The healthcare system in India is suffering from a widening gap between the rural and urban areas in the country. While the urban cities are having a surfeit of super specialty and multi-specialty hospitals, the healthcare infrastructure in the rural areas is in a pathetic condition and the poor are solely dependant on the not so well equipped government hospitals or RMP (Registered Medical Practitioners) clinics, says Dr. Anita Krishnan an ENT consultant at Nova Hospital.

Throwing more light on the current healthcare scenario in India particularly in the rural areas, the doctor felt that the Indian healthcare systems suffer from low spends vis-à-vis global and developed economies.” There is a major level of imbalance in healthcare systems in India, where a huge chunk of rural population has no access to basic healthcare services. Additionally, about 70 per cent of the expenses on healthcare services are borne by the people as a result of low investment by the government on healthcare”, Dr. Anita said,

While talking about the ENT (Ear Nose & Tongue) healthcare segment, she said that the urban focus on this segment gets lesser priority than other specialties. The main reason for this is because of lesser incidence of life threatening illness coming under the ENT purview.

ENT hospital infrastructure in India
Hospital infrastructure is not limited to the building or the engineering and the equipment used. It encompasses various other aspects such as the supply chain, consumables, in short overall resources required to manage and run a hospital.

“Though the overall scenario of hospital infrastructure is improving, there is still a lot that needs to be done, especially outside the private/corporate hospitals. For instance, many government hospitals re-use consumables that are usually meant for single use. This is due to high costs involved. In addition, there is a lack of standardisation of procedures and many of the newer less invasive technologies take longer to filter down to the public health care domain,” said the doctor.

Clearly, government hospitals need a facelift to be able to handle increased influx of patients as well as diseases, she added.

Growth prospects
According to various reports, the Indian healthcare sector is expected to reach US$ 280 billion by 2020. Over the years, the healthcare market in India has evolved as one of the major and advanced service sectors. It is believed to be the one of the most promising industries estimated at US$ 280 billion by 2020. Having said this, the healthcare spend by the government has to increase substantially to be at par with international standards and achieve the desired results.

Clinical trials
The doors for clinical trial were opened with execution of product patent and convergence of technology and healthcare. It has become one of the key businesses in India due to favourable costs coupled with state-of-the-art technology and increasing R&D investment by pharmaceutical companies. However, India as a clinical trial market still occupies a small portion of the overall global pie. Besides this, there are other challenges such as unethical trials and lack of exclusive data. According to some studies, the trials registered in 2011 showed a decline over trials registered in 2010.

ENT specializations
With more and more urban population looking at healthcare as a part of overall well-being, some of the ignored illnesses in the society are sleep apnoea, snoring and hearing loss etc. The healthcare experts are viewing these illnesses seriously as they are indications to other serious diseases in the long run. As a result, the markets for some of the ENT branches such as sleep surgeries, sinus surgeries and implantation otology looks promising. The other areas of ENT that require focus in the healthcare sector are phonosurgery and pediatric ENT.

Manpower shortage impacts healthcare
Healthcare experts believe that despite having so many multi-specialty international standard hospitals, government hospitals and thousands of individual clinics and nursing homes, the healthcare system in India is still facing acute shortage of qualified healthcare personnel.

According to Dr. Anita, one of the biggest concerns of the healthcare sector in India is the lack of manpower. A survey conducted by Techno park points out that there would be a requirement for 2.5 million hospitals, one million doctors, two million nurses and 10 million paramedics, by the year 2020. There’s huge a gap between demand and supply, to meet the growing market need. This is due to lack of standardised remuneration in private and public sectors and better opportunities in international markets.

To improve the scenario, there should be proper remuneration and the work environment should be made conducive by offering better infrastructure facilities and standardised training process. Additionally, it is imperative to have protocols in place for diagnosis and management of common diseases.

Sinusitis, an emerging problem
With growing work pressures and due to increasing mental stress, a large numbers of people in the urban and rural areas are suffering from Sinusitis problems. While about 37 million suffer from sinusitis, almost 900,000 patients not successfully treated. While about seven million patients seek prescriptions, 1.4 million fail medication annually. Only 35 per cent of these patients undergo surgery. Studies show that rhino sinusitis is more common in patients who already suffer from heart disease or asthma.

Therefore, there is a need to create more awareness about the triggers/symptoms and complications of sinusitis for the condition to be taken seriously.

The symptoms of sinus-related diseases directly depend on the type of infection and the area where it has been affected. For instance, maxillary sinus infections can cause pain in the upper teeth, frontal sinus infection causes headache and pain in the forehead or the temple, ethmoid infection affect the nasal bridge and eye movements and sphenoid infection can cause headaches mostly located in the vertex and fever.

According to the doctor, almost 80 per cent of children suffering from asthma attacks have associated allergic rhinitis symptoms like dark circles under the eye, nasal itching and watery secretions from the breathing passage of the nose and almost 60 per cent have adenoiditis. The sinusitis treatment approaches vary according to the nature of the infections and the symptoms the infections show. The best approach would be to undergo a physical examination (usually Endoscopy or Anterior Rhinoscopy) to detect the intensity of the infection caused by sinusitis. An X-ray or Sinus CT Scan is advised, to check for mucous thickening and air fluid levels and the use of medications like antibiotics, decongestants and certain approved steroids.