Organization of private and public Indian Surgery

Private and public (government) hospitals in India are as different from each other as chalk and cheese. A good private hospital in a metropolitan city will offer surgical care of such high standard so as to rival any top hospital in Paris. However, most public hospitals are neither well funded nor well staffed. I will mainly present my experience of working in resource-poor sub-optimal working conditions of public hospitals. I have modified prognosticating tools and surgical techniques in such a way that they do not need expensive equipment. This is ‘affordable/ appropriate technology’ for developing countries. These include simplifying prognostic scoring systems for daily use, simple and economical biochemical test to assess liver dysfunction, usage of economical alternatives for dressings and accessories, operations for Portal hypertension (Devascularization procedure), Cancer of esophagus (Easy technique for trans-hiatal resection) and Cancer of rectum (Low Anterior Resection). Our motto is to “Modify-Simplify-Apply”. Working on a shoestring budget, we try to provide standard results with the help of simple innovations in science rather than using unaffordable technology, and by striking the “right balance between science and technology”. I also try to teach self reliance in technology by teaching how to work against odds, what I like to call “Geographical training”. My philosophy can be summed by my favorite quotation:“Attitudes are more important than abilities;Motives are more important than methods;Character is more important than cleverness;and stick-to-it-iveness is more important than the starting place”