HMS Dean Joseph Martin gets firsthand tour of Indian health care

Dr. Martin and his wife, Rachel, stand in front of the Taj Mahal during a sightseeing excursion

Dr. Joseph B. Martin, dean of Harvard Medical School, recently spent two weeks in India meeting HMI’s Indian partners and learning about their accomplishments, concerns, and challenges as well as their hopes for Indian health care. This visit marked the first time the Dean traveled to India to see firsthand the fruits of these ongoing collaborations. It was also an opportunity for Martin to gain a better understanding of India from an historical, cultural and societal perspective.

“I think Dr. Martin’s visit demonstrated the value that he places on our partnerships with Indian health care leaders,” said Dr. Harvey Makadon director of health systems for HMI. Makadon added that Martin, who is the chairman of the board for HMI, has always been extremely supportive of HMI’s connections in India and wanted to see them in action.

Over the course of two weeks, Martin traveled from Delhi to Agra, Jaipur, Mumbai, and Chennai. During the trip he gave a series of lectures and spoke with hospital leadership, medical students, physicians and other health professionals. He witnessed the opening of a new hospital, lectured on breakthroughs in neuroscience to medical students and met with medical educators. He also was able to see some of the most interesting and impressive sights in India.

“This was an extremely fascinating and personally gratifying adventure,” said Martin. “India is a country of great contrasts. It has to deal with complicated political, economic and health care challenges with 3.5 times the population of the U.S. in a country a third of the size” he said.

Making inroads in the HIV/AIDS epidemic
In Mumbai, Martin witnessed the certification of 40 new WHARF (Wockhardt-Harvard Medical International AIDS Research and Education Foundation) faculty for the HIV/AIDS primary care program train-the-trainer program. Since their own initial training two months before, these providers have already trained 200 additional health care professionals.

A meeting of WHARF participants gave Dr. Martin, center front, a chance to hear the progress that the program has made so far

Martin heard firsthand how WHARF trainee faculty felt about the joint HMI/Wockhardt initiative. Representatives of the new faculty talked about their achievements and challenges, including ethical, social and legal issues. One participant, Dr. Zulica Barretto, felt that one of the most important issues “was not so much the disease itself but the fear of the disease”—a fear that had caused some doctors and hospitals to turn away HIV/AIDS patients. Overall, the faculty believed that the WHARF program had made them recognize the potential scale of the AIDS epidemic and had given them a new model of care that they could both use and share with others to address the HIV crisis.

However, during a later press conference, Martin was able to see the lingering sense of unreality concerning the enormous challenge of HIV/AIDS when some members of the media questioned why HMI and Wockhardt had initiated the program. Despite three million known HIV positive countrymen, much of the Indian public still seems to feels that the epidemic will only affect sex workers and truck drivers, he learned.

A health care delivery system in transition
During Martin’s visit, Wockhardt Hospitals Ltd. announced the opening of a new private multi-specialty hospital located north of Mumbai. The HMI heath systems team worked closely with Wockhardt to develop a hospital design based on disease-focused multi-disciplinary teams, continuous quality measurement, and patient centered care. They also helped design systems that integrate with community care programs.

Dr. Martin, left, helps Habil Khorakiwala, chairman of Wockhardt Hospitals, inaugurate Wockhardt's new hospital

The Dean was continually impressed with the ability of the Indian health care leadership to develop and implement innovative solutions with modest resources. He also witnessed the ongoing debate over public and private sector responsibilities for Indian health care—whether the government is doing enough to address the real needs of the people, and whether the private sector is just focusing on profitable areas.

Wockhardt has formed a foundation to pay for free care and developed lower fees than most private hospitals in India. Still, during press briefings, reporters questioned the private versus public spending and the responsibility of both sectors. Dr. Robert Crone, president and CEO of HMI, commented that HMI’s role was to help its partners develop successful models for health care delivery. These had to be financially viable otherwise they would not be sustainable. However, he said, the two sectors should be complementary. He used the analogy of a new highway bypass being built around Mumbai. “The road is costing the government money and it will probably become a toll road. But, at the same time, it will free up the city center for those who can not afford it,” he said.

Recognizing advances in education and research
In Mumbai, Martin also toured King Edward Memorial Hospital (KEM), one of the oldest and most prestigious academic medical centers in India. After a meeting with the dean of KEM, Dr. Nilima Kshirsagar, Martin gave a lecture on advances in neurosciences to an auditorium packed with medical students.

At Sri Ramachandra Medical College and Research Institute (SRMCRI) in Chennai, Martin met with faculty and students as well as the school’s chancellor, Dr. Shri V.R. Venkatachalam, toured the hospital and gave a Convocation address for 700 graduates from the faculties of medicine, dental surgery, nursing, pharmacy and allied health sciences. Among the graduates were 90 physicians who received a diploma in family medicine, a new program set up by Dr. Krishna Sheshadri, assistant professor of medicine at SRMCRI as part of an effort to further the development of community and primary care.

Dr. Martin gives a talk on neuroscience for medical students at King Edward Memorial Hospital

In his address to an audience of over 2,000, the dean congratulated the graduates on their degrees and awards and he stressed the importance of lifelong learning for all health care professionals. Quoting Dr. Alan Gregg of the Rockefeller Foundation, Martin said: “A good education leaves much to be desired.” He also congratulated the leadership and faculty for the speed of the college’s development and the range of its activities including scientific and medical research, and an active scholarly exchange program with Harvard Medical School.

At his last official engagement in India, the dean presented the first Wockhardt Medical Excellence Awards, organized by HMI, to five of India’s leading medical professionals: Dr. S. Padmavati (cardiology), Dr. Noshir Wadia (neurology), Dr. Prafulla Desai (oncology), Dr. N. Gopinath (cardiac surgery), and Dr. Sam G. P. Moses (diabetology). All have been responsible for researching and developing innovative technologies to care for their patients in India, and for motivating, training and developing countless numbers of Indian specialists and healthcare professionals. Martin said: “The achievements of these physicians aptly reflect the mission of Harvard Medical School: to create and nurture a community of the best people committed to leadership in ending human suffering caused by disease.”