By Akhila Karnataka Vayovruddar

Copyright thehindu

While Namma Clinics were launched with the promise of providing free neighbourhood-level healthcare and free supply of medicines, a new survey shows that senior citizens in Bengaluru often receive only 10 to 15 days’ worth of diabetes and hypertension drugs, instead of a month-long supply, forcing many to buy medicines privately or skip doses.

The survey, conducted by Akhila Karnataka Vayovruddara Okkuta (AIKYATA), which represents senior citizens and retired informal sector workers’, assessed public health facilities across Bengaluru including Namma Clinics, Primary Health Centres (PHCs), and general hospitals, documenting accessibility, infrastructure, service delivery, and medicine availability.

The survey was supported by Sylvia Karpagam, public health doctor and Akhila Vasan, public health researcher, and the report was made public on Friday.

Erratic drug supply

“When we go to the Namma Clinic, we do get medicines for blood pressure and sugar, but this supply runs out in 15 days. No amount of requesting the clinic staff is of any use. We ask them to give us medicines for a whole month, but they didn’t. So, we end up taking the medicine erratically. Sometimes we take it, sometimes we don’t. Then the staff shout at us for being careless,” a senior citizen said.

Moreover, all those dispensing medications in Namma Clinics were nurses who were not trained to manage the pharmacy. This is a dangerous practice and can lead to patients being given the wrong medication. There is a need for a public health cadre that is trained and qualified to regularly monitor these facilities, the report argued.

A doctor from Namma Clinic, however, said that they take stock of what they don’t have and send indents regularly, but the supply is not according to their indent. “We have repeatedly told our officials to have more rational practice, but after some time it doesn’t feel like it makes any difference,” the doctor said.

The medicine supply remained an issue even in General Hospitals (GHs). Pharmacies in most GHs were functional, but shortages persisted. Some patients were directed to private pharmacies. Even PHCs faced similar problems. Despite the presence of Jan Aushadhi Kendras, private pharmacies outside hospitals advertised generic medicines at 50 to 75% discount.

Challenges in locating clinics

During the survey, the AIKYATA teams reported challenges in locating Namma Clinics. On one visit, the team spent over an hour trying to find a clinic that did not appear correctly on Google Maps. The absence of proper signage on main roads makes it difficult for first-time visitors, particularly elderly patients, to access these facilities. Such difficulties could discourage repeat visits, contributing to low patient load, the report pointed out.

“Anyone, especially the elderly, visiting for the first time will be so put off that they may not return for the next visit. This could be one of the main reasons why the case load in this Namma Clinic was very low,” it stated.

Some clinics were located in non-residential commercial areas and on upper floors with steep ramps unsuitable for senior citizens or wheelchair-bound persons.

While the report acknowledges that a few clinics had separate rooms for doctors, lab technicians, pharmacies, and that they were neat, the planning of Namma Clinics, it said, was properly done.

“Though modelled on Delhi’s Mohalla Clinics, there was little consultation before establishment. Currently, 225 clinics operate within the limits of the Greater Bengaluru Authority, offering 14 basic diagnostic tests. In some areas, there are a lot of clinics while there is a complete absence in other places, indicating that accessibility for patients was not a priority in planning. Community mapping and consultation could have ensured more rational placement,” it added.