Dear Editor,
Kumar et al.[1] suggest ways for capacity building of primary care physician working at remote Uttarakhand, India, and provide an integrated tertiary care approach during coronavirus disease (COVID-19) pandemic in their original article in February 2021 issue of that journal. They conducted a 1-day hands-on workshop for the purpose accompanied by pre- and post-test questionnaire.
In that article, there is a heading called ‘COVID-19 preparedness at primary care’ and then there is a subheading ‘Following preventive measures had been addressed during training session’. Here in fifth point, the authors write that there is an instruction to use PPE when coming in close contact of COVID-19-positive patient and non-intact skin. But there is no evidence that contact with non-intact skin poses any threat of novel coronavirus transmission. WHO has a dedicated webpage having COVID-19 advice for the public: MythBusters. On this webpage, there is no description of anything like that. Therefore, this point needs correction.[2]
Then, the authors describe their experience of interaction with Medical Officers while conducting the workshop. While many invitees did not show up at the venue, some of the officers disclosed that they were preparing for their postgraduation examination and some were not expressing willingness to attend similar workshops in future. What is intriguing is that we already face a shortage of workforce and Kasthuri emphasised this point 3 years ago.[3] This shortage came to haunt us during this pandemic and we need to learn its lessons. When government advertises vacancies, far smaller number of applicants express their willingness to join public services than the number of posts and at every level of screening, their number keeps on getting shorter – leaving many posts vacant. And this resulting shortage has a domino effect – those in the system end up compensating for the vacant hands.
Authors need to explore such open-ended questions to find out its reasons so that we can fix it. The shortage has been existing for a long time and we need to put our heads together to discover causes due to which young graduates shun the public services.[4] Posts of specialists show a huge vacancy across the states in government services.[5] We need to realise that new knowledge is emerging rapidly about COVID-19 and there is a need to update ourselves regularly. If hard-working people having perseverance for higher ideals are not around, those lower in hierarchy may remain directionless.
When we cover all the aspects of professional challenges staring at them, we will be able to truly understand various pressures, bias or favouritism towards these officers, or a status otherwise. We should realise that the workshop for a few officers is just the beginning of a long march and there is a need to strengthen the system by choosing the best ones in the field to lead us. Our dream of making a self-reliant Aatmanirbhar Bharat will be realised only when capacity of human resources is utilised to the fullest.
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Conflicts of interest
There are no conflicts of interest.
Footnotes
We accessed all the webpages at the time of submission of this Letter to the Editor.
References
- 1.Kumar S, Das A, Agarwal D, Kant R, Rawat S. Capacity building of primary care physician working at remote Uttarakhand, India: An integrated tertiary care approach during COVID 19 pandemic. J Family Med Prim Care. 2021;10:820–5. doi: 10.4103/jfmpc.jfmpc_1437_20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.WHO. Coronavirus disease (Covid-19) advice for the public: MythBusters, Updated 23 Nov 2020. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters .
- 3.Kasthuri A. Challenges to healthcare in India-The five A’ s. Indian J Community Med. 2018;43:141–3. doi: 10.4103/ijcm.IJCM_194_18. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Asnani R, Upadyay V, Thakur RK. Doctors, nurses posts lie vacant in states even as Covid-19 rages across India. Indian Express 27 Oct 2020. Available from: https://www.newindianexpress.com/nation/2020/oct/27/ doctors-nurses-posts-lie-vacant-in-states-even-as-covid-19rages-across-india-2215480.html .
- 5.Rawat M. In Uttarakhand, doctors demand better infra, vacancies filled before being transferred to hills. Hindustan Times 26 Feb 2018. Available from: https://www.hindustantimes.com/dehradun/provide-infra-fill-vacant-posts-before-sending-doctors-to-hills/story-mckuBNp4pF4sIdysfovvqL.html .