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(单词翻译:双击或拖选)
By Anjana Pasricha
New Delhi
03 May 2006
Most of India's billion-plus people struggle with a public health care system that is overburdened in cities and virtually nonexistent in villages. On the other hand, private health care is booming, and the country's state-of-the art hospitals and highly skilled doctors even attract patients from countries where health care costs are much higher. The challenge before India is to make such top quality care accessible for the majority of its people.
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Sakeena, 4, is administered polio vaccine1 as her mother looks on in Srinagar
When Pardip Singh's elder brother fell ill with a severe nerve ailment3 in a remote village in the eastern state of Bihar, he brought him all the way to New Delhi's All India Institute of Medical Sciences - the country's premier4 government-run hospital.
Singh had little choice. There were no health centers or doctors near his village who could even diagnose his brother's condition. At the New Delhi hospital, some of the country's best doctors attend to his brother. Twenty-eight-year-old Singh's worries should have ended - but they have just begun.
Singh says he has given up his job as a security guard to stand in long lines with his brother at the hospital. The treatment is free, but to pay for the tests, he has borrowed 350 dollars at a crippling interest of nearly 50 percent a year.
Like Singh, thousands of people flock everyday to big public hospitals in Delhi and other cities for treatment.
But in these overcrowded hospitals, they must first battle serpentine5 lines to see specialists, wait months to undergo tests and surgeries, and spend more than they can afford for board and lodging6. Many sick people never gather the resources needed to make the journey and tens of thousands of others borrow money or sell assets to cover expenses.
Mother with child at Malipur Maternity7 Home in Delhi, India
The head of All India Institute's cardiology department, Srinath Reddy, says one of the primary problems confronting the country is that two-thirds of its billion plus people live in villages - but most hospitals are in big cities.
"We have maldistribution," Reddy explained. " The rural areas and some of the underdeveloped states do not have adequate medical facilities. It is not so much acute lack of vaccines8 or hospital beds. But most of the beds are in urban areas whereas most of the people are in rural areas, so that is where the problem is."
It is not just advanced care that poses a problem. Even good basic care is inaccessible9 to the vast majority of people. Thousands of primary medical centers exist, but they are perpetually short of personnel and medicines.
The government, led by the Congress Party, has promised to increase health care services for the rural areas and the poor by appointing community health workers, and implementing10 a national insurance program - but little has been done so far to meet those goals.
The lack of an effective public health system has led to a booming private system, which takes care of three-quarters of the country's needs.
But the system is unregulated, and poor people are often forced to turn to medical practitioners11 who are little more than quacks12.
Dr. Reddy at the All India Institute is a member of a new private initiative called the Public Health Foundation, which wants to train thousands of public health professionals to meet the country's vast needs.
"There are no standard guidelines (for) treatment which are universally disseminated13 and adopted for practice by primary care physicians, there are no quality checks," he said. " And therefore both malpractice which is intentional14 as well as inadequate15 medical treatment, these are problems that plague the private sector16 health care delivery."
The scene is radically17 different for those who can pay for top-of-the-line private services.
India's million plus doctors include specialists on par2 with the best in the world.
These doctors staff state-of-the-art facilities that not only cater18 to middle class Indians but also attract patients from other countries.
That has encouraged a budding medical tourism industry - drawing foreign patients to India for world class treatment at relatively19 low cost.
New Delhi's Apollo Hospital is at the forefront of this emerging business. Last year it treated 12,000 patients from across the globe - neighboring Bangladesh and Pakistan, to Africa and even developed countries such as the United States, Canada and Britain.
Some people come for knee replacements20 and heart surgeries for which they may have to wait for months in their home countries, others seek cosmetic21 procedures that are five to 10 times cheaper in India than in developed countries.
Apollo Hospital's marketing22 head, Anil Maini, says such hospitals are "centers of excellence23". He says once the hospital door is shut, overseas patients never glimpse the urban slums, overcrowding and other problems in India that might erode24 their confidence in seeking treatment in a developing country.
"Within the four walls of the hospital, we pick him up from the airport and bring him in, he is totally cocooned25 in the hospital and not exposed to any Third World bane as we say," Maini said.
Fernanda Wagland from Britain was traveling in India with her husband when he was hit by a stomach infection.
She brought him to Apollo Hospital and describes the experience as "pleasant." She may even consider seeking treatment here in the future.
"In England, we would be in the kind of multiple (bed) ward26, a bit more hectic27, so we are getting more exclusive treatment here. If you really wanted something special done with more care and one-to-one treatment, perhaps one could consider coming here," she said.
The challenge before the country now is to put such high quality services within reach of the poor. Doctors say there is little time to lose - millions in the country suffer from infectious diseases such as tuberculosis28 and other killers29 such as AIDS, and lifestyle diseases such as diabetes30 and heart problems are emerging on a massive scale in rapidly growing cities.
1 vaccine | |
n.牛痘苗,疫苗;adj.牛痘的,疫苗的 | |
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2 par | |
n.标准,票面价值,平均数量;adj.票面的,平常的,标准的 | |
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3 ailment | |
n.疾病,小病 | |
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4 premier | |
adj.首要的;n.总理,首相 | |
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5 serpentine | |
adj.蜿蜒的,弯曲的 | |
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6 lodging | |
n.寄宿,住所;(大学生的)校外宿舍 | |
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7 maternity | |
n.母性,母道,妇产科病房;adj.孕妇的,母性的 | |
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8 vaccines | |
疫苗,痘苗( vaccine的名词复数 ) | |
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9 inaccessible | |
adj.达不到的,难接近的 | |
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10 implementing | |
v.实现( implement的现在分词 );执行;贯彻;使生效 | |
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11 practitioners | |
n.习艺者,实习者( practitioner的名词复数 );从业者(尤指医师) | |
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12 quacks | |
abbr.quacksalvers 庸医,骗子(16世纪习惯用水银或汞治疗梅毒的人)n.江湖医生( quack的名词复数 );江湖郎中;(鸭子的)呱呱声v.(鸭子)发出嘎嘎声( quack的第三人称单数 ) | |
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13 disseminated | |
散布,传播( disseminate的过去式和过去分词 ) | |
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14 intentional | |
adj.故意的,有意(识)的 | |
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15 inadequate | |
adj.(for,to)不充足的,不适当的 | |
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16 sector | |
n.部门,部分;防御地段,防区;扇形 | |
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17 radically | |
ad.根本地,本质地 | |
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18 cater | |
vi.(for/to)满足,迎合;(for)提供饮食及服务 | |
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19 relatively | |
adv.比较...地,相对地 | |
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20 replacements | |
n.代替( replacement的名词复数 );替换的人[物];替代品;归还 | |
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21 cosmetic | |
n.化妆品;adj.化妆用的;装门面的;装饰性的 | |
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22 marketing | |
n.行销,在市场的买卖,买东西 | |
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23 excellence | |
n.优秀,杰出,(pl.)优点,美德 | |
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24 erode | |
v.侵蚀,腐蚀,使...减少、减弱或消失 | |
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25 cocooned | |
v.茧,蚕茧( cocoon的过去式和过去分词 ) | |
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26 ward | |
n.守卫,监护,病房,行政区,由监护人或法院保护的人(尤指儿童);vt.守护,躲开 | |
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27 hectic | |
adj.肺病的;消耗热的;发热的;闹哄哄的 | |
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28 tuberculosis | |
n.结核病,肺结核 | |
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29 killers | |
凶手( killer的名词复数 ); 消灭…者; 致命物; 极难的事 | |
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30 diabetes | |
n.糖尿病 | |
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