrudayalaya and Biocon to address healthcare needs of the community.

Devi Shetty: The telemedicine project started in Chamarajnagar first, and then ISRO (Indian Space Research Organisation) went along with us all the way. Now this unique project to save lives is 110 centres strong in the country. Post tsunami, the Andamans relied extensively on it. Do you know today all it takes is three minutes to demystify the ECG that is sent to us from Leh or the North-East or anywhere in the world?

Sudarshan: This is the man who is working on ideas like vaccines to prevent heart attacks, even if it will mean that cardiac surgeons become redundant! Collaborating with him has meant contemplating the hitherto unthinkable — allowing the community to run primary health centres.

Devi Shetty: In seven to 10 years, India will have the best mass health care programme, dissociated from affluence. Technology has become affordable, and scalable. One can't do it alone, of course. Even Microsoft knows that the new buzzword is collaboration. Competition is passé.

Sudarshan: In Gumballi and Thithmatti, we have shown that privatisation of PHCs can work, and in Anekal, we want to say it is possible in secondary and tertiary health care too. We are walking an uncharted course, but we know where we want to arrive. Who we are doing it with is just as important.

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