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Children standing in as Bal doctors in Gujarat

Copyright: niyazz / 123RF Stock PhotoGujarat has employed an eccentric new tactic in response to mass shortages of medical staff across the state. The state is using children, some as young as eleven, as stand-in Bal doctors within schools, complete with stethoscope and doctors outfit.

The plan may seem an absurd coping mechanism to shortages of doctors. However, the basic premise of these “bal doctors” may prove beneficial.

The children are provided with a small stock of ayurvedic medicines to administer to fellow students in the case of minor illnesses. In this aspect their impact is highly restricted. They are permitted to use AYUSH treatments. However, as children, they will not be allowed to delve into allopathic medicine. They will be given training for this purpose by selected teachers.

“As children, they will not be allowed to delve into allopathic medicine”

It is not in this capacity that the project may see results. The bal doctors are charged with monitoring the Weekly Iron and Folic Acid Supplementation (WIFS) Programme of the National Health Mission, held every Wednesday. They are also tasked with looking after the general wellbeing of their classmates, including ensuring they remain addiction free.

The children are to encourage good hygiene practices amongst their peers. This will involve giving instructions such as washing hands before meals. The children are also be expected to provide information to fellow students regarding seasonal diseases. For this purpose they are given with booklets and posters to distribute.

Assurances have come from Gujarat Health Commissioner Dr Jayanti Ravi that the children are not expected to act as actual doctors. “We are giving them white coats and small stethoscopes so they feel important… bal doctors are not going to treat the students. They are there to keep a check and report. Trained doctors will be there to handle the children when needed.”.

Despite these assurances, criticisms of the project are abundant from both health professionals and the media. The initiative has drawn flak from the Gujarat chapter of the Indian Medical Association (IMA). “Though I am not aware of the initiative, I can definitely say that this must not happen,” said Dr Yogendra Modi, president of IMA’s state branch, “We only believe in allopathic medicines and a person must be considered a doctor only after they’ve done MBBS.”

“The situation in Gujarat is dire”

Many of these criticisms tie in with the shortage of doctors in the state. The situation in Gujarat is dire. Gujarat suffers a 93.7 percent shortage of specialists. It has just 92 of the 1,452 required according to rural health statistics for the 2016-17 period.

Gujarat ranks 28th among states and union territories in terms of availability of allopathic doctors. The low number of available practitioners extends beyond just specialists. There are mass shortages in local health centres, with limited numbers of physicians and general practitioners. 

As mentioned by Dr Ravi, the children are not expected to be a replacement for actual doctors. The use of the title of doctor, as well as the coat and stethoscope, are simply used to encourage children to take up the position. For criticism to come from one of India’s largest medical institutions simply for using the title of doctor could dissuade beneficial awareness campaigns from being created in the future.

Raising awareness amongst children about hygiene, common illnesses and nutrition is likely to have a positive impact. Though this drive is not expected to have the same manner of effect as increasing the number of doctors in the state, awareness campaigns still have their place.

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