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Story Publication logo July 25, 2013

India: Inside the Crumbling Walls of Osmania Hospital

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India has launched programs to make healthcare available to rural families, but crippling medical...

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The cathedral-like central dome of Osmania General Hospital. Image by Jonathan Cox. India, 2013.

Seen from a distance, Osmania General Hospital has an almost ethereal beauty. Its pale spires, in the delicate Nizam style, soar above the surrounding buildings in Afzalgunj, a neighborhood in downtown Hyderabad. It is one of the oldest hospitals in India, the oldest in the state of Andhra Pradesh. As a public hospital, it has a long history of treating all comers, regardless of whether or not they can pay.

As you push through the crowds at the entrance of Osmania, a very different picture meets your eyes. Instead of spires, you notice the dejected crowds sitting in the shade by the side of the out-patient building, waiting for treatment. Beggars holding X-rays walk up to you, hand outstretched, begging for money to buy medicine. The architecture of the in-patient building, so awe-inspiring from a distance, becomes more dilapidated the closer you get. Plaster is peeling off the walls, which are crumbling in many places.

As a heritage site striving to provide modern medical care in the face of budget cuts and popular prejudice, Osmania Hospital could be the emblem of the struggling Indian public healthcare system. The "promotion of public health" is enshrined in the Indian constitution as one of the directive principles of state policy, but the past two decades have seen a steady decline in the condition of public hospitals. Of course, Osmania's tragedy is really the tragedy of the poor laborers who come here for treatment, many of whom face unsanitary conditions and a shortage of necessary drugs.

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