'Our way of looking at disasters has now changed'

Civil Society News, New Delhi

FROM floods to earthquakes and the Covid-19 pandemic, Doctors For You has played a key role in providing medical services and relief. Founded by Dr Ravikant Singh in 2007 in Mumbai when he was  a student, the organization has grown across India in the past 17 years.

It has built systems for intervening in crises and attracts talented doctors who want to give their time to serve meaningfully and improve public healthcare. During the pandemic Doctors For You (DFY) used all its experience to create Covid-19 facilities almost overnight in different parts of the country, helping various state governments.

Civil Society spoke to Dr Rajat Jain, the present president of Doctors For You, on how the organization has grown and adapted itself to meet current needs.

 

Q: Doctors For You was started to deal with calamities. Is this still your core mission?

It remains an important area we are working on. After so many years, we have finally been able to set up our Disaster Secretariats. Previously we were only responding to disasters which were of national importance. But now we are responding to disasters which are local in nature and of importance to a particular state. Dealing with calamities is definitely a part of our core mission.

 

Q: What do you mean by local calamities?

It would typically be limited to a state. The state might have run out of resources to deal with it. An example would be a flood in Kashmir, which we know has been going on for 15 days but is not in the national news. In dealing with a disaster, a state may go beyond its resources. The external support it needs may be small but crucial.

Usually, you get to know about a disaster when it becomes news and comes to the attention of the nation. But now that Doctors For You has Disaster Secretariats we are monitoring developments. We get to know of a local calamity. We have a secretariat in Delhi, we have a secretariat in Guwahati, we have a secretariat in Bihar. We have one in Mumbai and in Bengaluru too.

 

Q: What is a Disaster Secretariat? How does it function?

A Disaster Secretariat identifies calamities and monitors situations round the clock. It monitors the work teams are doing on the ground. It ties up with local organizations. The secretariat makes it possible to respond in small but important ways. We  responded to a flash flood in a village in Kashmir and got people evacuated over two days. Then we looked at what else we could do for them in terms of hygiene and other kinds of follow-up. Dealing with the aftermath of a disaster is important.

Q: What major disasters have you addressed in the recent past?

Climate change is providing challenges because of extreme weather conditions. There have been cold waves and heat waves. These have become disasters in themselves.

Last year, in the winter, we responded to an extreme cold wave in a major part of north India. Right now, in May, we prepared for a heat wave. There is a lot of construction going on. Construction workers get badly affected in very hot conditions. Are they able to maintain their hydration? We undertake advocacy and awareness activities.

Our way of looking at disasters has changed in the past 17 years. Previously, for us, a disaster meant a flood, an earthquake. It would be in the news and we responded to the medical management of that disaster. But now we are looking at an overall contribution that we can make.

 

Q: You mentioned heat disasters. The effects of global warming are widespread. Are you looking at it in any specific way, involving specific communities?

It is the vulnerable sections of society that are affected the most. Labour is vulnerable, for instance. The vulnerable have always been our focus and remain so as we address global warming’s impacts.

 

Q: Could you explain the idea of a Disaster Secretariat? Why don’t municipalities and state governments have Disaster Secretariats? Is yours a model that needs to be adopted?

As a doctor, the one thing I understand is that early intervention is the key. How can you diagnose anything early? It’s as simple as that. The sooner you identify and diagnose the problem, the better you can treat it.

Previously we would hear of the news and then swing into action. Now we are working one step ahead and a lot of the time we are the people who give news of the disaster. It means our response is much faster. In the first 10 years of Doctors For You, our average response time was two to three days. Now, our average response time is less than 24 hours.

That brings us to the question of how the Disaster Secretariat functions. There is a team. They look at newspapers. They go out into the field. They talk to other NGOs. Doctors For You currently has a presence across states from north to south and east to west. We have teams on the ground who connect with local people.

Previously my team was sitting in Mumbai or Delhi. And we would hear news of a flood somewhere. It would take time to get there. But now what we would do in days we achieve in hours. It is also much easier to make a primary assessment as to whether external intervention is needed or not.

 

Q: How are the secretariats staffed? What kind of preparedness do you have?

We have a warehouse in Bihar with everything needed for a disaster. From portable tents to a portable hospital, we can pull it all together. In case of a flood, we have our own boats which can be sent. It is a large warehouse and it is in Bihar because we have space that belongs to us.

Thanks to our partners, we have the resources to employ people for dedicated tasks. Earlier, there was a lot of multitasking. The pandemic has led to the realization that  early intervention matters. Our partners now see this.

 

Q: Improving the functioning of government health facilities was an important objective of Doctors For You.

It remains a major objective for us and a major dream for me personally. I am a radiologist, but Ravikant (the founder of DFY), who is a public health person, helped me realize that it is not possible to replace the government in healthcare. Strengthening government facilities has a much larger impact than creating a parallel ecosystem, no matter how much money you might pump into it.

If I utilize my resources to strengthen the public healthcare system, I will be creating a much, much bigger impact. There is an impression that government doctors don’t want to work. The fact is that they lack the infrastructure and systems that would allow them to perform to their true potential.

We have found that plugging small gaps helps the system. There could be 10 things required for a surgery, but if one of them is missing the surgery can’t take place. Working with the government system and strengthening it is an important part of what we do.

 

Q: What does it take to work with the government?

It is difficult to give a clear answer to that because most of the time we are working with individuals. There are those who have vested interests and there are those who want to work for the people.

Getting the first permission in a hospital is always difficult. We only work with permission. There is a lack of trust and resistance. If the system is not working, obviously there must be a reason. It is a challenge.

We always try to include good bureaucrats who want the system to work better. So, most of the time the intervention is at the level of the bureaucracy. There are politicians. But it is the bureaucracy that gets things done.

 

Q: What did the Covid-19 experience teach you? You set up so many facilities at lightning speed and there was high praise. 

I have grown as a human being working during the Covid-19 pandemic. The way I was working before and after is completely different. In the medical field we react to situations. The pandemic underlined the need to prepare. But the good part also was that, faced with a crisis in our country, people went out of their comfort zone and tried to support one another. That’s a very, very unique aspect of our country. We tend to think people are self-centred. No, they are not. They are just busy with their own lives. Given a challenge, they come forward.

 

Q: During the pandemic, Doctors For You was creating facilities in record time. How did you do that?

We already had 15 years of experience in setting up facilities quickly during disasters. Whether it’s a small clinic or a big clinic, the broad model remains. We employed that experience. We had our checklists. We also knew how to put trained manpower in place.

The biggest challenge for the government was to get manpower to run its facilities. Doctors and paramedical staff were worried about getting infected. Because of my background of working with doctors on a professional front, it was easy for me to reach out to motivated people who wanted to work. But they still needed to be trained. I took the challenge upon myself because it is best to set an example. You have to do it yourself first and show people you are doing it. I overcame my own hesitation and began working in Covid-19 hospitals. I sat with people who were managing Covid-19 and learnt the protocols from them.

I was able to train young doctors who joined us and, seeing me work, they felt motivated. We said, ‘Give three months of your life to the country.’ I am very thankful that people came forward. We moved trained people around to train others. So, if 10 people went from Delhi to Bengaluru where another 20 were trained, we had 30 people in Bengaluru.

Post the pandemic you can’t imagine the kind of requests we get from people who want to volunteer with us. They also come from management and engineering institutes. They come from Europe and America.