What are some of the steps you’re taking to ensure health and sanitary conditions in the state?
We are a team comprising of government and local bodies and health is one department that needs support of all the departments. Public health is a mixture of so many activities. And this is one department, which technically needs the support of all the departments, though we are the primary focus. Public health is a mixture of so many activities, including individual choices, and there has to be a demand for health. On sanitation side, we work very closely with local bodies because the impact is on health. We work closely with all the other departments. All the finance commission grants are routed through the local bodies. Covid has taught us that all the department including NGOs and people have to work together. Similarly on water supply and other disease aspect, including maternal and child health, advocacy is very important. People need to understand that they need to change their behaviour. And following hygienic practice is not doing any favour for someone else. It is something which they are doing for themselves and the society and family. So health is something where we work very closely with everybody. People also should realise that we all have to work together.
How is a typical work day in your everyday life like? What does your work profile entail as the Health Secretary of Tamil Nadu?
Pre Covid days it was different. There were days when we have handled crisis and worked almost 20 or 24 hours a day or so. But post covid, the challenge has been that on one side we have to daily monitor the situation. So it is almost 24 hours. It is not just at my level. It is a team of dedicated people. We have a 24-hour control room, which works all the time. Health is one department where there are a lot of meetings and functions, both national video conferences, despite covid, state level meetings at the level of Chief Minister on a regular basis for higher than what used to happen earlier. This is mainly because everyone has to take collective decisions at the highest level. Initially when I was doing Chennai Corporation coordination with the Corporation Commissioners, my typical day used to start with the fieldwork at 6:30 am from the containment area. But later, when I had a full-fledged health responsibility I also used to visit hospitals. We had to see the challenges of an ICU.
You cannot tell people what to do without experiencing what they go through. So every time, you cannot put another man to risk. So apart from wearing PPE, you have to also wash yourself and then attend meetings. So this used to go till late night and every night. By the time one wave would get over, another wave will start and another activity will start. Then vaccination started and then the challenges of vaccination. The health team has been working throughout on around 20-hour shift, because the last of the lab results come at 12 midnight. So we need to get the initial preliminary rush trend to check up whether there is an error or is this a definitive trend. Early morning we have to report to honorable Chief Minister’s office and also Collectors on the need where they need to focus. In between the challenges were also that non-communicable diseases could not be neglected and work on how to overcome vaccine hesitation and more importantly vaccine apathy. Now, there is no more resistancy because 99% have taken the vaccine. But there is an apathy that, even after taking the first dose some people don’t want to take the second dose. At least some people are like that.
How do you take out time to balance family, your other passions and work?
It is very tough. But in earlier days, right from the start, whenever there was a long trip, I would request my family to come along, even though my wife is equally busy and my son was also doing MBBS, but they were kind enough to come along. They were able to independently utilise their time when I was not free. Although work keeps us busy, there have been occasions where we try to meet people and take out time for our family.
Earlier we would love to travel whenever we got a chance in Tamil Nadu – Yercaud, Ooty, Kodaikanal, Salem, Mahabalipuram and of course all the temples in and around. Also, Karnataka has been our favourite too. We love going to Bangalore. We have travelled to all the places in the Himalayas. Everyone goes to Nainital and Musoorie, but there are some unseen places that are very beautiful – like Mukteshwar and going to deeper areas where there is really very little of the civilisation. My family has joined me occasionally on International trips, which at present have become very few and far in between. So, at present, they do complain. I shouldn’t say that, as they are very understanding of my work. Despite complaining they allow me to have a last word because they know about my work requirement. Whenever I get time I play tennis and cricket.
What does your work profile entail as the Health Secretary of Tamil Nadu?
I’m very grateful that the government has given me an opportunity to work in various posts including the post of the Health secretary. Health secretary has evolved into a very complex post. It has one side at the basic level, public health and preventive medicine where, we are looking at the most basic provision of services such as maternal child health services and disease prevention, then, at the middle level, we have secondary care hospital, directorate of medical and health services, and rural health services, where we have Taluk, non Taluk and district headquarters hospital. At the third level, we have tertiary and quaternary care hospitals for the tertiary care diseases.
Overall in the last few years we are focusing on one side Maternal Child Health and on the other side communicable diseases and non-communicable diseases. Then there is also vaccine-preventable diseases and challenges of how to take it to the people. There’s also the challenge of how we can improve the levels and reduce the cases of preventable and curable diseases.
What have been the challenges during the tough past two years of pandemic?
The past two years, I think straight away, we can tell that Covid pandemic has been the challenge. It is not that this is the first time. Earlier we had Swine flu that ultimately became a seasonal kind of flu, then in between we also had to handle Dengue and then Malaria is also not yet totally eradicated. But then we also had a new case of Zika, which we could prevent. Then in our neighbouring state of Kerala, there was Nipa, but it didn’t come to Tamil Nadu. But, in this last two years, there have been many challenges related to Covid. This started from the wet Market in Wuhan, and ultimately spread worldwide. The biggest challenge is that it is going on mutating and every time we seem to gain control, it comes out in another form.
We started two years back and had to work on increasing the facilities in so many number of hospitals, beds for such an activity or for that matter even diagnostic facilities. Building up medical infrastructure to tackle Covid-19 challenge was a challenge, lack of immediate clinical protocol specifically, addressing covid-19 was a challenge. Then how to utilise Indian medicine was a challenge. Making people understand the need for containment quarantine and lockdown was a challenge, but as we went and won over the first wave, the second challenge was people rapidly abandoning the non-medical methods, like mask, social, distancing and hand washing was a challenge. Then we had the second Delta wave. There were other variants coming in. With the Delta rapidly increasing deaths was a challenge and also procuring oxygen was a challenge. The latest challenge was despite vaccination coming in as early as January 2021, in Tamil Nadu up to May there was a lot of vaccine resistance even among eligible people. Now that Omicron is dominating, we cannot rule out that there will be no new variants so keeping a watch internationally is going to be a challenge and ensuring that this large-scale awareness, which has come among people about Covid-19 translates to a behavioral change of safe practices.
The biggest challenge during all these waves, in addition to covid-19 was that in the third wave our entire doctor and paramedical and midday nurses and the paramedical team ensured that the non-communicable diseases did not get neglected and people did not suffer for want of treatment or medical care.
I request people to follow self-regulation, which is going to be the key, if we want to avoid any further such spells.
How was your experience in your earlier days when you worked on the relief work in Nagapattinam and Thanjavur districts during the 2004 Indian Ocean earthquake and Tsunami in 2020?
The Kumbakonam tragedy preceded just before I joined and that was a very shocking incident in a school. Suddenly, so many children died in a fire. It was a very tragic experience and that had an impact on us. Time can never heal those wounds. Then on the day of tsunami, I was asked by the then government to rush to Nagapattinam. The site was really very shocking. I saw over 900 bodies lined up and by late evening and next day after we did the helicopter recce we found more bodies. Nagapattinam was a death ground. But what we learned out of the disaster is that we quickly set up self-contained units of seven villages where we put collector level teams, under the leadership of ex-secretary and went about working on relief measures. We had to build the habitat back – not just construction, not just replacement of traits or giving back boats or ensuring that the sand is removed from the agricultural lands. The initial problem was to dispose of bodies in a hygienic way and then ensure water supply sanitation, build shelters and support them in trades and above all continue to provide security to children.
The scale was such that we had to divide it into various regions and we had to set up NGO coordination committees. We have to work on a robust early warning system. Disaster management act has come into place and we are not doing only relief.
You have done a lot of good work so far and have also received recognition for it. Anything on this that you would like to highlight?
The actual credit should go to the government for giving opportunity to not only me in handling various kinds of disasters, but a dedicated team, some at senior levels and also grassroots levels, who work behind the scenes to ensure that we are safe. We are a symbol representing them. We have to take responsibility and not try to pin the blame to the next level.
You were born in Chennai but have spent your growing up years in many cities across the north of India. How has your experience been both in the north and south of India?
I was born in Chennai but when I was a few months old we moved to Kanpur and then Chandigarh and Nasik. In all these places, the biggest experience was meeting people across India. Within the campuses, all the religious festivals were celebrated with equal fervour. There was a plethora of languages and families would interact everyday with each other. There was no television in those days and then came community television sets. In mid 80s people started owning television sets. I have fond memories of my growing up days in the north India.
How has the overall health chart in the state of Tamil Nadu improved over the years?
We should be proud that Tamil Nadu has achieved maternal and child health sustainable development goals. State of health index always ranks us in the top two. We rank just after Kerala. From the time I joined service where accessibility was an issue, now we have comprehensive neo natal care centres and so much more. We have new schemes and also a robust relationship with the private sectors. On disease recovery also we have shown a lot of improvement. Covid has taught us how to tackle new and rare diseases. As a humanity, we have to ensure that universal health care is accessible and not just a Utopian dream. Covid ensured that government hospitals were credited on how they went about treating millions of lives. While pandemic cannot be ignored, non-pandemic deaths could not be neglected either. One has to be constantly on the guard and watch. Tamil Nadu has a history of Siddha of over 2000 years. First modern hospital was started in Tamil Nadu by the Britishers. We are proud of what we have achieved and should be humble and continue to do a lot more. We have to work on incurable diseases and there’s so much more to do to excel in the field of medical care.
What kind of movies and music do you enjoy?
We listen to a variety of music, whether it is Ilayaraja music or for that matter RD Burman music but off late I like Anirudh Ravichander’s beats. Not that he’s alone my favourite. There’s also SP Balasubramaniam, Nazia Hassan, Usha Uthup, Boney M and Abba. I also love listening to Tamil music as it lifts your mood. I love all of Rajinikanth and Kamal Haasan movies and also Ajith and Vijay’s movies. I watch in the car and sometimes late at nights. I also enjoyed watching Pushpa recently. I love classics, Guns of Navarone, all of James Bond movies and some Chinese movies also. I also like Spiderman movies.
Your favourite cricketer?
Krishnamachari Srikanth, Kapil Dev and Sachin Tendulkar. Ashwin is good these days and also Natarajan.
– By Namita Gupta