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Policy Matters

No bones about it

Nagaland (TH): Bone-setters have been included in NRHM to overcome acute lack of doctors in Nagaland

Faced with an acute shortage of medical doctors, the Nagaland government is now encouraging traditional systems of medicine to provide healthcare to its people. This is being done by including traditional healthcare practitioners in the National Rural Health Mission (NRHM) under the AYUSH (ayurveda, yoga, unani, siddha and homoeopathy) system.

While most systems of alternative medicines are integrated in the NRHM, Nagaland government has also included bone-setting under the system. Bone-setting is an art that is passed on from generation to generation.

“We have a strong system of traditional medicines and people accept these systems very well,” Dr Yangerlemla, Principal Director, Department of Health and Family Welfare (Nagaland) said, adding that it was a conscious decision to incorporate bone-setters in the health stream.

There is a great demand for orthopaedics in Nagaland as falls and accidents are common in this mountainous terrain. Traditional healers applying locally made herbs and setting broken and dislocated bones within minutes is a common sight. “Not all these cases may be successful in treating patients but are, more or less, known to be very effective. So we have decided to make the method more hygienic and acceptable by training the traditional practitioners,” Dr Yangerlemla said.

Each of the 11 districts in Nagaland has about 15-20 bone setters who will be trained under the NRHM and integrated into the mainstream healthcare system.

At present Nagaland has only 400-odd MBBS doctors but requires 800 more such doctors. However, there is a blanket ban on appointment of regular doctor since 1998. Appointments are made only on contractual basis which does not attract doctors who prefer to move out and serve in the neighbouring States or bigger cities.

There is no medical college in Nagaland but it has 40 medical undergraduate seats from the Central quota. It is mandatory for students to serve in the State for five years after completion of the medical course if the government can provide them regular employment. But, since the government cannot provide them employment, these doctors prefer to move out of the State. As far as the specialists are concerned, there are only seven eye specialists and nine gynaecologists in the entire State.

Worse, difficult terrain and lack of facilities does not attract professionals to serve in the rural areas despite the State government paying Rs 60,000 per month to those willing to serve in the far-flung areas. Bad roads, lack of telecommunication and interrupted power and water supply makes functioning for the doctors impossible. There are also no vehicles for doctors which makes them immobile.

Under the AYUSH system, there are seven doctors serving under the AYUSH and 29 have been appointed on contractual basis.

There are 396 health sub-centres, 126 primary health centres and 21 community health centres with very few private practitioners. The few private practitioners available are in cities such as Kohima and Dimapur.

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