JHU student studies global public health
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Alka Pradhan was researching globalization and developing countries when she came across a gap in topics not fully examined by political scientists. Despite studies on the effects of globalization on nearly every aspect of a country, no one had examined globalization's impact on public health issues.
"I couldn't find any existing literature regarding this specific paradigm, so I decided to investigate it myself," said Pradhan.
Finding that researching books and articles from journals for data on globalization and public health hardly yielded any worthwhile content, Alka Pradhan decided to make her own observations.
"For practical information, I traveled to India, Thailand and Cuba to work with various organizations specializing in public health and gain experience firsthand. I conducted interviews with government representatives, non-governmental organizations, and members of urban and rural populations," said Pradhan.
Her article on public health and the economy in India is in the spring 2003 issue of the Hopkins Undergraduate Research Journal (HURJ).
In her article, Pradhan examines the current history of India and its liberalizing economic trends. The gap between the rich and poor, and the uneven development of India, are problems worsening due to the influence of globalization, and wreaking havoc with the strides India has made in public health over the last half century.
Due to the enormous population of India, the national healthcare system consists of tiers from the federal government down to the community level. The Ministry of Health and Family Welfare provides funding to state governments, which allocates money to District Health Organizations. The district organizations pass on financial support to Community Health Centers, the party responsible for the Primary Health Centers and sub-centers.
The United Nations can only do so much. Part of their public health program included The Health InterNetwork, which aims to support and strengthen public health services and to provide access to high quality, relevant and timely health information. It further aims to improve communication and networking among public health care workers, researchers and policy makers.
According to her article in HURJ, this unwieldy structure is rife with corruption and suffers from lack of accountability. According to an interview Pradhan made, the president of the Medical Council of India, which sets the qualifications of healthcare professionals, was arrested for accepting bribes. The utter number of layers composing the healthcare system limits the capacity the national government has to enact change.
With a phrase, "much policy, little substance, no infrastructure," Pradhan succinctly summarizes the current state of healthcare in India.
To muddle the healthcare system even further, India has endorsed programs from the World Bank to fix structural problems inherent in the system. Pradhan lays out these proposals in her article: "cuts in public spending on health services, programs to strengthen population control, transitions of curative care into the private sector, introduction of cost-recovery mechanisms in public hospitals, and definitions of essential clinical and public health packages."
The decision to limit spending on public health and to rely on external assistance had a significant impact on the ability of the government to effectively deliver healthcare, especially to its poorer citizens. Increases in the rates of infectious diseases, with half the population infected with the tuberculosis bacteria, according to the HURJ, are the result.
Because of the increasing failure of the public health system to effectively fight disease, the populace is becoming more and more disenchanted with the current state of affairs.
Through her research, Pradhan has come to believe that the West and its experts have no experience with the problems facing developing countries while globalizing.
Alka Pradhan plans to study the legitimacy of separatist movements and the terrorist components which provide both monetary and ideological support in the future.