Tuesday, 23 August 2011


The word hospital, Wikipedia informs us, comes from the Latin hospes, signifying a stranger or foreigner, hence a guest. Another noun derived from this, hospitium came to signify hospitality, that is the relation between guest and shelterer. Hospes is thus the root for the English words host (where the p was dropped for convenience of pronunciation) hospitality, hospice, hostel and hotel.

I was recently admitted in the Navy's hospital Asvini in Mumbai because of a complicated and potentially dangerous Psoriatic (skin) condition. I record some of my musings as a stranger, foreigner or guest of the Navy.

The first thing that occurs to you in a hospital is that you are now confirmed sick. There is no fig leaf of pretension anymore. A hole in your socks is a mere accident; but, getting it darned is a sure sign of poverty. Similarly, the moment you are admitted you realise that your illness is beyond your own control and the docs have to do the darning. You are a proclaimed patient.

The second thing is that whilst earlier you could do your work simultaneously and attend to your complication, in a hospital, your complication is the only focus of attention for yourself and those around you. You don't have many options in a hospital; certainly not in Asvini whereat most cellphones don't even have a network. You are cut off, isolated, and entirely at the mercy of the staff. Fortunately the Navy has the best of the doctors and nursing officers, who are not just completely professional but devoted. Most of them you have grown up with and they are more your warm hearted friends than specialists at other hospitals who often subject you with cold-blooded detachment.

You are made to feel special and cared for in a Navy hospital much better than you would in a civil hospital. The doctors and the staff actually conduct themselves as hosts giving you the confidence that you are in safe hands. I have compared notes with even cancer patients. All of them have the confidence that nowhere they can get treatment comparable to Navy's own hospitals.

However, the same can't be said of the maintenance of the hospital infrastructure by the MES (Military Engineering Service) staff. These worthies often compete with the nation's worst in inefficiency and corruption; but, the Navy often finds that it doesn't have any choice. Curiously, with the best that the Navy offers in various aspects, eg, strategic thinking, operational efficiency, naval diplomacy, disaster relief, camaraderie and esprit de corps, it becomes helpless in inefficiently spending crores of rupees in new projects and in maintenance of existing facilities through MES. Everyone knows that it costs nearly thrice as much to get anything done by MES and that MES designs and methods are archaic, but, such is the stranglehold of MES that there is no escape.

One of the reasons it lands itself in this mess (MES?) is because of the penchant to do everything itself. For example, the same persons who are operationally engaged (and these days with ever increasing responsibilities from coastal security, anti-piracy to war, these personnel are hard pressed to even do justice to their primary responsibility) are also made responsible to oversee that works undertaken by corrupt and inefficient MES are executed properly and in accordance with laid down standards. It is the same in the naval hospital Asvini, which was inaugurated only a few years back as one of the finest in Mumbai, but, is already coming apart. The doctors, hard pressed for time with other responsibilities, are also made responsible for overseeing works (which is a highly specialised job) and are often taken for ride by the MES. Please have a look at the pictures of the ward that I was in. What a coincidence that the patient and the room were both getting darned at the same time

The last two pics are two cupboards on either side of same room. And here is the wonderful view from my window; MES has, like its civil counterpart PWD (Perpetual Works Department) has mastered the art of perpetually engaging itself in meaningless works. They often engage themselves in breaking walls and pavements and bannisters and re-building them.

Despite the proven sub-optimal track record of the MES, and naval officers and sailors constantly moaning their indifference and inefficiency, as soon as a naval officer gets promoted to a Flag Officer's rank he/she suddenly develops tremendous respect for MES. The reasons are not difficult to find. A retired C-in-C once told me that during his tenure, to his dismay, he found that "each of these officers spent an average of Rupees Five Lakhs in doing up their already well maintained houses". During our visit to one of them the lady of the house proudly took us to the bathroom and fawned over her colour choice of floor and wall tiles. The last occupant, she asserted, had such awful taste in colour.

Talking about bathroom, here is what I found in the toilet of my ward in the hospital:

For the life of me I cannot imagine as to why should Toilet Paper be specially manufactured for the Indian Navy; unless the intention is to show that the naval personnel have probably thicker skin. This is even more quaint because the Navy doesn't have uniform cloth, shoes, head gear etc "specially manufactured" for it, even though these items, as compared to toilet paper, are unique for its personnel. Some attempts have been made in the past but the corrupt procurement personnel ensured that the entire exercise was brought to a nought. I was personally responsible for obtaining 18 months Rigorous Imprisonment for one of the senior officers engaged in this.

So what exactly is the solution?

I think the main reason for being in this mess is because the Navy feels that since it is so efficient in its core areas of responsibility, it has to somehow prove that it is equally efficient in administration, maintenance, catering, house-keeping, logistics and other allied activities. It is high time that we offload these to people (even if civilians) who are good at it. By this if the Navy loses a bit of power and control, it should be acceptable.

Let me just give three examples. The Navy runs shore messes at great cost to itself (if one has to take in the overall cost of infrastructure, training and running costs). All it has to do is to outsource these activities to civilians. It may fear two things whilst doing so: one, the Flag Officers who feel obliged to lavishly entertain civilians and uniformed personnel, will not have similar options as they now have of being large hearted about such entertainement. Two, the naval tradition of great style, pomp and glory will see a come-down. I think both these are misplaced anxieties. As a corollary, a mall like Big Bazaar, for example, is able to provide more discounts than the Indian Navy Canteen Service and yet make more profit.

The second is the concept of supporting establishment to the headquarters, eg, Indian Naval Ship Angre to Headquarters Western Naval Command. Gone are the days when this establishment used to provide support for pay and clothing of sailors and general administrative support. At present it is expensive to keep it both in terms of manpower and infrastructure. However, we often are stickler to naval tradition (a euphemism for not acepting desirable change) and must keep this stone-ship alive. Most of what Angre does these days can be easily outsourced except perhaps to parade guards of honour to visiting dignitaries. But that doesn't really warrant a full fledged establishment.

The third is the Naval Transport Pool. In today's environment when cabs and particularly radio cabs are freely available, it would be much cheaper (as compared to the overall cost of owning vehicles, looking after their fuel, maintenance and most inefficient drivers and maintenance staff) than providing personnel with "naval transport". Oh, but the Navy personnel have to move in transports with stars and flags. I am sure an arrangement can be made with the transport hiring agency and they would easily oblige.

In 2009, together with the present Chief of Naval Staff I visited the Naval War College of the US for a Sea Power Symposium in which Chiefs of Navy and Coast Guard of over a hundred countries participated. I was pleasantly surprised to see that despite the Newport, Rhode Island US Naval Base being larger than most of our bases, it didn't have the equivalent of our Command Mess or for that matter an Officers Mess. All of us were accommodated in a hotel adjacent to the base. All of us were transported to and from the venue of the symposium by buses and there was no unnecessary and misplaced pomp and glory.

Indian Navy is one of the finest institutions of our nation, if not the best. It is fairly quick to assimilate changes, especially in comparison to its sister services (Indian Army and Indian Air Force). It is already making some transition into outsourcing non-critical services. For example, it is common, these days, to see officers stay in starred hotels on temporary duties rather than in the naval messes. However, it is high time that it goes whole hog and gets rid of its flab and white-elephants like the MES and support or depot establishments.

This will enable the Navy to concentrate on its core competencies and further excel at things that it is good at. My being admitted in the Navy Hospital after 17 months of retirement redeemed my faith in the excellence of Navy doctors, near angelic MNS (Military Nursing Staff), and medical assistants. But the state of my ward got me thinking about the baggage that we unnecessarily carry and must rid ourselves of now.

Lets not pride ourselves in having Toilet Paper specially manufactured for the Indian Navy.

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