In the past few months I have had occasion to visit three hospitals, as a patient. A small private hospital, a medium-sized corporate hospital, and a public hospital. Each one had its standard procedures and code of conduct. It was interesting to observe and experience the similarities, and the differences. It was also an opportunity to think about a subject that would not normally feature in my list of ‘explore and discover’ topics.

Perhaps the biggest trail of exploration was triggered by my visit to the Civil Hospital in Ahmedabad. Locating the building that we had to reach was the first step. The real eye opener was the sight of hundreds and hundreds of people going and coming, and waiting…One would imagine that such a huge moving population would end up in a railway station-kind of melee with noise, jostling, shoving, and seeming chaos. Here however, there was no unnecessary noise, people (patients as well as their accompanying members) were seated in an orderly fashion on chairs as they awaited their turn to reach one of the several registration desks. This was the first step in what would become the ‘case file’ that would be the key document for their future treatment. This process certainly involved a great deal of filling of forms, and being sent off from section to section to go through the numerous steps required. It was heartening to see that most of the staff were helpful in guiding a large number of people who were from all walks of life, some obviously from distant rural areas who had come here for treatment. This was creditable considering that the continuous stream of people certainly could have tried the patience of a saint. All said and done, things were moving. We too joined the flowing mass of humanity, as we were directed from counter to counter and building to building, over a large part of the day; experiencing how a large part of India’s population encounters the public health system, but also discovering some fascinating facts about the civil hospital.

The Civil Hospital as it is loosely described, is in fact a complex of a number of large medical institutions spread over area of 110 acres in the Asarva area of Ahmedabad. The complex includes facilities for specialized diagnostic, therapeutic and rehabilitative care starting with the general outpatient department to dedicated institutions providing medical and surgical treatment for specific diseases including cancer, TB, kidney and heart, and dental ailments. The campus also houses the BJ medical college, the Gujarat  Medical Council, Gujarat State Pharmacy Council and Gujarat Nursing Council.

No wonder then that this complex, familiarly called Civil Hospital is Asia’s largest public hospital, and possibly the oldest. It’s unique history and heritage goes back 168 years.

 It origins as an institution can be traced back to 1841 when it started operating from the Collector’s Office. The brick and mortar building of the hospital was constructed in 1858 at a cost of Rs. 96,000. This was an immense sum in those days, and the then colonial government had no role in its funding. But Ahmedabad also has a long history of philanthropy, when the affluent merchants of city contributed generously to public causes. Two prominent citizens Shri Hutheesing and Shri Premabhai were among the key donors for establishing the hospital, along with an Englishman, D. Wyllie, who was the Surgeon General at the time. A block of the hospital was named the Wyllie Ward after him. The objective was to provide free health services, aid and treatment to the people. The Old Civil Hospital was located at the Collector’s Office in Gheekanta. There were 12 wards and rooms for 92 in-patients. A medical school attached to the hospital was started in 1871 with 14 students who were designated as Hospital Assistants. As patients continued stream in, there was a need for expansion of space and facilities. Once again, the philanthropists of the city stepped in. Over the few decades, donations helped to open a Medical College, an eye hospital, outdoor patients section, and construct a maternity unit and women’s and children’s wards. The common people of Ahmedabad also contributed. From funds collected by the public, a well-equipped surgical ward was created; it was named the Mary Lambert Operation Theatre.

Despite these extensions and expansions, the hospital could not meet the huge need and demand for its services. Thus work, funded by the government, began on new premises in the Asarva area, starting in 1952. The New Civil Hospital as it was called shifted here in November 1953. Over the years, the campus has grown and spread to earn its distinction as the largest public hospital in Asia. The New Civil Hospital has more than 2000 beds and 44 wards for indoor patients. Over 1 lakh indoor patients are treated here every year. And over 9 lakh patients avail of the OPD facilities annually. And all treatments and investigations are provided free of charge, or at minimal charges. Mind boggling, to say the least.

No doubt, the system is not without its flaws and issues. And an equal number of stories may be shared about harrowing experiences. But the fact that such a complex of facilities continues to function, where even a common person can avail of medical treatment at minimal cost, is certainly worthy of commendation. Yes, there are crowds, there are long waits, there are points of confusion and frustration. But then, one hears of months-long wait in Britain’s NHS system to get a bed for a routine surgery; and the American system where one needs to wait months before one can get an appointment to see a specialist, or an MRI when quick diagnosis and treatment are of the essence…

In our own quest to be leaders in ‘medical tourism’ today we are seeing an upsurge of huge corporate hospitals springing up. These are bewildering concrete and glass jungles in themselves, where even a critically-ill patient cannot be admitted until the Billing Desk declares them “fit to pay”. Where every breath, and every procedure and pill is billed, and from where it is a challenge to emerge sound in body, mind, and bank balance!

In such greatly changed times, and certainly in the face of huge challenges, it is humbling to know that the Civil Hospital continues to adhere to its original mission of “Providing the best healthcare services to all sections of society at free of cost through unrelenting strategy of motivation, quality improvement, value addition and dedication towards humanity with selflessness.”

–Mamata