Ground Realities In developing countries of Asia (Japan, Singapore, South Korea and Taiwan are
excluded from this group) a vast majority of the population is rural. Poverty, igno rance and illiteracy combined with misguided allocation of scant resources and poor organization from lack of political will and bureaucratic tangles act as big obstacles for overall development. In countries with developing economies health expendi ture averages 1% of Gross Domestic Product (GDP) as against 6% in countries with established economies. In India 70% of the population is rural, while 70% of the medical manpower, 100% of neurologists and facilities for investigations are urban. Because of this skewed distribution, a vast majority of the country s population has litde or no access to fruits of modern development for quality health care. Forty percent of the population in India is below the poverty line. Health (medical) insur ance in developing countries of this continent is practically nonexistent. In India health insurance excludes certain chronic diseases like asthma, diabetes and epilepsy from their ambit. Thus private health care is hard to afford and out of reach for the poor both rural and urban.2 Critical care medicine is unknown except in metropoli tan and large cities with resultant heavy toll in rural areas from acute illnesses and their complications, status epilepticus being a classical example. "The National Health Systems are not cost effective because 70% are siphoned off to big hospitals in lieu of immunization and basic preventive health care. This is a silent disaster waiting to strike”.2 However, some realization in recent years of this inequity offers a ray of hope.