India’s health care system is one of the best in the world – if you have the rupees to pay for private care. Government hospitals are for the indigent and exist for the betterment of government workers.  Government jobs pay well compared to private-sector wages and offer good retirement benefits. Best of all, when a government worker retires, s/he can bequeath the job to a family member.

Good performance is not rewarded; poor performance is not noticed. Perks abound in the coveted hospital jobs. The government provides food for indigent patients, and industrious hospital workers skim cream off the milk, add water and deliver it to the patients along with the reduced rations of rice and dal. After all, the hospital workers must provision their home larders before feeding bed patients who will probably die of neglect anyway.

The government provides cheap drugs, but the rest must be purchased by the patient or family. The indigent quietly or horribly die. To free up the bed, the corpse is tossed on the floor until the ward boy is paid by the family to remove it or until it begins to stink. Then, the ward boy must actually perform one of his job duties – after tea and 25 urgent, personal phone calls.

Corrupt politicians (I hope you’ve noticed I’ve shifted to the US now) may find their dirty laundry aired for our disgust. But, really, it is a relative thing. In India, dirty laundry is not aired, for government nurses never change or wash sheets unless blindingly bribed by a handful of rupees or sparkling bangle. 

Corruption here; corruption there. I just bribed Puti with cake to clean my bathroom. It is part of his job; but we know how things work – here, there, everywhere. Tomorrow, he will want ice cream on his cake—which I will charge to the charity as part of my “room and board” gratuity. Here, as everywhere, “bribes” are the unwritten clause of every contract.

You would think I would find all of this strange and foreign – but once I was employed by the State of Illinois. Business as usual in India is, regrettably, familiar.


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