V.D. IN MAHARASHTRA
by Major M. P. Vora
Freedom First, May 1980. (329)
Page no. 14 and 15.
It may be interesting and worthwhile to narrate briefly the history of V.D. institutions and activities in the state of Maharashtra. In March 1916, a medical conference was held in Bombay to discuss the report of the Royal Commission on V.D. As the outcome of this meeting, the League for combating V.D. was established with Sir.S.G.Curtis as the Founder President and the late Dr. J. A. Turner, the former Executive Health Officer, Bombay, as the Vice President. They started in 1918 the first model V.D clinic in the city with public donations. In 1926, the V.D. clinic was taken over by the Bombay Municipal Corporation. It is the biggest clinic in the city. In the same year, Dr. David Lees visited India. In consultation with him, it was decided to dissolve the League and replace it by the formation of the Bombay Social Hygiene Council. In December 1968, its Golden Jubilee was celebrated. The Jubilee Committee raised finances and secured from the Bombay Municipal Corporation substantial help to set up a free diagnostic centre for V.D. in Bombay. The laboratory is doing commendable work to help general practitioners in the city.
In 1928, the late Col. Jalal.M.Shah I.M.S., was appointed as the venereologist to the then Presidency of Bombay. He soon established a separate chair for V.D in the Grant Medical College and a separate V.D. department in the J.J.Hospital, Bombay. Four specialist posts were sanctioned. In 1930, he opened a separate department for V.D. in the St. George’s Hospital Bombay. Two specialist posts were sanctioned. Cama and Albless Hospital, Bombay came next and one specialist post was sanctioned. It was his ambition to give one V.D. clinic to each district hospital in the State. When the National Government took over the administration in 1945/46, the post of the venereologist to the Presidency was allowed to lapse, and no one was appointed in his place when he retired. In 1948, the Indian Association of Dermatologists and Venereologists was formed and its first conference was held in Bombay under his presidentship.
In1950/51, when Shri Shantilal Shah was the Minister for Health for the State, an offer of Rupees ten lakhs was made by the WHO for the establishment of a V.D. Training Centre at the J.J.Hospital, Bombay, with a condition that the State would contribute 1/3 of the amount. The Health Minister, uninformed and with little foresight, refused the offer. He felt that itamounted to an encouragement to immorality. Subsequently the sum was given to Madras.
In 1958, Shri Kannamwar, the Chief Minister of the State who happened to be more appreciative and responsive, sanctioned the establishment of the V.D. Training Centre at the J.J.Hospital, Bombay. With, the funds sanctioned, a new building was erected, necessary equipments was purchased, and even appointments of some personnel was made. With this, hope and expectations of the founding fathers soared high. One has every reason to believe that there were deliberate attempts to throttle it from it inception and create conditions that would render it ineffective. Because of non-cooperation and hostility at the local level, it soon became functionless. Posted men and equipment were distributed among other departments of the hospital ultimately. Thus the hopes of the training centre were destroyed.
In 1958, the B.S.H.C. passed a resolution requesting the State to pay greater attention to the problem of V.D., and to increase and expand facilities for diagnosis and treatment of V.D. in all hospitals. In September 1959, the Secretary, Local Self- Government and Public Health, Government of Bombay wrote (No-MCG1459/60417/2 G dated September 19, 1959): “The needs of good V.D. clinics will be taken into account while formulating proposals for new medical colleges and hospitals.” In November, 1959 the B.S.H.C. passed a resolution, requesting the State authorities to recognize Venereology as a separate speciality in medical colleges and hospitals. A similar resolution was passed by the V.D. Advisory Committee, Maharashtra State.
In June 1965, a Seminar on V.D. was held in Bombay. On this occasion, the Hon. Chief Minister, Shri P.V.Naik suggested creation of a coordinating committee consisting of the representatives of the Government of Maharashtra, the Bombay Municipal Corporation and the Health Committee of the Association for Moral and Social Hygiene, Bombay branch. In August 1966, a meeting of the three representatives was held in pursuance of the suggestion of the Chief Minister and the V.D Advisory Committee, Maharashtra State was formed. It met regularly bi-monthly till 1973/74 and made various useful suggestions for the effective control of V.D. But unfortunately none of them were implemented. They remained on paper only. Free refresher courses in V.D. for general medical practitioners are held twice a year in the city for more than ten years under the auspices of the V.D. Advisory Committee. The Association for Social Health in India, Bombay branch has been offering free advisory-cum-consultative service to V.D. patients for some time.
In 1971, Dr. C.S.Nicol, the British Venereologist visited India. He publicly praised the work done by the separate and independent V.D. departments and criticized unsatisfactory work done by combined departments for dermatology and venereology in Bombay. Nearly the same thing had happened when Dr. Guthe, the former WHO expert, had visited city hospitals a few years earlier. Their remarks had severe repercussions. The advocates of the concept of dermato-venereology, whose performance in the past has been particularly dismal as regards V.D. felt hurt and decided to do away with separate venereology and its institutions. Being more in number and influential, they hastened the end of separate V.D. departments, which had been functioning satisfactorily for the previous four decades and had done a commendable job under great difficulties. Can such a wrongful action born out of professional jealousy and rivalry be justified?
Shri Zakaria, the Minister for Public Health, Maharashtra said on 27 th March, 1968, in the Legislative Assembly that Government wanted to encourage specialization of medical services even in district hospitals. However there was a great inconsistency between talk and practice. In 1972/73, the era of separate and independent V.D. or autonomy in the field of venereology came to an end: a new uniform policy of dermato-venereology came into existence, betraying bankruptcy of thinking and lack of perspective on the subject. V.D. institutions, which had been built up through years of hard work, were smothered and destroyed. This was the most ill-advised and unforgivable decision of the State authorities. It was an unjustified interference in sanctioned and authorized professional institutions. An unassailable fact is that the lead regarding V.D. that was gained once in India by Bombay, has been lost by the contradictory and vacillating policies of the State.
The circular of the Government of Maharashtra Urban Development and Public Health Department dated the 10 th February 1976 (No. PHD-1675/2225/PH-S Sachivalaya Bombay 32) was merely a misrepresentation of facts and a distortion of the real meaning of the resolution of the 2 nd Joint Meeting of the Central Council of Health and Central Family Planning Council held at New Delhi in April 1975. But no one could question the perverse decision of the State to redesignate the V.D. clinics in the State. The State Government is under obligation to retrace its step and undo the mischief.
There has been enough experience clearly against this step. No arguments can alter the pertinent fact that venereal work, education, training and services become subordinated, their importance becomes undermined and the larger slice of the budget is cornered so as to leave precious little for the poorer venereologists. A raw deal and an apparent deterioration in standards are common.
It is hoped that the State authorities will make due amends for the neglect of V.D., adopt a more reasonable and imaginative attitude, allocate adequate resources and man-power, and give top priority to the proper management and control of V.D. in the State. The yearly incidence of V.D. in the State could not be less than 5 million.
These facts were brought to the notice of the University of Bombay, the State health authorities, the Medical Council of India, the authorities in charge of E.S.I.C., and the Bombay Municipal Corporation many times during the last thirty years without any results. A spirit of respect and positive recognition of the opinion of the venereologists seems rare in the State. Now it is for you, responsible readers, to take up the cause and get reversed the ill-conceived policies of the State Health authorities and medical educationists. The vital need of the hour is to put venereology back on the rails.*
*The writer is open to correction as regards the precise chronology of the events he has mentioned.