Extraordinary Indians: Drs Arun Gadre and Abhay Shukla are Fighting for Ethical Healthcare in India

“No one can be good for long if goodness is not demanded of him,” playwright Bertolt Brecht once wrote. The story of Arun Gadre and Abhay Shukla is a sharp denial of this theory.

In 1978, Abhay Shukla was selected for the coveted computer science course at the Indian Institute of Technology, Kanpur, where his father taught physics. Shaped by scientific enquiry with dreams of social change, and encouraged by his socialist father, he decided to work as a trainee with Dr Debasish and Chandana Bakshi, who ran a street clinic in Calcutta.

“The Bakshis’ work and reading Dr Norman Bethune’s moving life story, The Scalpel and the Sword, I decided to become a doctor instead,” looks back Shukla, 56. Bethune was an extraordinary surgeon, a campaigner against private medicine, and pioneered the use of blood transfusions on the battlefield saving hundreds of lives. Inspired, young Shukla was restless to launch into a life of service, battling injustice and inequity.

A brilliant student, he made it to the All India Institute of Medical Sciences studying Public Health and Community Medicine. He then returned to Kanpur to work in occupational health with leather workers. Shukla’s association with rights-based, people’s movements and Dr Anant Phadke, coordinator of SATHI (Support for Advocacy and Training to Health Initiatives), brought him to Pune in 1995.

Dr Arun Gadre, 61, never imagined he would have to give up his two-decade-long labour of love—the small maternity home built along with his anaesthetist wife Dr Jyoti in Lasalgaon—to move to Pune.

Graduating from Mumbai’s Grant Medical College, Gadre’s early days were inspired by the social worker Baba Amte. As a young intern, Gadre would hop on to a truck to head to Hemalkasa, Amte’s ashram, and work amongst the tribal people. This experience, along with his encounter with Dr Paul Brand, the missionary doctor who worked with leprosy patients, stoked the desire in him to work for the underprivileged. “Jyoti and I decided to leave Bombay and eventually move to Lasalgaon, a village 67 km away from Nashik,” he says. “The first 10 years were a dream come true, a real opportunity to serve the poor,” he says. The couple charged patients minimally, sometimes performing heroic medical feats in the face of odds. “There was no blood bank, no paediatrician, no hi-tech equipment. Yet, we could successfully turn around bad situations, because patients had faith in us,” he says.

However, the toxic winds of commercialization meant a breakdown in this relationship. Unwilling to give commissions to referee doctors and hospitals, Dr Gadre’s practice started dwindling. Politicians and patients were sucked into this culture of profiteering as well; shattering Gadre’s dreams of building a community of care and trust. A couple of flashpoints where their lives were endangered—a violent mob of 300 people assembled to threaten him, in one case—prompted the couple to shut down their nursing home and flee. They followed their elder daughter to Pune in 2006 when she moved there to study. This is where Gadre met Phadke and ultimately joined SATHI in 2013.

SATHI, which works for health rights issues in partnership with civil society organizations and facilitates advocacy at various levels, was where Gadre also met Shukla. Together they, along with fellow activists, have made a significant impact in building a counter-narrative in health care. They have been able to create models that have emerged as an alternative to the current paradigm. “Working both on public and private health care, they have been fostering health rights for all and campaigning for a more rational and humane system of care,” says Phadke, their mentor. 

The doctors turned whistle-blowers with a report on unethical medical practices in 2014. Their book Dissenting Diagnosis came out of their interviews with 78 doctors across the country, who revealed the grave corrupt practices they were either forced into or witnessed. This later led to the formation of the Alliance of Doctors for Ethical Healthcare (ADEH), a collective of 200 doctors from around India who are campaigning for better patient rights, calling out corruption and commercialization.

Gadre and Shukla’s key contributions have been in establishing community-based monitoring of health delivery systems, ensuring people’s participation and accountability, which could well emerge as a national model. Working under the Jan Swasthya Abhiyaan, they are campaigning tirelessly for the right to universal health care. Whereas Shukla brings to bear his rigour as a researcher and the fire of his activism, Gadre’s experience as a clinician and his insights into private health care have powered their relentless struggles to make the medical profession noble once again.